- Design
- Single-centre randomised trial, 6 months
- Population
- 120 myopic children aged 6–12, Guangzhou
- Primary outcome
- Axial length change
- Effect
- 0.15 vs 0.25 mm; difference 0.11 mm (95% CI 0.07–0.15)
This single-centre randomised trial in Guangzhou assigned 120 myopic children aged 6 to 12 to a head-mounted virtual-reality defocus training device for 15 minutes a day at home plus single-vision spectacles, or spectacles alone.
At six months, axial length grew by 0.15 mm with training against 0.25 mm without (difference 0.11 mm, 95% CI 0.07 to 0.15), and refraction moved by −0.23 D against −0.46 D. No training-related adverse events were reported. Adherence was high, which may be harder to sustain outside a trial.
The effect is real but small and short, and the authors say its clinical relevance cannot yet be judged. It joins a crowded field: low-dose atropine, defocus spectacles and contact lenses, and time outdoors all have longer and larger evidence bases.
- Do not use VR defocus training in place of proven myopia control options.
- Continue to advise at least two hours of outdoor time daily for children at risk of myopia.
- Low-dose atropine and defocus spectacles or lenses have stronger evidence.
- Ask families about screen-based devices marketed for myopia, and explain what evidence exists.
Why it matters
Families are being offered home devices for myopia, and this is the first trial evidence for one approach.
Don't overread it
Six months, one centre, a surrogate outcome — it does not show lasting myopia control.
The statistics, in plain English
A 0.11 mm difference in axial length over six months is statistically clear but small. Whether it adds up over years, or fades, is unknown. A single-centre trial in one city may not reflect use in other settings.
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