Myopia

Myopia can be corrected with glasses, contact lenses, or refractive surgery; however, efforts to slow its progression are of significant interest, particularly in children and young adults. Modern ophthalmology now recognizes myopia as a progressively developing condition, the progression of which can be substantially slowed through a combination of environmental interventions and specialized optical control methods (myopia control).

Outdoor activities — the most powerful preventive intervention

Systematic exposure to natural light is the most scientifically proven method for preventing the onset and slowing the progression of childhood myopia. Multicenter studies (particularly from Australia, Singapore, and Taiwan) have shown that children who spend at least 2 hours a day on outdoor activities have a significantly reduced risk of developing myopia and a slower progression when it is already present. The main mechanism appears to be linked to high outdoor light intensity (10,000–100,000 lux versus 200–500 lux indoors), which stimulates the release of dopamine from the retina — a neurotransmitter that inhibits pathological elongation of the ocular axis.

At Athens Vision, we strongly recommend that all parents encourage their children to spend at least 90–120 minutes daily on outdoor activities, regardless of the type (sports, recreation, school breaks). This recommendation applies equally to children without myopia (as primary prevention) and to children with established myopia (as secondary prevention against progression).

Healthy visual habits

Prolonged close-up work (reading, screens, cell phones, tablets) is statistically linked to an increase in myopia. Adopting organized visual habits can make a significant difference: frequent breaks following the 20–20–20 rule (every 20 minutes of close-up work, take a 20-second break looking into the distance at 20 feet / approximately 6 meters), proper reading distance (at least 30–40 cm), adequate task lighting, and limiting total screen time for children under 10 years of age.

Modern Methods of Myopia Control — Peripheral Defocus Technology

In recent years, the field of optometry has developed a new generation of glasses and contact lenses designed exclusively to control the progression of childhood myopia. Unlike standard myopia glasses—which correct only central vision but allow the peripheral image to focus behind the retina (hyperopic peripheral defocus), a stimulus that, in animal models, promotes eye elongation—these modern lenses introduce a deliberate myopic peripheral defocus, which inhibits the biological growth signal. Many randomized controlled trials (RCTs) have documented a 50–67% reduction in the progression of myopia compared to conventional corrective methods. At Athens Vision, we apply the following certified technologies in a personalized manner:

• Hoya MiYOSMART (D.I.M.S. Technology): eyeglasses featuring Defocus Incorporated Multiple Segments technology—a central optical correction zone surrounded by hundreds of small segments of myopic defocus (+3.50 D). This is the first technology of its kind with published two-year and six-year clinical data from the Hong Kong Polytechnic University, documenting a >50% slowdown in myopia progression and a ~50% slowdown in axial length elongation.
• Essilor Stellest (H.A.L.T. Technology): eyeglasses featuring Highly Aspherical Lenslet Target (H.A.L.T.) technology — 1,021 aspheric micro-lenses arranged in 11 concentric rings, creating a continuous volume of myopic defocus in front of the peripheral retina. Long-term clinical data show an average progression slowdown of >50% when worn for at least 12 hours daily.
• ZEISS MyoCare: eyeglasses featuring Cylindrical Annular Refractive Elements (C.A.R.E.) technology — alternating focus and support rings that provide a continuous optical signal to control eye elongation. It offers specialized versions (MyoCare and MyoCare S) tailored to the child’s age and activity level.
  

The selection of the appropriate technology is personalized following a comprehensive ophthalmic and refractive evaluation, while effectiveness is objectively monitored through regular measurements of axial length.

Pharmacological Approach

Clinical studies are being conducted worldwide with low-dose atropine formulations (0.01–0.05%), which have shown significant effectiveness in slowing the progression of childhood myopia. Currently, there is no officially approved medication for the prevention of myopia in Greece; however, low-dose atropine can be prescribed as part of personalized treatment at strictly selected pharmacies capable of compounding “galenic” medications in accordance with current European standards. Athens Vision has been recommending and using this technique since 2012. It also organized the first myopia prevention workshop in Greece at the Intraocular Lenses and Refractive Surgery Conference in 2014. (Anast. K. Charonis)

Timely ophthalmological monitoring and personalized guidance for both children and adults are the most effective means of maintaining stable and healthy vision. At Athens Vision, we offer a comprehensive myopia management program that combines monitoring of the axial length, personalized selection of peripheral defocus technology, the use of low-dose atropine, orthokeratology, and guidance on outdoor activities and healthy visual habits.