May 7, 2026
Photo Credit: Getty Images
The Association for Research in Vision and Ophthalmology (ARVO) 2026 Annual Meeting is being held in Denver, Colorado, from May 3-7, 2026.
Myopia management is one of the most popular research topics at the event, with many leaders in the industry sharing their myopia-related findings. While the meeting featured hundreds of presentations and posters on myopia management, Review of Myopia Management will be highlighting several noteworthy research findings throughout the event.
Here are some of the research highlights from day four of ARVO (Wednesday, May 6, 2026).
Spectacles
Gaze behaviour with myopia management spectacle lenses
Katharina Rifai, Padmaja Sankaridurg, Siegfried Wahl
In most myopia management (MM) spectacle lenses, a central zone of the lens of clear vision at straight ahead gaze is surrounded by regions of altered image quality. In natural behavior, eye movements constantly shift the line of sight, moving peripheral lens effects dynamically over the retina. The current study demonstrates an individual kinematic gaze fingerprint of MM lenses.
A kinematic fingerprint of two sample MM lenses has been identified in unadapted observers. Head movements increased, varied in specific directions and increased in speed with MM. Thus, gaze movements specifically contribute to the spatiotemporal distribution of MM lens signals on the retina.
Luiz Melk de Carvalho, ARTHUR BACK
Recent clinical data indicate that a spectacle lens incorporating a ring array of conjoined lenslets featuring doubled lenslet power and increased asphericity (Stellest 2.0), provides superior myopia control compared to the original design (Stellest 1.0)1,2. However, the optical mechanisms underlying this improvement remain unclear. We aim to demonstrate how increased lenslet power affects retinal image quality using optical simulations to evaluate the modulation transfer function (MTF) of both designs.
Both optical designs demonstrated comparable performance at mid-to-high spatial frequencies, indicating similar resolution capabilities for fine image details. However, doubling the lenslet power in the S2.0 design shifted the MTF drop toward lower spatial frequencies, resulting in a sharper decline and broader contrast attenuation across the spatial frequency range. This optical behavior may influence contrast-sensitive retinal pathways more effectively, potentially contributing to the superior myopia control efficacy observed with the Stellest 2.0 design compared with the original Stellest 1.0 lens.
Jose Miguel Cleva, Eva Chamorro, Pablo Concepcion Grande, Xiangui He, Linlin Du, Min Tong, Jun Chen, Jinliuxing Yang, jingjing wang, Bo Zhang, Xinhui Huang, Xun Xu, ARTHUR BACK
To evaluate the subjective wearing experience of two novel free-form spectacle lenses incorporating open concentric rings for myopia management compared with a commercially available peripheral defocus lens.
Novel free-form spectacle lenses with open concentric rings provide initial subjective wearing experience and comfort comparable to an established commercial peripheral myopic defocus lens, with vision and daily usability attained being satisfactory for short-term wear.
Contact Lenses
Hetal Buckhurst, Phillip Buckhurst, Annabelle Mawhinney
Accurate optical modelling of a multifocal contact lenses for myopia management requires reliable zone-specific curvature data. This study combines optical coherence tomography, NIMOevo power profiling, and ray-trace modelling to characterise the MiSight design, and compares OCT-derived radii with those predicted analytically from back-surface geometry and centre thickness.
OCT imaging combined with NIMOevo profiling provides a robust method for determining zone-specific radii of curvature in MiSight lenses. Implementing these radii in OpticStudio produces optical models that align with analytically predicted curvature requirements, reinforcing confidence in both methods. This integrated approach offers precise optical characterisation of multizone contact lens designs and improves understanding of the mechanisms underlying myopia-control optics.
Repeated Low-Level Red Light Therapy
A dose and duration-dependent effect of blue and red light exposure on axial length in humans
Swapnil Thakur, Michael Powner, John Lawrenson, Pavan Kumar Verkicharla
Considering the recent interest in using light therapy for myopia control, we investigated if narrowband blue-light and red-light exposure for short-term demonstrate a dose and duration dependent effect on axial length in humans.
While the dark session and blue light exposure of 3 tested intensities did not alter the axial length, low and moderate intensity for short-term red-light exposure showed small increase in axial length. Investigating the dose and duration dependent outcomes with long term light exposures could provide insights on recommedations to achieve better outcomes with light based myopia control therapies.
