Is Myopia Management Available on the NHS?

Written By: Jason Higginbotham and Richard Kadri-Langford

Part 1 Introduction: What is Myopia?

Why Myopia Matters: More Than Just Blurry Distance Vision

Myopia, commonly known as short-sightedness, is a growing global epidemic affecting children at an alarming rate. It causes difficulty in seeing distant objects clearly due to the elongation of the eyeball, leading to blurred vision. By 2050, an estimated 50% of the world’s population will be myopic.

There are two main types of myopia:

Refractive Myopia – caused by excessive curvature of the cornea or lens.

Axial Myopia – caused by elongation of the eyeball, which poses the greatest risk for long-term complications.

While myopia can be easily corrected with glasses or contact lenses, these solutions do not slow down its progression. Myopia control treatments aim to reduce the rate of progression, ultimately lowering the risk of severe eye diseases.

The Importance of Treating Myopia

Why Does High Myopia Increase Health Risks?

As the eye elongates in myopia, structural changes occur that weaken the retina and other essential eye components. This increases the risk of developing a range of serious ocular diseases, many of which can lead to permanent vision loss.

Serious Health Risks Associated with Myopia Progression

Retinal Detachment – A Leading Cause of Vision Loss

People with high myopia have a 5-10 times greater risk of experiencing retinal detachment compared to non-myopic individuals.

As the eyeball elongates, the retina is stretched and becomes thinner. A thinner retina is more susceptible to developing small tears or holes, which can lead to detachment, where the retina pulls away from its underlying supportive tissue.

Symptoms include a sudden increase in floaters, flashes of light in peripheral vision, and a shadow or curtain effect across vision.

If left untreated, retinal detachment can lead to permanent blindness. Emergency surgery is required to prevent vision loss.

Glaucoma – The ‘Silent Thief of Sight’

Myopic individuals are twice as likely to develop glaucoma, and those with high myopia face an even higher risk. In Southeast Asia, 90% of people over 70 with highly elongated eyes (>30 mm) are likely to have glaucoma!

The optic nerve is more vulnerable in myopic eyes due to stretching and thinning of the eye’s internal structures. This makes it more susceptible to damage from intraocular pressure, leading to the development of open-angle glaucoma.

Symptoms include gradual loss of peripheral vision, blurred vision, and haloes around lights.

Glaucoma is irreversible and a leading cause of blindness worldwide. Early detection through regular eye exams is crucial.

Myopic Maculopathy – Progressive Vision Loss

One in three people with high myopia develop myopic maculopathy, a condition that destroys central vision.

As myopia progresses, damage to the retina and choroid (the layer of blood vessels beneath the retina) occurs, leading to atrophy and degeneration of the macula.

Symptoms include distorted or blurry central vision, difficulty reading or recognising faces, and blind spots in central vision.

Unlike other forms of macular degeneration, myopic maculopathy can affect younger individuals, leading to significant visual impairment before old age.

Cataracts – Earlier and More Severe

People with high myopia are two to three times more likely to develop cataracts earlier in life.
Structural changes in the lens occur more frequently in myopic eyes, leading to a higher risk of cataract formation, especially nuclear cataracts, which affect central vision.

Symptoms include blurry or cloudy vision, difficulty seeing at night, and increased sensitivity to light.

Cataracts can be surgically removed, but highly myopic patients face more complications during surgery, including an increased risk of retinal detachment post-surgery.

Why Early Intervention is Crucial

While myopia is often seen as a simple need for glasses, it is far more than just a refractive error. It is a progressive eye condition that, if left unmanaged, can lead to serious, sight-threatening complications. Myopia tends to progress fastest in children, especially those diagnosed between ages 6 and 10. The earlier myopia starts, the higher the risk of developing high myopia in adulthood.

Key facts about myopia progression:

Children with myopia before age 10 are more likely to reach high myopia (-6.00D or worse) as adults.

Without intervention, myopia can progress rapidly by -0.50D to -1.00D per year.

