Advances in myopia prevention and control in children and adolescents: updated interventions and risk-stratified management

Myopia prevention and control in children and adolescents is shifting from a passive refractive error-centered approach to an active long-term management focusing on axial elongation and the risk of later complications. In recent years, behavioral management tools, defocus-based optical designs, low-dose atropine, and digital tools for follow-up and decision support have continued to evolve. However, differences remain in long-term efficacy, indications, accessibility, and real-world implementation. Focusing on myopia prevention and control in children and adolescents, this article summarizes recent advances in behavioral, optical, pharmacological, and digital strategies on the basis of randomized controlled trials, systematic reviews, and expert consensus statements. It discusses the evidence base, clinical applicability, and translational limitations of these interventions, and further examines the role of risk stratification, longitudinal monitoring centered on axial length and cycloplegic refraction, and structured follow-up in long-term myopia management. This article aims to inform clinical decision-making and the optimization of management pathways for myopia prevention and control in children and adolescents.