Optical interventions for myopia control

Area of Science:

• Ophthalmology
• Optometry
• Vision Science

Background:

• Myopia progression is a growing concern globally.
• Optical interventions are a primary strategy for myopia control.
• Evidence on the comparative effectiveness of different optical methods is crucial.

Purpose of the Study:

• To review and summarize outcomes of peer-reviewed randomized controlled trials (RCTs) of optical interventions for myopia control.
• To compare the efficacy of spectacles, soft contact lenses, and orthokeratology in slowing axial elongation and refractive error progression.

Main Methods:

• Systematic review of RCTs with a minimum 18-month duration.
• Included studies assessed spectacles, overnight orthokeratology, soft contact lenses, and combined orthokeratology with low-concentration atropine.
• Data on axial elongation and refractive error progression were extracted and summarized.

Main Results:

• Overnight orthokeratology demonstrated consistent slowing of axial elongation (0.24–0.32 mm over 2 years).
• Novel spectacle designs with peripheral lenslets showed significant efficacy (up to 0.35 mm elongation and 0.80 D progression reduction over 2 years).
• Dual-focus soft contact lenses were effective (0.28 mm elongation and 0.67 D progression reduction over 3 years), outperforming older designs.

Conclusions:

• All reviewed optical interventions (spectacles, soft contact lenses, orthokeratology) can significantly slow myopia progression.
• Vision quality and safety are generally satisfactory across modalities.
• Further research is needed on post-treatment progression and the adjunctive benefits of atropine.