Myopia management contact lenses are designed to firstly correct your child’s vision so they can see well and secondly to slow the process of eyeball growth, with the aim of reducing how short sighted they eventually become. The aim of treatment is to slow the rate of decline by around 50%. Myopia management contact lenses cannot be expected to completely halt the progression, nor can it reduce your child’s prescription from the point at which they start with the contact lenses.
There are two contact lens options – either soft daily disposable multi focal contact lenses (MiSight) that are worn during the day or specially designed gas permeable lenses Orthokeratology lenses (OK) which are worn when asleep.
MiSight lenses have two or more powers in them and are thought to slow the progression of myopia in children by focusing light not only at the centre of the retina but across the surrounding parts of the retina at the back of the eye too.
OK lenses are rigid gas permeable contact lenses worn overnight to reduce myopia by temporarily and reversibly reshaping the cornea (front surface of the eye). These contact lenses are taken out in the morning so that the wearer can have clear vision all day without having to wear spectacles or contact lenses and are great for people who swim or have an active lifestyle. These are thought to slow the progression of myopia in the same way as the soft contact lenses. Patients get used to them very quickly and their sleep is rarely affected by them.
In early 2021, the first spectacle lens for myopia management became available in the UK. The Hoya MiyoSmart lens works very similarly to the contact lenses in giving clear vision through the centre of the lens and a variation in the power of the lens away from the centre to create defocus on the peripheral retina helping reduce the eyes desire to grow. The results of a two year study suggest that these spectacles are as effective as the contact lenses in slowing the progression of myopia. Although the initial vision through these spectacles will feel different to previous spectacles your child might have worn this is expected to settle within two weeks.
Atropine is a prescription eye drop used to temporarily open the pupil and limit the ability to focus. If it is used at a very low concentration it does not cause any visual difficulties with focussing but has been found to slow the progression of myopia. It is thought to do this by interaction with some of the receptors in the eye that control eye growth. Atropine is not currently available for this use in the UK however a three-year trial started in 2019 which may lead the way to availability in the future.