Myopia control spectacle lenses explained: how defocus designs slow progression

Why myopia gets worse

Short-sightedness in children is almost always a matter of the eye growing too long from front to back. Light from distant objects then focuses in front of the retina, and the world beyond arm’s length goes soft. Each year of growth tends to add length and minus power, which is why a child’s glasses are often updated yearly until the late teens.

The concern is not only stronger glasses. Longer eyes carry a higher lifetime risk of retinal detachment, glaucoma and myopic damage to the retina, and that risk climbs with every dioptre. Slowing the growth while the eye is still growing is the whole point of myopia control.

The defocus signal

A conventional single vision lens focuses light sharply on the centre of the retina. Because the retina is curved and the lens is not designed for the periphery, light from the sides of the field tends to focus slightly behind the retina. Animal studies and trials in children point the same way: the retina can tell whether the surrounding image falls in front of or behind it. An image behind the retina is associated with continued growth; an image in front, known as myopic defocus, with slower growth.

Myopia-control lenses are built around that idea. They keep the central image sharp so the child can see, and deliberately place a region of myopic defocus across the surrounding retina. The signal is continuous while the glasses are worn, which is why wearing time turns out to matter so much.

How the lenslet designs work

The most widely used approach in spectacles puts the child’s full prescription in a clear central zone roughly the size of a small coin, and surrounds it with hundreds of tiny lenslets arranged in concentric rings. Each lenslet adds a little plus power, so light passing through them focuses in front of the retina while light passing between them still forms the corrected image. Essilor’s Stellest lens is the best-known example of this design; it uses rings of aspherical lenslets that together create a volume of defocus in front of the retina rather than a single surface.

Other manufacturers reach a similar goal with different micro-structures, such as honeycomb-style segments of plus power or fine light-scattering dots that soften contrast in the periphery. The principle is the same: protect central vision, change what the peripheral retina sees.

On the face, these lenses look like normal glasses. The lenslets are visible only as a faint texture when the lens is examined close up, and children adapt to them quickly because the centre of the lens is an ordinary corrected view.

What the evidence shows, in cautious terms

The strongest data for the lenslet design comes from a two-year randomised trial in China, published in 2022, in children aged eight to thirteen. Children who wore the lenses for at least twelve hours a day progressed on average about two-thirds less, in both prescription and eye length, than children wearing single vision lenses. Follow-up reports have found the effect continuing over longer wear. In 2025 the first-generation design received authorisation from the United States regulator for slowing myopia progression in children, which reflects the weight of that evidence.

Who is a candidate

These lenses are intended for children and young teenagers whose myopia is progressing, typically from around six years of age, when there is still growth to slow. Risk is higher when myopia started early, when it is increasing by half a dioptre or more a year, or when one or both parents are short-sighted. The decision belongs to an optometrist or ophthalmologist who has measured the child’s refraction and, ideally, the length of the eye, and who can set a baseline to judge progress against.

They are not a treatment for adults, whose myopia has usually stabilised, and they do not replace a proper examination to rule out other causes of blurred vision.

Wearing them properly

1. Full-time wear. The trial benefit was measured in children wearing the lenses at least twelve hours a day. Glasses worn only at school deliver a much weaker signal.
2. Keep the prescription current. The treatment zone only works if the central correction is right, so the lenses are updated whenever the prescription changes.
3. Review every six months. Refraction and, where available, axial length are measured and compared with expected growth to see whether the lenses are doing their job.
4. Add outdoor time. Around two hours a day outdoors is associated with later onset and slower progression of myopia and costs nothing.
5. Break up near work. Regular pauses from screens and books support the same goal.

Other approaches

Spectacle lenses are one of several options. Soft contact lenses with similar defocus designs suit older children who can manage lenses; orthokeratology uses rigid lenses worn overnight to reshape the cornea temporarily; low-dose atropine drops are prescribed by eye doctors in some cases; and these are sometimes combined. The right choice depends on the child’s age, prescription, lifestyle and how comfortable the family is with each method, which is a conversation for the examining clinician rather than a website.

Getting started in the UAE

Everything begins with a proper eye test and a baseline measurement. In Abu Dhabi, Optic One on Hamdan Street offers a free eye test for children and adults and fits Stellest lenses for children whose optometrist recommends them.