DSDO Spectacles and Myopia in Children: Evaluating Treatment Efficacy

A new randomized clinical trial out of China is offering fresh momentum in the race to delay myopia onset in children—without turning to pharmaceutical interventions. Researchers from Peking University People’s Hospital have found that a specialized spectacle lens design, known as diversified segmental defocus optimization (DSDO), significantly reduced the risk of developing myopia in children over the course of one year. Notably, adding low-dose atropine eye drops to the intervention did not provide additional benefit.

The trial enrolled 450 children between the ages of 5 and 12 who had not yet developed myopia, defined as having a spherical equivalent refraction (SER) between 0.00 and 1.00 diopters after cycloplegia. Participants were randomly assigned to one of three groups: DSDO spectacle lenses with placebo drops, DSDO lenses combined with 0.01% atropine drops (DSDOA), or standard single-vision lenses with placebo drops as the control. The primary outcomes were the development of myopia (defined as SER ≤ –0.50 D) and incidence of fast myopic progression (≥0.50 D shift) over one year.

The findings were striking. In the control group, 15.3% of children developed myopia over the year. In contrast, only 5.8% of children wearing DSDO lenses and 4.8% of those in the DSDOA group crossed the diagnostic threshold. Similarly, fast myopic progression was seen in 42.7% of children in the control group, but only 15.7% and 9.6% in the DSDO and DSDOA groups, respectively. These differences were statistically significant when compared to control, with P values below .05 across the board.

Yet what stands out just as clearly is what wasn’t found: the addition of 0.01% atropine to the DSDO lenses conferred no statistically significant advantage over the lenses alone. That’s a crucial point, especially given the growing global interest in using low-dose atropine to slow myopia progression. While 0.01% atropine is already widely studied and considered safe for myopia control in children, its preventive use in children who have not yet developed myopia remains less well established.

This study, then, reframes the conversation by emphasizing a non-pharmaceutical option that’s both accessible and seemingly effective. DSDO lenses are engineered to create intentional defocus in peripheral segments of the visual field, a mechanism designed to modulate ocular growth. The hypothesis is that these peripheral defocus zones signal the eye to slow axial elongation, which is a known driver of myopia development.

Measurements of axial length and subfoveal choroidal thickness—secondary outcomes of the trial—were also collected to provide structural context, though the primary results reported focused on refractive outcomes. Further reporting on these secondary endpoints will help clarify whether anatomical changes reinforce the observed visual trends.

For clinicians, the implication is clear but preliminary: DSDO spectacle lenses could become a front-line tool in delaying the onset of myopia in children at risk, potentially sparing them from earlier dependence on corrective lenses and reducing long-term risk of complications such as retinal detachment or glaucoma associated with high myopia.

But the researchers are cautious in their conclusions. As with many short-term trials in pediatric populations, the durability of the effect remains uncertain. Myopia is a chronic, progressive condition, and a one-year delay—while meaningful—does not guarantee long-term prevention. Replication across diverse populations and longer-term follow-up will be key to determining whether DSDO lenses offer a sustainable strategy.

Still, the results speak to a growing shift in the field: a move from reactive treatment toward proactive prevention. As the prevalence of myopia climbs globally, especially in East and Southeast Asia, early interventions like DSDO lenses may represent a new frontier—not just in how we manage myopia, but in how we approach pediatric eye health overall.