Myopia Progression in Adults · Concord Eyecare, North Strathfield, Sydney
Can myopia still progress in your 20s?
Yes. About 1 in 3 Australians with myopia progress by half a dioptre or more during their twenties, and it is genuine eye growth, not just a prescription quirk. The first step is measuring axial length — the eye's actual length — to find out whether yours is still changing.
Find out if my eyes are still changing Free 30-minute assessment · no commitmentPrefer to talk it through first? Call 02 8765 9600.
Is adult myopia progression real?
Real, common — and measurable.
In the Raine Study — the largest Australian data we have — 37.8% of young adults with myopia progressed by 0.50 dioptres or more between ages 20 and 28[1]. Progression in your twenties is not rare and it is not imagined. It is also measurable, which is where the useful answer starts.
Does a stronger prescription mean my eyes are still growing?
A changing script is a clue, not a diagnosis.
Not by itself. A prescription can shift with tiredness, long hours of close work, or simple measurement variation between visits. Real progression means the eye itself has grown slightly longer. Measuring axial length — the front-to-back length of the eye — is how we tell the difference.
When adult eyes do progress, it is genuine growth: research shows the change happens in the length of the eye, not in the cornea or the lens[6]. That is exactly why we don't ask you to interpret your own prescription history. We measure the eye directly, and the comparison is done in millimetres — see how axial length is measured.
What we rule out before calling it progression
In the landmark adult study, progressing eyes lengthened by 0.24 mm over two years while non-progressing eyes changed by just 0.03 mm — and the cornea, lens and front chamber of the eye didn't change at all[6]. Because a myopic shift in adults occasionally has other causes, we also map the corneal surface (topography) to rule out corneal ectasia, and check the eye's natural lens, before attributing any change to eye growth[3].
Why is my myopia still getting worse at 25?
Screens, study and close work keep pushing myopia in your twenties.
Because the things that drive myopia don't stop at 18. If your twenties are full of lectures, screens and deadline weeks, you are in the group where progression is most common — that's your life, not a failing. Across a heavy-study decade, the average change is around one dioptre[3].
When does myopia stop progressing?
Most eyes settle in the late teens. Not all.
Most childhood myopia stabilises in the mid-to-late teens. But stabilising is a curve, not a switch: about 1 in 10 people whose myopia began in childhood are still progressing at 21, and roughly 1 in 25 at 24[2]. And myopia can also start fresh in adulthood — it did for 14% of young adults who weren’t short-sighted at 20 in the Raine Study[1].
No one can promise you that your eyes have finished changing. Your own measurements can tell you.
Wondering about a child's timeline instead? See when to start myopia control.
Does adult myopia progression actually matter?
Every dioptre counts — but your personal risk depends on where you started.
Higher myopia, still progressing
Worth acting on
Recent-onset, low myopia
Much lower absolute risk
Each additional dioptre of myopia is associated with roughly 67% higher prevalence of myopic maculopathy later in life — so dioptres gained in your twenties are not automatically trivial[4]. Here is the honest counterweight: if your myopia began recently and is low, you are very unlikely ever to reach high myopia, and your personal risk stays much lower[3]. International guidance puts it plainly — the case for acting is strongest in adults with higher myopia and demonstrated progression, not in every worried twenty-something with a mild prescription[3]. Which group you're in is not a guess. It's a measurement.
Can anything slow myopia progression in adults?
Honest answer: nobody has run the trial yet.
Established
Adult vision correction
Adult myopia control
Not yet established
No myopia-control treatment has ever been tested in a controlled trial in adults. That is an evidence gap, not evidence that nothing works — the trials simply haven't been run. The first one ever mounted, in adults aged 18 to 40, reports around 2028[8].
In children, myopia-control treatments slow eye growth by roughly 40–60% in clinical trials. In adults, those same treatments have never been tested — so we will not quote you a children's percentage as your expectation[3]. What international guidance does say: clinicians can still consider adults with demonstrated progression as candidates for myopia control, decided case by case with the evidence gap on the table[3]. That conversation only makes sense after your measurements show real progression — which is why this page keeps coming back to measurement.
The adult evidence, treatment by treatment
Every treatment used to slow myopia in children — overnight reshaping lenses (Ortho-K), myopia-control spectacle lenses, myopia-control soft contact lenses, and prescription eye drops used for childhood myopia control — has its entire controlled-trial evidence base in children. None has a controlled efficacy trial in adults; the eye-drop option has never been efficacy-tested in anyone over 18[3]. A major research review of myopia-control treatments excluded adult trials by design, because there were none to include[9]. One reason the gap has persisted: adults who progress do so slowly — typically around 0.1–0.2 dioptres a year — so any treatment effect would be small and hard to detect. The first adult trial in existence, a myopia-control spectacle-lens study run in the UK in adults aged 18–40, completes in late 2027 and reports around 2028[8]. We will update this page when it does.
