How the healthcare ecosystem is responding to change the trajectory of myopia

Across Asia and globally, stakeholders are adopting more evidence-based solutions to address childhood myopia. 

The rise in childhood myopia is an increasing public health concern, particularly across Asia, where prevalence rates are amongst the highest globally. In some urban populations, up to 80 to 90% of adolescents are affected. Globally, nearly 740 million children are projected to be living with myopia by 2050.

This trend places increasing strain on healthcare systems and raises concerns about long-term ocular health outcomes.

Myopia is not simply a refractive error to be corrected. It is a progressive condition associated with an increased risk of retinal detachment, glaucoma, cataract, and myopic macular degeneration later in life. As a growing public health concern with long-term economic and social implications, addressing myopia requires a shift in how healthcare systems, clinicians, and industry approach it.

This means moving beyond correction toward long-term management grounded in scientific evidence, coordinated care, and clinically meaningful guidance for real-world practice.

A progressive condition requiring lifelong management
Myopia develops gradually, often beginning in early childhood and progressing through adolescence. Earlier onset is associated with higher levels of myopia and increased risk of complications in adulthood.

This underscores that myopia cannot be addressed through a single intervention. Instead, it requires a continuous approach spanning prevention, early detection, timely intervention, and long-term management. Regular eye examinations and the involvement of eye care professionals (ECPs) play a key role in early detection, monitoring progression, and guiding appropriate management strategies.

Scientific advances over the past decade have improved understanding of the mechanisms underlying myopia progression, particularly the role of retinal signaling in regulating eye growth. This has supported the development of optical interventions designed not only to correct refractive error, but also to help slow axial elongation.

Amongst available interventions, spectacles represent a simple and non-invasive solution for children. Spectacle lenses incorporating highly aspherical lenslets (HAL) are one evidence-based approach to myopia management. This design uses HALT technology to generate a volume of non-focused light in front of the retina, creating a signal that helps slow eye growth.

Randomised controlled trials in China and the United States, together with multi-year follow-up studies, have shown reductions in axial elongation and myopia progression compared to single vision lenses (standard myopia correction), with effects maintained over time. HAL spectacle lenses have also received US Food and Drug Administration (FDA) market authorisation.

More recent research has focused on refining this optical signal. Clinical studies suggested a dose-response relationship, where increasing the asphericity and optical characteristics of the lenslets is associated with improved outcomes. This insight has informed the development of HAL spectacle lenses using HALT MAX technology, designed to optimise the strength and distribution of the signal whilst maintaining visual performance.

A one-year crossover clinical trial conducted in Singapore enabled direct comparison of different optical designs within the same patient. This study design reduces variability and provides additional evidence that optimised designs can further slow axial elongation, whilst maintaining visual acuity and high levels of wear compliance.

Combination therapies are also promising, with low-dose atropine drops paired with optical interventions such as HAL spectacle lenses to enhance treatment efficacy and significantly slow myopia progression.

These advances illustrate how optical design continues to refine myopia management and improve outcomes for young patients with myopia, particularly those with progressive or faster rates of progression. In parallel, emerging research is exploring the use of such plano lenses in children at risk of myopia, with early findings suggesting a potential role in delaying onset.

How the healthcare ecosystem is responding to change the trajectory of myopia 
Across Asia and globally, stakeholders across the healthcare ecosystem are adopting more structured and evidence-based solutions and technologies to address childhood myopia. 

Clinical practice is evolving, with eye care professionals increasingly integrating myopia management into routine care. This complements decades of public health efforts and targeted measures to address the issue in schools, which include screening, risk assessment, and ongoing follow-up.

In several Asian markets, annual school-based screening programs and routine pediatric eye examinations support earlier detection.

Across Asia, such as in Singapore, approaches to childhood myopia are moving beyond isolated clinical interventions toward more structured models that integrate early diagnosis, treatment, and long-term monitoring. This evolution reflects a growing public health priority for healthcare systems to take collective responsibility for myopia management. Embedding it within a coordinated, ecosystem-based model aligns clinicians, researchers, educators, and industry partners around shared guidelines and standards, early intervention, and evidence-based care across the continuum of myopia management.

Across the region, public health initiatives, professional guidelines, and collaboration with global and regional medical organisations are helping to strengthen awareness of childhood myopia and its management, particularly in markets where early onset and high prevalence place growing pressure on health systems.

Collaboration with a range of organisations, such as the International Myopia Institute, the World Society of Paediatric Ophthalmology and Strabismus, Singapore National Eye Centre, and the Global Myopia Awareness Coalition, supports the development and dissemination of evidence-based practices.

Supporting eye care professionals with training, tools, and access to information remains an important part of implementation. This includes education platforms, clinical tools, and decision-support systems that help translate evidence into routine practice.

Within this evolving ecosystem, clinical innovation and the translation of evidence into clinical practice also play a critical role in strengthening standards of care. These include conducting clinical research, contributing to peer-reviewed publications, and presenting new research findings on evidence-based interventions and technologies at international scientific meetings such as the Association for Research in Vision and Ophthalmology (ARVO) and major Asia-Pacific ophthalmology congresses. These activities facilitate knowledge exchange, help inform clinical decision-making, and strengthen evidence-based standards of care across the region.

This approach underscores the need to bridge research, clinical practice, practitioner support, and patient engagement within a more coordinated ecosystem model. One that enables timely translation of evidence into real-world practice and supports sustainable myopia management.

As a result, families in the community are empowered with clear, evidence-based information to make informed choices for their children.

The next frontier: From management to prevention
Evidence suggests that delaying the onset of myopia may impact long-term outcomes. This highlights the importance of identifying children at risk before the onset.

Environmental and behavioural factors include the need for time spent outdoors and screen breaks, alongside considering emerging interventions such as HAL plano spectacle lenses.

At a systemic level beyond individual responsibility, rethinking school policies and expanding healthcare access to integrate early screening and prevention within public health strategies are important steps.

Toward a more personalised and connected model of care
Similar to the management of chronic conditions, myopia care is increasingly moving toward personalized, long-term management. Myopia progression varies between individuals. A child at risk may require a different approach from an adolescent with established progression. Management strategies, therefore, need to be adaptable.

Advances in diagnostics and digital tools are supporting this transition. More precise measurement of axial length and refractive change, together with tools to monitor adherence and behavior, can help inform clinical decisions.

The aim is a more connected model of care, where management is continuous and supported by data over time.

Looking ahead
Future progress in myopia care will depend on early action, continued research, and collaboration.

Myopia is increasingly being managed from an earlier stage, supported by clinical evidence and ongoing research. Improvements in optical design informed by clinical studies continue to contribute to treatment approaches. More can be done through coordinated action.

For healthcare systems, this includes integrating myopia management into standard care. For clinicians, it involves early identification and ongoing management. For families, awareness and timely action are important.

As the prevalence of myopia continues to increase, particularly in Asia, a coordinated and evidence-based approach will be needed to support better long-term outcomes.