Myopia evidence for clinicians
The effect sizes and assumptions behind the outlook calculator, and a free workspace for tracking follow-up in your own clinic.
Treatment effects used in the calculator
| Option | Refraction | Axial length | Trial length | Source | Population |
|---|---|---|---|---|---|
| MiyoSmart (DIMS) spectacle lenses | 52% | 62% | 2 years | Lam CSY et al., Br J Ophthalmol 2020;104:363-368 | Hong Kong, ages 8-13 |
| Essilor Stellest (HAL) spectacle lenses | 55% | 51% | 2 years | Bao J et al., JAMA Ophthalmol 2022 | China, ages 8-13 |
| MiSight 1 day contact lenses | 59% | 52% | 3 years | Chamberlain P et al., Optom Vis Sci 2019;96:556-567 | 4 countries, ages 8-12 |
| Orthokeratology night lenses | 43% * | 43% | 2 years | Cho P, Cheung SW, Invest Ophthalmol Vis Sci 2012;53:7077-7085 (ROMIO) | Hong Kong, ages 6-10 |
| Atropine 0.05% | 67% | 51% | 1 year | Yam JC et al., Ophthalmology 2019;126:113-124 (LAMP) | Hong Kong, ages 4-12 |
| Atropine 0.025% | 43% | 29% | 1 year | Yam JC et al., Ophthalmology 2019;126:113-124 (LAMP) | Hong Kong, ages 4-12 |
| Atropine 0.01% | 27% | 12% | 1 year | Yam JC et al., Ophthalmology 2019;126:113-124 (LAMP) | Hong Kong, ages 4-12 |
| Repeated low-level red light | 75% | 66% | 1 year | Jiang Y et al., Ophthalmology 2022;129:509-519 | China, ages 8-13 |
* ROMIO measured axial length only; the same effect is assumed for refraction.
How the projection works
- Untreated progression at age 9 is −0.82 D/year in East Asian and −0.55 D/year in other children, falling 15% for each year of age up to 13 and 30% a year after (Donovan 2012; Brennan 2021 meta-analysis).
- Axial elongation is taken as 0.5 mm per dioptre, as in the control arms of LAMP and DIMS.
- Each treatment reduces progression by its trial percentage. Because trials last one to three years, a second, cautious scenario halves the effect after year three.
- With two pre-treatment axial lengths and the interval, the untreated rate is scaled to the child's measured growth (limited to 0.2 to 3 times the average).
- Long-term risk comes from Tideman 2016: visual impairment by 75 in about 4% (24 to 26 mm), 25% (26 mm or more), over 90% (30 mm or more).
Clinic workspace
Record glasses power, keratometry, axial length and treatment at every visit, chart growth against expected rates, and read printed biometry reports with built-in text recognition.
Sign-in is for approved clinicians. Ask Dr. Khan at the clinic to request an account.
References
- Donovan L, Sankaridurg P, Ho A, et al. Myopia progression rates in urban children wearing single-vision spectacles. Optom Vis Sci 2012;89:27-32.
- Gwiazda J, Hyman L, Hussein M, et al. A randomized clinical trial of progressive addition lenses versus single vision lenses on the progression of myopia in children (COMET). Invest Ophthalmol Vis Sci 2003;44:1492-1500.
- Tideman JWL, Snabel MCC, Tedja MS, et al. Association of axial length with risk of uncorrectable visual impairment for Europeans with myopia. JAMA Ophthalmol 2016;134:1355-1363.
- Brennan NA, Toubouti YM, Cheng X, Bullimore MA. Efficacy in myopia control. Prog Retin Eye Res 2021;83:100923.
- Yam JC, Jiang Y, Tang SM, et al. Low-concentration atropine for myopia progression (LAMP) study. Ophthalmology 2019;126:113-124.
- Lam CSY, Tang WC, Tse DY, et al. Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression. Br J Ophthalmol 2020;104:363-368.
- Bao J, Huang Y, Li X, et al. Spectacle lenses with aspherical lenslets for myopia control vs single-vision spectacle lenses: a randomized clinical trial. JAMA Ophthalmol 2022.
- Chamberlain P, Peixoto-de-Matos SC, Logan NS, et al. A 3-year randomized clinical trial of MiSight lenses for myopia control. Optom Vis Sci 2019;96:556-567.
- Cho P, Cheung SW. Retardation of myopia in orthokeratology (ROMIO) study. Invest Ophthalmol Vis Sci 2012;53:7077-7085.
- Jiang Y, Zhu Z, Tan X, et al. Effect of repeated low-level red-light therapy for myopia control. Ophthalmology 2022;129:509-519.