Frequently Asked Questions About Myopia
Expert-reviewed answers to the most common questions parents ask about childhood myopia, progression risks, treatment options, costs, and finding the right specialist.
About Myopia
What is myopia (nearsightedness)?
Myopia, commonly called nearsightedness, is a vision condition where close objects appear clear but distant objects appear blurry. It occurs when the eye grows too long from front to back, causing light to focus in front of the retina instead of directly on it.
Why is childhood myopia a concern?
Childhood myopia tends to progress (get worse) until early adulthood. Higher levels of myopia significantly increase the risk of serious eye conditions later in life, including retinal detachment, glaucoma, cataracts, and myopic maculopathy. Early intervention can help slow this progression.
What causes myopia in children?
Myopia is caused by a combination of genetic and environmental factors. Children with myopic parents are at higher risk. Environmental factors include excessive near work (reading, screens), limited outdoor time, and starting school at a young age.
At what age does myopia typically start?
Myopia typically begins between ages 6-14, though it can start earlier or later. Earlier onset often leads to higher final prescription levels, which is why early detection and management are important.
Treatment Options
What is myopia control?
Myopia control refers to treatments specifically designed to slow the progression of myopia in children, not just correct their vision. These include orthokeratology (Ortho-K), MiSight contact lenses, low-dose atropine drops, and specialized spectacle lenses.
How effective are myopia control treatments?
Research shows that myopia control treatments can slow progression by 50-60% on average. Ortho-K and low-dose atropine both show approximately 50-60% efficacy, while MiSight lenses have shown 59% reduction in axial length growth in clinical trials.
Is Ortho-K safe for children?
Yes, Ortho-K is considered safe for children when properly fitted and cared for. The lenses are FDA-approved and have been used for decades. The key is proper hygiene, following wear schedules (5-6 hours nightly), and regular follow-up visits with your eye care provider.
What are the side effects of low-dose atropine?
At low concentrations (0.01%-0.05%), atropine has minimal side effects. Some children may experience mild light sensitivity or difficulty focusing up close, but these effects are typically minor and temporary. Higher concentrations have more noticeable side effects.
Can treatments be combined?
Yes, some eye care providers recommend combining treatments for enhanced effect. For example, low-dose atropine can be used alongside Ortho-K or MiSight lenses. Your myopia specialist can advise on the best approach for your child.
Finding Care
How do I find a myopia specialist?
Use our Find a Specialist directory to locate eye care professionals who specialize in myopia control. Look for providers who offer multiple treatment options and have experience with pediatric patients. Ask about their training and the technologies they use.
What should I ask at my child's appointment?
Key questions include: What is my child's current prescription and axial length? How quickly is their myopia progressing? What treatment options do you recommend and why? What is the expected efficacy? How often will we need follow-up visits?
Does insurance cover myopia control?
Coverage varies by insurance plan. Some vision plans cover a portion of specialty contact lenses or Ortho-K. Atropine drops may be covered under medical insurance. We recommend contacting your insurance provider and asking your eye care office about payment options.
How often should my child have eye exams?
Children with myopia should typically have eye exams every 6 months during active progression years. Your eye care provider may recommend more or less frequent visits based on your child's specific situation and treatment plan.
Lifestyle & Prevention
Can outdoor time help prevent myopia?
Yes! Research shows that spending 2+ hours outdoors daily can reduce the risk of myopia onset by up to 50%. The bright light outdoors is believed to trigger dopamine release in the retina, which helps regulate eye growth.
Should I limit my child's screen time?
While screen time alone doesn't cause myopia, excessive near work (including screens) is associated with increased risk. Encourage the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds. Balance screen time with outdoor activities.
Does reading cause myopia?
Reading itself doesn't cause myopia, but prolonged near work is a risk factor. Encourage good reading habits: proper lighting, holding books at arm's length, taking regular breaks, and balancing reading with outdoor time.
What is the 20-20-20 rule?
The 20-20-20 rule is a simple guideline to reduce eye strain: every 20 minutes of near work, look at something 20 feet away for at least 20 seconds. This helps relax the focusing muscles in the eyes and may help reduce myopia progression risk.
Are there special glasses that can slow myopia?
Yes, specialized spectacle lenses like MiyoSmart (DIMS technology) and Stellest have been shown to slow myopia progression by 50-60% in clinical trials. These lenses use special optical designs to reduce the stimulus for eye elongation while providing clear vision.
Costs & Insurance
How much does myopia control cost?
