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Newswise — Myopia, already affecting over 30% of the global population, is on the rise—fueled by lifestyle shifts including increased screen exposure and reduced time spent outdoors. In children, unchecked progression often leads to high myopia, which dramatically raises the risk of irreversible vision impairment. Current interventions—such as atropine eye drops and specially designed contact lenses—face limitations: long-term data are scarce, accessibility remains uneven, and ethical constraints restrict the use of untreated control groups in pediatric trials. This underscores an urgent need for scalable, evidence-based solutions that can safely curb the progression of myopia from an early age.

Published (DOI: ) on March 5, 2025, in , a team from Wenzhou Medical University's Eye Hospital reported five-year outcomes from children using highly aspherical lenslets (HAL) lenses. The study included 43 children and employed an innovative extrapolated control model to navigate the ethical challenges of long-term pediatric trials. The results were compelling: myopia progression in the HAL group was −1.27 D, versus −3.03 D in controls. Axial elongation, a key marker of myopia severity, was 0.67 mm with HAL lenses versus 1.40 mm in the control group. This is among the first studies to robustly demonstrate the long-term efficacy of optical interventions for myopia control.

Conducted as a five-year randomized trial, the study followed 43 children aged 8 to 13 who wore HAL spectacles, tracking their outcomes against an extrapolated control group informed by historical data. HAL lenses slowed myopia progression by 58%, and axial elongation by 52%. Strikingly, only 9% of children in the HAL group developed high myopia, compared to 38% in the control cohort—a fourfold reduction in risk. The extrapolated control model, carefully validated against real-world trial data, offered a rigorous yet ethical solution for long-term pediatric research. Notably, the slowing of myopia progression became more pronounced over time, hinting at cumulative effects. Younger children showed stronger responses, consistent with age-related trends in myopia development. Safety profiles were strong, with no reported adverse effects such as dizziness or blurred vision. While the study's modest sample size and reliance on modeled controls beyond two years are noted limitations, its alignment with independent studies—such as the LAMP trial on low-dose atropine—reinforces its credibility. HAL lenses stand out as a practical, effective, and safe long-term intervention for managing childhood myopia.

“Our results confirm HAL lenses as a viable long-term option for myopia control,” said Dr. Jinhua Bao, co-lead author of the study. “While larger trials are warranted, this work provides a valuable framework for ethical, long-term pediatric eye care research.” Myopia expert Mark Bullimore, who was not involved in the study, commented: “The extrapolated control design is a novel approach. For real-world implementation, it will be important to assess the cost-effectiveness of HAL lenses in various healthcare settings.”

With their non-invasive design and ease of integration into standard vision care, HAL lenses could reshape public health strategies targeting myopia, particularly in high-incidence regions such as Asia. Unlike pharmacologic or contact lens alternatives, HAL lenses offer scalability without the same barriers to use. Moreover, this study sets a new precedent for employing modeled control groups in long-term pediatric trials. Looking ahead, researchers aim to explore the synergy between HAL lenses and other interventions—like increased outdoor activity—as well as real-world adherence patterns. As myopia prevalence continues to climb, solutions like HAL lenses may play a pivotal role in alleviating the long-term health and economic burdens of high myopia.

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Funding information

This work was supported by grants from the Zhejiang Province Natural Science Foundation of China (Grant No. LQ23H120003), the Medical and Health Science and Technology Project of the Zhejiang Provincial Health Commission of China (Grant No. 2022PY072), and the collaborative research project with Essilor International (Eye Hospital of Wenzhou Medical University Grant No. HXKT-202404).

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is an open access, peer-reviewed journal for ophthalmologists and visual science specialists. It welcomes research articles, reviews, commentaries, case reports, perspectives and short reports encompassing all aspects of eye and vision. Topics of interest include but are not limited to: current developments of theoretical, experimental and clinical investigations in ophthalmology, optometry and vision science which focus on novel and high-impact findings on central issues pertaining to biology, pathophysiology and etiology of eye diseases as well as advances in diagnostic techniques, surgical treatment, instrument updates, the latest drug findings, results of clinical trials and research findings. It aims to provide ophthalmologists and visual science specialists with the latest developments in theoretical, experimental and clinical investigations in eye and vision.