How fast does myopia progress in children?

Average myopia progression is 0.50–0.75 diopters per year in children aged 7–12, with axial length growing 0.20–0.35mm per year. Rates are fastest in younger children and slow toward the late teens. Progression above 0.50D/year or 0.20mm/year axial length is considered fast and typically warrants treatment consideration.

Is 1 diopter per year fast for myopia?

Yes — 1 diopter per year is fast. Normal progression in children is 0.50–0.75D/year. A rate of 1D/year or above places a child at the 90th percentile or higher for their age group and indicates a high risk of reaching high myopia (-6D or above) by adulthood. Treatment should be seriously considered.

Myopia Progression: What's Normal, What's Fast, and When to Act (2026)

Q: When does myopia stop progressing?

Myopia typically stabilises in the late teens to early 20s, usually around age 18–21 in most populations. However, children with early-onset myopia (before age 10) tend to stabilise later and at a higher final prescription.

0.50–0.75D

Average annual progression in children aged 7–12

0.20mm

Axial length threshold for treatment consideration (per year)

Age 18–21

When myopia typically stabilises in most populations

Is 1 diopter per year fast?

Yes — 1 diopter per year is fast. Normal progression is 0.50–0.75D/year. At 1D/year, a child starting at −1.00D at age 8 projects to −9D by 18 without intervention. Treatment is strongly indicated. This rate corresponds to axial elongation of roughly 0.35–0.40mm/year — well above the 90th percentile for all age groups in Tideman 2018 normative data.

What's a normal myopia progression rate?

Progression rates vary substantially by age. Younger children progress faster; rates slow as the eye matures. The reference below shows Tideman 2018 normative data for European children — East Asian children typically progress 15–20% faster.

Age	Slow (<25th %ile)	Normal (25–75th)	Fast (>75th %ile)	Clinical action
6–8	<0.15mm/yr	0.25–0.35mm/yr	>0.40mm/yr	Consider treatment if fast
8–10	<0.12mm/yr	0.20–0.30mm/yr	>0.35mm/yr	Consider treatment if fast
10–12	<0.10mm/yr	0.15–0.25mm/yr	>0.30mm/yr	Review if not already treating
12–14	<0.08mm/yr	0.10–0.20mm/yr	>0.25mm/yr	Monitor; treat if >0.25mm
14–16	<0.05mm/yr	0.05–0.12mm/yr	>0.18mm/yr	Monitor for stabilisation

Based on Tideman JWL et al. (2018), JAMA Ophthalmol. Clinical thresholds are expert consensus — not formal IMI-mandated cutoffs. AL/D conversion: −2.50D ≈ 1mm.

Diopter progression vs axial length — which matters more?

Diopter progression (how much the prescription changes) and axial length growth (how much the eye physically elongates) are related but not identical. Two patients can have the same diopter change with different amounts of axial elongation depending on corneal curvature and lens contribution.

Axial length is the clinically superior metric because structural complications (retinal detachment, macular degeneration, glaucoma) are driven by physical eye length, not the prescription number. The IMI 2025 Digest formally recommends axial length measurement as part of standard myopia monitoring.

Rule of thumb: −0.50D/year ≈ 0.20mm/year axial elongation (based on the −2.50D/mm conversion). This approximation has individual variation of ±2–3D and should not replace biometry where available.

How to calculate your child's progression rate

You need two measurements taken at least 6 months apart: either two refraction readings (diopters) or two axial length measurements (millimetres). Divide the change by the interval in years.

MyopiaTracker calculates this automatically and plots it against age-matched normative percentiles from Tideman 2018. It takes under 30 seconds and requires no login.

Calculate your patient's exact progression rate

Enter two axial length measurements with dates. MyopiaTracker calculates mm/year and compares to Tideman 2018 age-matched normatives instantly.

Calculate progression rate →

Free · No login · Under 30 seconds

When does myopia stop progressing?

In most populations, myopia stabilises between ages 18–21. However, children who develop myopia early (before age 10) tend to stabilise later and at a higher final prescription. Children who develop myopia after age 12 typically stabilise earlier and at a lower final level.

Some adults continue to progress into their 20s and 30s, particularly those with higher prescriptions or who spend significant time on near work. See our article on myopia progression in adults for the evidence on late-onset and continuing progression.

Treatment thresholds — when is intervention indicated?

The IMI 2025 Interventions report recommends considering treatment when any of the following apply:

Axial length growth >0.20mm/year at any age
Refraction change >0.50D/year
Myopia onset before age 10
AL above 75th percentile for age and ethnicity
Both parents myopic (warrants early counseling and monitoring)

These are clinical decision frameworks, not rigid cutoffs. Individual patient factors including ethnicity, lifestyle, and family history all influence the treatment decision.

Myopia Progression: What's Normal, What's Fast, and When to Act

What's a normal myopia progression rate?

Diopter progression vs axial length — which matters more?

How to calculate your child's progression rate

Calculate your patient's exact progression rate

When does myopia stop progressing?

Treatment thresholds — when is intervention indicated?

Related resources