Medical Insights

Learn more about the world of eye health with Dr Allan Fong’s educational articles.

Myopia Control Lenses vs Atropine Drops in Singapore

Myopia control contact lenses and low-dose atropine drops can slow the progression of children's myopia.
Summary:
  • Atropine drops and special contact lenses slow the progression of myopia, but they work through different mechanisms and are indicated for different ages, progression rates, and lifestyles.

  • Younger children may start with myopia control spectacle lenses and consider contacts in their pre-teen years. Teenagers are more likely to follow a treatment they helped choose.

  • However, these treatments will not be effective if your child does not follow it consistently.

In less than a year, the optometrist says your child’s prescription has jumped sharply. You nod, collect the new slip, and walk out thinking: will it keep getting worse?

Yes, without intervention. 

Myopia tends to progress fastest between the ages of six and 14, and a prescription that climbs quickly in childhood carries consequences in adulthood. High myopia is associated with an increased risk of retinal detachment, glaucoma, and macular degeneration later in life (Li et al., 2026, PMID 41826348; Arnal et al., 2025, PMID 41103309).
The good news is that there are treatments that can slow your child’s myopia progression. Find out what you need to know below.

Which Myopia Control Treatment Is Right for Your Child?

The right myopia control treatment depends on your child’s age, how fast their myopia is progressing, and what they can realistically maintain everyday.

In Singapore, treatments to slow down myopia include:

  • Low-dose atropine drops
  • Myopia control spectacle lenses
  • Orthokeratology (ortho-K) lenses
  • Soft myopia control contact lenses
  • Combination therapy

Each of these work differently. Here is a comparison to help you understand your options before speaking to an ophthalmologist.

The differences between myopia control treatments

Treatment When to wear Suitable for
Low-dose atropine (0.01%) Nightly drops
  • Most age groups
  • Can be combined with other treatments
Myopia control spectacle lenses During waking hours
  • Younger children
  • Moderate progressors
  • Those who would resist drops or contact lenses
Orthokeratology (ortho-K) Overnight (to be removed in the morning)
  • Active children who want daytime freedom from glasses
  • Motivated school-age children with parental hygiene support
Soft myopia control contact lenses During the day
  • Older children and teenagers who want to wear contact lenses
Combination therapy As per individual treatments
  • Fast progressors where a single treatment is not producing adequate control

If you are unsure whether your child needs myopia control, these are the signs worth looking out for.

What to Watch For

  • Squinting or tilting their head to see clearly at a distance
  • Sitting closer to the TV or holding devices very close to their face
  • Complaints of difficulty seeing the board at school
  • A prescription that keeps getting stronger every year
  • A family history of high myopia (above 6.00 dioptres) in one or both parents — this increases your child’s risk

Better yet, speak to a doctor. Book an assessment with Dr Allan Fong and leave with a plan for your child.

Which Myopia Treatment Works for Your Child's Age Group?

In Singapore, spectacles are commonly recommended to younger children, while pre-teens can consider myopica control contact lenses. Teenagers can make a decision based on their preferences.

Age group First-line option When to consider adding atropine Contact lens options
6 to 9 Myopia control spectacle lenses If progression is rapid Ortho-K possible with consistent parental oversight
10 to 13 Spectacle lenses, ortho-K, or soft lenses Fast progression or single treatment insufficient Ortho-K and soft lenses both practical
14 and above Whichever option your teenager will sustain Fast progression or single treatment insufficient All options available

You can also consider LASIK (laser eye surgery) for your child once their prescription has been stable for at least one to two years, which usually happens in their early twenties (American Academy of Ophthalmology, 2023).

Why Axial Length Matters More Than the Glasses Prescription

Axial length measures the physical growth of your child’s eyeball, which is the primary driver of long-term eye health risks, while a prescription only measures their current need for visual correction.

Beyond the glasses prescription

A prescription can appear to stabilise whilst axial length continues to grow. Tracking axial length at every review appointment gives you and your ophthalmologist a more complete picture of whether the treatment is producing a real effect.

An axial length that grows by 0.1 mm per year rather than 0.3 mm per year represents meaningful protection — even if the difference in the prescription number looks modest on paper. (Rozema et al., 2026, PMID 42313375; Zhang et al., 2026, PMID 42266959)

If your child’s ophthalmologist is measuring axial length at each visit alongside the refraction, that is a sign that myopia management is being taken seriously. If you are unsure whether this is happening, it is worth finding out. Arrange a comprehensive assessment at Angel Eye & Cataract Centre.

Myopia Control at Angel Eye & Cataract Centre

At Angel Eye & Cataract Centre, Senior Consultant Eye Surgeon and Medical Director Dr Allan Fong builds a personalised myopia management plan for each child based on age, progression, axial length, and family circumstances, with regular reviews to adjust the approach as your child grows.

If your child’s prescription has been climbing, or if you want to understand their myopia risk more clearly, a comprehensive assessment is the right place to start. 

Contact Angel Eye & Cataract Centre today.

References

  1. Li S, Ren J, Wang F, et al. Routine blood tests and machine learning identify complications in high myopia. Nature Communications, 2026;17(1):3930. PMID: 41826348. DOI: 10.1038/s41467-026-70891-5
  2. Arnal LI, Mesfin Y, Ferreira G, et al. The association between the retinal sequelae of myopia and glaucoma in a global cohort. Clinical Ophthalmology, 2025;19:3749–3760. PMID: 41103309. DOI: 10.2147/OPTH.S542692
  3. Li Y, Yip M, Ning Y, et al. Topical atropine for childhood myopia control: the Atropine Treatment Long-Term Assessment Study. JAMA Ophthalmology, 2024;142(1):15–23. PMID: 38019503. PMC: 10690578. DOI: 10.1001/jamaophthalmol.2023.5467
  4. Radhakrishnan H, Lam CSY, Charman WN. Multiple segment spectacle lenses for myopia control. Part 2: impact on myopia progression. Ophthalmic and Physiological Optics, 2023;43(5):1137–1144. PMID: 37378880. DOI: 10.1111/opo.13194
  5. Wang J, Guo YM, Wei J, et al. Retrospective comparative analysis of myopia control efficacy: orthokeratology, defocus-incorporated soft contact lenses and their combination with 0.01% atropine in Chinese children and adolescents. Ophthalmic and Physiological Optics, 2026. PMID: 42098575. DOI: 10.1007/s44402-026-00104-5
  6. Grzybowski A, Lanca C. Management of myopia: a mini-review. Medical Hypothesis Discovery and Innovation Ophthalmology, 2026;15(1):19–39. PMID: 42083561. PMC: 13135658. DOI: 10.51329/mehdiophthal1538
  7. Rozema JJ, Wang NL, Li SM. Corrected percentile curves to track myopisation — the Anyang Childhood Eye Study. Ophthalmic and Physiological Optics, 2026;46(2):355–365. PMID: 42313375. DOI: 10.1007/s44402-026-00038-y
  8. Zhang S, Wang X, Ding Z, Zhao Q. Interocular asymmetry and ocular biometric patterns in pediatric high myopia: implications for early risk stratification. Frontiers in Medicine, 2026;13:1841384. PMID: 42266959. PMC: 13243021. DOI: 10.3389/fmed.2026.1841384
  9. American Academy of Ophthalmology. LASIK — laser eye surgery. AAO, 2023. aao.org
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