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This single-arm, prospective pilot study included 23 children with premyopia (mean age 5.4\u00a0years) who were identified from a community screening program in Taiwan. A stepwise DIMS spectacle regimen was implemented: part-time wear during near work before school entry followed by full-time wear after starting school. The primary outcome was the change in the spherical equivalent (SE) and the secondary outcome was axial length (AXL) elongation after 1\u00a0year. The mean SE change after 1\u00a0year was\u2009+\u20090.08 dioptres (0.35), whereas the mean AXL elongation was\u2009+\u20090.22\u00a0mm (0.12). None of the participants developed myopia. During the preschool stage, 91.3% had good adherence to part-time wear. However, adherence dropped to 52.2% during full-time wear after school entry. The majority of the participants (73.9%) had physiological AXL growth. Visual symptoms were minimal and the caregivers reported high acceptance. Stepwise use of the DIMS plano spectacles was well-tolerated and associated with stable refractive outcomes and physiological AXL elongation among preschoolers with premyopia. Larger, controlled studies in future are warranted to validate these findings and optimise intervention strategies.<\/jats:p>","DOI":"10.1038\/s41598-026-52489-5","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T10:15:16Z","timestamp":1778667316000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["One year results of a pilot study on stepwise defocus incorporated multiple segment spectacle wear for myopia prevention in preschool children with premyopia"],"prefix":"10.1038","volume":"16","author":[{"given":"Hsin-Yu","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Der-Chong","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiao-Yu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Chieh","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Wei","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Wei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mong-Ping","family":"Shyong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Hwa","family":"Chiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu-Tang","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Lin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nai-Wei","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"key":"52489_CR1","doi-asserted-by":"publisher","first-page":"1115","DOI":"10.1001\/jamaophthalmol.2021.3563","volume":"139","author":"Y Hu","year":"2021","unstructured":"Hu, Y. et al. Rates of myopia development in young Chinese schoolchildren during the outbreak of COVID-19. JAMA Ophthalmol. 139, 1115\u20131121. https:\/\/doi.org\/10.1001\/jamaophthalmol.2021.3563 (2021).","journal-title":"JAMA Ophthalmol."},{"key":"52489_CR2","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.18-25957","volume":"60","author":"DI Flitcroft","year":"2019","unstructured":"Flitcroft, D. I. et al. IMI \u2013 defining and classifying myopia: a proposed set of standards for clinical and epidemiologic studies. Invest. Ophthalmol. Vis. Sci. 60, M20-M30. https:\/\/doi.org\/10.1167\/iovs.18-25957 (2019).","journal-title":"Invest. Ophthalmol. Vis. Sci."},{"key":"52489_CR3","doi-asserted-by":"publisher","first-page":"M1","DOI":"10.1167\/iovs.18-25980","volume":"60","author":"JS Wolffsohn","year":"2019","unstructured":"Wolffsohn, J. S. et al. IMI - Myopia control reports overview and introduction. Invest. Ophthalmol. Vis. 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Written informed consent was obtained from the participating children and their parents or guardians. This study adhered to the tenets of the Declaration of Helsinki of 1964 and its later amendments.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}],"article-number":"21895"}}