Tag: myopia

Categories : OphthalmologyTags :

Indigo Light Might Prevent and Treat Myopia

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Graphical abstract, Cell Reports Medicine (2026).

As technology use increases and children spend less time outdoors, researchers have noticed an epidemic increase in myopia over the past six decades also known as the ‘myopia boom’. Myopia, or nearsightedness, has become a major health problem across the world, largely impacting children and adolescents.

“It is projected that nearly half of the world’s population could be myopic by 2050,” said Rafael Grytz, PhD, professor in the University of Alabama at Birmingham Department of Ophthalmology and Visual Sciences. “Myopia results in higher risk to develop glaucoma, retinal detachments and other blinding disease later in life.”

However, a new study published in Cell Reports Medicine suggests that controlled exposure to the indigo light, wavelengths that are abundant in sunlight but mostly absent indoors, could be an effective treatment for myopia. Partnering with researchers from Cincinnati Children’s Hospital Medical Center, this study poses a new treatment and prevention strategy that could impact current ophthalmologic practices and environment lighting standards.

The right wavelengths for developing clear vision

Myopia develops in children and can be defined as the condition when the eye is deemed too long. This extended length causes the light that enters the eye to focus in front of the retina. This results in distant objects’ appearing blurry and out of focus. While standard glasses and contact lenses may improve sight and mitigate myopia symptoms, they do not slow the development of the condition.

Grytz, lead author of the paper, says indigo light can likely be used to slow the progression of myopia in children because it has proved to be composed of just the right wavelengths to completely suppress myopia development in juvenile animal models.

“If we can implement indigo light into our indoor environment or provide it directly to the eye, we may slow the progression of myopia and even work to prevent it from developing at all,” Grytz said.

While the sun is abundant in indigo wavelengths, the modern age of increased indoor time and exposure to white LED light via technology use and modern lighting design present a clear correlation to the myopia boom.

The indigo wavelengths were found by optimizing opsin 5 activation while accounting for light that is filtered out by the ocular lens. OPN5 is a protein that exists in the retina that serves as a light sensing receptor.

Earlier work in animal models that rely on night vision suggested that violet light could suppress myopia by activating OPN5. But violet wavelengths did not work in different animal models that rely on daytime vision with an eye very similar to that of humans, because the ocular lens blocks most violet light below about 400 nanometers.

Corresponding author Richard Lang, Ph.D., director of research in the Division of Ophthalmology at Cincinnati Children’s, says that “human lenses don’t transmit a lot of light in the ultra-violet spectrum.”

Based on this finding, Grytz predicted the optimal wavelength that could stimulate OPN5 in the animal model eye. This prediction led the team to explore slightly longer wavelengths, including indigo wavelengths. Ultimately, the team established a new metric, called the μ-opic, that can quantify how effectively different light wavelengths may protect against myopia.

“We found that indigo light from 419 to 446 nanometers were the most effective wavelengths,” Lang said. “So, if indigo light can suppress myopia in these tests, then it should also be quite effective in humans.”

The future of myopia treatment

Grytz founded Electric Indigo, a UAB startup that focuses on developing ways to practically manage myopia. This startup was founded with the support of UAB’s Bill L. Harbert Institute for Innovation and Entrepreneurship. HIIE offers the infrastructure necessary to help UAB faculty, staff, and students bring new ideas and technologies to market across the region and beyond.

“At Electric Indigo, we have developed eyewear with LEDs in the frame that emit indigo light at controlled conditions to the eye to effectively treat and slow myopia progression in children,” Grytz said.

Grytz says this approach offers a simpler and new strategy that could surpass current treatment options, which may have difficult side effects and limited efficacy levels.

Compared to the increasingly popular red-light therapy, Indigo Eyewear presents an easier approach to treatment by offering a practical method of exposure.

“If our hypothesis is confirmed that absence of indigo light indoors caused the myopia boom, our eyewear will be the first treatment that attacks the root cause of this epidemic,” Grytz said.

Source: University of Alabama at Birmingham

Categories : OphthalmologyTags :

Myopia Surge Could be Caused by Focus Strain in Low Light

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For years, rising rates of myopia have been widely attributed to increased screen time, especially among children and young adults. But new research from scientists at the SUNY College of Optometry suggests the story may be more complicated – and more human.

In a new study published in Cell Reports, researchers propose that myopia may be driven less by screens themselves and more by a common indoor visual habit: prolonged close-up focus in low-light environments, which limits how much light reaches the retina.

