Consensus and guidelines on myopia control in children by the Taiwan Myopia Disease Society

Myopia is a major public health concern in East Asia. Despite available interventions, clinical variations persist in diagnosis and treatment. This study aimed to develop consensus-based clinical recommendations for myopia control in Taiwanese children using a structured Delphi methodology.

A modified Delphi method was used to develop consensus-based clinical recommendations for myopia control in children. Delphi statements were derived from a literature review and were evaluated by an expert panel of 12 ophthalmologists through a two-round anonymous rating process. Agreement was assessed using a five-point Likert scale, and consensus was defined a priori as ≥75% agreement. Descriptive statistics were used to summarize panel responses.

Seventeen statements across seven predefined domains were evaluated using a two-round Delphi process. High levels of agreement were achieved for all statements. Key recommendations were as follows: cycloplegic refraction is essential, and premyopia (spherical equivalent > -0.50 D to ≤ +0.75 D) is recognized as a distinct condition requiring active monitoring; family history and environmental factors must be routinely assessed; increased outdoor time is the foundational strategy for all children; low-dose atropine (starting concentration ≤0.05%) and optical interventions are effective primary treatments. Combination therapy is recommended for patients with an inadequate response to single-modality treatment.

Using a modified Delphi approach, we established comprehensive consensus-based clinical recommendations for myopia control in children and adolescents in Taiwan. These recommendations reflect broad expert agreement and provide a structured framework to support clinical decision-making and future guideline development for the management of childhood myopia.