Misight

[emergentmd]

So My 12 yo kid was recommended Misight for his nearsightedness. I did some research and almost all recommendations online are from optometrists selling the product (red flag #1). Also, improvement is in the 20-50% range so projection without is -4, and with is -2 to -3. From a practical standpoint, doesn't make much of a difference. Expense is somewhat high too and from what I understand, most of the $$$ goes to the optometrists pocketbook.

Talked to our pediatrician, who never heard of it (red flag 2). Talked to my ophthalmologist who said, "ehhh... don't do it"

Am I missing something? Our optometrist is a family friend and I would hope they would not push something other than for monetary gains.

Thoughts from practicing optometrists?

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[VA Hopeful Dr]

So My 12 yo kid was recommended Misight for his nearsightedness. I did some research and almost all recommendations online are from optometrists selling the product (red flag #1). Also, improvement is in the 20-50% range so projection without is -4, and with is -2 to -3. From a practical standpoint, doesn't make much of a difference. Expense is somewhat high too and from what I understand, most of the $$$ goes to the optometrists pocketbook.

Talked to our pediatrician, who never heard of it (red flag 2). Talked to my ophthalmologist who said, "ehhh... don't do it"

Am I missing something? Our optometrist is a family friend and I would hope they would not push something other than for monetary gains.

Thoughts from practicing optometrists?

That's just a contact lens that both corrects vision and slows myopic progression to my understanding.

I'd put my kids in it if they were near sighted and the right age.

As a guy that's -5, I'd love to be -3. Won't pass my driver's test but that is a noticeable difference uncorrected.

 

[percyeye]

Being a -2.00 vs a -4.00 is a bigger deal than you would think it would be. Especially when you get to a presbyopic age.

They definitely aren't trying to scam you but some ODs just have more of a passion of slowing down Myopia and find satisfaction in it. I personally don't have the time or patience for it but if my own kid was starting to show signs of myopia at a young age I'd try and slow it down.

And don't fret too much over the Optometrist trying to make money off of the contacts. We make almost nothing off of contact lens sales nowadays.

 

[wysdoc]

So My 12 yo kid was recommended Misight for his nearsightedness. I did some research and almost all recommendations online are from optometrists selling the product (red flag #1). Also, improvement is in the 20-50% range so projection without is -4, and with is -2 to -3. From a practical standpoint, doesn't make much of a difference. Expense is somewhat high too and from what I understand, most of the $$$ goes to the optometrists pocketbook.

Talked to our pediatrician, who never heard of it (red flag 2). Talked to my ophthalmologist who said, "ehhh... don't do it"

Am I missing something? Our optometrist is a family friend and I would hope they would not push something other than for monetary gains.

Thoughts from practicing optometrists?

I asked my husband, an ophthalmologist, about it & he said studies do support that it slows the progression of myopia severity. His practice doesn't see a lot of contact lens patients or children, so he doesn't have direct experience with it.
The contacts are daily wear/disposable and specially tailored multifocal lenses for each patient, so they are more costly than typical soft contacts. The cost to the optometrist to get them made for you is at least half of the price.
Here's a web page that explains it a little better How Do MiSight Contact Lenses Work?

 

[Optogal]

Popular also these days is low-dose atropine.

How to Use Low-Dose Atropine to Slow Myopic Progression in Kids

Experts discuss their use of low-dose atropine for treatment of rapidly progressing myopia in children. Web Extra: Learn about a possible biomarker for pathological myopia.

www.aao.org

 

[UnicornOpt]

Kaiser Permanente does low dose atropine and misight for myopia progression.

 

[zyg0te]

So My 12 yo kid was recommended Misight for his nearsightedness. I did some research and almost all recommendations online are from optometrists selling the product (red flag #1). Also, improvement is in the 20-50% range so projection without is -4, and with is -2 to -3. From a practical standpoint, doesn't make much of a difference. Expense is somewhat high too and from what I understand, most of the $$$ goes to the optometrists pocketbook.

Talked to our pediatrician, who never heard of it (red flag 2). Talked to my ophthalmologist who said, "ehhh... don't do it"

Am I missing something? Our optometrist is a family friend and I would hope they would not push something other than for monetary gains.

Thoughts from practicing optometrists?

I'm an optometrist. I don't sell any product. I recommend it for the right patients.

Are you surprised a pediatrician doesn't know something about the eyes? When is the last time you asked your family med doctor about ocular hypertension?

