Implications of the Hoya Vision Care Myopia Consensus on Pediatric Myopia Management

Hoya Vision Care has published a myopia consensus statement that reframes childhood myopia as an actionable clinical and public-health priority, calling for routine pediatric services to prioritize early detection and structured myopia control.

The statement shifts practice from ad hoc identification to systematic early detection, recommending population-level prioritization rather than treating childhood myopia as a cosmetic refractive issue. This reorientation implies embedding proactive risk assessment and clear escalation criteria into routine eye-care workflows to enable earlier intervention and follow-up.

The statement endorses starting preschool screening and embedding universal pediatric vision screening programs to detect early refractive error and axial elongation. Initiation thresholds include documented spherical equivalent progression of ≥0.5 D per year or rapid axial length increase relative to age norms. Priority risk factors are a positive family history, longer axial length, higher baseline myopia, ethnic groups with higher incidence, and limited outdoor time. In practice, preschool children with these markers or measurable progression become priority candidates for myopia control.

Recommended interventions emphasize an individualized approach. Optical strategies include multifocal soft contact lenses and dual-focus spectacle lenses for cooperative school-aged children, and orthokeratology for motivated older children with suitable corneal parameters and contact-lens tolerance. Low-dose atropine (typically 0.01%–0.05% nightly) is advised for appropriate candidates—often those with continued progression despite optical measures or unsuitable for contact lenses. Monitor intraocular pressure, pupil size, accommodation, and adherence; counsel families about transient photophobia and near-vision blur. Selection depends on age, progression rate, tolerance, and lifestyle, with combined modalities considered when single measures are inadequate.

When it comes to monitoring, obtain a baseline examination with cycloplegic refraction and axial length. Reassess at 3–6 months after starting therapy to gauge early response, then at 6–12 month intervals with annual axial-length measurement as the primary objective metric. A change exceeding 0.5 D/year or axial-length growth beyond age-adjusted norms should prompt therapy escalation or a change in modality. Use brief, age-appropriate scripts to explain risk and goals, and support adherence with scheduled follow-ups, reminders, and school-based reinforcement to improve timely escalation and long-term outcomes.

Key Takeaways:

• Consensus elevates early, systematic detection and defines progression thresholds that trigger escalation.
• Preschool and school-aged children with risk markers or documented progression are priority candidates for myopia control.
• Clinics should adopt screening pathways, objective axial-length tracking, and standardized follow-up to guide timely treatment decisions.