The Rising Tide of Myopia
Over the past three decades, myopia has surged worldwide, with projections suggesting that by 2050, half of the global population could be nearsighted. This trend has sparked intense research into slowing its progression in children—both to improve quality of life now and to reduce the risk of serious eye diseases later.
BLINK & BLINK2: Modest Wins for Multifocal Lenses
The Bifocal Lenses in Nearsighted Kids (BLINK) trial tested whether high‑add multifocal soft contact lenses could slow myopia progression in children aged 7–11. Over three years, the high‑add lenses slowed refractive change by 0.46 diopters and axial elongation by 0.23 mm compared to single‑vision lenses.
The follow‑up BLINK2 study extended observation for another three years. All participants wore high‑add lenses for two years, then switched to single‑vision lenses for one year. The original high‑add group still showed 0.31 mm less axial length and 0.71 D less myopia than the original single‑vision group—suggesting the benefit persisted with minimal rebound after stopping.
ATLAS: Atropine’s Long‑Term Reality Check
In contrast, the Atropine Treatment Long‑Term Assessment Study (ATLAS) followed participants from earlier atropine trials (ATOM1 & ATOM2) for 10–20 years. The verdict: childhood atropine use did not significantly change adult myopia severity or the rate of myopia‑related complications.
What This Means for Myopia Care
- Optical treatments like multifocal lenses, myopia‑control spectacles, and orthokeratology may offer small but sustained slowing of eye growth, with less rebound than atropine or red light therapy.
- Atropine remains an option, but expectations for long‑term impact should be tempered.
- The ultimate goal—reducing lifetime risk of retinal detachment, myopic macular degeneration, and other complications—remains unproven.
- Compliance may be better with optical methods, as they double as vision correction and have few side effects.
The Big Unanswered Question
Even with these advances, the field still faces a critical unknown: Will slowing myopia in childhood translate into fewer cases of vision‑threatening disease decades later? Until that’s answered, myopia control remains a game of incremental gains—important, but not yet transformative.
Citation:
Kehler LAF, Wallace DK. Myopia Control—Are We Getting Any Closer? JAMA Ophthalmology. Published online January 16, 2025. doi:[10.1001/jamaophthalmol.2024.6083]
