Best Myopia Treatments Ranked by What Actually Works
2026 Evidence-Based Guide
Short answer: The treatments with the strongest evidence are Stellest® spectacle lenses (67% AL reduction), MiSight® contact lenses (55%), orthokeratology (50%), and atropine drops (30–58% depending on concentration). The best option depends on your child's age, progression rate, and lifestyle.
All treatment options ranked by efficacy
| Treatment | AL reduction vs untreated | Key trial | Min age / notes |
|---|---|---|---|
| Combination therapy † | ~68% (modeled) | Multiplicative model | Any age; stacks two modalities |
| Stellest® HAL lenses | 67% (≥12hr/day wear); ~51% ITT | Bao et al. 2022 | School age; worn ≥12hr/day |
| Atropine 0.05% | ~58% at 3 years | LAMP (Yam et al. 2019) | Any age; compounded drops |
| MiSight® 1 day | ~55% at 3 years | Chamberlain et al. 2019 | FDA-approved age 8–12 |
| MiyoSmart® DIMS | ~52% at 2 years | Lam et al. 2020 | School age; spectacle lenses |
| Orthokeratology | ~50% (meta-analysis) | Multiple RCTs | From ~age 7; overnight lenses |
| Atropine 0.025% | ~45% at 2 years | LAMP (Yam et al. 2019) | Any age; compounded drops |
| Atropine 0.01% | ~30% at 2 years | ATOM2 (Chia et al. 2012) | Any age; fewest side effects |
| Outdoor time (≥2hr/day) | ~18% onset reduction | Wu et al. 2018 | All ages; less effect once established |
† Combination therapy efficacy is a modeled composite (multiplicative, capped at 75%). No single RCT directly validates a specific combination at these figures. Efficacy values represent change in axial elongation vs untreated control at ~2-year endpoints. Individual outcomes vary. Treatment availability and regulatory approval vary by country.
Choosing the right treatment
Under age 8 — or contact lens not suitable
Stellest® or MiyoSmart® spectacle lenses, or atropine 0.01–0.025% drops. No contact fitting required. Atropine can be added to spectacle lenses for additive effect.
Age 8–12, moderate progression
MiSight® (FDA-approved) or Stellest® are the leading options. MiSight requires daily contact lens handling; Stellest requires wearing the lenses ≥12 hours per day for full effect.
Fast progression at any age
Combination therapy — typically orthokeratology or MiSight® plus atropine. Produces the highest achievable efficacy. Consider if single-modality treatment is insufficient.
Prefers no daytime lenses
Orthokeratology — worn only overnight, providing glasses-free daytime vision. Requires nightly lens care and fitting by an experienced OD.
What about LASIK?
LASIK corrects vision but does not slow progression or reduce axial length. It is not a myopia management treatment and is generally recommended only after myopia has stabilised (typically not before age 21). See Is LASIK safe for myopia?
When to start
The IMI 2025 consensus: at diagnosis, not when progression becomes "fast enough." Every year of fast progression without intervention is permanently added to lifetime axial length and cannot be recovered.
See projected outcomes for your child's data
Enter age and axial length measurements. Get all 9 treatment modalities projected to age 18 — side by side — based on your child's actual growth rate. Or see all treatments compared: myopia treatment comparison →
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This page is for educational purposes and does not constitute medical advice. MyopiaTracker is a decision-support tool — not a diagnostic device. MiSight® is a registered trademark of The Cooper Companies. Stellest® is a registered trademark of Essilor International. MiyoSmart® is a registered trademark of Hoya Corporation. Treatment availability and regulatory approval vary by country. Consult a qualified optometrist or ophthalmologist for personalised advice.