Worried that your child’s short-sightedness (myopia) keeps getting worse every time they have an eye test? Wondering whether low dose atropine eye drops, specialised myopia control glasses, specialised myopia control soft contact lenses or OrthoK contact lenses are the “best” treatment to stop their prescription from increasing?
The truth is, there is no one-size-fits-all solution for myopia control. While we’re fortunate to have a range of evidence-based treatments supported by cutting-edge research, what works for one child might not work for another. Read more about That’s because myopia is a complex condition, influenced by a variety of individual risk factors—from genetics and physical health to lifestyle habits, screen use, posture, and even personality.
Why Personalised Treatment Matters
Scientific studies give us valuable insights into which myopia control methods can work. But until we sit down with your child, assess their visual system, and understand their lifestyle, hobbies and challenges, we can’t guarantee how well any single strategy will work well for them.
At The Eye Collective, we take a personalized approach to every myopia case—because no two kids are the same. Let’s walk through two very different cases to show how tailored treatments lead to better outcomes.
Case 1: The Avid Reader with Binocular Vision Dysfunction
This 9-year-old boy came in for his first eye test and was detected to have myopia. Only one of his parents had a mild degree of myopia, so his genetic risk was considered moderate. However, his lifestyle told us a lot more:
- He loved reading and spent hours doing it.
- He disliked outdoor play and sports.
- His parents were concerned he held books extremely close to his face.
Our eye exam revealed that he had a binocular vision dysfunction—specifically accommodation insufficiency combined with convergence excess. In simple terms, his eyes were struggling to focus during near tasks like reading, and over-converging to compensate, creating more stress on the visual system.
These visual dysfunctions, paired with his intense near work and indoor lifestyle, were likely driving his myopia progression.
His Personalised Myopia Management Plan Included:
- Multifocal/Progressive Spectacles: Chosen to reduce the stress on his eyes during reading by supporting his focusing ability.
- No Atropine Drops (Yet): Although low-dose atropine is often combined with multifocal lenses, it can further reduce accommodation ability. Given he already had difficulty focusing, we chose not to use atropine initially.
- Lifestyle Adjustments:
- Strict implementation of the 20-20-20 rule (every 20 minutes, take a 20-second break and look 20 feet away).
- Ensured good posture and lighting during reading.
- Encouraged outdoor reading, such as sitting on his balcony in natural daylight.
Outcome:
Over the past three years, his prescription has remained stable. While there has been some increase in his axial length (the structural growth of the eye), the change is within the normal range for his age, and he continues to do well with just progressive lenses. Read our previous blog to learn more about binocular vision dysfunction and myopia control.
Make An Appointment
Case 2: The Sporty Teen Needing Freedom and Function
Our second patient was a 13-year-old girl who came to us for a second opinion after her myopia continued to progress despite already using MiyoSmart lenses and low-dose atropine drops.
She was an active child—a passionate hockey player, swimmer, and beach lover. She often removed her glasses during sport and swimming, which meant she wasn’t wearing her myopia control lenses during some of the daytime hours.
Our examination showed mild convergence excess, which means her eyes tend to turn in slightly more than needed when reading up close. However, her focusing system was working well, so this didn’t appear to affect her ability to read comfortably. Based on her lifestyle and binocular vision profile, we recommended Orthokeratology (Ortho-K)—overnight contact lenses that reshape the front of the eye while she sleeps, allowing clear vision all day without glasses.
Why Ortho-K Was the Right Fit for Her:
- Lifestyle Compatibility: Ortho-K gave her freedom during sport, swimming, and beach outings—something glasses couldn’t offer.
- Additional Benefits: After switching to Ortho-K, her mild convergence excess normalised. When children move from glasses to Ortho-K, their eyes often converge slightly less during close-up tasks like reading. For kids with mild convergence excess, this shift can help improve how well their eyes work together at near—making reading more comfortable and efficient.
- Unexpected Bonus: Her parents were initially concerned that she might be sensitive to the feeling of the lenses and take longer to fall asleep. However, she actually reported falling asleep more easily—her eyes felt more comfortable when closed with the lenses in, and wearing them reduced her urge to look at her phone before bed.
Outcome:
After 1.5 years, her axial length has remained stable and within normal limits for her age. While it’s harder to measure her exact prescription with Ortho-K, there has been no significant visual regression. She enjoys great vision, active days, and solid control over her myopia.
So, What’s the Best Strategy for Your Child?
There’s no single “best” method—because the best strategy is the one that suits your child. At The Eye Collective, we don’t treat numbers—we treat people. Every child who walks through our doors gets a comprehensive assessment and a tailored myopia control plan, with ongoing reviews and adjustments as they grow.