IMI-Interventions for Controlling Myopia Onset and Progression 2025

Abstract

Myopia is recognized as a significant public health problem, particularly in East and Southeast Asia. This has led to the development and evaluation of a range of interventions to slow its progression and delay its onset. Since the publication of the 2019 International Myopia Institute's review of interventions for controlling myopia onset and progression, treatment options have continued to grow in number. This article reviews the efficacy of such interventions under five categories: optical, pharmacological, environmental (behavioral), colored light, and surgical. In summarizing the efficacy of mature technologies, only randomized controlled trials were considered, although such data are very limited for emerging treatments. The overall conclusion is that there are multiple effective interventions in most categories. Further research should aim to understand the mechanisms underlying myopia progression and the modalities that slow its progression in order to develop more effective treatments.

Figure 1.

Hypothetical axial elongation in groups of untreated patients with myopia (A), treated patients with myopia (B), and patients with emmetropia (C). Formulae are shown for the calculation of absolute treatment efficacy, percentage treatment efficacy, and emmetropic progression ratio.

Figure 2.

(A) Myopia control spectacles; (B) SoV contact lenses; (C) Overnight orthokeratology; (D) 0.01% atropine; (E) Atropine concentrations ≥0.02%; (F) Red light therapy. Reduction of axial elongation relative to untreated control children as a function of treatment duration for different myopia control interventions. For each panel, the legend is arranged by approximate treatment efficacy, not date. ATOM, Atropine for the Treatment of Myopia; ATOM-J, Atropine for the Treatment of Myopia - Japan; CARE, cylindrical annular refractive elements; CHAMP, Childhood Atropine for Myopia Progression; DIMS, defocus incorporated multiple segments; DISC, defocus incorporated soft contact; DOT, diffusion optics technology; EDOF, extended depth of focus; HAL, highly aspherical lenslets; I-ATOM, India - Atropine for the Treatment of Myopia; LAMP, Low-Concentration Atropine for Myopia Progression; MF, multifocal; MOSAIC, Myopia Outcome Study of Atropine in Children; MPDL, myopic peripheral defocus; MTS-1, Myopia Treatment Study-1; NLARI, negative power lenslets; PLARI, positive power lenslets; PSA, positive spherical aberration; SAL, slightly aspherical lenslets; SMC, Shamir myopia control; WA-ATOM, Western Australia - Atropine for the Treatment of Myopia. See Supplementary Figures S1–S6 for individual plots.