Optical Interventions for Myopia Control

Myopia is a common eye problem that is becoming more prevalent worldwide, particularly in East Asia. The cost of long-term care for myopia-related eye diseases significantly impacts the respective economies and places a great burden on the public health services. There is no doubt that myopia is a major East Asian public health concern and a significant concern globally, and effective control of myopia would help to alleviate the costs that are related to this problem. Currently, there are many types of optical interventions involving the use of spectacle lenses or contact lenses to slow down myopia progression in children. However, none of these myopia control methods have been proven to stop the development or progression of myopia completely and each method has their own limitations. Orthokeratology, soft bifocal contact lenses, prismatic bifocals, and myopic defocus incorporated spectacle lenses have all been shown to have clinically meaningful reductions in myopia progression ranging from 45% to 60%. Although pharmaceutical agents such as atropine have relatively better myopia control effects than optical methods, the associated side effects and uncertainty in the safety of long-term atropine use may hinder its widespread clinical application. Optical interventions are non-invasive and have become more popular compared to pharmaceutical treatments. This chapter provides an overview of the optical interventions for slowing myopia progression and their effectiveness in myopia control. Other myopia control methods will also be discussed briefly

MiSight Assessment Study Spain: Adverse Events, Tear Film Osmolarity, and Discontinuations

OBJECTIVES: To assess the relative clinical success of MiSight contact lenses (CLs) (study group) and distance single-vision (SV) spectacles (control group) in children in terms of adverse events (AEs), discontinuations, and tear film osmolarity over a 2-year period. METHODS: Seventy-four subjects aged 8 to 12 with myopia of -0.75 to -4.00 D and astigmatism less than 1.00 D were randomly assigned to MiSight CLs or SV groups. Subjects were monitored at 6-month intervals over the course of 24 months and advised to report to the clinic immediately should AEs occur. Adverse events were categorized as serious, significant, and nonsignificant. Discontinuation was defined as cessation of participation in the study. RESULTS: Forty-four children were corrected with MiSight CLs and 33 with SV spectacles. No serious or significant AEs were found in any of the participants in either group. Two nonsignificant AEs were found in MiSight group, corresponding to a foreign body on the cornea in two children. There were five discontinuations in MiSight group, one because of change of residence and four because of unwillingness to use the CL. There were no discontinuations in SV group. Neither group showed any significant changes in osmolarity data over the 24 months of follow-up (P≥0.05). CONCLUSIONS: No clinically serious events were observed in either group. Our results show that correct use of MiSight CLs is a safe option for myopia correction. The success of this treatment requires a combination of proper lens fitting, good adherence to routine follow-ups, and timely treatment of complications.Depto. de Optometría y VisiónFac. de Óptica y OptometríaTRUEpu

Light disturbance analysis in the controlled randomized clinical trial MiSight assessment study Spain (MASS)

Purpose: To evaluate the perception of light disturbances (LD) in children wearing Dual Focus (DF) MiSight (R) contact lenses (CLs) for myopia control compared with children wearing single vision spectacles (SV).Methods: This was a randomized, controlled clinical trial involving subjects aged 8-12 with myopia of -0.75 to -4.00D and astigmatism 0.05). However, monocular BFCIrreg. as well as monocular and binocular BFCIrreg.SD showed a significant decrease at 24 month visit compared with 12 month visit.Conclusions: DF lenses increase the monocular light disturbance perception compared with a single vision spectacle correction. However, this effect decreased over the follow-up time and presented a significant binocular attenuation effect.This study has been funded in part by projects PTDC/SAU-BEB/098392/2008 and PTDC/SAU-BEB/098391/2008, which in turn have been funded by the Portuguese Fundação para a Ciência e Tecnologia through the European Social Fund and by FEDER through the COMPETE Program and by the Portuguese Foundation for Science and Technology (FCT) in the framework of the Strategic Project UID/FIS/04650/2013. JMG-M has proprietary interests in the experimental device used to measure light disturbance.CooperVision S.L. Spain also provided financial support. CooperVision S.L. provided the study contact lenses and the funding to carry out the clinical trial. The sponsor had no role in designing or conducting this research