Childhood myopia: recognized treatments in 2025 (low-dose atropine, defocus lenses, specialized contact lenses)

The good news: today there are recognized treatments to slow down the progression of myopia. Since the 2000s, several studies have confirmed the effectiveness of three main approaches: low-dose atropine, defocus spectacle lenses (such as MiYOSMART, launched in 2014), and specialized contact lenses. All optometrists at VU can support your child in controlling the progression of their myopia with these three proven solutions.

Understanding myopia in children

Myopia usually appears between the ages of 4 and 12. It progresses during childhood and adolescence, then tends to stabilize in adulthood.

Three main factors influence this progression, in order of importance:

1. Prolonged near work, especially time spent on screens or reading, particularly when the child holds their devices or books at a very short distance.

2. Lack of exposure to natural light, as children spend less time outdoors than they used to. Regular outdoor play is now recognized as a protective factor against myopia.

3. Genetics, which plays a significant role: having one myopic parent doubles the risk of developing myopia, while having two myopic parents multiplies this risk by four. In addition, certain ethnic groups — particularly populations of Asian origin — have a higher predisposition to myopia.

This is why an eye exam starting in the preschool years (around age 3) is essential to quickly detect any signs of myopia or other visual disorders.
Reminder: in Quebec, eye exams for children under 18 are fully covered by the RAMQ.

What does the 2023–2025 literature say?

Here is a clear summary of the most recent findings:

How we measure myopia progression

At VU, we use the Haag-Streit Lenstar, a high-precision biometric instrument that measures the total axial length of the eye.

This is the most reliable method to monitor the progression of myopia, because relying only on symptoms or on refraction (the optical correction measured) can sometimes give a misleading impression of stability or progression.

During your visit, feel free to ask your optometrist how your child’s myopia is being monitored. Precise control of axial length offers a much more objective and rigorous assessment, and it is essential for optimal treatment.

Our preferred treatments are:

• MiYOSMART defocus spectacle lenses

• Specialized contact lenses for myopia control

• Low-dose atropine as a complement in certain cases

Simplified decision tree by age

Age 4–7 years

Goal: simplicity + acceptance

Age 8–12 years

Goal: balance between effectiveness and autonomy

Age 13–17 years

Goal: autonomy + long-term adherence

Practical tips to slow myopia at home

• Aim for at least 90 minutes per day outdoors

• Minimum reading distance: roughly the length of the forearm

• Limit continuous near screen time

• Apply the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds

Conclusion

Childhood myopia should be actively monitored and treated, not just corrected.

Thanks to MiYOSMART defocus lenses, specialized contact lenses and low-dose atropine, it is now possible to significantly slow down progression and protect your child’s long-term vision.

An eye exam makes it possible to precisely measure progression and establish a personalized plan.
You can schedule an eye exam for your child (covered by RAMQ) or a dedicated appointment to discuss treatment options.

Book an appointment.