What should I do about myopia progression in my 20s?
Measure first. Decide with data.
Start with a measurement, not a treatment. We take a baseline axial-length reading, repeat it after six months, and compare the two in millimetres. You'll know whether your eye has actually changed — not guess from a prescription. Six-monthly axial length is the method Optometry Australia recommends for tracking progression[5].
Baseline axial length
A $45 measurement visit; your eye's length on record.
Re-measure at six months
Same instrument, same eye, compared in millimetres.
Decide together
No change: reassurance and routine care. Real progression: your options, honestly.
The 30-minute assessment conversation is free, and books you into nothing. If measuring makes sense for you, the axial-length baseline visit is $45 — that's the whole cost of getting your answer started.
Considering Ortho-K for daytime vision?
If you'd also like freedom from daytime glasses or contact lenses, overnight Ortho-K is an established correction option for adults — Ortho-K for adults covers what it can and can't promise.
Quick questions
The things people ask us across the desk.
Is it normal for my prescription to change at 25?
It's common — about 1 in 3 Australians with myopia progress during their twenties[1]. But a small script change can also be measurement variation rather than real eye growth. An axial-length measurement settles which one you have, in millimetres, before anyone talks about treatment.
Will laser surgery stop my myopia progressing?
No. Laser surgery reshapes the cornea to remove your current prescription — it doesn't stop the eye lengthening, and progression after surgery is documented[3]. The eye-health reasons to keep an eye on progression remain, whichever correction route you choose.
How much progression is normal year to year?
My child's myopia is progressing — is this page for me?
This page is about adults. Children's eyes grow faster, and children have treatment options backed by strong clinical trials — start at progressive myopia in children for that pathway.
Reviewed by Dr Mark Joung, B.Optom (Hons) UNSW · Member, Orthokeratology Society of Oceania · Last clinically reviewed August 2026
The first adult myopia-control trial reports around 2028. We will update this page when it does.
References
- Lee SS-Y, et al. (Raine Study). JAMA Ophthalmol 2022;140(2):162–169. PMID 34989764 — 37.8% of Australian young adults progressed ≥0.50 D between ages 20 and 28; 14% new adult onset; risk factors.
- COMET Group. IOVS 2013;54(13):7871–84. PMID 24159085 — myopia stabilisation ages; ~10% still progressing at 21, ~4% at 24.
- Bullimore MA, et al. IMI — Onset and Progression of Myopia in Young Adults. IOVS 2023;64(6):2. PMID 37126362 — ~1.00 D average change across the twenties; no controlled adult myopia-control trials; candidacy for demonstrated progressors; post-surgery progression; adult progression rates.
- Bullimore MA, Brennan NA. Optom Vis Sci 2019;96(6):463–465 — each additional dioptre associated with ~67% higher prevalence of myopic maculopathy.
- Optometry Australia. Position Statement on Myopia Management, December 2024 — axial length the preferred method for evaluating progression; 6-monthly biometry.
- McBrien NA, Adams DW. IOVS 1997;38(2):321–33. PMID 9040464 — adult progression is elongation of the eye; 0.24 mm vs 0.03 mm over two years; no corneal or lens change.
- Mountjoy E, et al. BMJ 2018;361:k2022. PMID 29875094 — education causally increases myopia (~0.27 D per year of education).
- ClinicalTrials.gov NCT06520124 — first adult myopia-control randomised trial (myopia-control spectacle lenses, adults 18–40, Ulster University); completes ~December 2027.
- Walline JJ, et al. Interventions to slow progression of myopia in children. Cochrane Database of Systematic Reviews 2020;1:CD004916. PMID 31930781.
Book a free 30-minute assessment
Stop guessing. Start measuring.
Bring your questions — and your old prescriptions, if you have them. You'll talk it through with Mark, Nikki or Vivian, and leave knowing exactly what, if anything, to do next. The conversation is free. If measuring makes sense, your axial-length baseline is $45. And nobody here will recommend a treatment before your eyes have been measured.
Find out if my eyes are still changing Free 30-minute assessment · no commitmentPrefer the phone? 02 8765 9600.
Concord Eyecare · 161 Concord Rd, North Strathfield, Sydney · Korean, Mandarin and Cantonese spoken