Preventative treatments such as myopia management lenses, orthokeratology, or atropine drops can slow progression by 30-80% according to various studies.

Without intervention, millions of children will progress to high myopia, increasing their risk of serious sight-threatening conditions. Myopia management is about more than just clear vision; it is about protecting long-term eye health.

Parents should act early by seeking regular eye exams and considering myopia management options to reduce the risks of retinal detachment, glaucoma, maculopathy, and cataracts in later life.

Part 3 What is Myopia Management?

So What is Myopia Management?

Myopia management, also called myopia control, refers to a range of evidence-based treatments designed to slow the progression of myopia in children and young people. While traditional glasses and contact lenses correct blurry vision, they do not stop myopia from worsening. Myopia management aims to reduce the rate of eye elongation, lowering the risk of developing high myopia (-6.00D or worse) and its associated sight-threatening complications.

Scientific studies have shown that myopia management treatments can reduce myopia progression by 30–80%, depending on the method used.

Complete Guide To Myopia Management

Key Myopia Management Options

Specialist Myopia Control Glasses

Unlike standard prescription glasses, these lenses are designed to slow myopia progression by modifying how light enters the eye.

Multifocal and Bifocal Lenses

These lenses contain multiple focal points that reduce eye strain, and the effort needed for near-vision tasks.

Some studies suggest they can reduce myopia progression by around 25–50%, but other reviews state these are not effective therapies for children.

Specialised Myopia Control Glasses (e.g., Stellest, Miyosmart)

These advanced lenses use Defocus Incorporated Multiple Segments (DIMS) or Highly Aspherical Lenslet Technologys (HALT) to modify peripheral defocus, a key factor in myopia progression.

Studies indicate myopia progression can be slowed by 50-60% with these lenses. It is important to understand the veracity of different studies and take the data in context. As time progresses, more longitudinal studies are showing increasing efficacy.

Best for: Younger children who may not be ready for contact lenses.

Combining Myopia Management Strategies for Best Results

No single myopia management method is 100% effective. However, studies show that combining multiple treatments, such as Atropine with Ortho-K, or MiSight lenses with lifestyle changes, enhances effectiveness.

By starting early and using proven myopia management methods, parents can significantly reduce their child’s risk of developing high myopia and its associated complications in later life.

Part 4 Cost and Availability of Myopia Management in the UK

Unlike standard glasses, myopia management treatments are not covered by the NHS, making cost a major barrier for many families.

In the UK, prices of myopia management treatment vary due to a number of factors. Optometrist business owners are largely able to price their services independently, and will consider factors such as their location, client base, competition, time, service and of course which products they offer. Some clinicians break down the costs into monthly fees, whilst others opt for larger upfront costs, but lower or no monthly costs. This makes understanding the costs more challenging. The below therefore is just for guidance, (But at Myopia Focus, this is an area we are looking into).

Treatment	Estimated Cost	Availability
Atropine Eye Drops	£30–£100 per month	Limited private access
Ortho-K Lenses	£50–£100 per month	Private optometrists
MiSight Contact Lenses	£40–£60 per month	Private optometrists
Specialist Myopia Glasses	£200–£400 per pair	Private optometrists
Standard NHS Glasses	Free (for children)	NHS-funded

Due to these not-inconsiderable costs, many parents simply cannot afford private treatment for their children, leading to inequalities in care.

*There is no legal provision for free NHS glasses and many practices have stopped providing NHS services altogether due to the extremely low amounts of money provided.

The Role of Optometrists: Service and Monitoring

Parents navigating myopia management options should work closely with an optometrist offering enhanced service. Unlike standard NHS eye tests, private myopia management services include:

Initial Consultation

Assessing risk factors for myopia progression, such as family history, genetics and lifestyle.

Discussing treatment options based on age, lifestyle, and prescription.

Treatment Selection and Customisation

Optometrists help parents decide which solution, such as glasses, contact lenses, atropine, or combination therapy, is most suitable.

Specialised myopia control lenses and contact lenses require expert fitting.

