Combination Strategies – What is Their Role in Myopia Management?

Dr Krupa Philip, BOptom, PhD


Myopia, a growing public health concern, has been rising in prevalence with almost 50% of the world’s population estimated to be myopic by the year 2050. Sight threatening complications such as cataract, glaucoma, vitreous liquefaction, and a range of retinal and macular anomalies known as myopic maculopathy could occur as a result of high myopia (worse than -6.00 D). Younger ages are associated with greater annual progression and thus, early-onset myopia is likely to result in higher levels of final net myopia. It is, therefore critical to curb the burden of myopia through strategies aimed to control and slow the progression of myopia.

There now exist several optical and pharmacological interventions to slow myopia.

Presently, optical interventions for myopia control include peripheral defocus correcting spectacle lenses, bifocal spectacles, progressive addition spectacles, multifocal soft contact lenses and orthokeratology3. Of these, single vision spectacles designed to alter peripheral defocus demonstrated only a small treatment effect, less than 14% reduction in myopia progression4. Bifocal and progressive addition spectacles demonstrated variable treatment effect (6% to 51%) in reducing the progression of myopia. Among the optical interventions, orthokeratology (30% to 50%) and multifocal soft contact lenses (centre-distance multifocal contact lenses – 38%) showed promising results in slowing myopia progression.


BHVI is a not-for-profit organisation innovating commercially relevant technologies through to feasibility. BHVI supports the ophthalmic sector with myopia education and tools.

Review of Myopia Management is a leading source of clinical, practice management and research information on myopia for eye care professionals.

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