Myopia Management and Myopia Progression Assessments

Our Optometrists have a keen interest and expertise in fitting specialist spectacle and contact lenses that slow the progression of short-sightedness in children and young adults.

What is myopia and why does it matter?

Myopia (commonly known as short-sightedness) causes distance objects to appear blurred. It usually occurs when the eye becomes too long to focus properly. Some eye growth is normal during early to mid-childhood. Eye growth in myopic children is often faster and continues for longer than it does in children without myopia.

For many the primary concern about becoming short-sighted is inconvenience. The more short-sighted a person becomes the more essential their glasses or contact lenses become to function normally. Stronger spectacle lenses are also thicker and heavier to wear. More importantly however, is the fact that people with myopia are at dramatically increased risk of certain eye conditions including retinal detachment, cataract, glaucoma and macular degeneration. The more short-sighted a person is, the longer the eye and so the higher the risk of these complications.

Why do children become short-sighted?

Research into myopia has shown that eye growth and therefore myopia progression is influenced by the way light falls onto the peripheral retina. In a normal eye the peripheral light is focused on or near to the retina. In a short-sighted eye light is focused behind the peripheral retina. This peripheral defocus drives eye growth and myopia progression. Normal spectacle and contact lenses do not change the way light hits the peripheral retina and so do nothing to slow progression.

It has also been shown that children who spend more time outside in natural light are less likely to become short-sighted and may also progress less rapidly should they become short-sighted. The mechanism of this ‘protective effect’ is not well understood. There is also a body of evidence that suggests that excessive time spent on near tasks (reading, studying, looking at screens etc) may also increase the risk of myopia. We recommend that children should be encouraged to spend at least 2 hours a day outside and to limit time spent on near tasks.

The risk of a child becoming myopic is also influenced by genetics and increases when their parents are myopic. When neither parent is myopic there is a 22% chance of becoming short-sighted. This increases to 31% when one parent is short-sighted and to 46% when both parents are myopic.

How short-sighted will my child become?

Myopia tends to progress during childhood and into early adulthood. The rate of progression varies between children and is influences by their specific risk factors. The younger a child becomes myopic the more likely they are to develop high myopia. Short-sighted children are encouraged to book a Myopia Progression Assessment with one of our optometrists.

During the Myopia Progression Assessment the optometrist uses the Lenstar Myopia optical biometer to measure axial (eye) length and corneal curvature. The child’s current glasses prescription, age, environmental risk factors, corneal curvature and axial length measurements are fed into the EyeSuite Myopia software to provide expected future eye growth curves and predicted spectacle prescription at age 19. Measuring axial length in children with no glasses prescription and comparing against reference curves can also identify those children highly likely to become myopic in the future. Axial length monitoring is recommended for all myopic children especially those receiving one of the myopia management treatment options.

How can I access a Myopia Progression Assessment?

Our optometrists recommend the Myopia Progression Assessment to all children newly diagnosed with short-sightedness and to those undergoing myopia management treatment. Axial length measurements should be repeated periodically for children undergoing myopia management treatment to monitor progress.

It is normal for young children to have a small long-sighted; this allows normal eye growth to occur throughout childhood without them from becoming short-sighted. Children who lack a longsighted prescription at a young age are also invited to have a Myopia Progression Assessment; this will help identify those children at significant risk of becoming short-sighted and provides opportunity to discuss lifestyle changes that may reduce the risk of developing myopia as much as possible.

Myopia Progression Assessments are available to children that attend our practices for their NHS sight tests and to those that have received a recent sight test from another optical practice. Myopia Progression Assessments can be booked through our reception team, please see our contact us page. Current fees can be found on the fees page of our website.

What can be done to slow myopia progression?

There is currently no cure for short-sightedness. Even laser surgery does not change the length of the eye so does not reduce the risk of conditions associated with myopia.

Fortunately, we now have treatment options to slow the progression of myopia. The myopia management treatment options include the MiYOSMART spectacle lens and two types of contact lenses (ortho-k and dual focus soft contact lenses). These slow the progression of myopia in children compared to normal spectacles or contact lens correction. See below.

