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What Is Myopia Management?
Myopia management is an evidence-based plan intended to slow the progression of nearsightedness while providing clear vision. It is most often considered during childhood and adolescence, when the eyes are still growing. The goal is not to cure or reverse myopia, and no method can guarantee that progression will stop.
Myopia occurs when light focuses in front of the retina, often because the eye has grown too long from front to back. A child may notice blurred distance vision, squinting, trouble seeing a classroom board, or a prescription that changes repeatedly. Younger onset can leave more years for progression. Higher levels of myopia are associated with greater lifetime risk of retinal, macular, glaucoma, and cataract problems, although treatment cannot eliminate those risks.
At Eye Freedom, Dr. Edward Boshnick evaluates the child, the pattern of progression, eye health, visual needs, and ability to use the proposed correction safely before recommending a plan.
How Is Childhood Myopia Evaluated?
An evaluation begins with medical and ocular history, family history of myopia, current glasses or contact lenses, prior prescriptions, and the age and pace at which the prescription has changed. Refraction, visual acuity, binocular vision, and examination of the front and back of the eyes help determine whether the blur is straightforward myopia or whether another condition needs attention.
Progression is assessed by comparing reliable measurements over time. Cycloplegic refraction may be used when clinically appropriate, and axial length can add information when it is available. If overnight corneal reshaping is being considered, corneal topography is important for understanding corneal shape and planning the fit.
Bring earlier prescriptions and eye-growth measurements when available. A single prescription cannot show the rate of progression or determine which option is safest.
Myopia Management Options at Eye Freedom
Eye Freedom’s website describes two contact-lens approaches that may be considered for eligible children: daytime MiSight 1 Day soft contact lenses and overnight corneal refractive therapy, also called orthokeratology or Ortho-K. Each option corrects vision differently and has different product parameters, handling routines, risks, and follow-up needs.
Standard glasses or contact lenses can correct blurred vision but are not automatically myopia-management treatments. Other evidence-based approaches exist, but availability and regulatory status vary. Dr. Boshnick discusses options that are appropriate to the child’s measurements and coordinates with another suitable professional when care falls outside the practice’s scope.
MiSight 1 Day Contact Lenses
A Daytime Daily Disposable Option
MiSight 1 Day is a single-use soft contact lens worn during the day. Its dual-focus design corrects myopia while creating treatment zones intended to slow axial elongation. In the United States, the FDA indication applies to children with non-diseased eyes who begin treatment at ages 8 to 12 and meet the labeled refractive criteria.
MiSight is removed before sleep and discarded after removal. The child and caregiver must be able to manage insertion, removal, clean-hand hygiene, water avoidance, and scheduled follow-up. The MiSight parameters and FDA guide provides the current base curve, diameter, power range, indication, trial context, benefits, and limitations.
Corneal Refractive Therapy and Orthokeratology
Corneal refractive therapy and orthokeratology use custom rigid gas-permeable lenses during sleep to temporarily reshape the cornea. When the lenses are removed in the morning, selected patients may have useful unaided daytime vision. In children, published evidence indicates that Ortho-K can slow axial elongation on average, but response varies.
Because the lenses are reusable and worn overnight, fitting, cleaning, disinfection, water avoidance, and follow-up are especially important. The corneal effect is temporary and generally requires continued wear as directed. Ortho-K does not cure myopia, and stopping wear allows the cornea and daytime prescription effect to change back over time.
How Do MiSight and Ortho-K Differ?
A Practical Comparison
| Consideration | MiSight 1 Day | Orthokeratology / CRT |
|---|---|---|
| When worn | During waking hours | During sleep |
| Lens type | Soft, daily disposable | Custom rigid gas-permeable, reusable |
| Daytime correction | The lens corrects vision while it is on the eye | Corneal reshaping may provide unaided daytime vision after lens removal |
| Fitting inputs | Refraction, ocular health, on-eye fit, vision, handling ability, and labeled parameters | Refraction, corneal topography, ocular health, custom lens response, handling, and overnight-wear suitability |
| Care routine | Fresh lens for each day; discard after removal | Daily cleaning, disinfection, storage, and scheduled replacement |
| Important limitation | Fixed product parameters and a specific U.S. treatment indication | Temporary corneal effect and the additional risk considerations of overnight lens wear |
Neither option is automatically better. The appropriate choice depends on age, prescription, astigmatism, corneal shape, ocular surface health, progression, lifestyle, handling skills, wearing preference, and the findings observed during fitting and follow-up.
How Is Progress Monitored?
Myopia-management success is not judged only by whether the child sees clearly. Follow-up compares refraction and, when available and appropriate, axial length over time. The clinician also reviews visual acuity, comfort, lens fit, corneal and ocular-surface health, wearing habits, and whether the family can maintain the prescribed routine.
Progression may continue despite treatment. A plan may need to be adjusted if measurements change faster than expected, vision quality is unacceptable, the lens fit is unhealthy, the child cannot follow the routine, or another eye-health issue develops. Clinical-trial averages should never be presented as an individual promise.
