All about eye glasses for myopia control

• The term 'glasses' is used commonly to describe the combination of spectacle frames and spectacle lenses. This article focuses on the technology of spectacle lenses, which are the key component of glasses which function to correct vision.
• Single vision glasses do not help to slow myopia progression in children and teenagers.
• Instead, specialized designs of myopia control spectacle lenslets can both correct blurred far vision from myopia and work to slow down its progression.

Eye glasses (spectacles) are a simple-to-use and non-invasive way to correct blurred eyesight. Glasses offer a stable way to position a lens in front of the eye, which range from simple single vision lenses to complex lens designs that include multiple focus powers.

Single vision glasses are the most commonly prescribed by optometrists and eye doctors, and used to correct myopia (shortsightedness), hyperopia (longsightedness) and astigmatism. Single vision lenses are simple to manufacture and widely available, making them an ideal solution for most vision correction problems.

A problem with single vision glasses is that their fixed focus only allows them to correct for one single power. This becomes limiting when people start to lose their ability to focus up close in their 40s, called presbyopia. In this case, a different prescription for glasses is needed for far vision than for close up vision.

Multifocal spectacle lenses include more than one focus power within the lens, and utilize eye movement across the lens for the wearer to be able to use the appropriate lens power. These have the far distance correction at the top of the lens, and a gradual change in power down to the near vision correction towards the bottom of the lens for reading.

Bifocal spectacles can be thought of as two pairs of glasses stuck together, with far vision correction above the visible line in the lenses, and reading vision correction below the visible line.

Children, teenagers young people sometimes need to wear multifocal or bifocal spectacle lenses to correct problems with eye focus and eye muscle coordination.

Myopia causes blurred vision for far distance objects, but as myopia increases, the blur can start to be noticed even at arm's length or closer.

Single vision glasses offer a simple way to correct the blurred far vision for people with myopia. Research has revealed, though, that single vision lenses do not protect against myopia progression,¹ which has led to development of special types of spectacle lenses (glasses) to slow and control progression of myopia.

Myopia is not just about a pair of glasses. Once myopia in children and teenagers onsets, it typically progresses or worsens every few months until the late teenage or early adulthood years.²

Myopia progression brings with it:

• Increasingly blurred vision
• The need for frequent changes in spectacle or contact lens prescription
• Increased risk of eye diseases and vision problems over a person’s lifetime³

'Myopia control' has become the increasingly adopted term to describe the use of treatments aimed to slow progression of myopia. Myopia control is particularly important in children, because this is the stage in life when myopia is most likely to progress or worsen quickly.²

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 16,² but this means half are still progressing, so ideally myopia control treatment should continue into early adulthood.

The good news is that there is now a large and growing body of evidence to support that myopia progression can be slowed down using specially designed spectacle lenses (glasses), contact lenses, ortho-k and atropine eye drops.

Bifocal spectacle lenses were originally designed for people with near vision focus issues, and some children can need these lenses for eye muscle teaming problems.

Research has shown executive bifocals have been shown to slow childhood progression of myopia.⁴ Executive bifocals have a solid demarcation line across the whole lens with the distance focus power at the top and near focus power at the bottom.

One study has shown that executive bifocals can have a good result for slowing myopia progression in children aged 8-13 years compared to single vision glasses.⁴ Single vision correction is considered the baseline comparison for myopia control interventions. How executive bifocals achieve this myopia control effect is not understood.

Progressive addition spectacle lenses have a gradual change in power from the top of the lens, the distance vision zone, down to a close up or reading power zone at the bottom of the lens. They can be thought of like a bifocal, but without the line, but have only been shown to have a very small effect on slowing myopia progression in children.⁵ They are not as effective compared to all other myopia control spectacle options.

There is one type of 'peripheral defocus' spectacle lens called Zeiss MyoVision, which showed no impact on slowing eye growth in children.⁶

There are currently three specialty myopia control spectacle lens designs available to optometrists and eye doctors depending on country and region. These lens designs are relatively new to the market and yet to be released in some countries. All three have been shown in research studies to have among the highest efficacy across all myopia control treatment options.^7-9

The Essilor Stellest spectacle lens adopts Highly Aspherical Lenslet Target (H.A.L.T.) Technology. It features 11 concentric rings of highly aspherical lenslets. Each ring features lenslets of a different power, and within a ring the lenslets are contiguous (touching). There is a 9mm clear central zone, and spaces between each ring, for sharp distance vision.⁷

The Hoya MiYOSMART spectacle lens adopts Defocus Incorporated Multiple Segments (DIMS) Technology. The lenslets in this lens are all of the same power, and are not touching, instead in a honeycomb array. It also has a clear central zone of 9mm and there are spaces between each lenslet for sharp distance vision.⁸

The new SightGlass Vision Diffusion Optics Technology (DOT) spectacle lenses uses microscopic diffusers of around 1/10th of a millimetre and has a smaller central clear zone. This is different to the ‘lenslet’ spectacle designs, instead creating a diffusion or blur of light around the edges of the lens.⁹

In all three lens designs, the lenslets or diffusers work to create a slow-down signal for eye growth, to control myopia. The clear central zones and spaces between lenslets provide for clear distance vision.

