Slowing the Progression of Myopia in Children with the MiSight Contact Lens: A Narrative Review of the Evidence

Abstract

Myopia has become a major public health problem in the world due to the increase in its prevalence in the past few decades and due to sight-threatening pathologies associated with high myopia such as cataracts, glaucoma and especially myopic maculopathy. This article is a narrative review of the evidence that currently exists on a contact lenses (CLs) specifically designed to correct myopia and to slow its progression. To contextualise the topic we discuss the different classifications and definitions that have been used for myopia, the current burden of being myopic, and current treatment options to prevent and control its progression. There is evidence that exposure to sunlight reduces the risk of myopia onset and pharmacological treatment with atropine has been shown to be the most effective therapy for controlling its progression, followed by optical interventions such as CL fitting (orthokeratology or CLs specific for myopia control) designed to decrease retinal peripheral hyperopic defocus that seems to be the theory that suggests that axial elongation is driven by this defocus and explains why the eye continues to grow abnormally after emmetropisation and generates myopia. We will especially focus on MiSight CLs. MiSight is a daily replacement soft contact lens that has been clinically proven and approved by the US Food and Drug Administration (FDA) to control the progression of myopia in children. We analyse the optical design of MiSight CLs, as well as the results of the different efficacy and safety studies that led to the approval of the lens by the FDA. We also expose current knowledge gaps, limitations and future directions.

The effect of 0.01% atropine on ocular axial elongation for myopia children: a meta-analysis

“…The continuous progression of myopia will have a series negative effects [24]. As the loss of vision caused by high myopia is irreversible, myopia have become one of the main causes of untreated vision loss in the world [25]. The axis is an important monitoring index of myopia [21].…”

Lab‐on‐a‐Contact Lens: Recent Advances and Future Opportunities in Diagnostics and Therapeutics

“…MiSight's daily lens product was FDA-approved in 2019 for SCLs that slow myopia in children while correcting vision using a concentric ring design. [376,377] According to the NIH, the clinical approval period for this SCL was six years. Another SCL device on the market is the SENSIMED Triggerfish®, which performs intraocular pressure sensing and received FDA approval in 2017.…”

Digital Therapeutics: Exploring the Possibilities of Digital Intervention for Myopia

“…MiSight Contact Lens (CooperVision) is the first lens approved by the U.S. Food and Drug Administration (FDA) to control the progression of myopia in children ( 21 ). Randomized clinical trial (RCT) results showed that MiSight is safe and effective in slowing the progression of myopia over 2 ( 21 ) to 3 years ( 22 ).…”

“…MiSight Contact Lens (CooperVision) is the first lens approved by the U.S. Food and Drug Administration (FDA) to control the progression of myopia in children ( 21 ). Randomized clinical trial (RCT) results showed that MiSight is safe and effective in slowing the progression of myopia over 2 ( 21 ) to 3 years ( 22 ). Orthokeratology (Ortho-K), approved by the FDA in May of 2021, are a series of hard, hydrophilic, gas-permeable contact lenses designed to gradually flatten the central cornea.…”