Myopia Control in Children: Can Increasing Glasses Power Be Prevented?
Every year, the same story plays out in eye clinics across India. A child comes in for a check-up, the glasses number has gone up again, and the parent asks: “Why does it keep increasing? Can we stop it?”
The honest answer has two parts. Myopia (short-sightedness) cannot be cured, and a child who already has it will not outgrow it. But in many children the speed at which it worsens can be slowed down with proven treatments, and this is what doctors call myopia control or myopia management.
In this guide, the team at Total Retina Eye Care, an eye hospital in Nagpur, explains why myopia progresses, why ordinary glasses do not stop it, which treatments have real evidence behind them, and what you can start doing at home today.
What Is Myopia?
Myopia means a child can see near objects clearly but distant objects look blurred. It usually happens because the eyeball grows too long from front to back. Light then focuses in front of the retina instead of on it.
Children’s eyes keep growing through the school years, so myopia tends to worsen until the late teens or early twenties. That is why the prescription keeps changing.
Why Is Childhood Myopia Increasing?
Myopia is becoming more common in children around the world, and Indian studies show it is more common in school children in cities than in villages. Researchers believe the reasons include:
• Less time outdoors, especially during daylight hours. Many city children live in apartments, have little playground access and spend school and tuition hours indoors
• Long hours of close-up work, such as school work, homework, tuition and competitive exam preparation
• More screen time, with phones and tablets held very close to the face. Online classes and mobile games during and after the pandemic years added to this
• Family history: a child with one or both short-sighted parents is more likely to develop myopia, and often at a younger age
Genetics sets the stage, but daily habits matter. And habits are something a family can change.
Why Does the Glasses Number Matter?
Many parents think of myopia as only a nuisance that glasses fix. But the number matters for a bigger reason: the higher the myopia, the greater the lifetime risk of serious eye problems. Highly myopic eyes are more likely to develop retinal detachment, myopic maculopathy, glaucoma and early cataract. Cataracts can appear at a younger age in highly myopic eyes, and cataract surgery in Nagpur or anywhere else needs careful planning in these longer eyes.
As retina specialists, we see these complications in adults, and most of them began as childhood myopia that kept progressing. This is why slowing progression in childhood is worthwhile even if the child “manages fine with glasses.” Every bit of progression avoided helps lower the long-term risk.
Do Stronger Glasses Make Myopia Worse?
This is one of the most common worries, so let’s be clear.
• Ordinary (single-vision) glasses do not cause myopia to worsen. Not wearing them does not help either, and a child who cannot see the board clearly will struggle at school.
• But ordinary glasses also do not slow myopia. They correct the blur, while the eye keeps growing.
That is why a child on regular glasses typically needs stronger lenses year after year until the early twenties. To actually slow the process, a treatment aimed at the eye’s growth is needed.
Myopia Control Options That Have Evidence
Different options suit different children. Your eye doctor will choose based on age, current prescription, how fast the myopia is progressing, and how reliably your child can follow the treatment.
1. Outdoor Time (Free and Safe for Everyone)
Time spent outdoors in daylight is one of the best-supported habits for protecting children’s eyes. Current professional guidance suggests aiming for at least two hours outside every day. It appears to help most in delaying the onset of myopia, and it supports other treatments in children who already have it.
Outdoor play, a walk to school, cycling or sport all count. Indoor lighting, even a bright classroom, is far weaker than daylight.
In India’s heat, the practical way is to plan it around the day: early morning before school, the evening after tuition, school break time in the playground and weekends. Ask your child’s school to keep games and outdoor periods rather than replacing them with extra classes. A cap and sunglasses with UV protection are sensible in strong midday sun, since daylight is still helpful in the shade.
2. Low-Dose Atropine Eye Drops
Atropine drops in very dilute strengths (usually 0.01% to 0.05%) are used once a day at bedtime to slow eye growth. At these strengths, side effects such as light sensitivity and mild blurring of near vision are usually limited.
• Suitable for children from around age 5
• Needs to be used every day, for years, under a doctor’s supervision
• Results vary between children, and the drops are less likely to help in high myopia
• Strengths, brands and quality differ, so use only the product and strength your doctor prescribes. Never give a child ordinary atropine drops or one bought from a local chemist without a prescription, since full-strength atropine is far stronger and causes marked side effects
3. Special Spectacle Lenses (Defocus Lenses)
These look like ordinary glasses but have a design that changes how light focuses at the edge of the retina, which signals the eye to slow its growth. A well-known example is the Essilor Stellest lens, which has the approval of the US FDA for slowing myopia progression.
• Easy for younger children, as there is no need to handle contact lenses
• Must be worn full-time to work
• In the main trial, progression was reduced by roughly 70% over two years compared with ordinary glasses, though individual results vary
4. Myopia Control Contact Lenses
Soft, daily-disposable lenses with a special ring design (such as MiSight) correct vision and slow growth at the same time. They are best for children who are mature enough to handle lenses and follow hygiene rules, typically from around age 8.
