Optical coherence tomography is a valuable clinical tool that enables eye care practitioners to image the macula, disc, and mid-periphery. Doing so makes it possible to observe and monitor myopia-related degenerative change that can impact retinal structure, function and vision – as described in this article.
MiyoSmart, a first-of-its-kind spectacle lens for myopia control, has caught the eye care sector’s attention, with a massive 84% of local eye care professionals saying they would choose the lens over other myopia management options.*
Described as a “ground breaking technology”, Hoya’s innovative lens which has a simultaneous defocus treatment zone, has been shown to slow myopia progression by around 60%.#,1
We want to empower the entire practice with skills and knowledge to manage myopia using MiyoSmart lenses so that everyone can play a vital role in reducing the progression of myopia in children
MiyoSmart takes advantage of Defocus Incorporated Multiple Segments (D.I.M.S.) technology developed by Hoya Corporation and The Hong Kong Polytechnic University. The innovative technology won the Grand Prize, Grand Award and Gold Medal at the 46th International Exhibition of Inventions of Geneva in April 2018.
“MiyoSmart really is like no other lens on the market,” explained Ulli Hentschel, National Training and Development Manager at Hoya Lens Australia. “For the first time ever we have a myopia treatment option that delivers significant benefits with ease.
“From a technical point of view, it could be described as the most unique lens available today, with hundreds of tiny microlenses across the front surface. It is the result of an extensive, exhaustive process of collaboration with our research partners over many years.”
CONFLICTING SIGNALS, SIMULTANEOUS DEFOCUS
At a webinar for optometrists and optical dispensers, myopia experts, Drs Kate and Paul Gifford and Jagrut Lallu explained that the lens works by delivering “conflicting signals to create simultaneous retinal defocus – some visual information falls on the retina for clear vision, and some falls in front of the retina to create myopic defocus”.
It does this with a 9.4mm diameter central zone which provides the distance refraction, surrounded by a 33mm diameter annulus of multiple defocus segments – 1mm lenslets which give +3.5D of myopic defocus – with the spaces in between them providing more distance correction.
When the wearer looks through this ‘treatment zone’, the 50:50 ratio of clear vision to defocus makes it possible to simultaneously slow the growth of the eyeball and provide clear vision, independent of pupil size and gaze direction.
Frame fit is most important to ensure the greatest treatment effect and wearer comfort, Dr Gifford said. When the frame is correctly fitted, acuity of vision through the central zone as well as the lensletcovered treatment zone is clear, with only a slightly reduced contrast compared to single vision when looking through the treatment zone.
HIGH LEVEL OF EFFICACY
Studies demonstrate that the efficacy of MiyoSmart lenses for controlling axial elongation in myopia can be considered equivalent to MiSight contact lenses, orthokeratology and 0.05% atropine, based on current data. Indeed, a study of children in Hong Kong, aged eight to 14, found MiyoSmart curbed axial myopia progression by over 60%* and halted myopia progression in 21.5% of children over the two year study period.
TOUGH FOR KIDS
MiyoSmart lenses are made from tough, impact resistant polycarbonate 1.59. The lenses have UV protection, a special antireflection coating, are water repellent and easy to clean – practical properties that make them most suitable for long lasting wear by children. They are available in plano through to -10D, offering a wide range of myopia interventions. Dr Kate Gifford said it is impressive to note that Hoya Lens is offering prescription warranty if a child’s refraction progresses more than 0.50D over six months,** indicating a level of confidence in the efficacy of MiyoSmart to slow myopia progression.
SUITABLE FOR SIMPLE AND COMPLEX CASES
Speaking from New Zealand, Mr Lallu presented two myopia case studies demonstrating the treatment efficacy of MiyoSmart for both simple and more complex clinical cases. While acknowledging the safety profile of contact lenses, Mr Lallu noted that there are practitioners, patients and parents who continue to harbour concerns and/or fears about the safety of contact lens wear in children. He said MiyoSmart will be a particularly useful treatment option in these cases.
Feedback from webinar attendees was that one of the main barriers to myopia control strategies is convincing parents of the need to take action. Hoya Lens has developed a range of resources to help optometrists and optical dispensers describe myopia and the need for treatment. Additionally, Drs Kate and Paul Gifford have developed Mykidsvision.org, a patient friendly myopia information website. Myopiaprofile.org is another site established by Drs Gifford, which provides free resources and education for practitioners.
TRAINING FOR OPTOMETRISTS AND DISPENSERS
In partnership with Myopia Profile Pty Ltd, Hoya has established short accreditation courses for both optometrists and optical dispensers to complete before they begin prescribing the lens.
“We want to empower the entire practice with skills and knowledge to manage myopia using MiyoSmart lenses so that everyone can play a vital role in reducing the progression of myopia in children,” said Mr Hentschel.
“Unlike other lenses, MiyoSmart is a clinical treatment product, so practitioners need to understand how it works, its efficacy and how it should be prescribed. Additionally, they need to be able to accurately communicate the treatment option to parents and children to ensure compliance.
“We hope this is the catalyst for more myopia management in practices,” he said. “By offering training to optometrists and optical dispensers, practices can work holistically and collaboratively to protect children’s vision for the future.”
* When asked at the Hoya MiyoSmart webinar, 84% of optometrists and optical dispensers in Australia and New Zealand agreed they would choose Hoya MiyoSmart spectacle lenses over other myopia control treatment options.
# Myopia progression (SER) by 59% and axial elongation (AL) decreased by 60% compared with those wearing SV lenses.
- Lam CSY, Tang WC, Tse DY, Lee RPK, Chun RKM, Hasegawa K, Qi H, Hatanaka T, To CH. Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial. British Journal of Ophthalmology. Published Online First: 29 May 2019. doi: 10.1136/bjophthalmol-2018-313739.