ARVO2026 Recap #4 – Can we prevent myopia in children & treat it in adults?

Authors: Hsin-Yu Yang^1,2, Der-Chong Tsai³, Yu-Chieh Yang³, Chiao Yu Wang³, Mong-Ping Shyong¹

1. Ophthalmology, Department of Ophthalmology, Yuanshan and Suao Branch, Taipei Veterans General Hospital, Taiwan
2. National Yang Ming Chiao Tung University Institute of Clinical Medicine, Taipei City, Taiwan
3. National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan

This study evaluated the efficacy of 0.01% atropine and DIMS lenses in preventing myopia onset and progression in preschool children with a family history of myopia. In this prospective, randomised, controlled multicentre trial, 227 preschool children (mean age 5.28 years) were randomised to 0.01% atropine (n=76), DIMS lenses (n=73), or control (n=78). 

At 6 months, controls showed a myopic SE shift (-0.069 D), whereas atropine (+0.129 D) and DIMS (+0.123 D) maintained SE stability. Myopia incidence was lowest in atropine (2.6%) and DIMS (5.5%) versus controls (7.7%), with atropine reducing myopia risk by 66% and DIMS by 29%. Both interventions effectively stabilised early refractive development in high-risk premyopic preschoolers – with atropine mainly reducing myopia incidence and DIMS reducing rapid progression.

[Link to abstract]

Authors: Xiangui He¹, Jingjing Wang¹, Guangzhuang Jing¹, Linlin Du¹, Jinliuxing Yang1, Jun Chen¹, Haidong Zou¹, Xun Xu^1,2

1. Shanghai Eye Disease Prevention and Treatment Center, Shanghai, China
2. Shanghai General Hospital Department of Ophthalmology, Shanghai, China

This study evaluated the efficacy and feasibility of a school-based intervention in reducing myopia incidence and slowing myopic shift among primary school students. This prospective, cluster-randomised controlled trial included 43,185 children aged 6–12 years across 68 primary schools in Shanghai, China. Intervention schools were assigned outdoor activities (≥1hr/day on school days, ≥2hrs/day on weekends) and to wear highly aspherical lenslet (HAL) spectacles for pre-myopes and myopes. 

After 6 months, the intervention group demonstrated a 35.9% relative reduction in myopia incidence (8.66% vs 13.50%) and 48.2% slower AL progression (0.088mm vs 0.170mm) compared to controls. Greater daily HAL wearing time was associated with greater reduction in AL progression, achieving 72.7% in children who wore HAL lenses for ≥12h/day. These 6-month results indicate promising efficacy and acceptance for an integrated school-based myopia prevention and control approach.

[Link to abstract]

Authors: Wei Pan¹, Weizhong Lan¹

1. Aier Academy of Ophthalmology, Central South University, Changsha, Hunan, China

This study assessed regional differences in hyperopic reserve among European, Australian, and Asian children – to compare rates of hyperopic reserve consumption over time, and evaluated the performance of regional myopia screening programs. This study analysed a harmonised dataset from the CREAM-Kids Consortium comprising 20 paediatric cohort studies across Asia, Europe, and Australia, and included 28,505 non-myopic children aged 4–9 years. 

Among 7-year-olds, mean hyperopic reserve was higher in European (1.44D) and Australian (1.32D) children compared to those in Hong Kong (0.78D) and Singapore (0.59D), with a difference of approximately 0.80D. Asian children demonstrated faster annual consumption of hyperopic reserve (-0.35D/year) than their European and Australian peers (-0.12D/year), increasing their risk for early-onset myopia. These underscore the need to routinely monitor hyperopic reserve and region-appropriate myopia prevention strategies.

[Link to abstract]

Authors: Jody Summers¹, Manish Harrigill², Tammy Yanovitch², Michael Siatkowski²

1. Cell Biology, OU College of Medicine, Oklahoma City, Oklahoma, United States
2. Ophthalmology, OU College of Medicine, Oklahoma City, Oklahoma, United States

This study investigated whether systemic anti-inflammatory treatment in children delays the onset and slows the progression of myopia compared to untreated age-matched controls. This retrospective, mixed cross-sectional and longitudinal chart review compared refractive development in children aged 0–22 years receiving systemic anti-inflammatory treatment for chronic inflammatory conditions (e.g. juvenile idiopathic arthritis, lupus, and ankylosing spondylitis) against untreated age-matched subjects, across 154 patients in total. 

Myopia progression was significantly slower in the treated group compared to controls (-0.11D/year vs -0.24D/year), with estimated myopia onset delayed from age 10 in controls to age 17 in treated patients. In children aged 10 years and older, mean refraction was markedly less myopic in the treated group (+0.43D vs -1.02D). The results suggest inflammation may influence myopia development and that anti-inflammatory treatments could potentially delay the onset and progression of myopia.

[Link to abstract]

Authors: Juan Li¹, Rongrong Li^1,2, Yuxing Fan^1,3, Jiale Huang^1,3, Fan Yang¹, Zhen Zhang¹, Xiaofeng Wang^1,3, Yong Li¹, Yiting Zhang^1,3

1. Xi'an People's Hospital Shaanxi Eye Hospital, Xi'an, Shaanxi, China
2. Xi'an Medical University, Xi'an, Shaanxi, China
3. Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, China

This study assessed the efficacy of repeated low-level red-light (RLRL) therapy in modulating axial length, macular pigment optical density (MPOD), multispectral refraction topography (MRT), and myopia progression in adults with high myopia. In this randomised controlled study, 70 adults aged 18–40 years with high myopia were assigned to twice-daily RLRL therapy (650nm, 3 minutes per session; n=45) or routine follow-up alone (n=25), with measurements taken at baseline and at 1, 2, and 3 months. 

After 3 months, the RLRL group demonstrated progressive axial shortening) and SER improvement (-0.192mm, +0.579D) compared to no changes in controls. Additionally, MPOD increased while peripheral hyperopic defocus decreased, suggesting posterior-segment remodelling and enhanced macular function contributed to therapeutic efficacy. RLRL therapy significantly inhibited axial elongation, improved refractive status, enhanced macular pigment density, and reduced peripheral hyperopic defocus in highly myopic adults.

[Link to abstract]

Authors: Ranjila Shyangbo¹, Sarah Singh¹

1. University of California Berkeley Herbert Wertheim School of Optometry & Vision Science, Berkeley, California, United States

This study evaluated the 1-year change in spherical refractive error (SER) in young adult myopes wearing multifocal soft contact lenses (MFSCLs) compared to single-vision soft contact lenses (SVSCLs). This retrospective clinical study reviewed records from 84 young adults aged 18–30 years attending the Myopia Control Clinic at UC Berkeley, who wore either MFSCLs (n=56) or SVSCLs (n=28). 

At one year, MFSCL wearers demonstrated less myopic shift than SVSCL wearers (-0.08D vs -0.25D). An ≥0.25D change occurred in significantly fewer MFSCL wearers than SVSCL wearers (17.9% vs 46.4%). The results show measurable 1-year refractive progression in adult myopes, with less progression in MFSCL wearers compared to SVSCLs, suggesting MFSCLs may offer a protective effect. 

[Link to abstract]