Developed countries in East and Southeast Asia are now faced with a high prevalence of high myopia in young adults, and this trend is emerging in other parts of the world. This is likely to lead to increased levels of pathological myopia. Fortunately, several school-based clinical trials have demonstrated that interventions based on increasing the amount of time that children spend outdoors can significantly slow the onset of myopia. I argue that it is time to implement mandatory programs of this kind in school systems, within a framework of regular monitoring of visual acuity, so that those children who become myopic are referred for clinical treatment as soon as possible to slow progression of their myopia towards high and potentially pathological myopia.