The research offers a new hypothesis that could help explain a long-standing puzzle in vision science – why so many seemingly different factors, from near work and dim indoor lighting to treatments like atropine drops, multifocal lenses, and time spent outdoors, all appear to influence myopia progression.

“Myopia has reached near-epidemic levels worldwide, yet we still don’t fully understand why,” said Jose-Manuel Alonso, MD, PhD, SUNY Distinguished Professor and senior author of the study. “Our findings suggest that a common underlying factor may be how much light reaches the retina during sustained near work – particularly indoors.”

A different way of thinking about near work

Myopia affects nearly 50 percent of young adults in the United States and Europe and close to 90 percent in parts of East Asia. While genetics play an important role, rapid increases over just a few generations suggest environmental factors are also critical.

Scientists have long known that:

  • Spending more time outdoors appears to protect against myopia
  • Extended near work is associated with increased risk
  • Treatments as different as atropine eye drops, multifocal lenses, and contrast-reducing optics can slow progression

What has been unclear is why these diverse approaches work.

SUNY Optometry researchers propose a unifying explanation centred on the pupil – the eye’s natural “aperture,” similar to a camera diaphragm.

“In bright outdoor light, the pupil constricts to protect the eye while still allowing ample light to reach the retina,” explains Urusha Maharjan, SUNY Optometry doctoral student who conducted the study. “When people focus on close objects indoors, such as phones, tablets, or books, the pupil can also constrict, not because of brightness, but to sharpen the image. In dim lighting, this combination may significantly reduce retinal illumination.”

According to the researchers’ hypothesis, reduced retinal stimulation over long periods may weaken specific neural pathways involved in visual processing, contributing to myopia development and progression.

Explaining what we already observe

The proposed mechanism may help explain several well-known observations:

  • Why outdoor time is protective: bright light keeps retinal stimulation high
  • Why atropine may slow myopia: it limits pupil constriction, allowing more light into the eye
  • Why certain lenses help: they reduce the need for strong close-up focusing
  • Why prolonged indoor near work under low light may be particularly problematic

Importantly, the study does not claim that screens directly cause myopia, that light alone explains the condition, or that genetics are unimportant. Rather, it offers a testable hypothesis that reframes how visual habits, lighting, and eye focusing interact.

“This is not a final answer,” Alonso emphasised. “It’s a hypothesis grounded in measurable physiology that brings together many pieces of existing evidence. More research is needed, but it gives us a new way to think about prevention and treatment.”

Implications for families and clinicians

While the findings do not change clinical guidelines overnight, they may help inform future research, public health strategies, and conversations around children’s visual habits – especially as digital devices become a constant part of daily life.

The study was conducted by Urusha Maharjan in the laboratories of Jose-Manuel Alonso at SUNY College of Optometry.

Source: SUNY College of Optometry

Categories : OphthalmologyTags :

New Study Finds Low-dose Atropine Improves Myopia for 24 Hours

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Only one drop of atropine for beneficial effects, researchers say

Photo by Tima Miroshnichenko

Groundbreaking research from the University of Houston shows that a single low-dose atropine eye drop can produce daylong effects in managing myopia, or nearsightedness.

Professor of Optometry Lisa Ostrin and postdoctoral researcher Barsha Lal are reporting that even one drop in the eye of low-dose atropine (0.01%–0.1%) produces clear changes in pupil size and focusing ability that persist for at least 24 hours. Importantly, they also found that the drop shows no short-term structural effects on the eye, with only temporary changes in blood flow inside the retina.

Ostrin’s latest research is published in the journal Eye and Vision. It adds to a growing body of vision research from David Berntsen, Golden-Golden Professor of Optometry at the University of Houston, who is co-leading a clinical trial to delay the development of myopia in children by using the atropine drops.

Low concentration atropine is widely prescribed to slow myopia progression in children, yet its short-term retinal and choroidal effects remain incompletely understood. Ostrin’s new study evaluated short-term effects of a range of low atropine concentrations on the length of the eye, the blood vessels in the retina and the thickness of the retina and choroid, which sits just behind the retina. These are important measurements because longer eye length is associated with myopia and as it gets longer, the retina and choroid are stretched.

“These findings indicate that a single instillation of atropine does not alter axial length or retinal or choroidal thickness over 24 hours but may transiently affect superficial retinal perfusion in a time-dependent manner,” said Ostrin.

