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Do Bifocals Slow Progression of Myopia in Children?

January 26, 2010

For years, many optometrists have touted the use of bifocals to slow the progression of myopia in children.  This treatment was generally based on anecdotal reports.  A report in this month’s Archives of Ophthalmology appears to confirm the usefulness of this treatment modality.

In Randomized Trial of Effect of Bifocal and Prismatic Bifocal Spectacles on Myopic Progression, Cheng, et al randomly assigned 135  children (73 girls and 62 boys) with myopia of at least 1.00 diopter to receive single-vision lenses (41), +1.50-diopter executive bifocals (48), or +1.50-diopter executive bifocals with a 3-prism diopter base-in prism in the near
segment of each lens (46).  The results showed that myopic progression averaged −1.55 diopter  for children who wore single-vision lenses, −0.96 diopter  for those who wore bifocals, and −0.70 diopter for those who wore prismatic bifocals.The treatment effect of bifocals  and prismatic bifocals  was statistically significant.

The authors concede that the treatment effect of bifocal and prismatic bifocal lenses is still small. “Whether or not the effect tapers off will decide clinical significance,” they write. “If the treatment effects continued over
time, then the treatment could have a significant role in preventing the development of very high pathologic myopia.” They conclude that bifocal lenses can moderately slow myopic progression in children with high rates of progression after 24 months.

Although there is much more to be studied on this topic, we at OCLI will certainly be revisiting this treatment in children with progressive myopia.

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