Contemporary Strategies for Myopia Control in the Pediatric Population: A Narrative Review of Lifestyle, Pharmacological, and Optical Interventions

Abstract

Myopia, or near-sightedness, is a prevalent refractive error characterized by the convergence of parallel light rays anterior to the retina, leading to blurred distance vision. The refractive error development involves a complex interplay between optical components and eyeball anatomy, with both genetic predisposition and environmental influences contributing to its onset and progression. The global prevalence of myopia in children and adolescents has risen markedly in recent decades, driven by reduced outdoor activity, prolonged near work, and increased screen exposure. This trend poses a growing public health concern, given the associated risk of sight-threatening complications. This narrative review synthesizes current evidence on lifestyle, pharmacological, and optical interventions for controlling myopia progression in the pediatric population. Lifestyle modifications, particularly increased outdoor exposure, have demonstrated protective effects. Pharmacological approaches, most notably low-dose atropine, have shown dose-dependent efficacy in slowing myopia progression, with an acceptable safety profile. Optical strategies, such as orthokeratology, repeated low-level red-light therapy, and diffusion optics technology lenses, target peripheral defocus and choroidal changes to mitigate axial elongation in subjects with myopia. The myopia control and prevention strategies are economically viable interventions that are both safe and effective, as demonstrated in the existing medical literature. Overall, a multimodal, individualized strategy combining behavioral, pharmacological, and optical measures offers the most promise in reducing the burden of myopia in children. Future research should prioritize long-term safety, optimal treatment combinations, and strategies to enhance adherence to the suggested myopia control interventions.