In the double-masked, randomised study, twenty healthy adults received a single instillation of either a placebo or atropine in the right eye during five separate sessions. Researchers then checked the eye structure, thickness, and length in the central retina both one-hour and 24-hours later.

“Characterising these short-term effects is important for a better understanding of the physiological responses to atropine in clinical and research settings,” said Ostrin who previously published research results of a study investigating the short-term effects of a range of low-dose atropine concentrations on the pupils of young adults. In that study, she found similar results with a single drop of atropine inducing significant changes in the pupils.

Together, the studies indicate that atropine induces early functional and vascular effects in the eye, in the absence of structural change.

“By linking objective ocular responses with subjective visual experience, this work advances our understanding of how atropine works and supports more precise, evidence-based, and individualised approaches to myopia management,” said Ostrin.

By Laurie Fickman

Source: University of Houston

Categories : OphthalmologyTags :

Study Shows Effectiveness of Method to Stem Myopia

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Photo by Ksenia Chernaya

Capping ten years of work to stem the tide of myopia, David Berntsen, Professor of Optometry at the University of Houston, is reporting that his team’s method to slow myopia not only works – but lasts.

The original Bifocal Lenses In Nearsighted Kids (BLINK) Study showed that having children with myopia wear high-add power multifocal contact lenses slows its progression. Now, new results from the BLINK2 Study, that continued following these children, found that the benefits continue even after the lenses are no longer used.

“We found that one year after discontinuing treatment with high-add power soft multifocal contact lenses in older teenagers, myopia progression returns to normal with no loss of treatment benefit,” reports Berntsen in JAMA Ophthalmology.

The study was funded by the National Institutes of Health’s National Eye Institute with collaborators from the Ohio State University College of Optometry.

In Focus: A Major Issue

Leading the team at the University of Houston, Berntsen takes on a significant challenge. By 2050 almost 50% of the world (5 billion people) will be myopic. Myopia is associated with an increased risk of long-term eye health problems that affect vision and can even lead to blindness.

From the initial study, high-add multifocal contact lenses were found to be effective at slowing the rate of eye growth, decreasing how myopic children became. Because higher amounts of myopia are associated with vision-threatening eye diseases later in life, like retinal detachment and glaucoma, controlling its progression during childhood potentially offers an additional future benefit.

“There has been concern that the eye might grow faster than normal when myopia control contact lenses are discontinued. Our findings show that when older teenagers stop wearing these myopia control lenses, the eye returns to the age-expected rate of growth,” said Berntsen.

“These follow-on results from the BLINK2 Study show that the treatment benefit with myopia control contact lenses have a durable benefit when they are discontinued at an older age,” said BLINK2 study chair, Jeffrey J. Walline, associate dean for research at the Ohio State University College of Optometry.

Eye Science

Myopia occurs when a child’s developing eyes grow too long from front to back. Instead of focusing images directly on the retina, they are focused at a point in front of the retina.

Single vision prescription glasses and contact lenses can correct myopic vision, but they fail to treat the underlying problem, which is the eye continuing to grow longer than normal. By contrast, soft multifocal contact lenses correct myopic vision in children while simultaneously slowing myopia progression by slowing eye growth.

Designed like a bullseye, multifocal contact lenses focus light in two basic ways. The centre portion of the lens corrects nearsightedness so that distance vision is clear, and it focuses light directly on the retina. The outer portion of the lens adds focusing power to bring the peripheral light into focus in front of the retina. Animal studies show that bringing light to focus in front of the retina may slow growth. The higher the reading power, the further in front of the retina it focuses peripheral light.

BLINK Once…Then Twice

In the original BLINK study, 294 myopic children, ages 7 to 11 years, were randomly assigned to wear single vision contact lenses or multifocal lenses with either high-add power (+2.50 diopters) or medium-add power (+1.50 diopters). They wore the lenses during the day as often as they could comfortably do so for three years. All participants were seen at clinics at the Ohio State University, Columbus, or at the University of Houston.

After three years in the original BLINK study, children in the high-add multifocal contact lens group had shorter eyes compared to the medium-add power and single-vision groups, and they also had the slowest rate of myopia progression and eye growth.

Of the original BLINK participants, 248 continued in BLINK2, during which all participants wore high-add (+2.50 diopters) lenses for two years, followed by single-vision contact lenses for the third year of the study to see if the benefit remained after discontinuing treatment.

