Soft contact lenses for myopia control in children

• Contact lenses for children with myopia include soft disposable lenses worn during the day, and ortho-k lenses which are worn overnight.
• For children, soft disposable contact lenses are a safe way to correct their vision and have been shown to improve children’s confidence, participation and satisfaction compared to wearing glasses.
• Special types of soft contact lenses called dual-focus, extended-depth-of-focus and multifocal have evidence for slowing the progression of myopia in children from ages 7 to 16.
• Myopia control should ideally started as early as possible in children with myopia.

Myopia, also known as short-sightedness or near-sightedness, causes vision to become blurred in the long distance, and the need for glasses or contact lenses to bring the eye back into focus.

In most cases, myopia starts in childhood, and then progressively increases typically up until early adulthood when it stabilizes.¹ Myopia is a lifelong condition and increases risk of potentially sight threatening conditions in later life, leading the World Health Organization to classify myopia as a global health concern.²

'Myopia control' has become the increasingly adopted term to describe the use of treatments aimed to slow progression of myopia. These treatments can include spectacles, contact lenses or atropine eye drops. Myopia control is particularly important in children, because this is the stage in life when myopia is most likely to progress or worsen quickly. Taking action to control progression of myopia in children during this fast progression stage in their life will therefore likely achieve the most gains.³

Soft contact lenses offer an alternative option to spectacles for correcting vision. They are made from a flexible clear oxygen permeable material and fit to closely align with the front surface of the eye.

Contact lenses have been shown to be a safe option for vision correction in children as long as lens wear and care procedures are followed. They have also been shown to offer improved vision-related quality-of-life for children compared to wearing spectacles.^4,5

Foremost, children with myopia need their blurred vision corrected with spectacles or contact lenses. Standard types of spectacles and contact lenses, called single vision, can correct this blurred vision but they do not control progression of myopia.

There are now several types of soft contact lens designs which have been shown in published scientific research to slow down the progression, or worsening, of myopia in children aged 7-16 years.^6-11 Myopia control contact lenses are special designs which include multiple focal powers within the lens.

The largest volume of evidence in soft contact lenses is for daily disposable dual-focus contact lenses, which currently have published data for a six year study.¹¹ This is the CooperVision MiSight 1 day contact lens. The United States FDA has approved MiSight for slowing myopia progression in children aged 8-12 at the start of wear, which is an important regulatory marker of safety and effectiveness.

Other soft contact lens designs which have been developed specifically for myopia control in children are the Johnson & Johnson Acuvue Abiliti 1-Day,⁸ and Mark'ennovy Mylo monthly replacement lens.⁹

There are also types of multifocal soft contact lenses which can be used for myopia control in children, as well as correcting vision in presbyopia (the need for reading glasses over age 45). These are the Visioneering Technologies NaturalVue Multifocal 1 Day¹⁰ and the CooperVision Biofinity Multifocal center distance +2.50 Add monthly replacement lens.⁶

The Mark'ennovy Mylo lens⁹ and Visioneering Technologies NaturalVue Multifocal 1 Day¹⁰ have European CE marking, which indicates suitability for the European market and is recognized in many countries, but is not an ‘approval’ of safety and efficacy as for the FDA indication. The Johnson & Johnson Acuvue Abiliti 1-Day,⁸ has received Health Canada approval for slowing myopia progression in children aged 7-12 years at the start of treatment.

Each of these contact lenses have some research evidence for myopia control, although some have more evidence than others. Direct comparisons between lenses are rare and all are likely to show a positive impact on slowing myopia progression.

There are a growing number of ways that your child's myopia can be corrected while providing a myopia control effect, including special types of spectacles, soft contact lenses, ortho-k and atropine eye drops. At this stage, research shows that there is no clear winner of the bunch, with effective options available for each.³

The best option for your child will depend on many factors such as what is available in your country, your child's prescription and their eye health, your child's activities and even your preferences as a family. Your optometrist or eye doctor will be able to provide you individualized advice.

The short answer is that a child should ideally benefit from myopia control as soon as they become myopic. Children will benefit more from myopia control at younger age because myopia progresses faster in younger eyes.¹

The research reveals myopia control soft contact lenses to be effective, safe and well tolerated in children from age 7-8.^6-9 However, age alone should not be the only consideration. For example, parents can think that contact lenses are not safe for their children to wear¹² when in fact, children 8-12 years appear to be safer contact lens wearers than teenagers and adults.¹³

The soft contact lens will be working to correct their vision if your child can see clearly and feels comfortable while wearing them.

To determine how well the soft contact lens is working to control myopia takes a little more to explain, including how myopia is measured. For more detail see our article How do I know if myopia control is working?

Children are susceptible to myopia progression up until early adulthood, meaning that in addition to correcting their myopia to provide clear vision, all children with myopia should be receiving some form of myopia control intervention.

