Every week in clinic I meet a child whose glasses are a little stronger than last year, and parents who have been told that this is simply what happens. It is not simply what happens. Myopia, or short-sightedness, is the result of the eye growing too long, and that growth can often be slowed.
A condition that is changing quickly
Modelling by Holden and colleagues estimated that about 23% of the world's population was myopic in 2000 and that this will reach nearly 50% by 2050, with high myopia rising from under 3% to about 10%. In Dubai, as across the Gulf and Asia, I see children becoming myopic younger and progressing faster than a decade ago.
Why the number on the glasses is not the point
Glasses correct blur. They do not protect the eye. The longer an eye grows, the greater its risk of retinal tears and detachment, glaucoma, cataract and myopic maculopathy later in life. Bullimore and Brennan have argued that every dioptre of myopia avoided lowers the risk of myopic maculopathy by roughly 40%. A study of European adults found that the chance of uncorrectable visual impairment by age 75 rises from about 4% with moderately long eyes to about one in four with eyes 26 mm or longer (Tideman 2016). So the aim of treatment is not thinner lenses; it is a shorter eye at age 18.
What works, and what does not work for everyone
Several treatments slow eye growth in trials: defocus spectacle lenses, myopia-control contact lenses, ortho-k night lenses, low-dose atropine drops and repeated low-level red light. Time outdoors helps prevent myopia starting. But averages hide a wide spread. In every trial some children respond strongly and others barely at all. Combining treatments is common, yet the evidence is mixed: atropine added to defocus spectacle lenses looks helpful, while atropine added to ortho-k mainly helped in younger children and short eyes, and atropine added to soft multifocal contact lenses showed no extra benefit. This is why measuring axial length at every visit matters more than the choice of any single product.
What we built
I built the platform for two groups. For families, there is an outlook calculator that shows how a child's glasses power may change by age 18 with and without treatment, a treatment planner that explains which options fit a child and when combinations make sense, and plain guidance on outdoor time and daily habits. Everything on these pages runs in your browser; nothing you type is stored or sent to us.
For eye doctors, there is a clinic workspace that records glasses power, axial length, keratometry and treatment at each visit, charts growth against expected rates, and includes a proprietary KPMRT™ risk-tracking score to help prioritise follow-up. It also reads printed biometry reports with built-in text recognition, with every extracted value reviewed by a clinician before it is saved. Access is for approved clinicians.
What it cannot do
The calculator gives an estimate from published trial averages. It cannot know how your child's eyes will behave, and it is not a diagnosis. The treatment planner is decision support, not a prescription. Choosing a treatment needs a full examination, a look at the cornea and retina, and a conversation about what suits your family. Please use these tools to prepare for that conversation, not to replace it.
Free, and open to scrutiny
My goal is that a child in any country can benefit from the same evidence-based approach, whatever the size of the clinic. The tools are free to use. Every effect size used in the calculator is listed on the evidence page with its source, so that colleagues can check it. If you are an eye doctor and spot an error, or you would like to take part in validating the platform in your clinic, I would like to hear from you.
This article is general information and not medical advice. For your child, see an eye doctor.
References
- Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 2016;123:1036-1042.
- Bullimore MA, Brennan NA. Myopia control: why each diopter matters. Optom Vis Sci 2019;96:463-465.
- Tideman JWL, Snabel MCC, Tedja MS, et al. Association of axial length with risk of uncorrectable visual impairment for Europeans with myopia. JAMA Ophthalmol 2016;134:1355-1363.
- He M, Xiang F, Zeng Y, et al. Effect of time spent outdoors at school on the development of myopia among children in China: a randomized clinical trial. JAMA 2015;314:1142-1148.
- Combination therapies for myopia control. Contact Lens Spectrum, May 2024 (summary of Kinoshita 2020, Tan 2023, Zhao 2021, Chen 2022, Huang 2022, Nucci 2023, Jones 2022, Erdinest 2022).