All three of these spectacle lens designs for myopia control have been shown to slow down myopia progression by about half - about 50%.

The Essilor Stellest and Hoya MiYOSMART spectacle lenses have been studied in children aged 8-13 years at the start of treatment, with evidence from two-year clinical trials.^7,8 Both studies are now reporting 3 year data, indicating that these lenses can be presumed safe and effective in kids aged 8 to 16 years.

The SightGlass DOT lens has been studied in children aged 6 to 10 years at the start of treatment. As the newest option, data has only been reported for one year so far. This means that there is evidence for children aged 6 to 11 years.⁹

If your child is younger or older than this, the treatment may still work for them, but the expectations for treatment may need to be adjusted.

The specialized myopia control glasses lens designs have been designed based on long-standing research showing eye growth can be controlled based on how images are focussed in the peripheral parts of the retina, the light sensitive layer at the back of the eye. It is not just central vision that is important to visual development in kids, but peripheral vision signals as well.

When standard single vision glasses are worn to correct myopia, central vision is made clear but peripheral light rays are focussed behind the retina - see the image below. This appears to trigger the eye to grow towards where the peripheral image is focused, behind the retina, leading to accelerated eye growth.

The principal of myopia control vision correction is to create the opposite profile, by making the peripheral light rays focus in front of the retina. This is type of optical profile instead creates a 'slow-down' signal for eye growth, to stop the retina moving further away from the peripheral light focus which is now in front of the retina. The result is that any slowing of eye growth will similarly slow progression of myopia.

The Essilor Stellest and Hoya MiYOSMART spectacle lenses adopt individual tiny lenslets that focus light in front of the retina with the remainder of the lens providing the focus power required to correct vision. The clever technology adopted into both of these designs causes light rays that pass through the lenslets to remain focused in front of the retina, to act as a stop signal for myopia eye growth, no matter which part of the lens a child is looking through.^7,8

The SightGlass DOT spectacle lens instead changes the contrast of the image that is formed on the retina while the lenses are worn. The human eye is sensitive to contrast, with some research showing eye growth as linked to image contrast. The SightGlass DOT lens aims to create an image contrast profile that is optimized for slowing myopia progression without causing any noticeable degradation in quality of vision.⁹

Blue-light blocking coatings on spectacle lenses can reduce eye strain for some people, when spending a lot of time looking at back-lit screens. There is a small amount of evidence that they can improve sleep quality in adults with self-reported insomnia, but may not have an effect in those with normal sleep patterns. Claims about these coatings protecting the health of the retina have not been supported by evidence.^12,13

The best advice is to pick this type of coating if your child or teenager feels more comfortable looking through it at a screen. In all of the research studies cited above, though, these coatings have not been applied to the myopia control spectacle lenses. It is not known if the blue-light filtering coating could impact the treatment effect or wearer experience with these special optical designs for spectacle lenses.

Right now this decision will largely be determined by the country and region that you live in, because some of the myopia control specific lens designs may not yet be available in your country. Age can also have an influence on which myopia control options to choose. See our following articles for age specific information on myopia control glasses, including more information on spectacle frames as well as spectacle lenses.

• Eye glasses for babies and toddlers
• Eye glasses for myopia control in children
• Eye glasses for myopia control in teenagers
• Eye glasses for myopia control in young adults

1. Donovan L, Sankaridurg P, Ho A, Naduvilath T, Smith EL 3rd, Holden BA. Myopia progression rates in urban children wearing single-vision spectacles. Optom Vis Sci. 2012 Jan;89(1):27-32. (link)
2. 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)
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7. 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. Br J Ophthalmol. 2020;104:363-368. (link)
8. Bao J, Huang Y, Li X, Yang A, Zhou F, Wu J, Wang C, Li Y, Lim EW, Spiegel DP, Drobe B, Chen H. Spectacle Lenses With Aspherical Lenslets for Myopia Control vs Single-Vision Spectacle Lenses: A Randomized Clinical Trial. JAMA Ophthalmol. 2022 May 1;140(5):472-478. (link)
9. Rappon J, Chung C, Young G, Hunt C, Neitz J, Neitz M, Chalberg T. Control of myopia using diffusion optics spectacle lenses: 12-month results of a randomised controlled, efficacy and safety study (CYPRESS). Br J Ophthalmol. 2022 Sep 1:bjophthalmol-2021-321005. (link)
10. Logan NS, Wolffsohn JS. Role of un-correction, under-correction and over-correction of myopia as a strategy for slowing myopic progression. Clin Exp Optom. 2020 Mar;103(2):133-137. (link)
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12. Downie LE. Blue-light filtering ophthalmic lenses: to prescribe, or not to prescribe? Ophthalmic Physiol Opt. 2017 Nov;37(6):640-643.
13. Lawrenson JG, Hull CC, Downie LE. The effect of blue-light blocking spectacle lenses on visual performance, macular health and the sleep-wake cycle: a systematic review of the literature. Ophthalmic Physiol Opt. 2017 Nov;37(6):644-654.