This means that you, your child and your child's optometrist or eye doctor will likely be on the myopia management journey together until your child finishes school, and possibly beyond. Stopping early has the potential for a 'rebound' effect where myopia progression can start again and even accelerate. This effect has been found when atropine¹⁴ or ortho-k¹⁵ is stopped before age 14-15, but so far has not been found with soft contact lens treatments.¹⁶

The longest research study of the CooperVision MiSight 1 day lens has shown the lenses to be effective, safe and accepted well by children from age 8 up until age 18.¹¹

1. Hou W, Norton TT, Hyman L, Gwiazda J; COMET Group. Axial Elongation in Myopic Children and its Association With Myopia Progression in the Correction of Myopia Evaluation Trial. Eye Contact Lens. 2018 Jul;44(4):248-259. (link)
2. The impact of myopia and high myopia. Report of the Joint World Health Organization-Brien Holden Vision Institute Global Scientific Meeting on Myopia. 2015 (link)
3. Brennan NA, Toubouti YM, Cheng X, Bullimore MA. Efficacy in myopia control. Prog Retin Eye Res. 2021 Jul;83:100923.
4. Walline JJ, Gaume A, Jones LA, Rah MJ, Manny RE, Berntsen DA, Chitkara M, Kim A, Quinn N. Benefits of contact lens wear for children and teens. Eye Contact Lens. 2007;33(6 Pt 1):317-321. 
5. Walline JJ, Jones LA, Sinnott L, Chitkara M, Coffey B, Jackson JM, Manny RE, Rah MJ, Prinstein MJ. Randomized trial of the effect of contact lens wear on self-perception in children. Optom Vis Sci. 2009;86:222-232.
6. Walline JJ, Walker MK, Mutti DO, Jones-Jordan LA, Sinnott LT, Giannoni AG, Bickle KM, Schulle KL, Nixon A, Pierce GE, Berntsen DA; BLINK Study Group. Effect of High Add Power, Medium Add Power, or Single-Vision Contact Lenses on Myopia Progression in Children: The BLINK Randomized Clinical Trial. JAMA. 2020 Aug 11;324(6):571-580. (link)
7. Chamberlain P, Peixoto-de-Matos SC, Logan NS, Ngo C, Jones D, Young G. A 3-year Randomized Clinical Trial of MiSight Lenses for Myopia Control. Optom Vis Sci. 2019;96(8):556-567. (link)
8. Cheng X, Xu J, Brennan NA. Randomized trial of soft contact lenses with novel ring focus for controlling myopia progression. Ophthalmol Sci 2022:Oct 18. (link)
9. Sankaridurg P, Bakaraju RC, Naduvilath T, Chen X, Weng R, Tilia D, Xu P, Li W, Conrad F, Smith EL 3rd, Ehrmann K. Myopia control with novel central and peripheral plus contact lenses and extended depth of focus contact lenses: 2 year results from a randomised clinical trial. Ophthalmic Physiol Opt. 2019 Jul;39(4):294-307. (link)
10. Cooper J, O'Connor B, Aller T, Dillehay SM, Weibel K, Benoit D. Reduction of Myopic Progression Using a Multifocal Soft Contact Lens: A Retrospective Cohort Study. Clin Ophthalmol. 2022 Jul 4;16:2145-2155. (link)
11. Chamberlain P, Bradley A, Arumugam B, Hammond D, McNally J, Logan NS, Jones D, Ngo C, Peixoto-de-Matos SC, Hunt C, Young G. Long-term Effect of Dual-focus Contact Lenses on Myopia Progression in Children: A 6-year Multicenter Clinical Trial. Optom Vis Sci. 2022 Mar 1;99(3):204-212.
12. Zeri F, Durban JJ, Hidalgo F, Gispets J; Contact Lens Evolution Study Group (CLESG). Attitudes towards contact lenses: a comparative study of teenagers and their parents. Cont Lens Anterior Eye. 2010 Jun;33(3):119-23. (link)
13. Bullimore MA. The Safety of Soft Contact Lenses in Children. Optom Vis Sci. 2017;94(6):638-646. (link)
14. Yam JC, Zhang XJ, Zhang Y, Wang YM, Tang SM, Li FF, Kam KW, Ko ST, Yip BHK, Young AL, Tham CC, Chen LJ, Pang CP. Three-Year Clinical Trial of Low-Concentration Atropine for Myopia Progression (LAMP) Study: Continued Versus Washout: Phase 3 Report. Ophthalmology. 2022 Mar;129(3):308-321. (link)
15. Cho P, Cheung SW. Discontinuation of orthokeratology on eyeball elongation (DOEE). Cont Lens Anterior Eye. 2017 Apr;40(2):82-87. (link)
16. Ruiz-Pomeda A, Prieto-Garrido FL, Hernández Verdejo JL, Villa-Collar C. Rebound Effect in the Misight Assessment Study Spain (Mass). Curr Eye Res. 2021 Aug;46(8):1223-1226.(link)