Ophthalmic lenses can help to control myopia progression
A decade ago, eye care providers used a combination of bifocals and progressive lenses to try to slow myopic disease progression. (See “Understanding Myopia Control,” below.) Over time, under-correction contributed to myopia. Through the last several years, both hard and soft contact lenses have been prescribed to prevent myopic disease progression, with increased public awareness of the myopia epidemic leading to the development of now numerous contact lens options for patients. Additionally, ophthalmic lenses have come back around to help slow myopia progression in those patients who are not candidates for contact lenses.
It is important to have knowledge of the latest optical technology to make patients aware that we are up to date on the most current technologies that may someday be available to them. This creates patient loyalty and word-of-mouth referrals.
Here, I discuss the ophthalmic lenses for myopia control that are not yet available stateside.
UNDERSTANDING MYOPIA CONTROL
Myopia is increasing at an exponential rate. In 2000, 1.4 billion people were myopic, and this number is expected to increase to 4.8 billion people by 2050.3
A child’s risk of myopia increases if even one parent has myopia. It also has been reported that there is a greater than six-fold increased risk of juvenile-onset myopia if both parents are myopic.
High myopia translates to a longer axial length that dramatically increases the risk for vision-threatening conditions, such as retinal detachments, cataracts, myopic degeneration, and glaucoma.
While the true etiology of myopia is not fully understood, myopic progression is thought to be a combination of both genetics and environmental factors. Studies show that wearing refractive correction for myopia can cause overcorrected peripheral vision in children.4 That peripheral overcorrection leads to accelerated growth of the eye and, therefore, increases the axial length.
Most myopia control strategies are centered around the idea of manipulating the light entering the eye, so that the light is focused inward and not behind the eye.
MIYOSMART
This spectacle lens, made by Hoya Vision Care, uses defocus incorporate multiple segments (D.I.M.S.) technology that provides multiple defocus segments centered around a central optical zone for refractive error correction.1
![Image courtesy of Hoya Vision Care.](https://res.cloudinary.com/broadcastmed/image/fetch/q_auto,f_auto/dpr_auto/https://optometricmanagement.com/media/ukglxmlk/om_oct_6001.jpg)
The design allows for clear distance vision, while providing myopic defocus at all distances, the company says. Hoya further says its clinical data on the lens shows it curbs myopia progression in children by 59% and slows axial eye growth by 60%.
This lens is currently available in Canada and Europe.
STELLEST LENS
This ophthalmic lens, from Essilor, uses a constellation of 1,021 invisible lenslets to slow the progression of axial length, according to the company.2 Additionally, Essilor says Stellest can slow myopia by 67%.
![Image courtesy of Essilor.](https://res.cloudinary.com/broadcastmed/image/fetch/q_auto,f_auto/dpr_auto/https://optometricmanagement.com/media/qa0aubaq/om_oct_6002.jpg)
In May of 2021, the FDA gave the Stellest lens the breakthrough device designation. This designation enables timely access to medical devices that offer more effective treatment or diagnosis of life-threatening or irreversibly debilitating diseases or conditions by speeding up their development, assessment, and review. The lens is currently available for purchase in Canada and Asia. OM
References
- MiyoSmart. https://www.hoyavision.com/en-ca/discover-products/for-spectacle-wearers/special-lenses/myopia-management/. Accessed Aug. 16, 2022.
- Stellest. https://www.essilor.ca/en/products/stellest. Accessed Aug.16, 2022.
- Holden, BA, Fricke TR, Wilson DA, Wong TY, Naduvilath TJ, Resnikoff S. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036-42. doi: 10.1016/j.ophtha.2016.01.006.
- Logan NS, Wolffsohn JS. Role of un-correction, under-correction and over-correction of myopia as a strategy for slowing myopic progression. Clin Exp Optom. 2020;103(2):133-137. doi: 10.1111/cxo.12978.