Common Interventions

Intervention Positives Concerns

Drugs: Atropine

  • Slows refractive error and axial length change2

  • Easy delivery method via eye drops2,6

  • Generally well-tolerated by children²

  • Ocular & systemic side effects that may cause rebound²

  • Long-term effects on a large population of children are unknown2,6

  • Potential for adverse events and side effects due to higher doses, particularly in high myopes2,6

  • Available only from compound pharmacies which means higher costs for patients and less availability

Rigid contact lens: Ortho-K

  • Reshapes the cornea in order to reduce the optical factors that are thought to cause an increase in myopia2

  • Wear at night only with no need for glasses during the day2

  • Expensive and complex1

  • Discomfort for patient1,2

  • Risks of infection/inflammation due to night time wear2,3,5

  • Rebound effect if not worn consistently7,8

  • Potential for adverse events1,7

Peripheral defocus modifying contact lenses: Soft contact lens (SCL’s)

  • Considerable use by eye care practitioners (51%) of those actively managing myopia4

  • Comfortable for patients1

  • Easy to fit for most doctors (mainstream modality)

  • Potential for adverse events5

Progressive Addition Lenses or Bifocal Spectacles

  • Can be used at any age

  • Easy to prescribe, easy for kids to wear

  • Some studies suggest better control with fast progressors, esophoria at near, high lags, and larger plus zones

  • Most studies show majority of effect in first year

  • Effectiveness ranges from a low of 20% in large studies with general populations to as high as 55% with reactive subgroups and large segment lenses

  1. Huang J, et al. (2016). Efficacy Comparison of 16 Interventions for Myopia Control in Children. Ophthalmology. 123(4): 697-708.
  2. Cooper, J., Schulman, E., Jamal, N. (2012). Current Status on the Development and Treatment of Myopia. Optometry. 83(5):179-199.
  3. Cope j., et al. (2016). Acanthamoeba Keratitis among Rigid Gas Permeable Contact Lens Wearers in the United States, 2005 through 2011. Ophthalmology. 123(7): 1435-1441.
  4. Nichols, J. (2017). Contact Lenses 2016. Contact Lens Spectrum. 32(January 2017): 22-29.
  5. Chalmers, R. L., Keay, L., McNally, J., & Kern, J. (2012). Multicenter Case-Control Study of the Role of Lens Materials and Care Products on the Development of Corneal Infiltrates. Optometry and Vision Science. 89(3): 316-325.
  6. Tan, D., Tay, S. A., Loh, K., & Chia, A. (2016). Topical Atropine in the Control of Myopia.  Asia-Pacific Journal of Ophthalmology. 5(6): 424-428.
  7. Liu, Y. M., & Xie, P. (2016). The Safety of Orthokeratology—A Systematic Review. Eye & Contact Lens: Science & Clinical Practice. 42(1): 35-42.
  8. Gifford, P., & Gifford, K. L. (2016). The Future of Myopia Control Contact Lenses. Optometry and Vision Science. 93(4): 336-343.