Myopia Control for Children in Amman, Jordan — Stellest, MiYOSMART, MyoCare, Ortho-K + Atropine

Quick answer for parents. Myopia control is a category of clinically validated treatments that slow the progression of short-sightedness in children. Without intervention, a typical myopic child’s prescription worsens by roughly -0.50 to -1.00 dioptres per year, and the eye grows progressively longer — increasing the lifelong risk of myopic maculopathy, retinal detachment, glaucoma, and early cataract. With evidence-based myopia control, that progression slows by roughly 50–70%. In 2026 there are four well-validated approaches: myopia-control glasses (Essilor Stellest, Hoya MiYOSMART, ZEISS MyoCare), orthokeratology (Ortho-K) overnight contact lenses, soft myopia-control contact lenses (CooperVision MiSight), and low-dose atropine eye drops. At Vision Experts in Amman we fit all four and tailor the recommendation to the individual child. Initial paediatric consultation is approximately 60–90 minutes, including cycloplegic refraction and axial-length measurement.

Reviewed by Bilal Rawashdeh, Optometrist & Contact Lens Specialist, founder of Vision Experts. Has fit Stellest, MiYOSMART, MyoCare, and Ortho-K in paediatric patients since each became available regionally. Last clinical review: 31 May 2026.

Why myopia control matters

Myopia (short-sightedness, nearsightedness) is the condition where the eye is too long for its optical power, so distant images focus in front of the retina rather than on it. Glasses or contact lenses correct the optical blur — but they do not address the underlying anatomical change. The eye continues to elongate. The child’s prescription continues to climb.

This used to be considered a benign annoyance — a stronger pair of glasses every year. Modern epidemiology has changed that view. Holden et al. (2016) projected that by 2050 half the world’s population will be myopic and nearly 10% will have high (sight-threatening) myopia (worse than -6.00 D). The increase is too fast to be genetic — it is driven by environment: more near work, less outdoor time, longer screen exposure.

The Middle East sits on the higher end of the global curve. Gulf urban populations are showing prevalence rates well above the global average; school-screening studies in Saudi Arabia and the UAE have reported myopia rates in 10–14 year-olds approaching the levels seen in East Asia.

High myopia is not just a strong prescription. It is a lifelong elevated risk of:

Myopic maculopathy — a thinning of the retina at the macula that causes permanent central vision loss in adulthood.
Retinal detachment — risk is multiplied by 10× or more in high myopes.
Open-angle glaucoma — the lifetime risk is double that of non-myopes.
Early cataract — onset is typically 5–10 years earlier in high myopes.

The point of paediatric myopia control is not to give a child clearer vision today — that is what regular glasses do. The point is to keep their adult prescription as low as possible, and thereby reduce their lifelong risk of these sight-threatening complications.

How myopia control actually works

The eye elongates because the peripheral retina receives “stretch signals” when the peripheral image focuses behind the retinal plane. By manipulating where light focuses in the peripheral retina — projecting a myopically-defocused image just in front of the retina — we send the eye the opposite signal: “stop elongating.”

All four evidence-based interventions do this in different ways. The central vision remains sharp (so the child sees clearly) but the periphery sees a defocused image that signals the eye to slow its growth.

The outcome metric that matters is axial elongation rate — how much longer the eye gets per year, measured by IOL Master or A-scan ultrasound. A myopic child’s eye growing by 0.30 mm per year is on a trajectory to high myopia. A child on effective myopia control growing by 0.10–0.15 mm per year is on a trajectory to manageable myopia.

Refraction change is the secondary measure. A child whose myopia would have progressed by -1.00 D per year might progress by -0.30 to -0.50 D per year on effective treatment.

When to start myopia control

The threshold for starting is myopia of -0.50 D or more with documented progression of at least -0.25 D over six months. Younger children with rapid progression benefit most because more years of slowing equals more cumulative axial-length reduction. We sometimes start as early as age 6 in fast progressors; commonly children begin between 7 and 12.

If a child has a strong family history of high myopia and shows early myopic shift on cycloplegic refraction, we may start preventive measures (outdoor time, screen breaks, axial-length monitoring) even before the formal threshold is met.

The window of efficacy stretches into the late teens. We continue myopia control until axial elongation stabilizes — typically by age 16–18 for most children, somewhat later for some.

The four evidence-based interventions

1. Myopia control glasses (the easiest entry point)

Three lens technologies dominate the 2026 myopia-control glasses category. All three are clinically validated. We fit all three at Vision Experts.