 

[zyg0te]

If you want some primary sources to look up:

Walline JJ, Greiner KL, McVey ME, Jones-Jordan LA. Multifocal contact lens myopia control. Optom Vis Sci.
2013

Lam CS, Tang WC, Tse DY, et al. Defocus Incorporated Soft Contact (DISC) lens slows myopia progression
in Hong Kong Chinese schoolchildren: A 2-year randomised clinical trial. Br J Ophthalmol. 2014

Aller TA, Liu M, Wildsoet CF. Myopia control with bifocal contact lenses: A randomized clinical trial. Optom
Vis Sci. 2016

Cheng X, Xu J, Chehab K, et al. Soft contact lenses with positive spherical aberration for myopia control.
Optom Vis Sci. 2016

Li SM, Kang MT, Wu SS, et al. Studies using concentric ring bifocal and peripheral add multifocal contact
lenses to slow myopia progression in school-aged children: A meta-analysis. Ophthalmic Physiol Opt. 2017

 

[emergentmd]

I'm an optometrist. I don't sell any product. I recommend it for the right patients.

Are you surprised a pediatrician doesn't know something about the eyes? When is the last time you asked your family med doctor about ocular hypertension?

I also went to my boarded ophthalmologist who essentially said its a waste.

 

[zyg0te]

I also went to my boarded ophthalmologist who essentially said its a waste.

In general or for your kid specifically?

 

[emergentmd]

I asked for my kids who had Misight recommended. Can't remember the exact words but his expression was essentially, "its a waste of time for possibly small improvement but he wouldn't do it"

 

[Drjc1977]

I'm an optometrist. I don't sell any product. I recommend it for the right patients.

Are you surprised a pediatrician doesn't know something about the eyes? When is the last time you asked your family med doctor about ocular hypertension?

To make sure I understand this, a pediatrician and an ophthalmologist both of whom have not examined the eyes of your child are making an opinion and you are actually listening?? Are you making decisions based on what is the best treatment for your child or how much is it going to cost.

 

[zyg0te]

I asked for my kids who had Misight recommended. Can't remember the exact words but his expression was essentially, "its a waste of time for possibly small improvement but he wouldn't do it"

I'm not making any recommendations here one way or another. All we know is your kid is already 12 and under -2.00. That's actually a pretty good starting point.

If that were my kid I'd probably lean towards doing it depending on progression so far, parents refractive error, kid's preference. If they wanted CLs regardless I'm absolutely putting them in Misight. You can calculate the difference in price between regular daily disposables vs the Misight and see if the additional benefit is worth it to you. Waste of money or waste of time is a value judgment for you to decide with the help of your optometrist/friend.

Just wanted to clarify that there is strong evidence for Myopia control. Anyone who hasn't heard of it is a few years behind on current research. I'd be willing to bet it becomes the standard of care in the next 5-10 years.

 

[emergentmd]

To make sure I understand this, a pediatrician and an ophthalmologist both of whom have not examined the eyes of your child are making an opinion and you are actually listening?? Are you making decisions based on what is the best treatment for your child or how much is it going to cost.

The optometrist recommended it. I did some research and all the literature and recommendations appears to be from ODs that sells it which appears lucrative. Money is not the issue, its the benefits + side effects vs potential improvement and the benefits seems iffy. So I asked my ophthalmologist and pediatrician. Pedi said none of her pts wears them, optho was like ehhhh waste of money. So if it was a great option with positive clear definitive studies then I would be all for it.

I am an ER doc and if someone asked me a question that is in my specialty, I I could give them advice without examining them 90% of the time. And if I needed to examine them, then I would tell them so.

 

[zyg0te]

The optometrist recommended it.

Your kids' optometrist recommended it. You claim this optometrist is a friend but you doubt their judgement and instead defer to generalists? You see the problem there?

I did some research and all the literature and recommendations appears to be from ODs that sells it which appears lucrative.

I shared links to some of the primary research above.

If you prefer some articles from your MD colleagues. I haven't listened to the audio, and both of these sources are 2-3 years old so take it for what it is.

A Review of Advances in Myopia Management

www.reviewofophthalmology.com

Current Options to Prevent Myopia Progression

Drs. Pavlina Kemp and Matthew Weed discuss current options for preventing myopia progression, ranging from topical therapy with atropine to orthokeratology to lifestyle or environmental measures.

www.aao.org

Money is not the issue, its the benefits + side effects vs potential improvement and the benefits seems iffy.

What side effects are you afraid of? No side effects greater than any other soft contact lens. Maybe a faint amount of blur which your kid should be able to tell you if it's noticable or not. Reduced myopia.
MiSight has been granted FDA approval for myopia control. That means our government thought the evidence was good enough to show SAFETY AND EFFICACY specifically for slowing progression.

So if it was a great option with positive clear definitive studies then I would be all for it.

You realize that's the same argument people made against COVID vaccines right? It is absolutely your choice to wait to see when we get better data in the future, but the problem is your kid is going to keep getting older regardless. As I mentioned previously, at 12 and under -2.00 maybe not as big of a concern. This is still an area where you have to make a decision with incomplete information.

I am an ER doc and if someone asked me a question that is in my specialty, I I could give them advice without examining them 90% of the time. And if I needed to examine them, then I would tell them so.

That's great for you. I'm an eye doctor and I make recommendations to strangers on the internet 0% of the time.