Ophthalmic lenses for myopia management: a comprehensive literature review and infographic design

Abstract

Purpose: To review and summarize current clinical evidence on the mechanism, effectiveness and clinical advance of spectacle lenses designed to slow myopia progression in children, with a focus on defocus based optical designs including Defocus Incorporated Multiple Segments (DIMS), Diffusion Optics Technology (DOT), and Highly Aspherical Lenslet Target (HALT) lenses. Methods: Anarrative literature review was conducted using published randomized controlled trials, extension studies and long term studies evaluating myopia control spectacle lenses. Outcomes of interest included changes in spherical equivalent refraction (SER), axial length (AL) and visual performance parameters. Both standalone optical interventions and combination therapies with low dose atropine were considered. Results: Across multiple studies, DIMS, DOT, and HALT lenses consistently demonstrated greater reductions in myopia progression and axial elongation compared with single vision (SV) spectacle lenses. DIMS and HALT lenses showed the strongest and most sustained treatment effects over periods of up to 6 years. DOT lenses provided moderate, but clinically meaningful efficacy, with minimal impact on visual performance. Long term studies reported sustained effectiveness and no evidence of rebound myopia after discontinuation. In children with insufficient response to low dose atropine, the addition of HALT lenses further reduced myopia progression. Conclusion: Spectacle lenses incorporating myopic defocus represent effective and safe options for controlling myopia progression in children. The current evidence supports their use as both individual and mixed treatments in myopia management. Further long term, head-to-head studies in diverse populations are required to better define relative efficacy and inform clinical decision making.