Myopia Management Program

Myopia — commonly called nearsightedness — is a condition where the eye grows too long from front to back. When that happens, light from distant objects focuses in front of the retina instead of on it, making faraway things look blurry while close-up objects remain clear.

In my practice, I explain it to parents this way: imagine your child's eye is like a camera that's been set to the wrong focal length. Glasses and contacts are like putting a filter over the lens — they correct the image, but they don't fix the camera. Myopia management actually works on the camera itself.

What makes myopia particularly important to address early is that it's not static. In children, the eye is still growing — and in many kids, it keeps growing too fast, making the prescription stronger year after year. This is called myopia progression, and it's what we're working to slow down.

Left: Normal eye — light focuses precisely on the retina. Right: Myopic eye — the elongated eyeball causes light to focus in front of the retina.

Children's eyes are biologically programmed to grow during childhood. In a normal eye, this growth stops when the eye reaches the right length. In a myopic eye, the growth signal doesn't turn off when it should — the eye keeps elongating, and the prescription keeps climbing.

Three factors drive this accelerated growth:

The critical insight here is that myopia progression is not inevitable. We have evidence-based tools that can slow — and in some cases nearly stop — the progression. The earlier we start, the more we can accomplish.

This isn't a niche concern. The World Health Organization projects that by 2050, half of the world's population will be myopic. In the United States, myopia rates have doubled in the last 30 years. Among school-age children in East Asia, rates exceed 80–90%. We are in the middle of a global myopia epidemic, and Fayetteville families are not immune.

Research consistently shows that 90+ minutes of daily outdoor time in natural sunlight is one of the most effective lifestyle interventions for slowing myopia progression.

Here's what I tell every parent who comes in thinking their child just needs a new prescription: a stronger prescription means the eye is physically getting longer. And a longer eye is a more fragile eye. High myopia — above -5.00 or -6.00 diopters — dramatically increases the lifetime risk of serious, potentially blinding conditions.

A standard vision screening at school only tells you whether your child can see the chart. It doesn't tell you how fast their myopia is progressing or what their risk trajectory looks like. At Eye Medics, we go further.

Axial length measurement with optical biometry — the most accurate way to track myopia progression over time.

Not all myopia treatments are created equal. Here's how the evidence-based options compare. Efficacy figures represent reduction in axial elongation versus single-vision glasses, based on peer-reviewed clinical trials.

Orthokeratology — Ortho-K — is the treatment I recommend most often for myopic children, and it's the one I'm most proud of offering. The concept is elegant: your child wears specially designed rigid gas-permeable lenses overnight. While they sleep, the lenses gently reshape the front surface of the cornea. When they wake up and remove the lenses, their cornea holds that new shape — and they can see clearly all day without glasses or contacts.

But here's what makes Ortho-K more than just a vision correction tool: it also slows myopia progression. Multiple clinical trials have shown that Ortho-K reduces axial elongation — the physical lengthening of the eye — by 43–64% compared to standard glasses. We believe this works because the reshaped cornea creates a peripheral defocus signal that tells the eye to stop growing.

At Eye Medics, we use the sleepSEE® system — a proprietary Ortho-K design that we customize to each child's corneal topography map. No two corneas are identical, and the fit matters enormously for both comfort and efficacy.

sleepSEE® Ortho-K lenses are worn overnight and removed in the morning, providing clear daytime vision without glasses or contacts.

Low-dose atropine (0.01%–0.05%) is a well-studied pharmaceutical option for myopia control. Originally used at higher concentrations to dilate pupils, researchers discovered that very low doses can slow myopia progression by 50–77% with minimal side effects. The exact mechanism isn't fully understood, but it appears to work through retinal receptors that regulate eye growth — independent of the focusing system.

In our practice, we often combine low-dose atropine with Ortho-K for children with rapidly progressing myopia or high-risk profiles. The combination approach can be more effective than either treatment alone.

While clinical treatments are the most powerful tools we have, lifestyle modifications play a meaningful supporting role — and they're free. I counsel every family on these evidence-based strategies regardless of what treatment we choose.

Myopia progresses fastest between ages 8 and 14. The earlier treatment begins, the more progression we can prevent — and the lower the final prescription will be. This isn't a condition where "wait and see" is a neutral choice. Every year without treatment is a year of unchecked progression.

We serve a large number of active duty and veteran families from Fort Liberty (formerly Fort Bragg), Pope Army Airfield, and the surrounding communities. Myopia management is especially relevant for military families because high myopia can affect a service member's eligibility for certain military occupational specialties and aviation roles.

TRICARE covers comprehensive eye exams, and may cover some myopia management services depending on your specific plan and medical necessity documentation. Our team is experienced with TRICARE billing and will verify your benefits before starting any treatment.

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Last reviewed: March 2026 by Dr. James H. Singletary, OD, FIAOMC