MYOPIA CONTROL · CONCORD EYECARE
When Should Your Child Start Myopia Control?
Earlier treatment means less myopia. Here's how to know when it's time to act.
Book a Myopia Assessment (02) 8765 9600Reviewed by Dr Mark Joung, B.Optom (Hons) UNSW · Last updated May 2026
WHEN IS THE RIGHT AGE TO START MYOPIA CONTROL?
Earlier treatment means less myopia — here's why the maths matters
There is no minimum prescription required before myopia control becomes worthwhile. Once your child's eyes measure −0.50 dioptres or more, active treatment can begin. The reason timing matters is straightforward — myopia progression is fastest in children aged 7 to 10 (Brennan et al., 2021), and a treatment that slows progression by 50% saves more total dioptres when started during those peak years than the same treatment started at age 12 or 13.
Think of it this way. A child who becomes myopic at age 7 without treatment might reach −5.00 D by age 16. Start myopia control at age 7 with 50% efficacy, and they may finish closer to −3.00 D. Wait until age 11 to start the same treatment, and the final result might be −4.00 D or higher — because the fastest progression years have already passed untreated.
This is why Bullimore and Brennan's widely cited research concludes that every dioptre matters. The difference between −3.00 and −5.00 isn't just thicker glasses. It's a measurably lower lifetime risk of retinal detachment, myopic maculopathy, and glaucoma.
HOW DO WE KNOW IT'S TIME TO ACT?
Two objective measures — not just a gut feeling
The axial length threshold comes from the CLEERE study (Mutti et al., 2007), which identified 0.2 mm annual growth as an indicator of impending or active myopia progression. This is why we measure axial length with the Zeiss IOLMaster 500 at every myopia assessment — not just refraction. Refraction tells you what prescription your child needs today. Axial length tells you how fast their eyes are actually growing, which is a more reliable predictor of where they're heading.
For children under 5 presenting with myopia, we take a different approach. Very early-onset myopia can have pathological causes, so we perform a full cycloplegic refraction and may refer to a paediatric ophthalmologist to rule out underlying conditions before starting myopia control.
WHICH TREATMENT WORKS BEST AT WHICH AGE?
It depends on the child, not just their birthday
Myopia control spectacle lenses or Ortho-K
Spectacle lenses like MiyoSmart (HOYA) and Stellest (Essilor) use peripheral defocus technology to slow progression by up to 60%. They look and feel like normal glasses, making them a practical first option at any age. But compliance can make or break spectacle-based treatment — the lenses only work when they're being worn. From around age 7–8, Ortho-K becomes an option — the lenses work overnight, so there's nothing for your child to remember or manage during the day.
Daily contact lenses open up
MiSight 1 day by CooperVision is indicated from age 8 (59% reduction in progression). Daily disposables with no cleaning routine — which makes compliance easier for many families. Ortho-K remains excellent for children who prefer no daytime correction at all.
Fast progressors — combination therapy
When a single treatment isn't enough, we add low-dose atropine (LAMP study, Yam et al., 2019). Eikance 0.01% and 0.025% are both TGA-registered in Australia.
Higher prescriptions — contact lenses preferred
At moderate to higher myopia, spectacle lenses become thicker and less comfortable — which can compromise both wear time and efficacy. Ortho-K or MiSight are often better suited.
IS IT EVER TOO LATE TO START MYOPIA CONTROL?
No — and myopia doesn't always stop at 18
For these patients, continuing treatment is clinically justified even though it falls outside the typical age range studied in most trials. Our criteria for stopping treatment: no measurable progression for at least two consecutive years, and the patient is 18 or older. Until both conditions are met, we continue monitoring and treating.
If your child is a teenager and hasn't started myopia control yet, it's still worth acting. The rate of progression is slower than at age 8, but slowing it by even one or two dioptres over the remaining growth years reduces their long-term risk profile meaningfully.
WHAT HAPPENS AT A MYOPIA CONTROL ASSESSMENT?
A thorough assessment before any treatment decision
Axial length measurement
Using the Zeiss IOLMaster 500 — the same biometry device used in cataract surgery planning, repurposed here to track eye growth with sub-millimetre precision.
Cycloplegic refraction
Accurate prescription measurement, especially important in younger children whose focusing muscles can mask their true prescription.
Risk factor assessment
Family history, outdoor time habits, near-work patterns, age of onset — everything that shapes your child's progression risk.
Treatment discussion
We walk through which options suit your child's specific situation, including realistic expectations for each treatment.
There's no obligation to start treatment on the day. Many families take a week or two to discuss options at home before committing.
FREQUENTLY ASKED QUESTIONS
Common questions about starting myopia control
Can a 6-year-old wear Ortho-K lenses?
Yes. We've fitted Ortho-K lenses on children as young as six. The deciding factor isn't age alone — it's whether the child can cooperate with lens insertion and removal, and whether the family can maintain the hygiene routine. Some six-year-olds manage this confidently with parental help.
Should I wait to see if my child's myopia gets worse before starting treatment?
No. Waiting to "see what happens" means allowing the fastest years of myopia progression to pass untreated. Research consistently shows that earlier intervention leads to less total myopia. We recommend assessment as soon as myopia is diagnosed — even at low levels like −0.50 D.
How long does myopia control treatment last?
Most children continue treatment throughout their school years. We typically continue until there's been no measurable progression for at least two years and the patient is over 18. For some patients, this means treatment continues into their late teens or even early twenties.
What if one treatment isn't working?
We monitor progression at every review using axial length measurement. If a single treatment isn't achieving adequate slowing, we can add low-dose atropine as combination therapy, or switch to a different primary treatment. The decision is guided by your child's biometric data, not a fixed protocol.
Does myopia control cure myopia?
No. Myopia control slows progression — it doesn't reverse or cure existing myopia. The goal is to reduce how much myopia your child ends up with by adulthood, which lowers their lifetime risk of complications like retinal detachment and glaucoma.
- Brennan NA, Toubouti YM, Cheng X, Bullimore MA. Efficacy in myopia control. Prog Retin Eye Res. 2021;83:100923.
- Bullimore MA, Brennan NA. Myopia control: why each dioptre matters. Optom Vis Sci. 2019;96(6):463–465.
- Flitcroft DI, He M, Jonas JB, et al. IMI – Defining and classifying myopia. Invest Ophthalmol Vis Sci. 2019;60(3):M20–M30.
- Lam CSY, Tang WC, Tse DY, et al. Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression. Br J Ophthalmol. 2020;104(3):363–368.
- Mutti DO, Hayes JR, Mitchell GL, et al. Refractive error, axial length, and relative peripheral refractive error before and after the onset of myopia. Invest Ophthalmol Vis Sci. 2007;48(6):2510–2519.
- Saw SM, Tong L, Chua WH, et al. Incidence and progression of myopia in Singaporean school children. Invest Ophthalmol Vis Sci. 2005;46(1):51–57.
- Yam JC, Jiang Y, Tang SM, et al. Low-Concentration Atropine for Myopia Progression (LAMP) study. Ophthalmology. 2019;126(1):113–124.
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