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Role of un-correction, under-correction and over-correction of myopia as a strategy for slowing myopic progression


Logan NS, Wolffsohn JS





Clinical and experimental optometry


  • This systematic review investigates the association between un-, under- and over-correction of myopic refractive error and myopia progression in children and adolescents (up to 18 years of age).

  • The literature search included three databases (PubMed, Web of Science, and Cochrane Central Register of Controlled Trials [CENTRAL]), and reference lists of retrieved studies in any language.

  • Eight prospective cohort studies and one retrospective analysis of clinical data provided comparison data on un- and under-correction of myopia versus full-correction of myopia; however, the quality of studies and length of follow-up times varied. 

  • A forest plot showed no beneficial effect of under-correction with some studies finding an increase in myopia progression. 

  • While one study suggested that myopia progression is slower in an un-corrected cohort compared to those who are fully corrected, another study suggests the opposite. 

  • One study utilised anisomyopes to allow comparison of under-correction of one eye with full-correction of the fellow eye indicating that under-correction in one eye appears to slow the rate of myopia progression in that eye. 

  • Another study on full-correction only in one eye found that progression was faster in the un-corrected eye. No benefits of over-correction of myopia was found. 

  • The overall findings are equivocal with under-correction causing a faster rate of myopia progression. There is no strong evidence of benefits from un-correction, monovision or over-correction. 

  • Hence, current clinical advice advocates for the full-correction of myopia. Further studies are warranted to determine the level of myopia that can be left uncorrected without impacting on myopia progression and how this changes with time.