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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).