THE MYOPIA CLINIC · CONCORD EYECARE
When your child's eyesight keeps getting worse
Progressive myopia isn't just "needing stronger glasses." It's a pattern — and understanding it is the first step to changing it.
BOOK A MYOPIA ASSESSMENTor call (02) 8765 9600
Reviewed by Dr Nikki Peng & Dr Vivian Li · Last updated May 2026
WHAT IS PROGRESSIVE MYOPIA?
Not a separate condition — a pattern of change
Every eye has a length — measured from the front of the cornea to the retina at the back. In myopia, the eye is slightly too long, so light focuses in front of the retina instead of on it. That's what causes the blur.
In progressive myopia, the eye keeps growing. Each millimetre of extra length shifts the prescription further. This is why your child needs new glasses every year — the eye is physically changing shape.
Standard glasses correct the blur, but they don't address the growth. That's an important distinction — and it's why understanding what myopia actually is matters before deciding what to do about it.
We track this growth directly with axial length measurement using the Zeiss IOLMaster 500 — because prescription alone doesn't tell the full story.
WHY DOES MYOPIA GET WORSE IN SOME CHILDREN?
Age, genetics, and how they use their eyes
Age of onset is the strongest predictor. A child who becomes myopic at six has many more years of eye growth ahead than one who starts at twelve. More years of growth means a higher final prescription — and a higher risk of complications. This is why early detection matters so much.
Genetics set the baseline. If one parent is myopic, their child's risk roughly triples. If both parents are, the risk increases six-fold (Mutti et al., 2002). Ethnicity also plays a role — the Sydney Myopia Study found that 42.7% of East Asian children were myopic by age 12, compared to 4.4% of European children (Rose et al., 2008).
Environment accelerates the timeline. Less than two hours of outdoor time per day significantly increases myopia risk. Sustained near work — screens, reading, devices held close — adds to the load. These factors don't cause myopia on their own, but they can turn moderate progression into fast progression.
Growth spurts matter. Myopia progression isn't always predictable from year to year.
HOW FAST IS TOO FAST?
What the numbers actually mean
Prescription change is the number most parents hear at each visit. But it only tells part of the story — axial length can increase before the prescription catches up. That's why we measure both.
We use the Zeiss IOLMaster 500 to track axial length changes precisely. It's a quick, non-contact measurement — and it gives us an early warning signal that prescription alone can miss.
WHY STRONGER GLASSES DON'T SLOW IT DOWN
The glasses fix the blur — not the growth
This is the part that surprises most parents. Glasses do their job — your child sees the board, reads comfortably, plays sport without squinting. But the prescription keeps changing because nothing is addressing why it's changing.
Myopia control is a different category of treatment. These aren't just "better glasses." They're specifically designed to slow the elongation of the eye — using optical, pharmaceutical, or combination approaches backed by clinical research.
Ortho-K
Night-wear lenses that reshape the cornea while sleeping. Clear vision all day without glasses. Research suggests 50–60% slowing.
Learn about Ortho-K →MiyoSmart Lenses
Spectacle lenses with HOYA's DIMS technology. Worn like normal glasses. HOYA data suggests around 60% slowing with 12+ hours daily wear.
Learn about MiyoSmart →MiSight Contact Lenses
Daily disposable soft lenses by CooperVision. FDA trial data shows 59% slowing over three years.
Learn about MiSight →Atropine Eye Drops
Low-dose drops used once daily at bedtime. Works alone or combined with other treatments for fast progressors. Up to 50% slowing (LAMP study).
Learn about atropine →WHEN DOES MYOPIA STOP GETTING WORSE?
Usually mid-teens — but not always
There's no exact age where progression stops for everyone. Most children see their prescription level out in the mid-to-late teenage years, as the eye finishes most of its growth. But we regularly see patients whose myopia continues to shift into their early twenties.
This is why "waiting to see if it settles" can be a costly strategy. By the time progression slows naturally, the prescription may already be high enough to carry long-term risk. Myopia control treatments work best while the eye is still growing — the window is finite.
For children already in treatment, we continue monitoring at regular intervals and adjust the approach as progression changes. Atropine eye drops can be added to spectacle or contact lens treatments when the progression rate warrants combination therapy.
WHAT IS HIGH MYOPIA AND WHY DOES IT MATTER?
Above -6.00 dioptres, the risks change
For many parents, the most concrete way to understand -6.00 is this: it's roughly the threshold above which laser eye surgery becomes unlikely. LASIK eligibility depends on both the prescription and how thick the cornea is — and at higher prescriptions, there often isn't enough corneal tissue to safely reshape. So a child whose myopia tracks past -6.00 may be looking at a lifetime of glasses or contact lenses with no surgical option.
Beyond the practical issue of correction, high myopia carries genuine health risks. The longer the eye grows, the more the retina stretches and thins. This makes it more vulnerable to:
Retinal detachment — the retina separates from the back of the eye. A medical emergency that requires surgery.
Myopic maculopathy — progressive damage to the central retina that can cause irreversible vision loss.
Glaucoma — myopic eyes are more susceptible to this silent optic nerve disease.
