Ortho-K and atropine are effective in preventing and controlling myopia. Photo: Robert Ensley, OD; Getty Images. Click image to enlarge.

There are now a number of options to consider in efforts to control myopia but questions remain about how to arrive at the optimal approach. To see which interventions are the most effective for myopia prevention and control in children, researchers recently analyzed and compared different options and found that combined measures (in any of various pairings) were more effective in achieving axial length and refraction targets, followed by atropine solo.

The authors selected 80 randomized controlled trials of 27,103 eyes that included numerous interventions to slow myopia progression in children. The main outcomes included mean annual change in axial length (millimeters/year) and refraction (diopters/year).

Most of the combinations were more effective than other types of interventions, with 1% atropine in combination with bifocal spectacle lenses and 0.01% atropine in combination with ortho-K being significantly more effective than progressive addition spectacle lenses for myopia prevention and control. Under-corrected single-vision spectacle lenses were less effective in slowing the increase in refraction than the other interventions. Ortho-K was significantly more effective than spectacle options like PALs or bifocal progressive addition lenses, the authors explained in their paper.

 “Combined measures can not only reduce the side effects of a single intervention but also produce greater effective sizes, which is worth recommending,” the authors wrote. “In addition, atropine (1%, 0.5%, 0.1%, 0.05%, 0.01%) and ortho-K are also effective in myopia prevention and control. Progressive addition spectacle lenses, under-corrected single-vision spectacle lenses and compound tropicamide eye drops are ineffective in children.”