Essilor Stellest (H.A.L.T. technology)

The lens surface has 1,021 contiguous tiny aspheric lenslets arranged in 11 concentric rings around a clear central optical zone. Each lenslet creates a “volume of myopic defocus” projected in front of the peripheral retina. The clinical anchor is the three-year Stellest trial, which reported 67% slowing of axial elongation versus single-vision lenses in Chinese children aged 8-13. Essilor’s six-year extension data suggests the effect persists through teenage years.

Vision Experts observation: Most-prescribed myopia-control lens in our paediatric practice. Adaptation is fast (2-4 days). The lenslets are invisible at conversational distance. Excellent for moderate prescriptions (-0.75 to -6.00 D) and full-time wearers

Hoya MiYOSMART (D.I.M.S. technology)

396 small (~1.03 mm diameter) round segments arranged in a honeycomb pattern around a clear central zone. Each segment carries roughly +3.50 D of relative defocus. The pivotal randomized controlled trial in the British Journal of Ophthalmology (2020) reported 59% slowing of myopia progression and 60% slowing of axial elongation over two years. Hoya’s three-year follow-up confirmed durability.

Vision Experts observation: Excellent for active children. The Hoya proprietary scratch-resistant coating and UV-blocking layer are standard. The honeycomb pattern is slightly more visible up-close than Stellest’s lenslets but invisible at conversational distance

ZEISS MyoCare (C.A.R.E. technology)

The newest of the three (launched 2022). Uses concentric ring-shaped (annular) elements rather than discrete dots or lenslets. ZEISS-published one-year data shows efficacy comparable to the other two lenses. The independent peer-reviewed evidence base is still emerging. Available in MyoCare and MyoCare S (for higher prescriptions).

Vision Experts observation: Excellent central optical quality. The annular ring pattern is essentially invisible cosmetically. Best fit for children with higher prescriptions where MyoCare S has a clear design advantage, and for families already using ZEISS frames

Comparison table

	Essilor Stellest	Hoya MiYOSMART	ZEISS MyoCare
Technology	H.A.L.T. (1,021 lenslets)	D.I.M.S. (396 segments)	C.A.R.E. (concentric rings)
Launched	2021	2018	2022
Axial elongation slowing (peer-reviewed)	~67% over 3 yr	~60% over 2 yr	~50-55% over 1 yr
Adaptation time	2-4 days	1-2 days	2-3 days
Best fit	First-line default	Active kids, longest evidence	High prescriptions, ZEISS preference
Vision Experts annual fee (JOD)	320-480	300-450	380-550

2. Orthokeratology (Ortho-K) — overnight contact lenses

Ortho-K uses specially designed rigid contact lenses worn only during sleep. The lenses gently reshape the front of the cornea overnight. The child takes them out in the morning and sees clearly without glasses or daytime contacts all day. The reshaping is fully reversible.

For myopia control, Ortho-K is one of the most-evidence-based interventions. A 2020 meta-analysis reported 40-55% slowing of axial elongation versus single-vision glasses. The mechanism is the same peripheral-defocus signal that the spectacle lenses produce, just delivered through corneal reshaping rather than through a lens in front of the eye.

Why families choose Ortho-K over myopia-control glasses:

The child has glasses-free daytime vision. For sport, for social comfort, for the convenience of waking up able to see — this matters at the child level.
The treatment is “always on” while the child sleeps; compliance becomes a parent-supervised bedtime routine.
The child can swim, play contact sport, and live normally without worrying about glasses.

Why some families prefer myopia-control glasses:

Lower handling burden — no nightly insertion or supervision.
Lower microbial keratitis risk (the small but real complication of any overnight contact lens wear).
Easier transition if discontinuation becomes necessary.

At Vision Experts, the Ortho-K fitting process is approximately 4 visits over 4 weeks; full clinical detail is on the Ortho-K hub page

3. Soft myopia-control contact lenses (CooperVision MiSight)

MiSight is a daily-disposable soft contact lens with built-in dual-focus optical zones — a central correction zone plus surrounding zones with +2.00 D of relative defocus. The six-year MiSight clinical trial reported 59% slowing of myopia progression versus single-vision contacts.

MiSight is suitable for children typically aged 8 and up who are competent at daily insertion and removal of soft contact lenses. The handling burden is between glasses (no handling) and Ortho-K (nightly handling)

4. Low-dose atropine eye drops

Atropine is a long-established medication that paralyzes the focusing muscle (ciliary muscle) and dilates the pupil. At standard concentrations (1%) it has been used diagnostically for over a century. At very low concentrations (0.01% to 0.05%) — used as a single drop in each eye at bedtime — it slows myopia progression with minimal side effects.

