Different designs of soft myopia control contact lenses have different impacts on the accommodation response, sitting alongside previous research which relates this to efficacy. The measurement technique used for accommodation also influences the outcomes.
Atropine 0.01% combined with orthokeratology slows axial elongation to less than 0.1mm/year over two years in Chinese children aged 6-11 years. This is the equal-longest study on this topic and first to measure potential mechanisms of pupil size and choroidal thickness. The largest effect of the combination occurred in the first 6 months.
In young adult myopes, Biofinity centre-distance +2.50 Add and NaturalVue multifocal contact lenses both showed reduced visual acuity in lower lighting and low contrast conditions, and especially with a glare source, compared to single vision. Reading rate under normal lighting was also reduced by 4-8%. The multifocal designs performed similarly, although Biofinity required more over-refraction for best distance acuity.
Estimates on the lifetime cost of myopia management options have shown that although the financial cost is higher in childhood, the cost of staying with traditional non-treatment single vision options is higher over a lifetime.
In this complex case of an 8-year-old child with very high myopia, management is discussed in view of specific recommendations from the International Myopia Institute Pathologic Myopia, Clinical Management Guidelines and Prevention of Myopia and its Progression Reports.
In myopic children, interventions to slow progression are warranted to prevent the development of high myopia and subsequent pathology and also to reduce the economic burden caused by uncorrected and pathologic myopia. This IMI Report describes the latest advice on preventing the development and progression of myopia – read the summary here.
This case is highlights that myopia management decision making includes much more than a child’s refraction. Learn how Keyur Patel involved the parent in the conversation and decision making, to determine the starting myopia management option for now, as well as considering the future.
Parents can be conservative about childhood contact lens wear, especially if they have no experience of myopia themselves. Read how Bhavin Shah successfully guided parents into embracing MiSight 1 day for their eight-year-old daughter, as her first myopia management strategy.
This study showed that aspheric multifocal soft contact lenses (Biofinity +2.50D and NaturalVue) reduce accommodative response and increase exophoria, while MiSight concentric dual-focus minimally impacts binocular vision function compared to single vision contact lenses. All myopia control contact lenses increased divergence range slightly but did not impact convergence.
The MiSight 1 day clinical trial is the longest in soft lens myopia control, showing efficacy in children and teens in up to 6 years of wear. The first three years showed a 50-60% axial length and refractive efficacy. In the second three years, all control group children were switched to MiSight and showed axial growth similar to children under continued treatment, indicating benefits for commencing wear in children and teens alike.
