IMI - Prevention of Myopia and Its Progression

  • The prevalence of myopia has markedly increased in East and Southeast Asia, and pathologic consequences of myopia, including myopic maculopathy and high myopia-associated optic neuropathy, are now some of the most common causes of irreversible blindness.

  • Hence, strategies are warranted to reduce the prevalence of myopia and the progression to high myopia because this is the main modifiable risk factor for pathologic myopia.

  • On the basis of published population-based and interventional studies, an important strategy to reduce the development of myopia is encouraging schoolchildren to spend more time outdoors.

  • As compared with other measures, spending more time outdoors is the safest strategy and aligns with other existing health initiatives, such as obesity prevention, by promoting a healthier lifestyle for children and adolescents.

  • Useful clinical measures to reduce or slow the progression of myopia include the daily application of low-dose atropine eye drops, in concentrations ranging between 0.01% and 0.05%, despite the side effects of a slightly reduced amplitude of accommodation, slight mydriasis, and risk of an allergic reaction; multifocal spectacle design; contact lenses that have power profiles that produce peripheral myopic defocus; and orthokeratology using corneal gas-permeable contact lenses that are designed to flatten the central cornea, leading to midperipheral steeping and peripheral myopic defocus, during overnight wear to eliminate daytime myopia.

  • The risk-to-benefit ratio needs to be weighed up for the individual on the basis of their age, health, and lifestyle.

  • The measures listed above are not mutually exclusive and are beginning to be examined in combination.

Clinical Summaries in several languages are available here:

Publication date

May 11, 2021


Investigative Ophthalmology & Visual Science, Arvo Journal

Sponsor Institution

International Myopia Institute supported by donations from Brien Holden Vision Institute, Carl Zeiss Vision, CooperVision, Essilor, and Alcon


Jost B. Jonas; Marcus Ang; Pauline Cho; Jeremy A. Guggenheim; Ming Guang He; Monica Jong; Nicola S. Logan; Maria Liu; Ian Morgan; Kyoko Ohno-Matsui; Olavi Pärssinen; Serge Resnikoff; Padmaja Sankaridurg; Seang-Mei Saw; Earl L. Smith, III; Donald T. H. Tan; Jeffrey J. Walline; Christine F. Wildsoet; Pei-Chang Wu; Xiaoying Zhu; James S. Wolffsohn
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