Benefits and Limitations
Potential benefits of an appropriate plan include clear vision and a slower average rate of myopia progression than with a comparison correction in published studies. Reducing the amount of myopia a child ultimately develops may reduce, but cannot eliminate, future eye-health risk.
Limitations include variable response, continued need for monitoring, cost, handling demands, product or prescription constraints, possible changes in vision quality, and contact-lens complications. Contact lenses can cause abrasions, inflammation, ulcers, or infection. Pain, pronounced redness, light sensitivity, discharge, sudden blur, or a new white spot on the cornea requires prompt lens removal and professional guidance.
Supporting a Child Through Treatment
Safe Lens Habits and Follow-Up
A child does not need to manage treatment alone. Parents and caregivers should understand the wearing schedule, reinforce clean-hand hygiene, keep water away from contact lenses, maintain backup glasses, and know which symptoms require a call to the practice.
MiSight lenses should be discarded after removal and never worn during sleep. Reusable Ortho-K lenses require the prescribed cleaning, disinfection, storage, and replacement routine. Neither lens type should be shared or exposed to tap, pool, shower, or hot-tub water.
Outdoor Time and Daily Habits
Regular outdoor time is associated with a lower risk of developing myopia and may be discussed as part of a child’s visual-health routine. Breaks from prolonged near work, comfortable working distance, and good lighting can also support visual comfort.
These habits do not replace an accurate prescription, a prescribed myopia-management treatment, or follow-up. Families should use practical, age-appropriate routines rather than blaming a child or relying on eye exercises, supplements, or online claims that promise to reverse myopia.
Choosing an Approach
Factors Dr. Boshnick Reviews
- The child’s age, current prescription, astigmatism, and documented rate of progression.
- Corneal shape, ocular-surface health, binocular vision, and other examination findings.
- Whether the child prefers daytime soft lenses, overnight custom lenses, or another correction approach.
- Insertion, removal, hygiene, water avoidance, and the level of caregiver support available.
- Visual demands, sports and activities, sleep routine, travel, cost, and ability to attend follow-up.
- The current evidence, regulatory labeling, expected benefits, limitations, and alternatives for the individual case.
The decision is made from the examination and a discussion with the family, not from age or prescription alone.
Request a Myopia Management Evaluation
To discuss your child’s changing prescription and whether MiSight, corneal refractive therapy, or another approach should be considered, request an evaluation with Dr. Edward Boshnick or call 305-271-8206. Families traveling from outside the area should contact Eye Freedom before arranging travel because examination, fitting, training, and follow-up requirements vary.
Medical and Product Sources
- International Myopia Institute: Clinical management guidelines
- National Eye Institute: Multifocal contact lenses and childhood myopia
- American Association for Pediatric Ophthalmology and Strabismus: Progressive myopia treatment
- U.S. Food and Drug Administration: MiSight 1 Day safety and effectiveness summary
- Randomized clinical trial: Three-year MiSight outcomes
- Peer-reviewed review: Orthokeratology in myopia management
This page is educational. It does not diagnose myopia, prescribe a lens, or guarantee that progression will slow by a particular amount.
Frequently Asked Questions
Myopia management is a plan intended to slow the progression of nearsightedness while providing clear vision. It may include a specially designed optical treatment, monitoring, safe wearing habits, and age-appropriate lifestyle guidance.
No established treatment cures myopia or reliably reverses an elongated eye. Management aims to slow future progression. Glasses, contact lenses, or corneal reshaping can correct blur, but continued monitoring remains necessary.
An evaluation is reasonable when a child develops myopia, has repeated prescription changes, has a strong family history or young onset, or when parents want to understand evidence-based options. Earlier records help establish the rate of change.
MiSight is a soft daily disposable lens worn while awake. Ortho-K uses custom reusable rigid lenses during sleep to temporarily reshape the cornea for daytime vision. Their parameters, care routines, risks, and candidacy requirements differ.
Many children can wear contact lenses safely when appropriately selected, trained, supervised, and followed. Contact lens wear still carries risks including abrasion, inflammation, ulcer, and infection, so hygiene, water avoidance, and prompt response to symptoms are essential.
The clinician compares refraction and, when available and appropriate, axial length over time. Vision, lens fit, ocular health, comfort, wearing habits, and adherence are also reviewed. One clear day of vision does not show whether progression has slowed.
No. Regular outdoor time may support a child’s visual-health routine, but it does not replace an accurate prescription, a prescribed treatment, or scheduled monitoring.
Not usually. Myopia-management research and product indications commonly focus on growing children whose prescriptions are progressing. Adults still need accurate correction and eye-health evaluation, but candidacy and goals must be assessed separately.
Schedule Your Consultation with
Dr. Boshnick
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7800 Sw 87 Ave Suite B-270
Miami, Florida 33173
