This is one of our most frequently asked questions. As one of the UK's leading providers of management of children’s myopia and short sight and after successfully fitting and helping hundreds of children with both options, we wanted to share our extensive insights to give you a rundown of each option.
MiSight lenses
MiSight are soft daily disposable lenses that were the first (and only) soft contact lens to be approved by the United States FDA for slowing the progression of myopia in children aged 8 to 12 years. They are also CE-Marked in Europe for this purpose.
The vision with this lens is clear immediately after application, right from the first day of wear.
MiSight lenses are available for prescriptions from -0.25 to -10.00D. The recommended wearing time of MiSight is at least six days per week (seven days is usually fine), 10 or more hours each day. These contact lenses should never be worn while sleeping. MiSight lenses consist of a central distance correction area surrounded by concentric zones of alternating distance and near powers which prevent myopic progression by imposing myopic defocus on the more peripheral retina as a stimulus to slow eye growth
OrthoK lenses
The OrthoK lenses are applied at bedtime and worn overnight. While your child is sleeping, the lenses gently reshape the front surface of your eye (the cornea) to correct their vision. The refractive effect in OrthoK is achieved by safely adjusting the layers of the cornea, without significant corneal bending.
Though you may see some improvement in your child’s vision after a day or two of overnight OrthoK, it can take several weeks for the full effect to be achieved. Once the effect is achieved, your child will be able to see clearly without glasses or contact lenses the following day. Some patience is needed while the reshaping process is taking place. The effect is temporary so will have to wear them each night to maintain good vision during the day.
OrthoK lenses are tailored rigid lenses specifically made for an individual patient’s eye shape and treatment effect required. OrthoK can correct a wide range of prescriptions, between -1.00DS and -6.00DS of myopia, and up to -2.00DC of astigmatism. Higher corrections are achievable using special lens designs.
Differences between MiSight and OrthoK
MiSight and OrthoK are both excellent optical treatments for children with myopia as are very effective at slowing the progression of myopia. Both lenses reduce myopia progression by focusing peripheral light in front of the retina, rather than behind the retina as regular glasses. Studies show that both OrthoK and MiSight can slow the rate of myopia progression in children by an average of around 50%, compared to wearing single-vision spectacle or contact lenses. Although both lenses achieve similar efficacy and the principles behind them are similar, there are some differences which need to be considered when choosing the best option for your child.
At a Glance:
Property | MiSight | OrthoK |
|---|---|---|
Initial consultation and fitting | Initial fitting and follow-up after 1-2 weeks | Initial measurements, fitting after 2 weeks, follow-up next morning, review in 1-2 weeks, additional reviews may be required |
Follow-up management and check-up schedule | Every 3 or 6 months | Every 3 or 6 months |
Youngest age of fitting | We have successfully fitted children from the age of 5 | We have successfully fitted children from the age of 5 |
Shape and design of lens | One standard shape/design of lens | Custom-made and tailored for your child |
Wearing schedule | daytime only | night time while sleeping |
Effectiveness of treatment | Approx. 50% reduction in rate of progression of myopia | Approx. 50% reduction in rate of progression of myopia |
Range of powers for myopia treatment | Upto -10.00DS | Ideal for prescriptions between -1.50DS and -4.00DS but it is possible to correct stronger prescriptions |
Range of treatment for astigmatism | Upto -1.00DC of astigmatism (if higher than this, other soft lenses are available) | Upto -1.50DC (it may be possible to correct higher than this) |
Lens replacement schedule | Every day (daily) | Every 6 months |
Time to achieve clear vision | Immediate on insertion of lens | Can take several days to 2 weeks to achieve stable, clear vision |
Ease of application/ insertion and removal of lenses | Children with smaller eye apertures and tight eyelids can sometimes have more difficulties at beginning inserting and removing soft lenses | Many children find OrthoK lenses easier to insert and remove because Ortho K lenses are smaller and rigid, which means they cannot fold over |
Comfort of lenses | Initially, MiSight lenses are more comfortable | Lenses are less comfortable at the start of the process. This usually improves over 2 to 4 weeks until there is no difference in comfort for each option |
Wearing for water-based activities | MiSight lenses cannot be worn for water-based activities | Lenses are not worn during daytime, your child can do any water-based activity |
Lens cleaning regime | Not required | Immediately after removal and sometimes before insertion |
Lost/broken lens replacement | Easily replaced from lens supply | New lenses are produced and sent out |
Risk of adverse incidents | Statistically around 2 in 10,000 wearers, per year | Statistically around 4-6 in 10,000 wearers, per year |
Cost for initial consultation and fitting | £200 to £300 | £300 |
Ongoing management, consultations, aftercare and replacement lenses | £55 | £55 |
Benefit for your child | Increased confidence, self-esteem and reduced risks when playing sports. Approx 34% reduction of risk of serious eye conditions in adulthood with every 2 years of wear | Increased confidence, self-esteem and reduced risks when playing sports. Approx 34% reduction of risk of serious eye conditions in adulthood with every 2 years of wear |
Summary
Which option is best for your child will depend on a number of factors like their prescription, eye shape, eye sensitivity, personal hygiene, lifestyle, the child and the parents’ motivation. Careful evaluation of these factors is an important part of the decision-making process.
As MiSight lenses are made with one standard size they may not fit optimally. The vision correction zones may be misaligned on the eye which can cause decreased vision and the treatment effect may be sub-optimal. On the other hand, OrthoK are tailored lenses and produced individually for each child, and it may take few visits and adjustments of design to produce an ‘ideal’ lens for your child.
For low levels of myopia (-1.00 or less), MiSight is arguably a better choice than OrthoK for vision correction and myopia control, while for moderate to high levels (-3.00 and over) OrthoK may be a better choice. OrthoK success rate appears to be better for higher prescriptions due to the increased myopia control effect in the peripheral retina.
For the first few days of OrthoK wear, there may be some eye sensitivity adapting to wearing, but this usually improves after the first week and the lenses generally do not cause any discomfort during sleep. On the other hand, MiSight lenses are comfortable from the first day of wear. It is possible that your child may need a temporary pair of soft contact lenses until their vision is fully corrected by the OrthoK lenses.
Although OrthoK has a theoretically higher risk of adverse events such as corneal infection, with good hygiene, lens care and regular aftercare and check-ups with an experienced practitioner, the actual risk is still very low.
The initial cost for parents is higher for OrthoK treatment as the process requires several professional consultations at the beginning to monitor and review treatment effects and eye health. However, beyond the first year, the ongoing cost of OrthoK with yearly lens replacement is comparable to MiSight.
Children who are existing spherical contact lens wearers can also be refitted with MiSight and OrthoK, providing that they fall within the prescription range. Additionally, it is important to tailor the myopia management approach to the individual child, taking factors such as lifestyle into account. There may also be other personal factors such as maturity level, individual preference, and the sensitivity of the eyes. With conclusive current scientific evidence, MiSight and OrthoK contact lenses are both fantastic treatment options for the control of myopia in children and young adolescents.
Still not sure which option is best for your child?
Ask the experts! To help make the right choice for your child, call us on 02083431122 or email [email protected] for an assessment and review of the options with you and your child to determine the best course of action. As part of the assessment we can test how sensitive your child will be when wearing contact lenses and allow them to experience the comfort for each option.
For some children we may give exercises or activities to practice and make their eyes less sensitive to contact lenses.