Ongoing Monitoring and Adjustments

Regular check-ups every 6–12 months to measure myopia progression and adjust treatment if needed. Some sources suggest three-monthly checks may be necessary.

Axial length scans, if available, help assess eye growth changes.

If a treatment is not effective, the optometrist may recommend an alternative or combination approach.

Myopia management is not just about prescribing a lens; it requires active monitoring and adaptation. A well-trained optometrist plays a crucial role in guiding parents through the best choices for their child’s eye health.

Why This Creates Inequality:

Wealthier families can afford comprehensive myopia control treatments, significantly reducing the risk of high myopia.

Lower-income families often rely on basic NHS glasses, which do not slow progression, leading to a higher chance of vision loss in adulthood.

Why This Matters:
Without NHS funding, access to effective myopia treatment depends on financial ability, not medical need, widening the health inequality gap. There is a real risk that children from less financially well-off families will be at significantly higher risk of developing sight threatening eye conditions in later life. This is surely not acceptable.

Part 5 What is Covered by the NHS for Vision and Eye Care?

We have already established that the NHS , does not cover myopia management treatment, but let’s quickly look at what is covered.

NHS-Funded Eye Tests

The NHS provides free eye tests to certain groups, helping to diagnose vision problems, including myopia. The following groups are eligible for free eye tests:

Children under 16 (or under 19 and in full-time education)

People aged 60 and over

People with diabetes or glaucoma

People at risk of glaucoma (e.g., if a close relative has it)

Those receiving income-related benefits (e.g., Universal Credit, Income Support)

People with complex prescriptions who qualify for NHS optical vouchers

Children with binocular vision anomalies or rapidly progressing myopia can have a six-monthly eye examination as opposed to the usual annual examination.

For those who do not qualify, an NHS eye test typically costs between £20-£30 at most opticians.

NHS Optical Vouchers for Glasses and Contact Lenses

Children under 16 (or under 19 in full-time education) are entitled to free NHS glasses or contact lenses through the NHS optical voucher scheme. A typical voucher will be worth just £42.40 towards the cost of glasses or contact lenses.

Adults on low incomes or with complex prescriptions may also qualify for vouchers to help with the cost of glasses.

The NHS does not provide free spectacles for children. Many Optician’s outlets do their best to cover the full cost of glasses with the NHS GOS voucher, but they don’t have to legally. Myopia management solutions are much more expensive, so the NHS voucher will often only cover 10 to 20% of the cost. If a family has many children with myopia, it is easy to see how substantial the costs can be. More worryingly, progressive myopic prescriptions are more likely to need updating more frequently, exacerbating the problem further.

NHS Support for Adults with Severe Vision Impairment

Adults with very high prescriptions (over ±10.00D) or certain eye conditions, such as cataracts and keratoconus, may receive some NHS-funded treatment, such as hospital-based contact lens services.
If myopia leads to a serious complication, such as retinal detachment, glaucoma, or macular degeneration, NHS treatment is provided through ophthalmology services.

Part 6 Why Doesn't the NHS Fund Myopia Management?

However, for those seeking treatments to slow myopia progression, the NHS currently offers no funding. But, why not?

Historical Context - The NHS Model of Eye Care

When the NHS was founded in 1948, its primary focus was on treating diseases and providing essential medical care. At the time, myopia was considered a simple refractive error, not a progressive condition that required intervention. Standard glasses and contact lenses were deemed sufficient solutions, and the long-term complications of high myopia were not well understood.

What Has Changed?

Myopia rates have risen dramatically. In the UK, twice as many children develop myopia today compared to 50 years ago.

Research now shows that high myopia increases the risk of serious eye diseases, including retinal detachment, glaucoma, and myopic maculopathy, leading to potential blindness.

Other countries, such as China, Singapore, and Canada, have started integrating myopia management into standard eye care, yet the UK has not adapted NHS policies to reflect this shift.