The pivotal evidence is the LAMP study series from Hong Kong, which compared 0.01%, 0.025%, and 0.05% atropine over 3+ years. The 0.05% concentration produced the strongest myopia-slowing effect (~70%) with manageable side effects (mild pupil dilation, occasional near-vision blur). 0.01% was effective with almost no side effects but with smaller absolute benefit.

Low-dose atropine is most powerful when combined with one of the optical methods above (Stellest + atropine, or Ortho-K + atropine) in fast progressors. We co-manage atropine prescriptions with paediatric ophthalmologists in Amman

How we measure progress at Vision Experts

Every myopia control patient gets the same measurement protocol so we can tell whether the intervention is working:

Baseline (first visit)

Cycloplegic refraction. Drops paralyze the focusing muscle so the autorefraction is not under-estimated. Non-cycloplegic refraction systematically over-estimates myopia in children — we never compromise on this.
Axial length measurement. The anatomical metric that matters most. We use IOL Master where available; A-scan ultrasound is the alternative.
Corneal topography. Needed for Ortho-K candidacy and for excluding keratoconus.
Binocular vision assessment. Convergence, accommodation, near-work strain.
Visual habits questionnaire. Screen time, outdoor time, near-work hours.
Family history. Parental myopia is a strong predictor of high myopia in the child.

4-week follow-up

Confirm comfort and full-time wear of chosen intervention.
Adjust frame fit or lens parameters if needed.

6-month re-assessment

Re-measure refraction and axial length.
The 6-month axial-length change is the strongest early signal of whether the intervention is working. If axial growth has slowed below 0.15 mm in the half-year, we are on track. If not, we discuss intensifying treatment (adding atropine, switching to Ortho-K, etc.).

Annual reviews

Continue until stabilization (typically late teens).
Some children need a treatment upgrade as their prescription climbs (Stellest → MyoCare S, or adding atropine to glasses-only management).

What parents and children can do beyond the lens

Optical and pharmacological treatment is only one half of the picture. Behavioural intervention has independent evidence of its own.

1. Outdoor time

The strongest single behavioural intervention against myopia onset and progression. Multiple randomized studies have shown two hours of outdoor light per day reduces myopia onset by approximately 50% and slows progression in already-myopic children. The likely mechanism is bright outdoor light triggering retinal dopamine release, which inhibits axial elongation.

For Jordanian children, the practical implication is: time in the sun matters. Not specifically sport, not specifically a particular activity — just time outdoors with the bright sky overhead. 30 minutes morning, 30 minutes afternoon, 60 minutes during recess at school adds up.

2. Near-work breaks

The 20-20-20 rule has weak but supportive evidence: every 20 minutes of near work, look at something 20 feet away for 20 seconds. The benefit is partly the visual break and partly the increase in blink rate during the break. Useful at minimum, and free.

3. Reading distance and posture

Children who read at less than 30 cm are at higher risk than those who read at arm’s length. Encouraging proper reading distance — book or tablet held at least at arm’s length, not balanced on the chest — matters.

4. Screen time

The evidence on screens specifically (versus near-work in general) is mixed, but the consistent finding is that long uninterrupted near focus is the risk factor. Whether the near-focus is on a book or a tablet, the optics are similar. Schools that switched from paper to tablets did not see myopia rates fall. Breaks remain the protective factor.

5. Sleep and circadian patterns

Emerging research suggests circadian-rhythm disruption (irregular sleep, late-night blue-light exposure) may interact with the dopamine pathway involved in eye growth. The practical recommendation is consistent sleep timing, especially in the teen years.

What we actually do at Vision Experts — a typical paediatric myopia consultation

An initial myopia consultation at our clinic looks like this:

60-90 minute appointment. Both parents typically attend the first visit. The child is the patient but the parents are the decision-makers and the supervisors.
Comprehensive baseline. Cycloplegic refraction, axial length, corneal topography, binocular vision, fundus exam.
Discussion of all 4 intervention options with realistic outcome expectations, handling burden, and cost for each.
Joint decision-making with the family about which path to take. We do not push the most expensive option — we recommend what fits the child and the family.
Frame fitting (for spectacle-based interventions) or lens trial (for contact-lens-based interventions). Frame fit matters more for myopia control lenses than for regular glasses; if the frame slides down the nose, the optical zones land in the wrong place.
4-week follow-up to confirm everything is working.
6-month re-assessment with axial-length re-measurement to confirm the trajectory.
Annual continuation until stabilization.

Frequently asked questions

At what age should myopia control start?

As soon as progression is documented. The clinically defined threshold is myopia of -0.50 D or more with progression of at least -0.25 D over six months. Some children begin treatment at 6, others at 12. Earlier intervention captures more years of slowing and produces a lower adult prescription.

