Strategies to Regulate Myopia Progression With Contact Lenses

Abstract

CLs were reported to be well accepted, consistent, and safe methods to address myopia regulation in children. Corneal refractive therapy (orthokeratology) is so far the method with the largest demonstrated efficacy in myopia regulation across different ethnic groups. However, factors such as patient convenience, the degree of initial myopia, and non-CL treatments may also be considered. The combination of different strategies (i.e., central defocus, peripheral defocus, spectral filters, pharmaceutical delivery, and active lens-borne illumination) in a single device will present further testable hypotheses exploring how different mechanisms can reinforce or compete with each other to improve or reduce myopia regulation with CLs.

Effect of Pupil Size on Wavefront Refraction during Orthokeratology

“…Over the last decade, systematic research reports, including randomized and controlled clinical trials, confirmed that OK provides a 40% to 60% eye growth regulation effect when compared with single vision spectacles or contact lenses 2 Despite this consolidated evidence, the limited effect (about 50%) raises concern about the prescription of OK as a first option to effectively control myopia progression.…”

The Current Management Strategies for Myopia Control in Children: Mini Review

“…Similarly, orthokeratology lenses, which are worn merely overnight flatten central cornea and reduce relative peripheral hyperopia (creating myopic defocus in the peripheral retina) that acts as a putative signal to slow the axial elongation and myopic progression [4,5,11]. However, the increasing risks of infective keratitis, the cost, and the requirement of ability to fit these lenses are the main restrictions for widespread use of these optical strategies [4,5,10,11].…”

“…Peripheral defocus modifying bifocal contact lenses with a center distance-periphery reading design, which are worn during the day, alter myopia progression by forming myopic defocus in the peripheral retina that acts as a putative stimulus to slow the axial elongation [4,5,10]. Similarly, orthokeratology lenses, which are worn merely overnight flatten central cornea and reduce relative peripheral hyperopia (creating myopic defocus in the peripheral retina) that acts as a putative signal to slow the axial elongation and myopic progression [4,5,11]. However, the increasing risks of infective keratitis, the cost, and the requirement of ability to fit these lenses are the main restrictions for widespread use of these optical strategies [4,5,10,11].…”

“…In terms of optical strategies, peripheral defocus modifying bifocal contact lenses and orthokeratology have been shown to be moderetly effective management options in myopia control [4,5]. Peripheral defocus modifying bifocal contact lenses with a center distance-periphery reading design, which are worn during the day, alter myopia progression by forming myopic defocus in the peripheral retina that acts as a putative stimulus to slow the axial elongation [4,5,10].…”

“…The non-accommodative mechanisms such as creating a myopic shift in the peripheral retina and altering corneal shape by optical interventions [3][4][5], and scleral collagen enhancement by pharmacological agents [3][4][5][6] have gained popularity in myopia control, and significant beneficial outcomes have been reported by many reserachers. This mini-review aimed specifically at investigating the comparative effectiveness of different interventions systematicaly and summarizing data on the myopia control in children from recent studies.…”