At the end of BLINK2, axial eye growth returned to age-expected rates. While there was a small increase in eye growth of 0.03 mm/year across all age groups after discontinuing multifocal lenses, it is important to note that the overall rate of eye growth was no different than the age-expected rate. There was no evidence of faster than normal eye growth.

Participants who had been in the original BLINK high-add multifocal treatment group continued to have shorter eyes and less myopia at the end of BLINK2. Children who were switched to high-add multifocal contact lenses for the first time during BLINK2 did not catch up to those who had worn high-add lenses since the start of the BLINK Study when they were 7 to 11 years of age.

By contrast, studies of other myopia treatments, such as atropine drops and orthokeratology lenses that are designed to temporarily reshape the eye’s outermost corneal layer, showed a rebound effect (faster than age-normal eye growth) after treatment was discontinued.

“Our findings suggest that it’s a reasonable strategy to fit children with multifocal contact lenses for myopia control at a younger age and continue treatment until the late teenage years when myopia progression has slowed,” said Berntsen.

Source: University of Houston

Categories : Ophthalmology PaediatricsTags :

No Cure for Myopia Progression in Sight as Eyedrops Trial Flops

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Photo by CDC on Unsplash

A US study shows that use of low-dose atropine eyedrops, commonly used in a higher dose to treat lazy eye, was no better than a placebo at slowing myopia progression and elongation of the eye among children treated for two years.

The first randomised controlled trial of its kind aimed at identifying an effective way to manage myopia was published last week in JAMA Ophthalmology. It was conducted by the Pediatric Eye Disease Investigator Group at at Vanderbilt University Medical Center (VUMC) and 11 other hospitals and practices across the United States and funded by the National Eye Institute (NEI).

“We found, interestingly, and honestly shockingly, that there was no difference in the use of 0.01% atropine and placebo in treating these children who ranged in age from 5 to 12,” said associate professor Lori Ann Kehler, OD, and the Vanderbilt site principal investigator for the study.

The onset of myopia usually occurs between the ages of 7 and 16 when developing eyes can start growing too long axially (from front to back). Instead of focusing images on the retina, images of distant objects are focused at a point in front of the retina which causes people to have poor distance vision while their near vision remains unchanged.

The condition results in the need for eyeglasses to improve distance vision, and it can also result in medical complications and serious uncorrectable vision loss later in life, like retinal detachments or myopic macular degeneration.

The study contradicts earlier studies from East Asia that showed the small dose of atropine is effective in slowing progression of myopia.

In 2017 the Academy of Ophthalmology endorsed the findings from East Asia saying that although the FDA had not approved atropine for this use, there was sufficient evidence for prescribing the low dose for myopia. Ophthalmologists across the country, including at VUMC, began to offer the prescription to young patients with myopia.

“That was a really exciting finding at the time because we had had no treatment options for many years,” Kehler said. The prescription of atropine for treating myopia is not covered by most insurance plans.

“The incidence of myopia is increasing worldwide,” Kehler said. “By 2030 it’s predicted that 39 million people in the US will have myopia. By 2050 that number is expected to increase to more than 44 million people in the US and to 50% of the global population. Once it’s detected in children, it tends to get worse every year,” she said. “Investigators all over the world have tried strategies to intervene, to either stop or slow the worsening of myopia.”

Kehler said it is not known why the incidence of myopia is increasing. “There are several theories. Some believe it’s the increase in the use of screens and screen time, but myopia was increasing even before screens were part of children’s lives. Others think it has to do with industrialisation. We were an agricultural society. We were outside more. We weren’t reading. We weren’t looking up close all day. Really, the prevailing thought is whether we’re at a screen or looking at a math book or reading most of the day, we think the lack of sunlight and sustained near effort is what’s causing the increase of myopia.”

Kehler said the percentage of children with myopia using the atropine drop at VUMC is low and estimates fewer than 5% of children with myopia are using the drops nationally.

Going forward, eye specialists should have a frank discussion with parents of children with myopia about the conflicting data between the Asian studies and the new U.S. study.

“The absence of a treatment benefit in our US-based study, compared to East Asian studies, may reflect racial differences in atropine response. The study enrolled fewer Asian children, whose myopia progresses more quickly, and included Black children, whose myopia progresses less quickly compared with other races,” noted the study’s lead co-author, Michael X. Repka, MD, professor of Ophthalmology at Johns Hopkins University, in a news release from the NEI.

