Advances in optical and pharmacological strategies for myopia correction in children

Myopia in children has become a global public health concern due to its increasing prevalence and potential long-term complications. Optical interventions, including single-vision lenses (SVL), bifocal/progressive addition lenses (PALs), peripheral defocus-incorporated multiple segments (DIMS) glasses, and orthokeratology (OK) lenses have shown varying success in slowing progression, though long-term safety and efficacy remain under investigation. Pharmacological treatments, including low-dose atropine (0.01%), pirenzepine, apomorphine, and 7-methylxanthine (7-MX), offer additional options. Low-dose atropine is the most effective, significantly reducing myopia progression with minimal side effects. Pirenzepine, though promising in animal models, faces challenges due to poor corneal permeability. Apomorphine shows potential but requires further clinical testing. 7-MX has demonstrated dose-dependent effects in slowing progression, yet its efficacy needs validation in broader populations. Emerging therapies like low-level red-light therapy (LLRT) and Diffusion Optics Technology (DOT) lenses also show promise, reducing axial elongation and refractive progression. However, their long-term safety and mechanisms remain unclear. In conclusion, while several interventions show potential, further long-term studies and personalized treatment strategies are needed to optimize outcomes. Future research should focus on new drug targets, technologies, and global collaboration to address the myopia crisis in children.