Carlos Carpena Torres, Blanca Alonso-Abad, Jose Maria Jareño Hidalgo, Gonzalo Carracedo
In animal models, stimulation of intrinsically photosensitive retinal ganglion cells (ipRGCs) with blue light has been linked to slower ocular growth. Clinically, blue-light phototherapy showed short-term axial shortening and choroidal thickening. This study evaluated the short-term effects of selective blue-light–transmission filters on axial length and related parameters to explore their potential as a myopia control option.
Selective blue-light filters produced short-term axial elongation, opposite to the temporary axial shortening reported for blue-light phototherapy and other myopia control treatments. This suggests that ipRGC stimulation may not be the sole mechanism modulating axial length, with factors such as chromatic aberration or accommodation potentially contributing.
Myopia Treatment
Blur sensitivity and myopia progression in children under myopia control treatment
Hiu Yan Lam, Nicola S. Logan
Studies have highlighted that myopes have strong blur adaptation leading them to be less blur sensitive. Optical interventions with peripheral myopic defocus have been used to slow myopic progression (MP) in children, but it is unclear if the lower blur sensitivity could impact the detection of the induced blur signal. This study explores the potential correlation between blur sensitivity and MP in children under myopia control.
This exploratory study suggests that higher BDT may be associated with faster AL elongation and MP in children undergoing myopia control treatment. It may indicate myopic children with less blur sensitivity contribute to relatively faster myopia and AL growth. Further studies are needed to clarify the role of blur sensitivity in paediatric myopia progression and control.
Effectiveness in Practice: How Much Myopia Are We Really Controlling?
Noel A. Brennan
In myopia control practice, progression or axial elongation during treatment of an individual is measured, not efficacy. Since the progression that would have occurred without treatment is unknown, varies markedly between individuals, and is difficult to deduce from demographic and genetic inputs, the practitioner is left to infer efficacy from a number of clues.
Factors that may impact the quality of this inference include the following: myopia control products really do work; there is a boost of efficacy during the first year of treatment; children generally progress more slowly as they get older; past progression is a poor indicator of future progression; and compliance with treatment is difficult to assess accurately.
Data from randomized, controlled trails (RCTs) provide insight, but these suffer from multiple limitations including the following: they are difficult to conduct because of the ethical question of not treating children in the control group and the resources required to follow children for extended time periods; they are usually conducted over limited time periods; they are mainly derived from younger children while the proportion of myopes is much higher in the teenage years; the majority of these trials are single site trials; and they are of variable quality.
Meta-analyses can provide further insight but also suffer from the limitations of the individual RCTs and the limited number of studies on specific treatments.
Demonstrated efficacy in RCTs is generally limited to 1D or less, so larger, longer-term impacts of treatments remain speculative in nature. Our researach suggests that 3-year efficacy is double 1-year efficacy and projects that 6- and 12-year efficacy will be triple and quadruple the 1-year efficacy. This implies that current best practice in controlling myopia progresion is unlikely to provide more than about a 2D reduction in the final degree of myopia.
Interventions for Childhood Myopia: Evidence and Innovations
Jason Yam
The alarming increase in childhood myopia has emerged as a significant public health concern. This presentation will provide a comprehensive introducation of interventions for slowing the onset and progression of myopia.
Samrat Sarkar, Sieu Khuu, Fuensanta A. Vera-Diaz, Emily Woodman-Pieterse, Xiaoying Zhu, Maria Liu, Jonathan Hernandez, Rachael Kwok, Kristen L. Kerber, Rohan Hughes, Yan Wang, Pauline Kang
Wearable sensors can quantify real-time near viewing duration (NVD) and light exposure (LE), known risk factors for myopia. This study measured NVD and LE for 12 months in children using different myopia control treatments to investigate their impact on treatment efficacy.
NVD and indoor LE duration increased during 12M of myopia control treatment, whereas outdoor LE decreased, likely due to children getting older. Increase in AL at 12M was associated with greater weekday NVD. Studies with larger samples with and without myopia control treatment are required to confirm these trends.
Mechanisms of Myopia Control: Consensus and Controversies
David Troilo
In this brief presentation I will describe some well established experimental findings concerning the visual control of eye growth that have formed the basis of current myopia management treatments. I will also discuss how these findings relate to a few of the ongoing controversies regarding the myopia development and the mechanisms of myopia control.
Low-Dose Atropine
Pharmacological Innovation in Myopia Control: From Atropine to Novel Agents
Regan Scott Ashby
Recent research has focused on optimising the therapeutic effects of atropine, with particular attention to dosing schedules, therapeutic half-life, mode of action, and combination therapy. Beyond atropine, though progress in the field is gradual, several emerging pharmacological agents are currently undergoing preliminary investigation or clinical trials. Additionally, a wide range of potential anti-myopic compounds have been identified in animal models, and this talk will examine the key barriers that have limited their transition to clinical testing.
