Preventing Myopia

Dtsch Arztebl Int. 2017 Sep 4;114(35-36):575-580. doi: 10.3238/arztebl.2017.0575.


Background: Nearsightedness (myopia) has become more common around the world recently, mainly because of changes in visual, educational, and recreational behavior. The question arises how the risk of myopia and its progression can be reduced. This would lessen the prevalence and severity of myopia and also lower the risk of secondary diseases that impair visual acuity.

Methods: The PubMed/Medline database was selectively searched for pertinent literature.

Results: The risk of myopia is lowered by exposure to daylight and increased by activities performed at short visual distances (close-up work). A person with little exposure to daylight has a fivefold risk of developing myopia, which can rise as high as a 16-fold risk if that person also performs close-up work. Two meta-analyses and a large randomized clinical trial from Asia have shown that the progression of myopia over two years of observation can be lessened by up to 0.71 diopters by the administration of atropine eye drops in a concentration that has practically no serious side effects. At higher doses, myopia progresses more severely than in the placebo group after the cessation of therapy. This is an off-label treatment. A weaker effect on progression has been shown for multifocal optical corrections that include both a distance correction and a correction for near vision.

Conclusion: Effective pharmacological and optical measures are now available to lessen the progression of myopia. The increasing prevalence of myopia should motivate pediatricians, parents, and schools to pay attention to risk factors such as close-up work and lack of daylight exposure, particularly in view of the increased use of digital media.

MeSH terms

  • Atropine
  • Disease Progression
  • Humans
  • Meta-Analysis as Topic
  • Myopia / prevention & control*
  • Randomized Controlled Trials as Topic
  • Visual Acuity*


  • Atropine