Myopia has become a major global public health concern, with rising prevalence and earlier onset among children worldwide. Excessive eye elongation during childhood increases the risk of irreversible vision-threatening complications later in life. Optical interventions—such as specialized contact lenses and spectacle lenses—have shown promise in slowing myopia progression, yet their long-term effectiveness often diminishes after the first year of use. One possible explanation is neural adaptation of the retina to persistent optical signals. Understanding whether altering these signals can maintain or enhance treatment effects remains an open question. Based on these challenges, there is a clear need to explore whether changing optical designs over time can improve long-term myopia control.
Researchers from Wenzhou Medical University and collaborating institutions reported the results of a two-year randomized clinical trial in Eye and Vision, published (DOI: 10.1186/s40662-025-00462-0) in 2025. The study followed 218 myopic children aged 6–12 who wore Lenslet-ARray-Integrated (LARI) spectacle lenses designed with either positive or negative power lenslets. By comparing children who continued with the same lens design to those who switched designs after one year, the researchers investigated whether altering optical cues could enhance long-term myopia control, particularly in slowing axial elongation of the eye.
Over the two-year period, children wearing LARI lenses showed significantly less myopia progression and eye elongation than those estimated to have worn conventional single-vision lenses. Average axial elongation in the LARI groups ranged from 0.33 to 0.44 mm, markedly lower than the extrapolated control group. While the protective effect on refractive error weakened during the second year, the reduction in eye elongation persisted.
A key innovation of the study was its investigation of lens switching. Children who changed from one lenslet design to the other after the first year exhibited smaller axial elongation during the second year than expected with continued single-vision correction. However, refractive error changes remained similar regardless of whether children switched designs or stayed with the same lenses.
The findings suggest that myopia control mechanisms may extend beyond traditional optical defocus theories. Despite opposite lenslet powers, both designs produced comparable retinal image modulation, potentially explaining their similar overall effects. Importantly, the results indicate that alternating optical signals may partially counteract the decline in treatment efficacy often observed with prolonged use of a single intervention.
"This study highlights an important shift in how we think about long-term myopia control," said one of the senior investigators. "Rather than relying on a single optical strategy year after year, adjusting the visual signals delivered to the eye may help sustain structural benefits, particularly in slowing eye growth. While switching lens designs did not further reduce refractive error progression, the continued suppression of axial elongation is clinically meaningful, as eye length is closely linked to future risks of pathological myopia."
The findings provide practical insights for clinicians managing childhood myopia. For children who show reduced responsiveness to a single optical intervention over time, switching lens designs may offer an additional strategy to slow eye elongation without increasing treatment burden. Although lens switching alone may not fully prevent refractive progression, it could be combined with other approaches, such as low-dose atropine or orthokeratology, for enhanced control. More broadly, the study supports a dynamic, adaptive approach to myopia management—one that acknowledges biological adaptation and emphasizes long-term structural outcomes critical for preserving lifelong eye health.
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References
DOI
10.1186/s40662-025-00462-0
Original Source URL
https://doi.org/10.1186/s40662-025-00462-0
Funding information
This research project was supported by Shanghai VisionXlab Medical Technology Co., Ltd (Eye Hospital, Wenzhou Medical University, grant number KJZX0263).
About Eye and Vision
Eye and Vision is an open access, peer-reviewed journal for ophthalmologists and visual science specialists. It welcomes research articles, reviews, commentaries, case reports, perspectives and short reports encompassing all aspects of eye and vision. Topics of interest include but are not limited to: current developments of theoretical, experimental and clinical investigations in ophthalmology, optometry and vision science which focus on novel and high-impact findings on central issues pertaining to biology, pathophysiology and etiology of eye diseases as well as advances in diagnostic techniques, surgical treatment, instrument updates, the latest drug findings, results of clinical trials and research findings. It aims to provide ophthalmologists and visual science specialists with the latest developments in theoretical, experimental and clinical investigations in eye and vision.