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Backroom Ops websiteHow short-sightedness develops in children, why slowing it matters, and what the evidence says about outdoor time, special lenses and atropine drops in NZ.
Every clinical statement in this guide is referenced to a peer-reviewed paper whose full text was checked. Last reviewed October 2026.
Myopia, also called short-sightedness, means things in the distance look blurry while things up close are usually clear. In children, myopia gets worse almost entirely because the eyeball grows too long, and eyes grow fastest in early childhood before settling down in the mid-teens.[1]
Myopia is becoming much more common. Experts project that about half of the world's population could be short-sighted by 2050.[2] How common it is in children varies hugely between regions, from about 3% of schoolchildren in parts of Sub-Saharan Africa to around 80–90% of senior high-school students in parts of East and Southeast Asia.[3]
Myopia is about more than needing glasses. A large review found that even low and moderate myopia raise the long-term risk of serious eye problems, such as myopic macular degeneration (damage to the back of the eye) and retinal detachment, and the risk is highest with high myopia.[4] Among people whose eyes were very long (26 mm or more), about one in three was at risk of low vision in both eyes as they got older.[4]
The age myopia starts also matters. In one Chinese study, fewer than 5% of children who became short-sighted at 12 or older went on to have high myopia (−6 dioptres or worse) as adults, compared with more than 50% of children who were already short-sighted at 7 or 8.[1] Based mainly on East Asian data, experts estimate that each year myopia is delayed may mean ending up at least 0.75 dioptres less short-sighted.[1]
Ordinary single-vision glasses or contact lenses make distance vision clear, but they do not slow myopia down.[11] In clinical trials, children wearing ordinary glasses kept getting more short-sighted: in a two-year trial in Hong Kong, their myopia increased by an average of 0.85 dioptres, and every child's eye grew longer.[12] Making glasses deliberately weaker than the prescription (under-correction) does not help either, and may make myopia progress faster.[1][11]
For a child whose myopia is getting worse, correcting the blur is no longer enough on its own. Experts writing for the International Myopia Institute state that single-vision correction “does not represent an adequate level of care by itself” for someone whose myopia is progressing or at risk of progressing.[13] The World Council of Optometry describes the standard of care as correcting myopia while also providing evidence-based treatments that slow it,[14] and Optometry Australia advises treatment for all children whose myopia is progressing.[15]
Our advice: if your child's myopia is progressing, ordinary single-vision distance glasses should not be the default choice. Because your child needs glasses anyway, myopia-control spectacle lenses are often a natural first option.[17] They correct vision in the same way, are generally well accepted, and carry minimal physical risk, comparable to ordinary glasses.[1][16] They work best when worn full-time, and results vary between lens designs, so ask your optometrist which option suits your child.[1] Myopia-control contact lenses and low-dose atropine drops are other options, described below. These treatments slow myopia; they do not stop it completely.[15]
Time outdoors is one of the simplest things families can do. A review of the research found that more time outdoors lowered the chance of children becoming short-sighted; in the clinical trials, children with more outdoor time were roughly half as likely to develop myopia.[5] School programmes that added outdoor time reduced new cases of myopia by up to 9 percentage points compared with usual routines.[1]
How much time? The authors of one recent review recommend at least 2 hours outdoors every day, ideally in bright daylight, although they rated the certainty of the evidence as low.[6]
Outdoor time seems to work mainly by preventing or delaying myopia. Once a child is already short-sighted, extra time outdoors did not slow it down in a large analysis.[5] If your child is already short-sighted, talk to your optometrist about options to slow it. And while outdoors, keep up normal sun-smart habits such as hats and sunscreen.
Several treatments can slow myopia in children. None of them stops or cures it, and the right choice depends on your child's age, prescription, lifestyle and how comfortable they are with each option. Your optometrist can talk you through what suits your family.
