The International Myopia Institute (IMI) has published its 2025 Digest, delivering the latest evidence-based guidance on myopia. The Digest, released in Investigative Ophthalmology & Visual Science and summarized in an accessible clinical summary, reflects a global expert consensus on the definitions, risk factors, prevention, and management of myopia in children and young adults. 

One of the standout themes in the 2025 Digest is an enhanced understanding of pre-myopia. Researchers now emphasize hyperopic reserve as a key predictive marker for future myopia. Children who have lower hyperopic reserve are more likely to become myopic, and evidence supports early identification and targeted interventions to delay onset. 

Importantly, simple lifestyle modifications such as increased outdoor time continue to emerge as one of the strongest protective factors against myopia onset, reinforcing public health strategies that encourage outdoor activity for children. 

Updated Clinical Management Guidelines

The Digest highlights a shift toward proactive and personalized management of myopia:

• Delaying onset may be more impactful in long-term outcomes than treating progression later—each year of delayed onset equates to multiple years of progression prevention.

• Optical interventions such as dual-focus contact lenses and peripheral defocus spectacle lenses are supported by long-term studies demonstrating sustained safety and effectiveness.

• Clinicians are encouraged to customize treatment based on individual risk profiles, quality-of-life considerations, and patient preferences.

Risk Factors and Emerging Insights

The 2025 Digest reinforces practitioners’ understanding of environmental and behavioral influences:

• Educational exposure—especially intensive near-work and academic demands—has a more substantial link to myopia development than chronological age alone. 

• Outdoor activity remains the most reliable protective factor, with evidence connecting higher levels of outdoor time to reduced myopia risk. 

While screen time and sleep patterns have been studied, their direct causal role remains less clear compared with outdoor exposure.