Controlling eye growth with corneal reshaping and soft bifocal contact lenses

Abstract

The increasing prevalence of myopia has made it an important health concern worldwide. Because there are no cures for myopia, controlling the progression during childhood has become the first line of defense to guard against the potential side effects, such as an increased risk of glaucoma, retinal detachment, or chorioretinal atrophy. Several methods of myopia control have been investigated, including undercorrection, bifocal/multifocal spectacles, gas permeable contact lenses, atropine, and pirenzepine. However, the most effective methods that deliver few side effects are corneal reshaping and soft bifocal contact lenses. These treatments benefit children significantly, and they also slow myopia progression. This lecture will discuss the relative benefits of contact lens myopia control versus other methods, both in terms of slowed eye growth and vision-specific quality of life. On average, corneal reshaping contact lenses slow myopic eye growth by 42% and soft bifocal contact lenses slow myopic eye growth by 52%. These rates are favorable, compared to undercorrection and gas permeable contact lenses, which have no effect on or may even increase myopic progression. Although pirenzepine slows myopic eye growth by 40%, it is not FDA approved for myopia control due to the potential risks and small benefits. The best myopia control is provided by atropine, about 80%, but practitioners rarely prescribe it for patients due to the cycloplegic and photophobic side effects.