Lens and refraction · D
Childhood myopia: options a doctor may discuss
Outdoors · atropine · optical defocus
Last reviewed: 2026-10-06 · 潘家健醫生
Key points
- Childhood myopia care aims to slow progression — not to shorten the axis or “cure” the degree.
- Outdoor daylight is associated with slower onset (public-health guidance, not a personal prescription).
- A doctor may discuss low-dose atropine, orthokeratology or defocus optics — individual assessment; no product pitch.
- Myopia control does not remove existing fundus risk; new flashes / many new floaters: same-day dilation; curtain or sudden blindness: A&E.
This summarises published research and classes of options often discussed in Hong Kong. It is not a pitch to buy drops, lenses or devices, and it cannot promise slower progression — nor is it a cure for myopia. Any medicine needs a prescription. Orthokeratology and contact lenses must be fitted by a qualified person.
Outdoor time (public-health measure)
Outdoor natural light is linked with a lower chance of myopia appearing. Shade, corridors and walking to school count. You do not need to chase harsh sun. How long each day is for school or a doctor to discuss by age and lifestyle — this is not a light-dose prescription. The outdoor-time tool is a public-health round-number log, not a personal progress report.
Childhood myopia in Hong Kong: before and after pandemic restrictions (education)
Hong Kong Children Eye Study repeated cross-sectional data (JAMA Network Open 2023): among children aged 6–8, myopia prevalence stayed about 23.5–24.9% in 2015–2019, rose to about 28.8% in 2020 (during restrictions), and about 36.2% in 2021 (after easing) — not your child’s personal odds, and not a brand comparison. Outdoor time fell versus pre-pandemic levels while near work / screen time rose; younger children and those from lower-income families had higher risk during restrictions (study observations). After easing, habits had not fully returned to pre-pandemic patterns — supporting continued attention to outdoor time and near-work hygiene, not a promise of slower progression.
Low-concentration atropine (prescription)
A muscarinic antagonist. Concentration, use and stopping must be a doctor’s decision. Do not dilute or buy unofficial preparations. The CUHK LAMP study compared 0.05%, 0.025%, 0.01% and placebo. It is important local literature, not a personal prescription.
| LAMP year-1 mean change (literature), not a prediction for one child | Spherical equivalent | Axial length | Approx. vs placebo (year-1 literature) |
|---|---|---|---|
| 0.05% | −0.27 D | +0.20 mm | SE ~67% / AL ~51% |
| 0.025% | −0.46 D | +0.29 mm | SE ~43% / AL ~29% |
| 0.01% | −0.59 D | +0.36 mm | SE ~27% / AL ~12% |
| Placebo | −0.81 D | +0.41 mm | — |
Possible effects include light sensitivity, mild near blur, rebound after stopping (more at higher concentration), and occasional allergic conjunctivitis. Daytime photochromic / UV-blocking lenses may be needed. This table cites year-1 published figures only; later years are reported separately; whether to continue is a doctor’s decision. Rebound can occur. This is not a ranking of which concentration is “best”, and not a cross-brand / cross-therapy efficacy league table.
LAMP2: children not yet myopic (incidence — not control of existing degree)
The same Hong Kong team’s LAMP2 randomised trial (JAMA 2023): children aged 4–9 who were not yet myopic by cycloplegic criteria used night-time low-concentration atropine for two years. Two-year cumulative myopia incidence: about 28.4% with 0.05%, about 45.9% with 0.01%, and about 53.0% with placebo; fast myopic shift was also lower in the 0.05% group. 0.01% did not differ significantly from placebo on that endpoint. These are trial results — not a personal prescription, not a ranking of which concentration is “best”, and not a cross-brand league table. Concentration, whether to use, and when to stop must be decided by a registered doctor after examination; parents must not dilute drops or buy unofficial preparations. Photophobia and other effects: see the paragraph above.
Optical defocus methods
Ordinary single-vision lenses can leave peripheral rays focused behind the retina (hyperopic defocus). Some defocus spectacles, daily-disposable contacts and orthokeratology aim to create peripheral myopic defocus. Registration, fitting qualifications and published data differ by design — a doctor or optometrist must explain under Hong Kong rules. This page does not compare brands, and does not quote unchecked “X% effective” figures, shops or prices.
- Orthokeratology: overnight rigid gas-permeable lenses. Infectious keratitis risk (including Acanthamoeba). Hygiene is strict; not for everyone.
- Defocus spectacles or defocus-design daily disposables: wear time must follow the fitter; not a “no follow-up needed” product, and not a promise of slower progression.
- Repeated low-level red-light devices: long-term macular safety is debated. Do not buy a home machine on your own. This site does not present them as an “emerging effective therapy”. Whether to use them is only a doctor’s assessment.
Key paper: Yam JC et al. LAMP year 1, Ophthalmology 2019. Later years reported separately.
Related public education video (HKOS)
Video source: Hong Kong Ophthalmological Society (HKOS) “Eyes Decoded” YouTube (public education)
This site is not affiliated with, and is not the same organisation as, the Hong Kong Ophthalmological Society (HKOS).
Selected public references (not a full bibliography)
These are the public studies this page draws on. PMID links go to PubMed (US National Library of Medicine) so you can check them. Figures are from those studies — not your prognosis and not a clinic success rate. Links are not a shop.
- Yam JC, Jiang Y, Tang SM, et al. Low-Concentration Atropine for Myopia Progression (LAMP) Study: a randomized, double-blinded, placebo-controlled trial of 0.05%, 0.025%, and 0.01% atropine eye drops in myopia control. Ophthalmology. 2019;126(1):113-124. PMID 30514630本港主導隨機試驗；第一年等效球鏡及眼軸數字出處。不是個人處方。
- Yam JC, Li FF, Zhang X, et al. Two-year clinical trial of the Low-Concentration Atropine for Myopia Progression (LAMP) Study: phase 2 report. Ophthalmology. 2020;127(7):910-919. PMID 32019700LAMP 第二年。濃度、是否繼續須由醫生決定。
- Yam JC, Zhang XJ, Chu WK, et al. Effect of Low-Concentration Atropine Eyedrops vs Placebo on Myopia Incidence in Children: The LAMP2 Randomized Clinical Trial. JAMA. 2023;329(6):472-481. DOI 10.1001/jama.2022.24162. PMID 36786791LAMP2：尚未近視兒童的發生終點。數字是試驗結果，不是個人處方或濃度「最好」比較。
- Zhang XJ, Zhang Y, Kam KW, et al. Prevalence of myopia in children before, during, and after COVID-19 restrictions in Hong Kong. JAMA Netw Open. 2023;6(3):e234080. DOI 10.1001/jamanetworkopen.2023.4080. PMID 36947037本港 6–8 歲散瞳調查：疫情前約 23–25%，2021 年約 36%。與中學篩查數字不可直接比較。
- 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(11):1142-1148. PMID 26372583廣州學校增加戶外時間的隨機試驗，與減慢近視出現有關。不是光度處方。
- Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology. 2008;115(8):1279-1285. PMID 18294691雪梨兒童隊列：戶外時間與近視較少相關。
This is general medical information, not a diagnosis, and cannot replace an in-person consultation with a registered ophthalmologist, refraction, or a dilated fundus exam. It is not advice to use any medicine or undergo any procedure. Medicines (including off-label use), laser or surgery must be decided by a registered doctor after examination, according to indications and Hong Kong registration. Figures from the literature are published averages, not any clinic’s results. This site does not book, prescribe or refer. Do not change treatment on your own.