Noha Ekdawi, MD, FAAP, recently shared her experience with MiSight contacts in treating myopia in children. Overall, she has had a positive experience with the contacts, although there have been a few cases where patients returned with multifocal contacts instead. This confusion may be due to patients not tolerating the MiSight contacts or being influenced by the lower cost of multifocals. Dr. Ekdawi no longer fits MiSight contacts in her busy clinic and instead refers patients to outside optometrists or other specialists within her clinic who handle MiSight contacts. However, those who do wear MiSight contacts find them comfortable most of the time, even though their vision may be slightly degraded. The contacts do not seem to bother children at school and they are able to read well, which are important factors when considering MiSight for children. Parents have generally had positive experiences with the contacts as well.
One drawback that Dr. Ekdawi mentioned is that some children do not wear the MiSight contacts for the recommended number of hours per day. Surprisingly, while many children overwear their contacts, some with MiSight contacts do not wear them long enough. Dr. Ekdawi is cautious about this issue due to her experience with contact lens irritation and keratitis in children. She does not force children to wear the contacts all day if they are not progressing and are already receiving low-dose atropine treatment and spending enough time outdoors.
Regarding the cost of MiSight, Dr. Ekdawi explained that it depends on the parents’ perspective. Some parents are immediately on board and want to do everything possible to address their child’s myopia. Others prefer to see progression or try one treatment at a time. The decision to use MiSight contacts is largely driven by the parents’ enthusiasm and their child’s response to previous treatments.
Dr. Ekdawi emphasized the importance of myopia control and where it is headed. She believes that combined therapies will play a significant role in the future. Her approach involves a three-pronged strategy to slow down myopia progression. While complete cessation of progression may not be achievable, the goal is to decrease progression and, most importantly, prevent future eye issues associated with high myopia, such as glaucoma, cataracts, retinal tears and detachment, and macular problems. Dr. Ekdawi aims to hold the axial length and minimize the risks associated with high myopia.
As a pediatric ophthalmologist, Dr. Ekdawi has witnessed the devastating consequences of high myopia, including retinal detachments in young children. This firsthand experience drives her to aggressively treat myopia and prioritize its control.
(Note: The transcript has been AI-generated and edited for clarity and readability.)