“All the studies have shown the drops are safe, so we aren’t putting children at risk if we continue to prescribe the 0.01%,” Kehler said. “But we are telling them there is a difference in these studies and it might have to do with your genetics; it might be that it’s more effective in children from Asia than in the U.S. population,” she said.

Further study is needed, Kehler said. The next step is likely to study a higher dose of atropine to see if children in the U.S. experience a benefit.

The LAMP study out of Hong Kong found that 0.05% might be more effective.

Kehler said other groups are studying the use of red-light therapy to slow the progression of myopia, and there are also new eyeglass lenses that have been developed to slow the progression of myopia, but they are not yet available in the U.S.

“It’s much harder to get drops in very young children,” Kehler said. “But if we had a spectacle option, that would open the door to treating our younger patients.”

Myopia usually stabilises in about half of children around 16 years of age and among an increasingly larger percentage as they get older. By their early 20s, about 10% of individuals with myopia will continue to grow more nearsighted, and by age 24 that percentage is 4%.

Source: Vanderbilt University Medical Center

Categories : Ophthalmology PaediatricsTags :

Atropine Eyedrops Fail to Slow Myopia Progression in US Children

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Photo by Jeffrey Riley on Unsplash

Use of low-dose atropine eyedrops (concentration 0.01%) was no better than placebo at slowing myopia progression and elongation of the eye among children treated for two years, according to a randomised controlled trial conducted in the US. The trial aimed to identify an effective way to manage this leading and increasingly common cause of refractive error, which can cause serious uncorrectable vision loss later in life. Results from the trial, published in JAMA Ophthalmology, contradict those from recent trials in East Asia.

The study was conducted by the Pediatric Eye Disease Investigator Group (PEDIG) and funded by the National Eye Institute (NEI).

“The overall mixed results on low-dose atropine show us we need more research. Would a different dose be more effective in a US population? Would combining atropine with other strategies have a synergistic effect? Could we develop other approaches to treatment or prevention based on a better understanding of what causes myopia progression?” said Michael F. Chiang, MD, director of the NEI, which is part of the National Institutes of Health.

Identifying an optimal approach for preventing high (advanced) myopia is urgently needed given the escalating prevalence of myopia overall and the risk of it progressing to high myopia. By 2030, it’s predicted that 39 million people in the U.S. will have myopia. By 2050, that number is expected to grow to 44 million in the U.S. and to 50% of the global population.

Much stronger concentrations of atropine eyedrops (0.5-1.0%) have long been used by pediatric eye doctors to slow myopia progression. While effective, such doses cause light sensitivity and blurry near vision while on the nightly eyedrops. Thus, there is interest in clinical studies assessing lower concentrations that have been shown to have fewer side effects.

“The absence of a treatment benefit in our US-based study, compared with East Asian studies, may reflect racial differences in atropine response. The study enrolled fewer Asian children, whose myopia progresses more quickly, and included Black children, whose myopia progresses less quickly compared with other races,” noted the study’s lead co-author, Michael X. Repka, M.D., professor of ophthalmology, Johns Hopkins University.

For the study, 187 children ages 5 to 12 years with low-to-moderate bilateral myopia were randomly assigned to use nightly atropine (0.01%) (125 children) or placebo (62 children) eyedrops for two years. Study participants, their parents, and the eye care providers were masked to the group assignments.

After the treatment period, and 6 months after treatment stopped, there were no significant differences between the groups in terms of changes in degree of myopia compared with baseline. Nor were there significant differences in axial length within the two groups when compared with baseline measurements.

“It’s possible that a different concentration of atropine is needed for US children to experience a benefit,” noted the study’s other lead co-author, Katherine K. Weise, OD, professor, University of Alabama at Birmingham. “Clinical researchers could evaluate new pharmaceuticals and special wavelengths of light in combination with optical strategies, like special glasses or contact lenses, to see what works in reducing the progression of myopia.”

Among children, myopia will stabilise in about half of children around age 16 years, and among an increasingly larger percentage as they get older. By their early twenties, about 10% of individuals with myopia will continue to grow more nearsighted, and by age 24 years that percentage is 4%.

“Vision scientists may help us figure out what’s different about the myopic eye, even among different races and ethnicities, to help create new treatment strategies,” she said. It will take a real convergence of eye research to solve the environmental, genetic, and structural mystery of myopia.”

Source: NIH/National Eye Institute