Axial Length
Sara Font Armadans, J Perez-Corral, Manel Espínola Estepa, Valldeflors Vinuela-Navarro
To examine correlations among horizontal peripheral refraction (PR), axial length (AL), and corneal topography (CT) in young myopic eyes, aiming to uncover clinically accessible relationships that could inform predictive models of peripheral optics and represent an initial step toward individualized myopia management strategies.
Strong correlations between AL, CT, and PR provide a solid foundation for predictive algorithms that model peripheral optics using simple clinical data. Harnessing these insights can enhance understanding of myopic eye dynamics and make more informed decisions—potentially moving toward truly individualized myopia management strategies.
Myopia Risks
Quan (Donny) V. Hoang
High myopia (HM), or extreme nearsightedness, is a leading cause of blindness worldwide when HM progresses to pathologic myopia (PM). HM itself comes with increased risk of a myriad of sight-threatening complications.
Moreover, PM manifests clinically in two distinct forms — tractional (namely posterior staphyloma and myopic traction maculopathy, MTM) and degenerative (myopic macular degeneration: MMD with or without myopic choroidal neovascularization: mCNV), with the two forms of PM often occurring concurrently. By 2050, it is predicted that 1 billion people worldwide will have HM and will be at risk of developing PM. This talk will focus on the vision-threatening changes that occur with HM and PM.
Environmental risk factors for myopia: what matters most?
Donald O. Mutti
Advances in genetics research have provided a solid foundation of evidence for a genetic basis for myopia, identifying numerous variants that influence refractive error development. The consensus view is that the visual environment can modify the level of risk of myopia provided by these genetic variants. The factors that generate the most debate are near work activities and time spent outdoors. Within those two broad categories are uncertainties about the effects of specific characteristics of the visual environment, such as accommodative demand, accommodative error, dioptric space, level of illumination, wavelength, and temporal integration of visual signals. The presentation will argue that the preponderance of evidence favors more time outdoors as the environmental factor with the greatest ability to modify genetic risk. The influence of near work is far less certain and far less likely to lead to effective interventions that would lower risk. The visual environment, including time outdoors, seems to have little effect of the rate of progression of existing myopic refractive error. Future research should concentrate on more detailed assessments of the visual environment beyond simple distance and time. Other productive avenues may include studying near work and time outdoors earlier in life in addition to the timing of the acquisition of literacy.
Five wearable sensors for objective measurement of near work and light exposure
Raman Prasad Sah, Nebee Yohannes, Pavan Narra, Lisa A. Ostrin
To compare viewing distance and illumination measurements for five wearable sensors to support more accurate quantification of myopia-related environmental exposures. The VEET recorded significantly more near and intermediate viewing time compared to the Clouclip, potentially due to different viewing angles built into each device. Objective light-exposure measurements were consistent across all five wearable sensors for indoor and outdoor time, despite two devices mounted at eye level and three devices on the wrist.
The VEET recorded significantly more near and intermediate viewing time compared to the Clouclip, potentially due to different viewing angles built into each device. Objective light-exposure measurements were consistent across all five wearable sensors for indoor and outdoor time, despite two devices mounted at eye level and three devices on the wrist.
Global Trends in Myopia and Their Clinical and Policy Implications
Seang-Mei Saw
In recent decades, the prevalence rates of myopia [spherical equivalent (SE) worse than -0.5 Diopters (D)] have risen rapidly to high levels in large East Asian and South-East Asian cities. In other parts of the world, there are slower rises in myopia rates and the current rates remain at low to moderate levels. Preventive strategies should be adopted to stem the myopia epidemic as more severe myopia is linked to age-related visually-disabling complications in adults. As the rapidly rising secular trends are primarily due to environmental factors, namely excessive nearwork and insufficient outdoor time, measures should be taken to educate and implement programs to reduce screen time and increase outdoor time in families, schools and the community. In parallel, rates of high myopia (SE worse than -6 D) are also rising worldwide. At-risk myopic children should be treated clinically to slow the progression of myopia from low to high myopia. Thus, multi-pronged nation-wide and family approaches targeted at the early childhood phase of myopia are essential.