The NHS has historically focused on correcting vision rather than preventing long-term complications. Until policies shift towards preventative eye care, myopia management will remain privately funded.

The WCO (World Council of Optometry) has stated that myopia can no longer be considered a simple refractive error but is an ocular condition that can lead to sight loss. In other words, myopia is an eye condition or disease and needs special care and attention.

NHS Funding Limitations - Where Are The Resources?

The NHS is under immense financial pressure, prioritising urgent and life-threatening conditions over preventative treatments like myopia management.

Why Isn't There Funding for Myopia Management?

NHS spending is directed towards conditions with immediate health impacts, such as cancer, heart disease, and diabetes.

Myopia is not seen as an urgent medical issue, even though it leads to costly complications later in life.

Specialist myopia treatments, such as MiSight lenses, Ortho-K, and atropine eye drops, are not classified as essential medical care, meaning they do not qualify for NHS coverage.

The Long-Term Cost of Inaction

Ironically, not funding myopia management today will likely cost the NHS more in the future. Studies show that:

Retinal detachment surgery, a common complication of high myopia, costs the NHS thousands per patient.

Glaucoma treatment and management for myopic patients results in higher long-term NHS expenses.

The global economic cost of uncorrected myopia is estimated at £200 billion annually, with the UK contributing a significant portion.

Funding myopia management now could reduce NHS costs in the future by preventing serious eye diseases that require expensive treatment.

Lack of Awareness and Policy Change – Why Is the NHS Slow to Adapt?

Despite overwhelming evidence supporting myopia control, UK policymakers have been slow to act.

Key Barriers to Change

Low public awareness – Many parents are not aware that myopia can be managed, not just corrected.

Optometrists lack NHS-backed guidelines – While private optometrists offer myopia management, there is no NHS framework for these treatments.

No government-backed funding proposals – Unlike diabetes screening or childhood vaccinations, myopia control has not been prioritised in NHS planning.

How Change Could Happen

Greater awareness campaigns could educate parents about the risks of high myopia and the importance of early intervention.

NHS trials and pilot schemes could assess the cost-effectiveness of funding myopia management.

Parent and optometrist advocacy is crucial—more public petitions and lobbying efforts are needed to push policymakers into action.

Without stronger advocacy from parents, optometrists, and eye care professionals, myopia management will remain an out-of-pocket expense rather than a standard NHS service.

Part 7 Why We're Campaigning for NHS-Funded Myopia Management

We understand that the NHS is stretched. We know that there are life-threatening conditions that need urgent funding. But we also believe that preventative eye care matters—not just for individual children, but for society as a whole.

Myopia isn’t just about glasses and blurry vision. It’s about a child’s future—their ability to learn, to play, to thrive. It’s about protecting long-term eye health and preventing avoidable blindness. It’s also about affordable access to eye care throughout life. Lower levels of myopia will require less expensive corrective lenses throughout a person’s life.

Right now, the UK is failing children with myopia. Parents who can afford myopia management can slow their child’s vision deterioration. But those who can’t afford it? Their children’s eyesight continues to worsen, unchecked. This isn’t fair—and it isn’t sustainable.

That’s why we’re fighting for change.

Sign The Petition

Fairness in Healthcare: Every Child Deserves the Same Chance at Healthy Vision

Right now, access to myopia control treatments is determined by one thing: how much money a family has.

If you can afford £50–£100 per month, you can get specialist myopia control lenses, Ortho-K, or atropine drops to slow progression.

If you cannot, your child gets standard NHS glasses that do nothing to prevent worsening eyesight.

Imagine two seven-year-olds diagnosed with myopia today:

One child is from a wealthy family. They get MiSight contact lenses or Ortho-K and slow their myopia progression by 50-60%.

The other child is from a low-income family. They rely on basic NHS glasses, and their myopia continues to worsen rapidly.

By the time they reach their late teens, the child who had access to myopia management may have mild or moderate myopia (-3.00D). The child who did not may have high myopia (-68.00D or worse), increasing their risk of retinal detachment, glaucoma, and blindness.

