Soft Contact Lenses Do Not Lead To "Myopic Creep" In Children, Study Shows (Medical N

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Soft contact lens wear does not result in clinically significant acceleration in the development of nearsightedness in children and does not cause relevant increases in axial length or corneal curvature, a new study shows.

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[Helfon Hanono]

this study would have been more accurate if they had separated children with esophoria and exophoria. I am convinced that children with esophoria will have myopic creep if they read with their contacts or glasses.

 

[Merrill Bowan]

this study would have been more accurate if they had separated children with esophoria and exophoria. I am convinced that children with esophoria will have myopic creep if they read with their contacts or glasses.

I am in total agreement.

One only needs to be in practice 10 years to know that SCL wearers progress willy-nilly. The design of the study was faulty in at least that way that you suggest, perhaps other ways, as well.

 

[Tom Stickel]

I'm not sure what you mean by more accurate. The purpose of the study wasn't to determine the effect of eso/exo on myopic progression, but to compare SCL to glasses. Anyway, that's a pretty good sample size, enough to most likely randomize esos and exos.

And Merrill, I'm an esophore, I read like crazy, and I was a -7.00 before I ever wore a CL. Then I wore GPs for a year at age 18. Then I wore SCL. I'm about a -7.50 now. Are you implying that I really would have been more myopic with SCLs than I already am with glasses?

FWIW, as near as I can tell, I gave up reading without glasses around -2.50 or so, fairly early on in the process.

Anyway, if you have a study saying progression is faster in SCLs than glasses, let me have it.

 

[Helfon Hanono]

a -700 is hereditary. glasses you can remove. i can tell you that in my experience an eso will definitely increase in minus if they read with glasses or contact lenses.
how many young patients have you had between -50 and -1.50 and never wear their glasses and are pretty stable for many years and the ones that do wear their glasses worsen with time.
unfortunately it is hard to do these studies. but watch for this in your practice and you will see a pattern.

 

[Helfon Hanono]

j

I'm not sure what you mean by more accurate. The purpose of the study wasn't to determine the effect of eso/exo on myopic progression, but to compare SCL to glasses. Anyway, that's a pretty good sample size, enough to most likely randomize esos and exos.

And Merrill, I'm an esophore, I read like crazy, and I was a -7.00 before I ever wore a CL. Then I wore GPs for a year at age 18. Then I wore SCL. I'm about a -7.50 now. Are you implying that I really would have been more myopic with SCLs than I already am with glasses?

FWIW, as near as I can tell, I gave up reading without glasses around -2.50 or so, fairly early on in the process.

Anyway, if you have a study saying progression is faster in SCLs than glasses, let me have it.

what is wrong with this picture? you say you are an esophore. you stopped removing your glasses at around -2.50. now you are -7.50.
DOES THAT NOT PROVE WHAT MERRYLL AND I ARE SAYING. you get worse whether you are wearing contact lenses or glasses. but with contacts you are using more focusing effort.
by heredetary i thought you were -700 at a very young age.

 

[Tom Stickel]

Helfon,

I'm not arguing the eso/exo assertion. I'm also not arguing my destiny as a high myope. Please read my PP.

What I want to know is a study in which it's shown SCLs cause significantly more myopia than glasses, in contradiction to the study cited below.

Why is it hard to do these studies? Someone just did it with over 500 patients enrolled over 3 years...

 

[Merrill Bowan]

Merrill, I'm an esophore, I read like crazy, and I was a -7.00 before I ever wore a CL. Then I wore GPs for a year at age 18. Then I wore SCL. I'm about a -7.50 now. Are you implying that I really would have been more myopic with SCLs than I already am with glasses?

FWIW, as near as I can tell, I gave up reading without glasses around -2.50 or so, fairly early on in the process.

Anyway, if you have a study saying progression is faster in SCLs than glasses, let me have it.

There are no studies. This new one was supposed to be a definitive study. I defended my statement the only way I could -- clinically: "One only needs to be in practice 10 years to know that SCL wearers progress willy-nilly." RGP's require time and clinical acumen to fit well. SCL's can be fit by "any donkey," as an optician who graduated from (OD) Bill Vincett's optician's course said 25 years ago, so there's little interest in doing the harder thing, expecially when there's transitional discomfort to be dealt with. Study of RGPs' ability to retard progression have been mixed, as you're prolly aware. Those too, have design faults.

Problem is researchers rarely, if ever, ask clinicians who are RGP successful fitters to either participate or to help design the parameters of the studies they design.

As to your own myopia, here's a flow chart:

STRESS + (Genetics + nutrition + personality style + environmental factors + peripheral defocus) --> Refractive error.


There's a lecture hidden in in each stage, SO:

• Here's one on stress: Stress and Eye: new speculations of refractive error. (The missing illustrations can be imagined.); and,
• Here's one on refractive pathophysiology: Preventing refractive error: what's a doctor to DO?

Here's a page that carries a link to my section on The Control of Nearsightedness.

Klaus Schmidt, in his opus magnus on myopia [(www.myopia-manual.de) -- >1200 references, searchable in .pdf format] has a section on RGP's and if you're truly interested, is a treasure trove of references. (Besides, he cites me about a dozen times, so he can't be all bad, in spite of his "Germanic" English. )

Help?

(BTW: there are studies that show that NOT wearing a correction causes greater progression, as I recall, so that was not the thing to do, it appears.)

 

[Gary R. Bell]

My clinical impression of myopes and non-silicon SCL's was that they did tend to cause myopic creep. My thoughts were that since the lens sits on the cornea that most likely the effect was a corneal anoxia effect.

I switched a number of these patients to silicon SCL's and noted that a number of them showed modest reductions in myopia. My clinical impression is that the silicon SCL's have a slight beneficial effect over non-silicon SCL's in regards to slowing myopic progression. Certainly this slight effect is not a significant factor in myopic development.