Abstract: Axial length (AL) is a crucial parameter for assessing eye development in children and adolescents,  as its growth is closely associated with the progression of myopia. In this age group,  AL exhibits a consistent growth trend with age,  making dynamic monitoring of its changes particularly significant. However,  several factors—including genetics,  baseline refractive status,  pathological myopia,  and anthropometric measurements—can influence AL changes. The presence of individual variability adds complexity to predicting refractive properties based on ocular axis length alone. Despite these challenges,  AL remains a vital indicator for forecasting the onset and progression of myopia. Research indicates that when AL is considered alongside other parameters such as corneal curvature radius,  corneal refractive power,  and uncorrected distant visual acuity,  it holds significant clinical value for myopia diagnosis. Interventions such as orthokeratology lenses,  low-concentration atropine,  low-energy red light therapy,  and increased outdoor activity have all been associated with delayed axial growth. It is essential to consider the specific circumstances of each individual patient when applying these treatments. Currently,  AL measurement primarily depends on optical biometry; however,  attention must be given to patient cooperation and the selection of appropriate equipment.  (Int Rev Ophthalmol, 2025, 49:  56-61)

Key words: axial length, myopia, prevention and control