Premyopia Management in China: From Biometrics to Clinical Management

ABSTRACT: Myopia represents a major global public health challenge, with prevalence rising particularly among children in China, imposing a substantial socioeconomic burden. Premyopia, defined by the International Myopia Institute as spherical equivalent refraction ≤ +0.75 D and >-0.50 D, represents a pivotal intervention window. This review summarizes evidence on premyopia management in China, including (1) biometric predictors such as hyperopic reserve, axial length (AL), and AL to curvature radius ratio (AL/CR ratio); (2) interventions including outdoor time, optical interventions, low-concentration atropine (LCA), combination therapy of optical intervention and LCA, and repeated low-level red-light therapy; and (3) a risk-stratified clinical management framework integrating biometric parameters for individual interventions. Despite promising results, challenges remain with compliance, safety, and regulatory approval for some treatments. A structured, evidence-based approach combining biometric monitoring and tiered interventions is essential to curb the myopia epidemic in China.