Costs vary by treatment type and location. Ortho-K typically costs $1,000-$2,500 for the first year including fitting, lenses, and follow-up visits, then $300-$600 annually for replacements. MiSight lenses cost around $500-$1,000 per year. Low-dose atropine drops are generally $30-$100 per month depending on pharmacy and concentration.
Does vision insurance cover myopia control?
Coverage varies significantly by plan. Some vision plans cover specialty contact lenses partially. Medical insurance may cover atropine as a prescription medication. Many providers offer payment plans. Always check with both your vision and medical insurance, and ask your provider about financing options.
Is myopia control worth the cost?
Many parents and eye care professionals believe the investment is worthwhile because slowing myopia progression reduces the lifetime risk of serious eye conditions. High myopia significantly increases risks of retinal detachment, glaucoma, cataracts, and myopic maculopathy. Take our Risk Assessment to understand your child's risk level. The cost of managing these conditions later in life can be substantial.
Are there affordable myopia control options?
Low-dose atropine is often the most affordable option, especially at lower concentrations. Some providers offer payment plans for Ortho-K. Specialized spectacle lenses may be partially covered by vision insurance. Outdoor time (2+ hours daily) is free and has been shown to help prevent myopia onset.
What is included in the cost of Ortho-K?
Ortho-K costs typically include: initial comprehensive eye exam, corneal topography mapping, custom lens fitting, the lenses themselves, follow-up visits (usually several in the first few months), and adjustments as needed. Annual costs after the first year include replacement lenses and monitoring visits.
Treatment Expectations
How long does myopia control treatment last?
Myopia management is typically continued until myopia progression naturally slows, usually in the late teens to early twenties. Treatment duration depends on when myopia started, how quickly it's progressing, and individual factors. Your eye care provider will monitor progression and recommend when to consider stopping.
Will my child's vision get worse even with treatment?
myopia control slows progression but doesn't stop it completely. Most children will still experience some increase in their prescription, but typically 50-60% less than without treatment. The goal is to reduce the final level of myopia and associated health risks.
How soon will we see results from treatment?
For Ortho-K, vision improvement is often noticeable within days to weeks. For measuring slowed progression, it typically takes 6-12 months to see meaningful differences compared to expected progression. Your provider will track axial length and prescription changes over time.
What happens if we stop treatment?
If treatment is stopped before myopia naturally stabilizes, progression may resume at the previous rate. Some studies suggest there may be a temporary "rebound" effect with certain treatments. Decisions to stop treatment should be made with your eye care provider based on age and progression patterns.
Can my child play sports while using myopia management treatments?
Yes! Ortho-K is particularly popular among young athletes because it provides clear daytime vision without glasses or contacts. MiSight and atropine users can wear their lenses or use drops as prescribed and participate in sports normally. Discuss any specific concerns with your eye care provider.
Is myopia control safe for young children?
Yes, when properly supervised. Ortho-K and MiSight are FDA-approved for children as young as 8. Low-dose atropine has been used safely in children for decades. The key factors are proper fitting, good hygiene habits, and regular follow-up visits. Your provider will assess if your child is a good candidate.
Comparing Treatments
Which treatment is best for my child?
The best treatment depends on your child's age, prescription, lifestyle, and ability to handle contact lenses or eye drops. Ortho-K works well for active children who don't want daytime glasses. MiSight is good for children comfortable with daily contact lens wear. Atropine is ideal for those who prefer drops over contacts. Many specialists recommend combining treatments for enhanced effect.
What is the difference between Ortho-K and MiSight?
Ortho-K uses rigid lenses worn overnight to temporarily reshape the cornea, providing clear daytime vision without glasses or contacts. MiSight are soft daily disposable lenses worn during the day. Both show similar efficacy (50-60% slowing). Ortho-K requires more careful hygiene; MiSight is simpler to use but requires daytime wear. See our side-by-side comparison for more details.
Can atropine be used with contact lenses?
Yes, low-dose atropine can be combined with Ortho-K or MiSight lenses for potentially enhanced myopia control. Some studies suggest combination therapy may be more effective than either treatment alone. Your eye care provider can advise on the best combination approach for your child.
Are specialized glasses as effective as contact lenses?
Recent studies show specialized spectacle lenses (like MiyoSmart and Stellest) can slow myopia progression by 50-60%, similar to contact lens options. They may be a good choice for children not ready for contact lenses or those who prefer glasses. Effectiveness depends on consistent full-time wear.
Still have questions? Find a myopia control specialist near you for personalized guidance.