Healthcare should not be based on postcode or income. Every child deserves the same opportunity to protect their vision.

The Long-Term Economic Benefits: Myopia Costs the NHS More in the Future

The NHS is struggling financially, but investing in myopia management now could save money in the long run.

The Cost of Doing Nothing

The global productivity loss from uncorrected myopia is estimated at £200 billion per year and is set to rise considerably..

Treating myopia-related eye diseases, including glaucoma, cataracts, and retinal detachment, costs the NHS hundreds of millions annually.

Retinal detachment surgery alone can cost over £3,000 per patient, a condition far more common in people with high myopia.

Preventative Treatment Saves the NHS Money

Myopia management can reduce progression by 30-80%, leading to fewer cases of high myopia.

Fewer people with high myopia means fewer cases of sight-threatening complications later in life.

Reducing demand for expensive NHS treatments, such as glaucoma medication and retinal surgeries, could result in significant cost savings.

Spending a little on myopia management today could prevent the NHS from spending far more on serious eye diseases in the future.

Why This Matters – And Why We Won’t Stop Fighting

This is not just about funding new treatments; it is about changing how we think about eye care.

If a child had diabetes, would we wait until they developed complications before offering help? No, we would provide early intervention.

If a child had weak teeth, would we only offer a toothbrush to some children? No, we would fund preventative care for everyone.

So why should we accept a system where only some children can access myopia management?

We are not asking the NHS to fund every single case of myopia management overnight. But we are asking for:

Pilot schemes to assess NHS-funded myopia control treatments.

Partial NHS funding for children at risk of developing high myopia.

Recognition that myopia is more than just a prescription—it is an eye health issue.

This is about fairness. It is about prevention. It is about protecting children’s eyesight for life. And that is why we will not stop fighting for change.

Part 8 What Needs to Happen Next?

While myopia management treatments are not currently available on the NHS, there are steps parents can take:

Take Action Now

Speak to a privatean optometrist about myopia management options.

Implement lifestyle changes, such as more outdoor time and reduced screen use.

Advocate for NHS Funding

Sign our petition campaigning for better NHS funding for myopia management.

Contact MPs and policymakers to raise awareness.

Join parent-led campaigns such as Myopia Focus who are advocating for policy change.

Regular Eye Checks

Ensure your child has annual eye exams to monitor myopia progression. Myopia children may even need an eye examination every six months.

The more awareness we raise, the more likely the NHS will be to adopt myopia management into standard care. Until the NHS prioritises myopia management, the burden will remain on parents—but change is possible with enough advocacy and awareness.

This article was written by Jason Higginbotham and Richard Kadri-Langford in collaboration with the Myopia Focus advisory team.

For more information, visit myopiafocus.org.

Is Myopia Management Available on the NHS?

Contents

Part 1

Introduction: What is Myopia?

Why Myopia Matters: More Than Just Blurry Distance Vision

Part 2

The Importance of Treating Myopia

Why Does High Myopia Increase Health Risks?

Serious Health Risks Associated with Myopia Progression

Why Early Intervention is Crucial

Part 3

What is Myopia Management?

So What is Myopia Management?

Key Myopia Management Options

Combining Myopia Management Strategies for Best Results

Part 4

Cost and Availability of Myopia Management in the UK

The Role of Optometrists: Service and Monitoring

Part 5

What is Covered by the NHS for Vision and Eye Care?

Part 6

Why Doesn't the NHS Fund Myopia Management?

Historical Context - The NHS Model of Eye Care

NHS Funding Limitations - Where Are The Resources?

Lack of Awareness and Policy Change – Why Is the NHS Slow to Adapt?

Part 7

Why We're Campaigning for NHS-Funded Myopia Management

Fairness in Healthcare: Every Child Deserves the Same Chance at Healthy Vision

The Long-Term Economic Benefits: Myopia Costs the NHS More in the Future

Why This Matters – And Why We Won’t Stop Fighting

Part 8

What Needs to Happen Next?