Myopia-control glasses. These look like ordinary glasses but have special treatment zones built into the lens. In a two-year trial of 183 children in China aged 8 to 13, one design slowed myopia by 0.44 dioptres and slowed eye growth by 0.34 mm compared with ordinary glasses.[1] In another two-year trial in China of 157 children, a second design slowed myopia by 0.80 dioptres and eye growth by 0.35 mm compared with ordinary glasses.[1] No serious side effects have been reported with these glasses, and there is no evidence that myopia speeds up again when they are stopped.[1]
Myopia-control soft contact lenses. Daytime soft contact lenses designed for myopia control slow eye growth.[1] Across trials, the slowing ranged from 0.03 to 0.19 mm after one year and from 0.07 to 0.28 mm after three years.[1]
Orthokeratology (ortho-k). Ortho-k lenses are worn overnight and give clear vision during the day without glasses or contact lenses.[1] Ortho-k is among the most effective options, slowing eye growth in trials by a median of 0.17 mm over one year and 0.30 mm over two years.[1]
All contact lenses carry a small risk of eye infection, in the order of 1 to 3 cases per 10,000 years of wear, and the risk is about ten times higher with overnight wear.[1] The infection risk with ortho-k is higher than with daytime lenses but lower than with lenses worn continuously day and night, and children are at no higher risk than adults with daytime wear.[1] Careful lens hygiene and following your optometrist's instructions are important.
Atropine eye drops. Atropine eye drops slow myopia.[1] Stronger concentrations work better but cause more side effects, such as sensitivity to light and difficulty seeing up close.[1] The most widely studied low dose, 0.01%, has a small effect: across 21 trials it slowed eye growth by a median of 0.08 mm in the first year and 0.12 mm over two years.[1] Results for 0.01% have also been inconsistent.[7] Of seven two-year trials that compared it with a control or placebo group, five found a benefit and two did not.[7] The latest International Myopia Institute review names 0.05% as the most effective of the low doses.[1]
In one trial of children aged 4 to 9 who were not yet short-sighted but had a short-sighted parent, fewer children using 0.05% drops became short-sighted over two years (28%) than children using placebo drops (53%).[1] This was a single trial, so ask your optometrist whether it applies to your child.
Side effects of low-dose drops are mainly sensitivity to light, and with doses above 0.01%, some reduction in near vision.[7] A 'rebound' (myopia speeding up after drops are stopped) appears to be minimal with doses below 0.1%.[1]
In New Zealand, atropine eye drops (Eikance) in 0.01%, 0.025% and 0.05% strengths are approved by Medsafe to slow the progression of myopia when started in children aged 4 to 14 (checked October 2026).[8] They need a prescription and are not funded by Pharmac, so families pay for them; a funding request is under assessment (checked October 2026).[9]
Combining treatments. In trials, using 0.01% atropine together with ortho-k worked better than either treatment on its own.[7]
Most of the evidence comes from overseas.[7] Over 70% of myopia-control trials were carried out in Asian populations, so results may be different for children in New Zealand.[7]
Treatments slow myopia rather than stopping it, and the benefit is measured in fractions of a millimetre of eye growth each year. Ask your optometrist how long treatment is likely to continue, how progress will be measured, and what the plan is for stopping.
Measuring the length of the eye (axial length) is the preferred way to track myopia control, because it is very repeatable, does not touch the eye and does not need dilating drops.[1] As a rough guide, every 0.1 mm of extra eye growth adds about 0.2 dioptres of myopia, and eye length is closely linked to the risk of later complications.[10]
To measure a young person's prescription accurately, experts recommend dilating (cycloplegic) eye drops for patients up to 20 years old.[10] For children at risk of developing myopia, experts suggest check-ups at least every six months, so treatment can begin as early as possible.[10]
Children don't always notice or say that their vision is blurry, so regular eye checks are worthwhile. Book an appointment if:
Use our directory of New Zealand optometrists to find a practice near you. When you call, it helps to ask whether the practice offers myopia management, whether they measure eye length (axial length), and which treatment options they provide.
This guide is general information and does not replace an eye examination.
No treatment cures myopia. Myopia-control glasses, contact lenses (including ortho-k) and atropine eye drops can slow it down.
Not on their own if the myopia is getting worse. Ordinary glasses make vision clear but don't slow progression, and international expert guidance says correcting vision alone is not an adequate level of care for progressing myopia. Ask your optometrist about myopia-control glasses, contact lenses or atropine drops.
The authors of one recent review recommend at least 2 hours outdoors a day, ideally in bright daylight, although the certainty of the evidence is low. Outdoor time mainly helps prevent myopia from starting rather than slowing it once it has begun.
No. Atropine eye drops are Medsafe-approved to slow myopia in children aged 4 to 14, but they are not funded by Pharmac and need a prescription (checked October 2026).
The latest International Myopia Institute review names 0.05% as the most effective low dose. The commonly used 0.01% dose has a small effect, and trial results for it have been inconsistent.
Studies of myopia-control glasses have not reported any serious side effects, and there is no evidence of myopia speeding up again when they are stopped.
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