Childhood Myopia Part I: Contemporary Treatment Options

Childhood myopia is a growing global public health concern. Treatments to control myopia are a priority because myopia, particularly high myopia, poses significant lifelong risks of vision loss from myopia-associated ocular pathologies. Intensive research efforts over the past two decades have led to the development of several effective strategies for controlling myopia in children: increased time outdoors, atropine eye drops, dual-focus and multifocal contact lenses, orthokeratology lenses, and specialized spectacle lenses. While the efficacy of these strategies is variable, evidence is growing regarding the potential benefits of applying these interventions in children with myopia, although none completely halt myopia progression. Despite this evidence, dual-focus contact lenses remain the only myopia treatment in the United States approved by the US Food and Drug Administration. This critical review article provides an evidence-based overview of treatment options currently available to prevent the onset of myopia and slow its progression in children. It is the first part of the commissioned paper "Treatment of Childhood Myopia" submitted to the National Academies of Sciences, Engineering, and Medicine for the consensus study "Focus on Myopia-Pathogenesis and Rising Incidence." Readers are referred to Part II for a review of treatment mechanisms, emerging and experimental treatments, and patient, treatment, and clinical trial considerations. Findings from this article demonstrate a growing body of strong evidence supporting the use of contemporary treatments in childhood myopia management. Regulatory approvals of these proven treatments worldwide would allow widespread, early intervention in at-risk children and potentially reduce the risk of vision loss from myopia-related complications later in life.