Last week, we reviewed atropine drop therapy as an option for myopia management in children. In this week’s tip, we’ll evaluate MiSight soft contact lenses by CooperVision and discuss orthokeratology (ortho-k).
MiSight
MiSight lenses were approved by the FDA in November 2019 as the first soft contact lens for myopia control in children 8 to 12 years old. Their study showed a 59% reduction in refractive progression and a 52% reduction in average axial elongation over a 3-year period vs single vision contact lenses.
The lenses are designed with ActivControl technology, which features a ring pattern that alternates between the patient’s corrective zone to fully address the refractive error and the treatment zone. The treatment zone creates myopic defocus to place the image in front of the retina instead of behind it, thereby slowing axial lengthening. This structure allows MiSight to correct myopia in all gazes.
MiSight lenses are available in 90-day packs as daily disposables and they correct refractive errors of -0.50 to -7.00 with 0.50 steps over -6.00. There is currently no toric option available. Practitioners who desire to fit MiSight should reach out to their CooperVision representative for the fit set and short training program.
Orthokeratology
Ortho-k is a form of corneal reshaping technology in which rigid gas-permeable lenses are worn overnight and removed during the day. They function by gently pressing on the cornea to reduce refractive error, the effects of which are temporary and reversible.
In myopia control specifically, ortho-k lenses flatten the central cornea to correct the patient’s refractive error while creating peripheral steepening that leads to myopic defocus. This myopic defocus slows axial elongation and refractive progression. Because the lenses are worn overnight, ortho-k can be a viable option for children who need assistance with insertion and removal at home.
There are currently many companies that offer ortho-k lenses, including Paragon Vision Sciences, Euclid, and Johnson & Johnson. The specific parameters of each lens vary, though most can correct between 5 D and 6 D of myopia and moderate amounts of astigmatism (1.50 D to 2.50 D depending on lens brand). When selecting a vendor partner, considerations should include pricing, warranty and remake policies, and turnaround time, as well as certification requirements.
Join me next week for the final part of this series in which we will explore the newest technology in myopia management: Stellest spectacle lenses.
