“Myopia management” should be reserved for approaches that combine myopia correction with a comprehensive approach to eye and vision care that aims to also slow myopia progression and reduce the risk of future, myopia-associated complications. Myopia management represents an evidence-based approach to eye and vision care for both patients with myopia and those at risk of developing it (i.e., pre-myopia).^6,7 It encompasses myopia risk assessment, early detection through regular vision screening, appropriate optical correction, and timely interventions to prevent and control myopia progression and excessive axial elongation. Myopia management also includes lifestyle recommendations, such as increased outdoor time and reduced screen exposure, and ongoing monitoring of refraction and axial length.^8,9 Importantly, myopia management should also address the long-term care and treatment of emerging myopia-related complications across the entire lifespan of the patient.¹⁰

Myopia control typically refers to the use of interventions specifically aimed at slowing down progression of myopia and reducing associated risks of sight-threatening myopic complications and, in this sense, is a narrower, more specific term. Such interventions may serve dual roles, also providing optical correction, or may only address the refractive progression and excessive axial elongation. In the latter case, the myopia treatment may need to be combined with myopia correction. Monitoring of treatment efficacy with refraction and axial length measurements is an integral part of myopia control.¹¹ In addition, there is also a very important regulatory dimension to myopia control in many countries.³ In many jurisdictions, such as the USA, myopia control has a specific regulatory meaning, with approved products that have as part of their indications for use, “myopia control” or that refer to “slowing the progression of myopia,” having demonstrated sufficient clinical evidence of efficacy to justify regulatory approval.

Regulatory approval of a product need not indicate that its efficacy in reducing myopia progression has been evaluated. Confusingly, there are products used for myopia control that have been given marketing clearance for “myopia management” but not “myopia control.” This distinction reflects the fact that their efficacy in slowing myopia progression or axial elongation was not assessed as part of the regulatory clearance process. In Europe, the CE marking that denotes an approved product does not specifically differentiate between spectacles used for myopia control (slowing myopia progression) and standard spectacles used for simple myopia correction (i.e., optical optimization of distant visual acuity). Both types of spectacles, regardless of therapeutic claims regarding myopia control, must meet the same fundamental CE marking standards for materials, manufacturing, and safety, based on materials and manufacturing standards (such as EN ISO 14889, EN ISO 21987, and ISO 8980). An optical product designed for myopia control can therefore be approved in Europe without needing to prove efficacy, provided no medical claims regarding the latter are made.

The diagram shown in the Figure demonstrates the relationship between myopia correction, myopia control, and myopia management. Myopia control, myopia correction, and the monitoring of refraction and axial length are the core clinical elements of myopia management. The concept of myopia management also encompasses the need for prevention, education, communication, risk assessment, vision screening, lifestyle recommendations, and the monitoring/management of potential myopia-related complications. Although clinicians may participate in many of these activities, a wide range of stakeholders needs to be involved to provide optimal myopia management at a public health level.