Myopia Control Options
The world’s best researchers in the myopia control field have conducted extensive studies into how we can slow down or stop the progression of myopia.
There are four treatment options, each with varying maximum degrees of myopia control.
Ortho-K contacts
Ortho K Vision Correction involves wearing a custom-designed contact lens retainer overnight which reshapes the surface of the eye, giving clear vision the next day without the retainers.
As well as being convenient, the treatment actually significantly slows and, in many cases, stops myopia progression. Research shows up to 100% slowing of myopia progression with Ortho-K retainer wear depending on the study and how it was performed.
The newest Ortho-K retainer designs that are designed for myopia control are FDA (U.S. Food & Drug Administration) approved and show an excellent myopia control effect that is superior to non-customised Ortho-K retainers. The results from Visique, and from other myopia control practices in Australasia, using these cutting-edge designs, show complete halting of myopia progression in many children and teenagers. The experience within our practice using the new generation designs has been a complete halt of myopia progression in the majority of our patients.
Ortho K is well established as the most effective and reliable treatment for myopia control, with a proven history of safe use in children.
Atropine drops
Atropine eye drops have been used for many years to try and control the progression of myopia. The higher concentrations used were good at slowing down change in myopia but they had issues with side effects. We now have clear evidence from large research studies showing that low concentration Atropine eye drops also reduce the progression of myopia and have a very low incidence of side effects.
Initially there were studies such as the ATOM2 study in 2015 that appeared to show 0.01% concentration Atropine drops were effective for myopia control. Further analysis in 2020 went on to show that 0.01% concentration Atropine drops in fact did not slow myopia progression at all. Further, they found the use of 0.01% Atropine drops “unfortunate and concerning” as it “would inevitably delay implementation of an effective dose”. In line with the latest research, at Visique we use the slightly higher 0.025% and 0.05% concentration Atropine Myopia Control eye drops for this method of myopia control.
At this time we don’t have conclusive evidence about how much low dose Atropine eye drops slow myopia progression long term, or how effective it is over the age of 12, but based on the LAMP research the myopia control effect for age 12 years and under is up to 51% when using 0.025% and 0.05% concentration Myopia Control eye drops.
Remember glasses or contact lenses still need to be worn during the day if using Atropine drops.
Multifocal Contact Lenses
Multifocal Contact Lenses attempt to mimic the altered image shape on the retina that Ortho K achieves, which is the mechanism that makes Ortho K the most effective form of myopia control.
Unfortunately, there is a reduced ability to design and manufacture the degree of optical change required to copy the successful effect in Ortho K retainers. This means Soft Multifocal Contact Lenses don’t have the ability at this time to recreate the Ortho K effect to the degree required to have a similar myopia control effect, even in lower amounts of myopia. The best quality evidence is a recent three year trial of Misight 1 Day Contact Lenses that shows up to 49% slowing of myopia progression in children age 6 to 10 and up to 45% slowing in those age 11 to 15, all with low degrees of myopia. So in these circumstances multifocal contact lenses are a treatment option. There has been no recognised research published to show how effective Soft Multifocal Contact Lenses are for controlling progression in higher amounts of myopia.
In summary, Soft Multifocal Contact Lenses will provide a degree of myopia control in lower amounts of myopia in younger children, but if you’re not suitable for Ortho K and still want your child to be independent of glasses while still seeing well for sport and other activities, then the latest information we are getting is it is best to use myopia control eye-drops in combination with multifocal daily disposable contact lenses to usefully reduce the progression of myopia.
MiyoSmart Glasses
Progressive and bifocal glasses have been used for several decades in an attempt to control myopia progression by reducing the amount of effort required for reading, computer work and other near tasks. As a result, there is a large body of research that now shows this form of intervention does not work.
Several scientific reviews of the well-performed studies have clearly shown progressive or bifocal glasses have no more beneficial effect than normal single vision glasses and contact lenses in that they do not slow the progression of myopia.
Other types of myopia control glasses have been designed in recent years that have attempted to mimic some of the altered image shape on the retina that Ortho K achieves. The latest lens called MiyoSmart is an innovative spectacle lens for myopia control developed by Hoya. Based on a two-year clinical trial results, MiyoSmart is proven to curb myopia progression in children up to 59% with its award-winning D.I.M.S. (Defocus Incorporated Multiple Segments) technology.