Objective:

To review available modalities for myopia control and guide practitioners in making informed recommendations for patients.

Approach:

• Considerations for Treatment: High astigmatism limits options; ortho-k is unlikely to correct it, while special spectacles can accommodate up to 4 D of astigmatism.
• Contact Lens Efficacy: High-add, center-distance multifocal soft lenses show mean differences of 0.46 D and 0.23 mm in myopia progression over 3 years.
• Combination Therapy: Considering optical methods in combination with atropine may be beneficial due to questions about atropine's long-term efficacy.
• Activity-Specific Recommendations: Understanding a child's activities can guide treatment; ortho-k may not be suitable for sports requiring fine acuity.
• Visual Performance: Sport-specific lenses may enhance visual performance while using myopia control modalities during non-sport activities.
• Patient Readiness: Myopia control spectacles are suitable for those not ready for contact lenses; contact lens wear is associated with improved self-esteem.

Key Findings:

• High astigmatism limits myopia control options.
• High-add multifocal lenses can significantly affect myopia progression.
• Combination of optical methods and atropine may enhance efficacy.
• Activity preferences can influence the choice of myopia control modality.
• Sport-specific lenses can optimize visual performance.

Limitations:

• Limited options for patients with high astigmatism.
• Uncertainty regarding long-term efficacy of atropine as monotherapy.

Sources:

• JAMA
• JAMA Ophthalmology
• Invest Ophthalmol Vis Sci
• Clin Exp Optom
• Optom Vis Sci