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Two optical treatment modalities can slow pediatric myopia progression without the need for pharmacologic intervention, ie, spectacle lenses incorporating highly aspherical lenslets (HAL) and orthokeratology (ortho-k) contact lenses. Both treatments are based on the same underlying theory that peripheral retinal defocus is a growth signal for axial elongation‚ but the treatments focus on different structures of the visual system, one through a manufactured spectacle lens surface (HAL) and the other through temporary corneal reshaping (ortho-k).

A preclinical study of the effects of aflibercept (Eylea, Regeneron Pharmaceuticals) and faricimab (Vabysmo-svoa, Genentech) showed that the two treatments were equal in their ability to maintain or restore the retinal endothelial barrier function and resultant visual integrity. Investigators attributed this result mainly to inhibiting vascular endothelial growth factor A165 from binding to its receptor.