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Myopia is becoming increasingly common in young generations all over the world, and it is predicted to become the most common cause of blindness and visual impairment in later life in the near future. Because myopia can cause serious complications and vision loss, it is critical to create and prescribe effective myopia treatment solutions that can help prevent or delay the onset and progression of myopia. The scientific understanding of myopia's causes, genetic background, environmental conditions, and various management techniques, including therapies to prevent or postpone its development and slow its progression, is rapidly expanding. However, some significant information gaps exist on this subject, making it difficult to develop an effective intervention plan. As with the creation of this present algorithm, a compromise is to work on best practices and reach consensus among a wide number of specialists. The quick rise in information regarding myopia management may be difficult for the busy eye care provider, but it necessitates a continuing need to evaluate new research and implement it into daily practice. To assist eye care providers in developing these strategies, an algorithm has been proposed that covers all aspects of myopia mitigation and management. The algorithm aims to provide practical assistance in choosing and developing an effective myopia management strategy tailored to the individual child. It incorporates the latest research findings and covers a wide range of modalities, from primary, secondary, and tertiary myopia prevention to interventions that reduce the progression of myopia., Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: JBJ discloses European patent EP 3 271 392, JP 2021-119187, and US 2021 0340237 A1: „Agents for use in the therapeutic or prophylactic treatment of myopia or hyperopia”; AG discloses grants from Alcon, Bausch&Lomb, Zeiss, Teleon, J&J, CooperVision, Hoya, Essilor, Thea, Polpharma, Viatris, consultation: Polpharma, Eyerising, lectures: Thea, Polpharma, Viatris, member of Advisory Boards: Nevakar, GoCheckKids and Thea; JAG discloses editorial board memberships: IOVS, TVST, OPO, grants panel: Fight for Sight UK, consultant for several companies, however the consultancy fee is paid directly by the company to an eye research charity chosen by the company; RCB discloses editorial board memberships: Investigative Ophthalmology and Visual Science (IOVS), Current Eye Research, Scandinavian Journal of Optometry and Visual Science (SJOVS). JRP discloses consultant: Essilor, Hoya, Sightglass, Vyluma, Government funding by ZonMw; JSW discloses consultant: Alcon, Allergan, AOS, Bausch & Lomb, CooperVision, CSIDryEye, DopaVision, M2C Pharmaceuticals, Medmont, Novartis, NuVision, Santen, Scope Ophthalmics, SightGlass, Théa, shares in AstonVision Sciences, Eyoto, Wolffsohn Research Limited, and funding by Alcon, Allergan, Johnson & Johnson Vision, Rayner, M2C Pharmaceuticals, Novartis, NuVision, Scope Ophthalmics, SightGlass, Théa, Topcon, The Eye Doctor; SW is employee of Carl Zeiss Vision International GmbH; SR discloses consultant: BHVI (C), Thea (C); DIF discloses trial support from CooperVision, Topcon and Vyluma Inc., consultant: Coopervision, Thea, Vyluma, EssilorLuxottica, Sightglass, Johnson and Johnson, and commercial interest in Ocumetra Ltd.KJS is in receipt of research funding from Hoya Vision and Vyluma Inc; SJM Is in receipt of research funding from Hoya Vision; HK is consultant for Hoya and Haag-Streit. The other authors declared no potential conflicts of interest with respect to the authorship, and/or publication of this article.

Purpose: To battle the spreading of the COVID-19 virus, nationwide lockdowns were implemented during 2020 and 2021. Reports from China revealed that their strict home confinements led to an increase in myopia incidence. The Netherlands implemented a more lenient lockdown, which allowed children to go outside. We evaluated the association between COVID-19 restrictions, myopia risk behaviour and myopia progression in Dutch teenagers., Method: A total of 1101 participants (mean age 16.3 ± 3.65 yrs) completed questionnaires about their activities before, during and after lockdown (March-October 2020). We used a repeated-measures ANOVA to compare time use between these time periods. Ocular measurements were acquired before the COVID-19 pandemic when participants were 13 years old; only 242 participants had ocular measurements at 18 years of age at the time of this analysis. Linear regression analyses were used to evaluate the association between lifestyle factors and myopia progression., Results: Children were on average 16.2 (1.03) years of age during lockdown. Total nearwork increased from 8.11 h/day to 11.79 h/day, and remained higher after lockdown at 9.46 h/day (p < 0.001). Non-educational nearwork increased by 2.22 h/day (+49%) during lockdown and was associated with faster axial length progression (B 0.002 mm/h/year; SE 0.001 p = 0.03). Before and during lockdown, the mean time spent outdoors was similar (1.78 h/day and 1.80 h/day, respectively). After lockdown, time spent outdoors decreased to 1.56 h/day (p < 0.001)., Conclusion: The Dutch lockdown significantly increased digitised nearwork in adolescents but did not affect outdoor exposure. The changes in time spent performing nearwork remained after the lockdown measures had ended. We expect that the COVID-19 pandemic may lead to an increase in myopia prevalence and progression in European children., (© 2023 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.)