Sandi Charlesworth reports on the MiYOSMART event which was chaired by Andy Sanders, the Professional Services Director for Hoya Lens UK. There were lectures from Professor Bruce Evans (speaking as a clinician treating myopia) and Professor Carly Lam (whose research and design led to MiYOSMART) followed by a Round Table discussion of academics and ECPs working in this area. Research papers show that slowing myopia by 1D reduces the likelihood of developing conditions such as myopic maculopathy by 40% in later life. Similar reductions apply to retinal detachments and glaucoma. As GOC standards state that we must assist patients (and parents) in making informed decisions, this is something we all need to be aware of and able to advise on.
Methods of reducing myopia were discussed, including lifestyle changes and optical approaches. Atropine was not discussed as it is not an option in the UK at present. While lifestyle changes are easiest to implement the effects are modest – approximately 0.25D over 2 years.
Until recently, contact lenses were the only optical approach with Ortho-K and centre distance vision dual focus soft contact lenses being shown to slow myopic progression and axial length growth by approximately 40-60%.
They are now being joined by spectacle lenses as an alternative or addition, as not all patients will be suitable for contact lenses and those that are suitable may not be advised to wear them all the time.
The Hoya lens solution is MiYOSMART and is a DIMS design (defocus incorporated multiple segments). This lens is cosmetically no different to standard SV. It has a 9mm central zone to correct distance vision surrounded by a ring of around 400 defocus segments of +3.50D. This provides myopic defocus and corrects the refractive error simultaneously. Although some patients notice the difference at the side, they adapt within a few days and then have no issues. The research carried out by Professor Lam which has now covered a 3-year period has shown an approximately 50-60% reduction in myopic progression with no impact on accommodative function.
The conclusion was that myopia control is an exciting chance to change from correcting vision to treating the progression and should be discussed with all young myopes. Spectacle lenses like MiYOSMART give a new option. In an ideal world, cycloplegic autorefraction and axial length measurements would be undertaken. However, non-cycloplegic refraction is a useful indicator of myopic progression and is likely to be what parents will judge success on, so there is no reason not to offer some form of myopic control.
There are some myopia calculators online which can show likely outcomes for specific patients, with and without myopia control, which could be very useful in explaining the benefits. Two mentioned were https://bhvi.org and https://myopia.care .
The recording of the full event is available by clicking the more information link below, you will have to enrol before watching.