Clinical Scorecard: Myopia: Spectacle Lens Use

At a Glance

Key Highlights

• Novel spectacle lenses (DIMS, HAL, CARE, DOT) show promise for myopia control but are not yet FDA-approved in the U.S.
• Faster progressing myopes (> -0.50D/6 months) and younger children benefit most from optical interventions.
• Optimal efficacy requires consistent daily wear of 12 to 14 hours and proper frame fitting to ensure retinal myopia control signals.

Guideline-Based Recommendations

Diagnosis

• Identify children with fast myopia progression (> -0.50D per 6 months).
• Assess age, with emphasis on younger children (6 to 8 years) for intervention.

Management

• Consider novel spectacle lenses as a non-invasive myopia control option once available.
• Potentially combine spectacle lenses with dual/multifocus soft contact lenses, orthokeratology, or low-dose atropine (0.01% to 0.05%) for synergistic effects.
• Encourage reduced screen time and increased outdoor activity to complement lens efficacy.

Monitoring & Follow-up

• Monitor compliance with recommended daily wear time (12-14 hours).
• Watch for side effects such as ghosting, glare, or reduced contrast sensitivity that may affect adherence.
• Evaluate frame fit to ensure adequate peripheral defocus exposure.

Risks

• Possible mild visual disturbances (ghosting, glare, contrast sensitivity reduction) from lenslet structures.
• Unknown long-term safety and effects on sports performance and motion perception require further research.

Patient & Prescribing Data

Children with progressing myopia, particularly younger children and those with rapid progression

Greater benefit observed in fast progressors and younger children; real-world compliance and wear time critically impact effectiveness.

Clinical Best Practices

• Ensure proper frame fitting to maximize peripheral defocus effect.
• Educate patients and families on importance of consistent daily wear time (12-14 hours).
• Advise lifestyle modifications including increased outdoor time and reduced screen exposure.
• Monitor for and address any visual side effects promptly to maintain compliance.
• Stay updated on emerging research regarding long-term safety and functional impacts before widespread prescribing.

References

• Yuval C et al. Evaluating the Effect of a Myopia Control Spectacle Lens Among Children in Israel: 12-Month Results
• Yang Y et al. Synergistic efficacy of orthokeratology and 0.01% atropine in controlling pediatric myopia progression