Survey: Low use but high interest in myopia control contact lenses

ByJustin Kwan, OD, FAAO

ByJennifer Palombi, OD, FAAO

The majority of eye care providers consider myopia to be one of the biggest problems affecting children’s eyesight; however, only standard vision correction is offered for most of these patients.

A survey of 313 U.S. eye care providers conducted by Harris Poll for CooperVision also revealed that the majority of respondents would be interested in using myopia control contact lenses for children.

The estimated prevalence of myopia in the U.S. has increased from approximately 25% in 1972 to 42% at present and is predicted to reach 58% by 2050 (Vitale et al., Holden et al.). Myopia not only impacts vision, but also increases the risk for sight-threatening diseases such as retinal detachment, myopic maculopathy and more (Flitcroft).

A wide range of resources are available to ECPs on myopia management (Gifford et al; Jones et al). In addition, the FDA approved MiSight 1-day contact lenses (omafilcon A, CooperVision) in November 2019 for slowing myopia progression in children 8 to 12 years old.

Contacts seldom used to control myopia in U.S.

Jennifer Palombi

Justin Kwan

Globally, prescribing contact lenses to slow the progression of myopia represents a small proportion of contact lens fits among children. Morgan et al. reviewed contact lens fittings in 66 countries every year from 2011 to 2018 (Efron et al). Among 31 countries with sufficient data (at least 100 fits), the proportion of myopia control contact lens fittings in children increased over the 8-year survey period from 0.2% to 6.8% (P < .0001).

The proportion of these fittings among children significantly differed among countries (P < .0001), ranging from no recorded fittings to 25%. The fitting rates were over 20% in Austria, Germany and Hong Kong, but were less than 5% in many countries, including France, the U.K. and the U.S.

Survey results

Harris Poll surveyed 313 U.S. eye care providers in June and July 2019; 62% were optometrists and 38% were ophthalmologists. Myopia was the most common condition seen in these practices. Seventy percent of children in these practices were using glasses as their primary mode of vision correction, while 30% used contact lenses, most of which were soft contact lenses (92%).

Survey results showed that, in general, ECPs are aware that pediatric myopia represents an important and growing problem. For example, 81% regarded myopia as one of the biggest problems currently impacting children’s eyesight. Additionally, more than half of ECPs (56%) agreed that, unless successfully treated, myopia increases the risk for irreversible vision loss later in life — although a sizable minority (44%) did not recognize this risk.

Despite the currently low use of myopia management strategies, ECPs showed interest and optimism in using contact lenses to control myopia. ECPs estimated that they simply correct pediatric myopia for 85% of their patients. Nonetheless, 87% of ECPs expressed interest in using myopia control contact lenses for children in the future. On average, ECPs would usually feel comfortable fitting contact lenses among children from age 11 years onward.

The survey also examined the opinions of ECPs regarding the parents of their pediatric patients. Ninety-seven percent of ECPs believed that parents should be educated more about the ways they can help protect their children’s vision. Likewise, 84% of ECPs agreed that parents need to understand that intervention is more urgent the younger a child is diagnosed with myopia. Ninety-two percent of ECPs reported that in-school eye screening is the top reason prompting parents to take their children for an eye exam; 84% of ECPs would have preferred that parents spoke with them sooner about their child's vision.

The survey confirms previous findings that — despite their concerns about myopia — few ECPs currently use strategies to slow its progression in children. Research by Wolffsohn and colleagues suggests that a large majority of ECPs still prescribe single vision interventions, despite increasing concern about myopia and increasing awareness of myopia management techniques. Likewise, a 2019 survey of British and Irish practitioners found that most ECPs did not use any myopia management strategies (Lumb et al).

Part 2 of this article will present two recent surveys that examined the understanding and attitudes of U.S. parents.

References:

American Optometric Association. Children & Contact Lenses: Doctors’ Attitudes & Practices in Fitting Children in Contacts. 2010. https://www.aoa.org/documents/npr10520_executivesummarychildrenandcontactlensesstudy_final.pdf.
Chamberlain P, et al. A 3-year randomized clinical trial of MiSight lenses for myopia control. Optom Vis Sci. 2019; 96(8):556-567.
The College of Optometrists. Myopia Management. 2014. https://www.college-optometrists.org/the-college/research/research-projects/contact-lens-practice-children.html.
Cooper J. J Pediatr Ophthalmol Strabismus. 2018;doi:10.3928/01913913-20180821-01.
CooperVision data on file 2019. Myopia Awareness, The Harris Poll online survey 6/27/19 to 7/18/19.
de Jong PT. Br J Ophthalmol. 2018;doi:10.1136/bjophthalmol-2017-311625.
Efron N, et al. Cont Lens Anterior Eye. 2020;doi:10.1016/j.clae.2019.06.008.
Flitcroft DI. Prog Retin Eye Res. 2012;doi:10.1016/j.preteyeres.2012.06.004.
Flitcroft DI, et al. Invest Ophthalmol Vis Sci. 2019;doi:10.1167/iovs.18-25957.
Gifford KL, et al. Invest Ophthalmol Vis Sci. 2019;doi:10.1167/iovs.18-25977.
Holden BA, et al. Ophthalmol. 2016;doi:10.1016/j.ophtha.2016.01.006.
Jones L, et al. Invest Ophthalmol Vis Sci. 2019;doi:10.1167/iovs.18-25963.
Lumb E, Sulley A. Parent and practitioner opinions on myopia management – part 2. Optician. Published August 23, 2019. https://www.opticianonline.net/features/parent-and-practitioner-opinions-on-myopia-management-part-2.
Vitale S, et al. Arch Ophthalmol. 2009;doi:10.1001/archophthalmol.2009.303.
Wolffsohn JS, et al. Cont Lens Anterior Eye. 2016;doi:10.1016/j.clae.2016.02.005.
Wolffsohn JS, et al. Cont Lens Anterior Eye. 2019;doi:10.1016/j.clae.2019.11.002.

For more information:

Jennifer Palombi, OD, FAAO, is the senior manager of education and development for CooperVision.

Justin Kwan, OD, FAAO, is the senior manager of myopia management for CooperVision.

Acknowledgment:

Thanks to Nathan Greenaway at Visioncare Research Ltd. and Anna Sulley at CooperVision for their help in preparing these articles.

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Sources/Disclosures

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Disclosures: Kwan and Palombi are employees of CooperVision.

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