Myopia Control for Adults: Options Beyond Childhood | Healio

Myopia, or nearsightedness, is often considered a childhood condition, but emerging evidence suggests it can continue to progress well into adulthood – and even begin in young adults who haven’t yet developed significant nearsightedness. This means that strategies for slowing the progression of myopia, traditionally focused on children, may also be beneficial for adults and those at risk of developing the condition. A discussion at Vision Expo highlighted the growing recognition of this phenomenon and the potential for intervention beyond adolescence.

According to Shalu Pal, OD, FAAO, FSLS, FBCLA, a practitioner based in Toronto, approximately 20 to 40 percent of adults in their 20s may experience continued, aggressive myopia progression. This progression isn’t limited to visual acuity; axial length – the physical measurement of the eye – can also continue to increase. Here’s significant because axial length is a key indicator of myopia progression and is linked to increased risk of certain eye diseases later in life.

Adult Myopia Progression: Challenging Conventional Wisdom

A 2024 study published in Investigative Ophthalmology & Visual Science further challenges the long-held belief that myopia stabilizes in the teenage years. Researchers Brennan and colleagues analyzed data from three large studies across multiple continents and observed a trend of myopic progression of at least 1 diopter (D) between the ages of 20 and 50. The full study can be found in Investigative Ophthalmology & Visual Science. This finding suggests that myopia control methods, previously reserved for children, could have a role in managing the condition in young adults as well.

The implications of this continued progression are substantial. Increased axial length is associated with a higher risk of developing sight-threatening conditions such as retinal detachment, glaucoma, and myopic macular degeneration. Interventions aimed at slowing myopia progression, even in adulthood, could potentially reduce the long-term risk of these complications.

Treatment Options for Adult Myopia Control

Fortunately, the same range of myopia control methods used successfully in children are also appropriate for adults. Dr. Pal emphasizes the availability of several effective options, including specialized spectacle lenses, low-dose atropine eye drops, orthokeratology (ortho-k) lenses, and soft multifocal contact lenses. Healio provides a detailed overview of matching myopia control methods to patient compliance. The key, she notes, is to identify adults who are still progressing and proactively implement these treatments.

For adults considering refractive surgery like LASIK, Dr. Pal points out that many surgeons prefer to wait until patients are in their mid-20s and have demonstrated stable refraction. In the interim, she often prescribes myopia control spectacle lenses to gradual progression. If these lenses are insufficient, she may add low-dose atropine to the treatment regimen. A study highlighted by Healio showed better myopia control with ortho-k lenses and atropine.

Understanding Atropine and its Role

Atropine is an eye drop that works by temporarily paralyzing the focusing muscle in the eye. While traditionally used at higher concentrations for dilating pupils, low-dose atropine has been shown to effectively slow myopia progression with fewer side effects. It’s thought to work by affecting the signaling pathways involved in eye growth.

Orthokeratology: Reshaping the Cornea

Orthokeratology involves wearing specially designed rigid gas permeable contact lenses overnight to temporarily reshape the cornea. This reshaping corrects vision during the day without the need for glasses or contacts. Ortho-k has also been shown to slow myopia progression, particularly in children and young adults.

Pre-Myopia: Intervening Before Onset

Dr. Pal also highlights the importance of addressing “pre-myopes” – individuals who haven’t yet developed significant myopia but are showing signs of its potential onset. Intervening at this stage could potentially prevent or delay the development of myopia altogether. This proactive approach is particularly relevant given the increasing prevalence of near work activities, such as screen time, which are known risk factors for myopia development.

The Role of Axial Length Measurement

Accurate measurement of axial length is crucial for monitoring myopia progression and assessing the effectiveness of treatment. Optical coherence tomography (OCT) is a non-invasive imaging technique that allows clinicians to precisely measure axial length. Regular axial length measurements can help identify individuals who are progressing rapidly and guide treatment decisions.

What Does This Mean for You?

If you are an adult experiencing worsening vision, or if you are a young adult concerned about your risk of developing myopia, it’s important to discuss your concerns with an eye care professional. They can assess your individual risk factors, measure your axial length, and recommend appropriate management strategies. The growing understanding of adult myopia progression offers new hope for preserving vision and reducing the risk of long-term eye health complications.

The field of myopia control is continually evolving. Ongoing research is focused on identifying the most effective treatment strategies for different populations and understanding the underlying mechanisms driving myopia progression. CISA released five industrial control systems advisories on March 12, 2026, which, while unrelated to eye health, underscores the importance of staying informed about emerging information across all sectors. As new evidence emerges, clinical practice guidelines will likely be updated to reflect the latest recommendations.

For more information: Shalu Pal, OD, FAAO, FSLS, FBCLA, can be reached at [email protected].