Early cataracts — clouding of the natural lens tends to develop earlier and more aggressively in highly myopic eyes.
These risks are why myopia control isn't just about reducing the strength of the glasses. It's about reducing the lifetime probability of something going wrong.
HOW CONCORD EYECARE MONITORS PROGRESSION
Baseline, monitoring, and acting at the right time
Baseline assessment
Full refraction, axial length measurement with the Zeiss IOLMaster 500, and corneal topography. This gives us an objective starting point — not just a prescription, but a map of the eye's shape and length.
Six-monthly monitoring
We review every six months rather than annually — because progression isn't always linear, and catching a spike early means we can adjust the treatment plan before significant change accumulates.
All three of our optometrists are therapeutically endorsed — meaning we can prescribe atropine directly, without a GP referral.
Dr Nikki Peng
B.Optom (Hons 1st Class) UNSW · Grad Cert Ocular Therapeutics · ACO Advanced Children's Vision
Dr Vivian Li
B.Optom (Hons) UNSW · Grad Cert Ocular Therapeutics · ACO Advanced Children's Vision Certificate
Dr Mark Joung
B.Optom (Hons) UNSW · Grad Cert Ocular Therapeutics · 800+ Ortho-K fits
FREQUENTLY ASKED QUESTIONS
What parents ask about progressive myopia
What is progressive myopia?
Progressive myopia is a pattern where a child's short-sightedness worsens year after year, driven by the eye growing too long. It isn't a separate disease — it's myopia on an accelerating trajectory. The faster it progresses, the higher the lifetime risk of complications like retinal detachment and myopic maculopathy. Learn more about what myopia is and how it works.
At what age does myopia stop getting worse?
Myopia progression typically stabilises between ages 16 and 17, but some patients continue progressing well into their twenties. Children who become myopic earlier tend to progress for longer and reach higher final prescriptions, which is why starting myopia control early makes a real difference.
Can myopia progression be stopped?
Current treatments can't stop progression entirely, but they can significantly slow it. Ortho-K and MiyoSmart are clinically shown to slow progression by around 50–60%, MiSight by 59%, and atropine eye drops by up to 50%. The goal is to keep the final prescription as low as possible.
What causes myopia to get worse quickly?
The main risk factors are early age of onset, family history (especially two myopic parents), limited outdoor time, and sustained near work. Ethnicity also plays a role — the Sydney Myopia Study found higher prevalence in East Asian children. Growth spurts can cause prescription jumps even when progression seemed stable.
Should I be worried about my child's myopia?
Any progression is worth monitoring — especially in children under 10. If your child's prescription is increasing by -0.75 dioptres or more per year, that's considered fast progression and active treatment is recommended. A myopia assessment with axial length measurement gives you a clear picture of where things stand.
What is high myopia and why does it matter?
High myopia — generally above -6.00 dioptres — significantly increases the lifetime risk of retinal detachment, myopic maculopathy, glaucoma, and early cataracts. It also typically rules out laser eye surgery like LASIK, depending on corneal thickness. The aim of myopia control is to keep the final prescription below this threshold.
References
- Brennan NA, Toubouti YM, Cheng X, Bullimore MA. (2021). Efficacy in myopia control. Progress in Retinal and Eye Research, 83, 100923.
- Mutti DO, Mitchell GL, Moeschberger ML, Jones LA, Zadnik K. (2002). Parental myopia, near work, school achievement, and children's refractive error. Investigative Ophthalmology & Visual Science, 43(12), 3633–3640.
- Rose KA, Morgan IG, Ip J, et al. (2008). Outdoor activity reduces the prevalence of myopia in children. Ophthalmology, 115(8), 1279–1285.
- Lam CSY, Tang WC, Tse DY, et al. (2020). Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial. British Journal of Ophthalmology, 104(3), 363–368.
- Chamberlain P, Peixoto-de-Matos SC, Logan NS, et al. (2019). A 3-year randomized clinical trial of MiSight lenses for myopia control. Optometry and Vision Science, 96(8), 556–567.
- Yam JC, Jiang Y, Tang SM, et al. (2019). Low-Concentration Atropine for Myopia Progression (LAMP) Study: A Randomized, Double-Blinded, Placebo-Controlled Trial of 0.05%, 0.025%, and 0.01% Atropine Eye Drops in Myopia Control. Ophthalmology, 126(1), 113–124.
- Flitcroft DI. (2012). The complex interactions of retinal, optical and environmental factors in myopia aetiology. Progress in Retinal and Eye Research, 31(6), 622–660.
- Sankaridurg P, Tahhan N, Engardahl S, et al. (2021). IMI — Update on myopia prevention. Investigative Ophthalmology & Visual Science, 62(5).
Serving Sydney families from our North Strathfield practice — 161 Concord Rd, North Strathfield NSW 2137. Free parking nearby. 6 minutes from North Strathfield Station.
Your child's progression doesn't have to be a guessing game
A myopia assessment with axial length measurement gives you a clear picture — and a plan.
BOOK A MYOPIA ASSESSMENTor call (02) 8765 9600