From Prevention to Precision: Treatment, Technology and the Next Front in China’s Myopia Fight

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July 27, 2026

By David Ng, OD, IACMM

In Part 1 of this two-part article series, I described one of the key components of the Vision China 2026 meeting. China bent its national childhood myopia curve—a 3.3% drop in prevalence from 2018 to 2024, sparing millions of children—through whole-government mobilization and screening at an unmatched scale. 

But myopia prevalence is only half the battle. The other half is fought in the clinic and the laboratory, working on slowing and eventually stopping progression.  

From single intervention to full-cycle care

Another key message of the meeting was that the myopia field is moving away from “single interventions” toward whole-cycle visual health management. 

The “Prevention, Lifestyle & Medication” session captured this range. Researchers presented environmental interventions—modeling illumination, color temperature, spatial frequency and refractive uniformity through dynamic light simulation. Additionally, they highlighted AI risk scoring under an “Environment–Gene–AI” framework. 

Perhaps most provocative, a randomization analysis of data found a causal link between myopia and both depression and anxiety—arguing that mental health belongs inside the myopia control system. And a health-economics model of 13 strategies reaffirmed that outdoor activity remains the most cost-effective intervention of all.¹

AI and precision ophthalmology

If screenings started to turn the tide, AI will make it even faster. Chinese groups are pushing AI-powered fundus-imaging to scale early detection and referrals. Wang Ningli’s team, for example, has advanced large-model ophthalmic imaging initiatives (the “Fuxi Huiyan” concept) to raise capture-and-referral efficiency.² 

The best example I encountered came from a Wenzhou Eye Hospital team that produced a prediction model. Machine learning was used to review more than 1.1 million records from roughly 300,000 children.  The result was a tool that could precisely forecast a child’s 10-year refractive and axial-length trajectory—and even estimate that child’s likely treatment response through causal-AI framing from a simple retinal photo.³ This is individualized risk assessment and management—not one-size-fits-all.

What is genuinely working

On the treatment side, the options mirror those in North America. Well-supported and widely-accepted treatments include: orthokeratology, defocus and diffusion spectacles⁴  and dual-focus or multifocal soft contact lenses.⁵ These are all backed by randomized trials. Additionally, low-concentration atropine (commonly 0.01%–0.05%)⁶ and daylight exposure are the best tools to delay onset. Increasingly, the strongest myopia control comes from combination therapy that pairs optical and pharmacological approaches.⁷ 

New atropine data in Tianjin pointed toward concentration optimization, with the choroid emerging as both a treatment target and a predictive biomarker, and a 2025 randomized trial suggesting 0.04% may outperform both OrthoK and 0.01% on axial control.⁸

Where experts still disagree

Repeated low-level red-light (RLRL) therapy—roughly 650 nm on home devices—has produced impressive efficacy signals in Chinese trials, but the safety question is unsettled. Although the laser emission is rated Class 1 under the IEC laser-safety standard (deemed eye-safe for incidental exposure), China’s NMPA reclassified the devices from Class II to Class III—its highest medical-device risk tier—effective July 2024. That move stripped oversight from provincial bodies, imposed national premarket review and now requires extensive safety and clinical evidence before any new device can be sold. 

Many clinicians accordingly endorse RLRL only within supervised protocols and OCT follow-up.⁹ Current devices are laser-based—semiconductor laser diodes—which is precisely why the scrutiny exists. LED-based alternatives, with a potentially more favorable safety profile, are under investigation and approaching market readiness.

Low-dose atropine remains contested on optimal concentration, treatment duration, rebound and stopping rules. And there is genuine tension over how aggressively to treat low-risk, slow-progressing children—early protection versus overmedicalization and compliance burden. Traditional Chinese medicine adjuncts, promoted in some provincial pilots, are still regarded by mainstream ophthalmology as unproven for progression control rather than established therapy.

The innovation engine: China Eye Valley – a whole city devoted to eyecare

Much of this momentum has an address. China Eye Valley, in Wenzhou’s Longwan District, was jointly built by the district government and the Eye Hospital of Wenzhou Medical University. It’s billed itself as the world’s first full-industry-chain innovation complex for eye health, aiming to become a “World Eye Health Center.” 