Have we bent the curve? Global impact of myopia control strategies
Timothy R. Fricke
We have described global patterns in the community-level distribution of refractive errors based on multiple Gaussian mixture models. Multivariable meta-regression of global data suggests refractive error distribution is affected by age (in ≤24-year-olds), cohort (in >24-year-olds), plus region, sociodemographic index (SDI), period, and latitude in all ages. Sex differences vary with age in the younger group, cohort in the older group, plus region, period, and gender development index in all ages. Urbanization differences vary with age in the younger group, period in the older group, plus SDI and population density in all ages. The effect of myopia prevention and control options on community distributions depends on penetrance (rate of uptake of the option in a community), targeting (the percentage of overall users who derive significant benefit), and efficacy (the degree to which it works on what percentage of users). We model the impact of myopia prevention and control strategies across a variety of locations, time periods (2030 to 2050), penetrance rates (10% to 100%), targeting abilities (50% to 100%), and efficacy rates (10% to 60%).
Profile of Myopia Risk and Approaches to Prevention in Childhood
Amanda French
Children with lower levels of hyperopic reserve, particularly at younger ages are more likely to be at risk of myopia development throughout adolescence. There is increasing acknowledgement that these children, defined as having pre-myopia, may be an important population to target for myopia prevention strategies. However, there is limited data available on the amount of hyperopic reserve required by age to avoid onset of myopia or how environmental risk factors including, lack of time spent outdoors and greater time in near activities drive the development of myopia in this group of children. Whether environmental modification is as effective for myopia prevention in children with pre-myopia is also unclear. Drawing on data from the Sydney Myopia Study, we explored the level of hyperopic reserve required for children aged 6 years and 12 years, to prevent myopia at 12 years and 17 years, respectively. The interaction between pre-myopia and environmental risk profile, particularly balance of time spent outdoors and in near activities, and education for predicting development of myopia was also examined. Children with pre-myopia who spent greater time in near activities compared to time outdoors, were significantly more likely to become myopic by follow-up, and had greater myopic shift in refraction, in both the younger and older cohort. This indicates that modification of environmental factors for children with pre-myopia is effective for preventing or delaying the onset of myopia. Including environmental risk factors in a profile of myopia risk for children with pre-myopia increases prediction of children who would benefit from intervention.
Parent Communication
Evaluation of Parental Knowledge, Attitudes, and Perceptions of Myopia Management
Wendi Zhang, Yi Pang
To evaluate parental attitudes and concerns regarding three established myopia control modalities: orthokeratology, soft multifocal contact lenses, and low-dose atropine eye drops. In addition, we evaluated whether significant differences existed between myopic and non-myopic parents in their knowledge of myopia treatment options.
Our findings indicated that parents often have limited knowledge about the risks of myopia and the options available for myopia management. They also often have misunderstanding about myopia and the implications it can have on their child’s overall eye health and visual potential. In addition, proper education improved parents’ knowledge on myopia and myopia management. Eye care practitioners should place greater emphasis on providing comprehensive education to families regarding evidence-based myopia management strategies.
Artificial Intelligence
Large Language Model and AI Agents for Myopia Care
Mingguang He
This presentation will introduce how large language models (LLMs) and AI agents can transform myopia care by leveraging large-scale, real-world longitudinal and multimodal data. Built on routine clinical data—including refraction, axial length, imaging, treatment history, and behavioral factors—our framework models individual progression trajectories over time rather than relying on static snapshots. The LLM serves as a clinical reasoning engine, while specialized AI agents perform tasks such as risk prediction, treatment-response modeling, rebound estimation, and personalized decision support. By integrating temporal data with contextual clinical knowledge, this approach enables dynamic, patient-specific management strategies and moves myopia care toward scalable, explainable, and real-world–ready AI-supported practice.
Pre-Myopia
Treating Pre-myopia: Can We Intervene Before Myopia Begins?
John R. Phillips
Following the principle that ‘an ounce of prevention is worth a pound of cure’ this presentation will briefly review the options for delaying the development of myopia in pre-myopic children, i.e. those identified as at risk of developing myopia on the grounds of their current refraction, lifestyle, parental myopia etc. Treatments for pre-myopic children include appliances (e.g. myopia control spectacles), light-based therapies (e.g. Repeated Low-level Red Laser-light) or pharmacological agents (e.g. atropine eye drops). However, because most myopia is caused by environmental factors it will be argued that much more effort should be directed towards improving the visual environment for all children, from an early age, to prevent the development of myopia. This would require initiatives in public health (e.g. parental education regarding outdoor time), architecture (e.g. improved design of school and pre-school buildings) and town planning (e.g. publicly accessible green spaces).
Catch up on ARVO myopia research highlights from day one, two and three