• Need to be worn most days, for many hours
• Small risk of eye infection, which falls with good hygiene
5. Orthokeratology (Ortho-K)
These are firm lenses worn overnight that gently reshape the front surface of the eye, so that your child sees clearly during the day without glasses. Studies suggest it can reduce progression by about 50 to 60%.
• The effect is reversible: if the lenses are stopped, the cornea returns to its original shape
• Overnight wear carries a higher risk of serious corneal infection, so strict cleaning and regular follow-up are essential
• Needs careful fitting by an experienced practitioner
6. Emerging Option: Repeated Low-Level Red Light Therapy
Short daily sessions of low-level red light have shown strong results in clinical trials, mostly done in East Asia. However, the long-term data are limited, and there are open questions about retinal safety, including changes seen on retinal scans and whether some devices deliver more light than is safe. It is an area where we recommend caution. Please do not buy a home device without a specialist’s advice.
Which Option Is Best?
There is no single best treatment. A young child who dislikes drops may do well with defocus spectacles. An older, motivated child may prefer contact lenses. Some children benefit from combining treatments. The right plan depends on the child, and it should be reviewed regularly.
Practical Points for Indian Families
• Hygiene and climate: contact lenses and ortho-k need clean hands, clean water and a clean lens case. In hot, humid or dusty conditions, or where reliable running water is a problem, spectacle lenses or drops may be the safer choice for a child
• Cost: most myopia control treatments are paid for out of pocket, and health insurance usually does not cover them. Ask for the full cost for the whole year, including follow-up visits and lens replacements, before you begin
• Avoid unsupervised shortcuts: contact lenses, ortho-k lenses and red light devices should only be fitted and monitored by a qualified eye care professional. Do not buy them online or from non-clinical shops
• Follow-up: these treatments only work if used consistently and checked regularly, so choose a plan your family can realistically keep up for years
What Parents Can Do at Home
These habits cost nothing and support every medical treatment:
1. Get children outdoors daily, ideally two hours or more, even on school and tuition days.
2. Follow the 20-20-20 rule. Every 20 minutes of reading or screen time, look at something about 20 feet (6 metres) away for 20 seconds.
3. Keep the distance. Books and screens should be held at a comfortable distance, not pressed close to the face. Prefer larger screens held farther away.
4. Limit recreational screen time, especially for younger children.
5. Use good lighting for reading and homework.
6. Do not skip eye check-ups. Children often do not complain about blurred vision, as they assume everyone sees that way.
When Should You Get Your Child’s Eyes Checked?
Take your child for an eye examination if:
• They squint, sit very close to the TV or hold books close
• They complain of headaches or tired eyes
• They cannot read the board in class
• One or both parents have significant myopia (start early checks even without symptoms)
• Their glasses number has changed by about 0.5 D or more in a year
Children who are at risk should have an eye test at least once a year, and those on myopia control are usually seen every 6 months.
Frequently Asked Questions
1. Can myopia in children be cured?
No. Myopia cannot be reversed, and eye exercises or herbal remedies do not cure it. The goal of treatment is to slow progression and keep the final prescription as low as possible.
2. Can myopia control stop the number from increasing completely?
Not in every child. Most treatments slow the progression rather than stop it, and response varies. Even a partial slowdown is valuable, as it reduces the final myopia and the long-term risk.
3. What is the best age to start myopia control?
As soon as myopia is diagnosed and is progressing. The younger a child becomes myopic, the more years the eye has to worsen, so early treatment is usually more important, not less.
4. Do eye exercises, ayurvedic drops or eating carrots reduce myopia?
There is no good evidence that eye exercises, herbal or ayurvedic eye drops, or special diets slow myopia. Healthy food is good for the body, but it is not a myopia treatment. Avoid spending money on products that promise to “remove glasses” and please do not use any drops on your child’s eyes without advice.
5. Can I stop treatment once the number stabilises?
Do not stop on your own. Stopping some treatments too early can allow the myopia to speed up again. Your doctor will tell you when and how to stop.
7. Is screen time the only cause of myopia?
No. Screens add to close-up work, but reading, homework, less outdoor time and genetics all play a role. That is why a balanced approach works best.
8. Is myopia control safe?
The approved and established options are generally safe when properly prescribed and followed up. Each has its own risks (such as infection risk with contact lenses), which is why they should be supervised by an eye specialist and not bought without advice.
Final Thoughts
If your child’s glasses number keeps going up, it does not mean you have done something wrong, and it does not mean nothing can be done. Myopia cannot be cured, but its progress can often be slowed, and slowing it protects your child’s eyes for life.
Start with the simple steps today: more daylight, shorter screen sessions and regular eye check-ups. Then speak to an eye specialist about whether a myopia control treatment is right for your child.
At Total Retina Eye Care, an eye hospital in Nagpur, our specialists can assess your child’s eyes, measure how quickly the myopia is progressing and help you choose a plan. Because high myopia can affect the retina later in life, regular retinal health checks matter too.
