Pediatric pre-myopia progression accelerates in recent years

A retrospective review of pediatric patients suggests that although rates of myopia onset remained consistent, children in more recent years experienced a faster decline in hyperopic reserve, with most clinicians continuing to monitor rather than intervene in pre-myopia.

Researchers analyzed records from 1,740 children aged 6 to 10 years across 15 optometry practices between 2017 and 2021. All patients were classified as pre-myopic at baseline, with refractive error between +0.75 D and -0.25 D. During the study period, 184 children (10.6%) developed myopia. Baseline age and refractive error were similar across all cohort years.

At initial visits, most clinicians (91.9% of cases across cohorts) chose to monitor patients without intervention. A small proportion recommended lifestyle modifications (3.5%) or single-vision spectacles or contact lenses (3.0%), with management patterns remaining stable over time.

The average age of myopia onset was consistent across cohorts at approximately 9.7 years. However, children in the 2020 and 2021 cohorts showed a more rapid decline in hyperopic reserve than those in 2017, with annual changes of -0.73 D and -0.71 D, respectively, compared with -0.26 D.

Reference
Chow AHY, Caffery B, Di Marco A, et al Pre-Myopic Children: Trends in Myopia Development and Management in Canada. J Clin Med. 2026;15(7):2748. doi: 10.3390/jcm15072748. PMID: 41977048; PMCID: PMC13073095.