Launched in 2018 and opened in 2020, it now hosts more than 710 enterprises with roughly RMB 8 billion in 2025 output. It incubated the world’s first myopia-control drug to receive a formal drug registration number—0.01% atropine—along with ophthalmic AI robots and brain–computer-interface retinal chips, in partnership with the likes of Bausch + Lomb, Huawei and BOE Technology Group.¹⁰ It reflects China’s ambition to own the full stack, from spectacle-lens IP and OCT hardware to AI screening and clinical-trial capacity, rather than only importing premium technology.

Why I was there

I attended Vision China 2026 as an invited speaker on clinical decision-making and the treatment of high myopia in children—which sits squarely at this new front. Age of onset is the single strongest predictor of adult high myopia: a child who becomes myopic at age 7 or 8 carries a lifetime high-myopia risk above 50%.¹¹ These cases call for early, aggressive, individualized intervention.¹² Combination therapy is usually the course, with more frequent monitoring of axial length. Axial length changes for each age group were discussed, along with how to use that data to guide the practitioner on when to escalate treatment.⁷

The lesson from Tianjin is simple: China is suppressing the myopia progression curve, and the data is showing us how to replicate that: screen early, screen often and treat when indicated. 

We have the same tools and the same data—are we starting to bend the curve?

 

Dr. David Ng is the owner of Bayview Vision Care and The Myopia Clinic in Toronto, where he provides myopia management with a focus on orthokeratology since 2005. He earned his Doctor of Optometry from the University of Waterloo in 1995 and holds the International Academy Certification in Myopia Management from the American Academy of Orthokeratology and Myopia Control (AAOMC). Dr. Ng currently serves on the AAOMC Board of Directors and the AAOMC Advisory Board actively contributing to the Accreditation, Education, and Content Procurement committees. You can contact him via email at themyopiaclinic.ca or on LinkedIn.

 

References

1. Vision China 2026 — “Prevention, Lifestyle & Medication” thematic session, China Myopia Conference. Tianjin, May 30, 2026. Official conference report.
2. “Fuxi Huiyan” ophthalmic artificial-intelligence imaging initiative (Wang Ningli and colleagues), as reported in Chinese ophthalmology, 2024–2025.
3. Liu S, Lu Y, Li X, et al. AI-guided personalized predictions on myopia progression and interventions (Myopia Progression Predictive Model, MPPM). Digital Medicine. 2026;9:129. doi:10.1038/s41746-025-02308-4.
4. Lam CSY, Tang WC, Tse DY, et al. Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial. British Journal of Ophthalmology. 2020;104(3):363–368.
5. Chamberlain P, Peixoto-de-Matos SC, Logan NS, et al. A 3-year randomized clinical trial of MiSight lenses for myopia control. Optometry and Vision Science. 2019;96(8):556–567.
6. Yam JC, Jiang Y, Tang SM, et al. Low-Concentration Atropine for Myopia Progression (LAMP) study. Ophthalmology. 2019;126(1):113–124.
7. Guo Z, Wei Z, Ming H, et al. Efficacy and safety of orthokeratology sequentially combined with escalating atropine concentrations for myopia control in children. Scientific Reports. 2025;15:38911. doi:10.1038/s41598-025-22722-8.
8. Xu H, Chen M, Ye L, et al. Orthokeratology, 0.04% atropine, and 0.01% atropine for myopia control: a randomized clinical trial. JAMA Ophthalmology. 2025;143(9):731–738. doi:10.1001/jamaophthalmol.2025.2321.
9. Jiang Y, Zhu Z, Tan X, et al. Effect of repeated low-level red-light therapy for myopia control in children: a multicenter randomized controlled trial. Ophthalmology. 2022;129(5):509–519.
10. China Eye Valley (Wenzhou, Zhejiang). Institutional overview and innovation portfolio. Eye Hospital of Wenzhou Medical University / Longwan District, 2018–2025.
11. Hu Y, Ding X, Guo X, Chen Y, Zhang J, He M. Association of age at myopia onset with risk of high myopia in adulthood in a 12-year follow-up of a Chinese cohort. JAMA Ophthalmology. 2020;138(11):1129–1134. doi:10.1001/jamaophthalmol.2020.3451.
12. Bullimore MA, Brennan NA. Myopia control: why each diopter matters. Optometry and Vision Science. 2019;96(6):463–465.