Expert Opinion on Myopia Tapering: Strategies for Managing Myopia Progression

A key unresolved challenge in global surge of myopia is how to taper or discontinue myopia control interventions while minimizing rebound of myopia progression. We aim to summarize current evidence and to propose clinically applicable guidelines for tapering these treatments to maintain stable myopia progression.

This commentary synthesizes data from clinical trials, longitudinal studies, and expert consensus documents on rebound effect following cessation or reduction of myopia control interventions. Evidence was qualitatively appraised with a focus on timing, magnitude, and risk factors for rebound, as well as practical tapering strategies reported in the literature or expert practice.

Available evidence indicates that the magnitude and likelihood of rebound vary by treatment modality, treatment duration, patient age, and baseline myopia. Rebound is most pronounced in younger children. Gradual tapering of dose or treatment frequency, continued monitoring of axial length and refractive error, and individualized decision-making based on age and progression rate appear to mitigate rebound risk.

Rebound after discontinuation of myopia control treatment is a clinically important issue that may compromise long-term management. This commentary highlights that gradual tapering of treatment, accompanied by regular monitoring, is critical to maintaining long-term stability and minimizing the risk of progression to high myopia.