Myopic children (and those at risk of developing myopia) should be encouraged to limit the time spent on near tasks and to increase the time spent outdoors in natural light. The optometrist’s provide tailored lifestyle advice based upon the individual's risk factors during the Myopia Progression Assessments.

MiYOSMART spectacle lenses

MiYOSMART is a new, innovative spectacle lens for myopia management developed by Hoya. In a two-year clinical trial, the MiYOSMART lens slowed myopia progression in children by 60%. The MiYOSMART lens features a central optical zone combined with multiple defocus segments evenly spaced across the lens mid-periphery. It is this D.I.M.S. (Defocus Incorporated Multiple Segments) design that changes the way light falls on the peripheral retina, limiting myopia progression, whilst also providing clear vision at all distances.

The MiYOSMART lens also provides UV protection and is impact resistant.

Dual focus soft contact lenses

Dual focus soft contact lenses utilise special optics to influence the way light falls on the peripheral retina whilst giving good vision. These lenses are worn during the day and are made of the same materials used to manufacture other soft contact lenses. We offer three brands of soft, dual focus contact lenses for myopia management, these are MiSight, Naturalvue and Mylo contact lenses. See below.

MiSight 1 Day Contact Lenses
MiSight 1 Day contact lenses were the first daily disposable soft lenses designed specifically to slow myopia progression. Studies investigating the effect of this lens upon myopia progression have monitored young wearers for over 5 years and have shown a 59% reduction in progression. MiSight contact lenses are available up to -10.00DS and are not suitable for those with moderate or high degrees of astigmatism.
Naturalvue Multifocal 1 Day Contact Lenses
Naturalvue Multifocal 1 Day contact lenses utilise a unique, Extended Depth of Focus (EDOF) design to control myopia progression. A 6 year study, published in 2021, has shown that the Naturalvue lens slows progression in 95% of wearers and 78% of those wearers achieved a 70% or better reduction in progression compared to their pre-treatment rates of change. Naturalvue Multifocal 1 Day contact lenses are available up to -12.25D and are suitable for those with astigmatism up to 1.00DC.
Mylo Monthly Contact Lenses
Mylo monthly contact lenses utilise the same design as the Naturalvue Multifocal 1 Day but, as a monthly replacement lens, is available in a wider range of fitting specifications and prescriptions (up to -15.00DS).

Orthokeratology (ortho-K)

Ortho-k contact lenses are worn overnight and gently reshape the front of the eye (the cornea) so, when removed on waking, the user continues to have crisp and clear vision all day. Ortho-K lenses change the way light focuses on the peripheral retina and as a result slow progression of myopia. Studies investigating ortho-K lenses have reported slowed myopia progression of between 40% and 60% (depending on the study) compared to those wearing standard contact lenses or glasses.

Ortho-K lenses are capable of correcting myopia up to -7.00D in the most negative meridian. Astigmatism up to -4.00D can also be corrected.

Find out more

If you would like more information, speak to one of our optometrists. Your Optometrist will advise if your child is suitable for the various treatments during their sight test/eye examination.

See our “Ortho-K contact lenses – what to expect” leaflet for more information about orthokeratology.

The following websites provide useful information about myopia control:

https://www.haag-streit.com/haag-streit-uk/products/haag-streit-diagnostics/biometry/lenstar-myopia/
https://www.eyedreamlenses.com/
https://www.coopervision.co.uk/contact-lenses/misight-1-day/
https://global.vtivision.com/patient/products/
https://markennovy.com/our_products/mylo//

Understanding the numbers

Research into the effectivity of myopia management treatments compares the treatment group to a control group which receive the standard treatment (e.g. standard contact lenses or normal glasses). The average rate of progression within the treatment group is then compared to that of the control group to give the difference in the rate of progression between the two groups. This means that the numbers given are averages rather than the guaranteed result for every child that uses the treatment. No myopia control contact lens has ever been shown to speed up progression of myopia (short-sightedness).

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Myopia Control