Soft contact lenses for myopia control in teenagers

• Contact lenses for teenagers with myopia include soft disposable lenses worn during the day, and ortho-k lenses which are worn overnight.
• Teenagers wearing soft disposable contact lenses show improved confidence, satisfaction and ability to participate in school and sport compared to those 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. There is a smaller amount of evidence for older teenagers.
• Myopia typically progresses or worsens until the late teenage years and in some into the early 20s so myopia control contact lenses can continue to be worn.

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.³

Myopia control is also important in teenagers as their vision can still be worsening, albeit at a slower rate than in younger children. Around half of teenagers reach stability of their myopia progression around age 16,¹ but this means half are still progressing, so ideally myopia control treatment should continue into early adulthood.

Contact lenses can be thought of as like spectacle lenses which sit on the surface of the eye, to correct vision. They have been shown to be a safe option for vision correction in teenagers as long as lens wear and care procedures are followed.

Teenagers wearing soft contact lenses report improved quality-of-life, better ability to participate in activities of school and sport and better perceptions of their own abilities in sport compared to wearing spectacles.⁴

Soft contact lenses can be single focus, or have more than one focus which are known as bifocal, dual-focus or multifocal contact lenses.⁵ Single focus contact lenses can be beneficial for many teenagers to correct their blurred vision, but for those with myopia they do not help to slow down the progression or worsening which typically occurs.

Instead, soft contact lenses with more than one focus can both correct the blurred vision of myopia as well as slow down the worsening or 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 kids aged 7-16 years.^6-11

There is less evidence for older teenagers as most of these studies recruit children aged 7 to 13 years at the start of the study and follow them for 2-3 years, meaning they are around 16 at the end of the study. Also, around half of teenagers with myopia stop progressing by age 16 so research tends to concentrate on the faster times of myopia progression (younger ages)¹ to have the largest treatment impact.

The largest volume of evidence in soft contact lenses is for daily disposable dual-focus contact lenses, with this technology adopted by CooperVision in their MiSight 1 day contact lens.¹¹ A recently published study on MiSight 1 day started with children aged 8 to 12, and has continued for six years so that the data now shows an impact for those 14 to 18 years of age.¹¹

Other soft contact lens designs which have been developed specifically for myopia control in children and younger teenagers 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 and teenagers, 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

Each of these contact lenses have some research evidence for myopia control, although most are only up to ages 14-15 and 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 teenager'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

As mentioned above, most evidence for myopia control treatments exists for teenagers up to around age 16. Beyond that, there is less evidence as there is less myopia progression in this age group, but it still can occur. There is a very small amount of evidence for ortho-k slowing myopia progression in older teenagers and young adults,^12,13 but this is not the same volume or quality of evidence as that for younger teens.

It's not as simple as one option suiting all teenagers. The best option for your teenager will depend on many factors such as their prescription, eye health, activities and even your preferences as a family. Availability of treatments in your country is also an important factor. Your optometrist or eye doctor will be able to provide you individualized advice.

Teenagers can benefit from starting contact lens wear at any time. There are many benefits of contact lens wear for teens including improved ability to participate in activities and satisfaction with their vision correction and their appearance.⁴

Younger teenagers (less than 16) are still highly likely to have progressive myopia¹ so should ideally start myopia control treatment as soon as possible. Older teenagers will gain the benefits of contact lens wear as well as the potential to slow their myopia progression.

While there is less evidence for contact lenses slowing myopia progression in older teenagers, there is evidence of a high safety profile. Teenagers aged 14 to 18 wearing daily disposable contact lenses full time showed healthy eyes with no signs of contact lens impact after six years of wearing time.¹⁴

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

Soft contact lenses should be worn full time to get the best treatment effect - this means 12 hours per day, 6-7 days per week.¹¹ 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?

Half of teenagers with myopia will stop progressing and show stable vision by age 16, but this means half will still progress into their later teens and early adulthood.¹ Because of this, experts recommend that myopia control treatment continues until early adulthood.³

Myopia control soft contact lenses do not need to be stopped at any particular time - even once myopia is stable in the late teens or early 20s, these contact lenses still work to correct blurred vision from myopia.

The safety of soft contact lenses and ability to handle lenses appears to be similar in teenagers to adults,^5,15 which is another reason why contact lens wear can continue throughout the teenage years and beyond.

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. (link)
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. Wolffsohn JS, Dumbleton K, Huntjens B, Kandel H, Koh S, Kunnen CME, Nagra M, Pult H, Sulley AL, Vianya-Estopa M, Walsh K, Wong S, Stapleton F. CLEAR - Evidence-based contact lens practice. Cont Lens Anterior Eye. 2021 Apr;44(2):368-397.
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. Gifford KL, Gifford P, Hendicott PL, Schmid KL. Zone of Clear Single Binocular Vision in Myopic Orthokeratology. Eye Contact Lens. 2020 Mar;46(2):82-90. (link)
13. González-Méijome JM, Carracedo G, Lopes-Ferreira D, Faria-Ribeiro MA, Peixoto-de-Matos SC, Queirós A. Stabilization in early adult-onset myopia with corneal refractive therapy. Cont Lens Anterior Eye. 2016 Feb;39(1):72-7. (link)
14. Woods J, Jones D, Jones L, Jones S, Hunt C, Chamberlain P, McNally J. Ocular health of children wearing daily disposable contact lenses over a 6-year period. Cont Lens Anterior Eye. 2021 Aug;44(4):101391. 
15. Walline JJ, Jones LA, Rah MJ, Manny RE, Berntsen DA, Chitkara M, Gaume A, Kim A, Quinn N. Contact Lenses in Pediatrics (CLIP) Study: chair time and ocular health. Optom Vis Sci. 2007;84:896-902.