How long does a child need to wear myopia control glasses?

Until the eye stops elongating — typically the late teens or early twenties. Stopping early can produce a “rebound” where some of the slowed progression catches up. We continue management until axial-length growth has plateaued for at least 12 months.

Is it possible to “outgrow” myopia?

No. Myopia is not outgrown. Once the eye has elongated, the prescription does not reverse. The goal of myopia control is to keep the final adult prescription as low as possible — for life.

Do myopia control glasses look different from regular glasses?

Not at any normal viewing distance. The lenslet/segment/ring patterns are sub-millimetre and invisible during conversation. Up close, on careful inspection, the patterns can be seen — but children and friends rarely notice.

Can my child wear regular glasses for sport and myopia-control lenses the rest of the day?

Not ideal. The time out of the control lenses removes the defocus signal. For high-impact sport where myopia-control glasses might break, prescription sport goggles with the myopia-control lens are available from some manufacturers.

What about contact lenses or Ortho-K instead of glasses?

Both are valid options. MiSight daily-disposable contacts achieve similar slowing for children age 8+ who can handle daily insertion. Ortho-K achieves similar slowing with the additional benefit of glasses-free daytime vision. We discuss all four options at the first consultation.

Are atropine drops safe long-term?

At low concentrations (0.01-0.05%), yes. The LAMP study followed children for 3+ years with no significant adverse events at these doses. The standard side effects (mild pupil dilation, slight near-vision blur in some children) are dose-related and manageable.

Can my child combine treatments?

Yes, and for fast progressors we often do. The most-studied combination is Ortho-K + 0.01% atropine; the next is myopia-control glasses + 0.01-0.05% atropine. Combination management is reserved for children whose axial length is growing faster than 0.20 mm per six months despite single-modality treatment.

How will I know if the treatment is working?

The 6-month axial-length re-measurement is the critical data point. We compare the 6-month axial length to the baseline. If axial growth has slowed below 0.15 mm per six months, the intervention is working. If not, we discuss adjustment.

What is cycloplegic refraction and why do you insist on it?

Cycloplegic refraction is refraction performed with eye drops that temporarily paralyze the ciliary muscle. This prevents the child’s eye from “self-correcting” through accommodation during the test. Non-cycloplegic refraction in children systematically over-estimates myopia by 0.50-1.00 D and under-estimates hyperopia by a similar amount. For myopia control management, we need the true refractive state — so cycloplegia is non-negotiable at baseline and annual reviews.

Are myopia-control glasses available in Arabic-speaking children’s frames?

Frame selection is independent of the lens technology. We stock frames sized for paediatric faces from multiple manufacturers, including frames designed for Middle-Eastern facial proportions.

Will my insurance cover this?

Coverage of specialty contact lens fitting varies by carrier and policy. We provide itemized invoices and the clinical documentation insurance requires. Please confirm coverage with your provider before scheduling.

What if my child doesn’t want to wear glasses or contacts?

Common in pre-teens. Ortho-K is often the “win-win” — the child doesn’t have to wear anything during the day. Atropine drops at bedtime are another option requiring no daytime visible intervention. The conversation about compliance is one we have explicitly with every family — without consistent wear, none of the interventions work.

What if we miss a few nights of atropine drops or Ortho-K?

One or two missed nights are not a problem. A week or more of missed treatment will start to show measurable effect. We track adherence as part of the 6-month review.

Can adults benefit from myopia control?

No. Adult myopia is stable; the axial elongation that myopia control addresses has stopped by the early twenties. Adults with high myopia benefit from regular comprehensive eye exams to monitor for the complications of myopia (retinal changes, glaucoma risk) — but the elongation itself is no longer modifiable.

What about LASIK for my teenager?

LASIK is contraindicated in patients whose prescription is still changing — which describes most teenagers and many young adults. Refractive surgery is reserved for after the prescription has been stable for at least 12 months, usually after age 18-20. Myopia control during the active progression years is what determines what kind of LASIK candidate the child grows up to be.

What to do next

If your child’s glasses prescription has changed in the last 6-12 months, or your child has been newly diagnosed with myopia, or there is a strong family history of high myopia — book a paediatric myopia consultation at Vision Experts.

The initial consultation is 60-90 minutes including cycloplegic refraction and axial-length measurement. By the end of the appointment you will have a written treatment plan, a recommendation, an honest cost estimate, and a follow-up schedule.

Book online at /appointments/, email info@visionexperts.net, call +962 6 566 6122, or WhatsApp +962 77 566 6122.