Bifocals beneficial for children with rapidly progressing myopia

January 01, 0001

Bifocals beneficial for children with rapidly progressing myopia

These investigators from multiple countries conducted a randomized controlled trial to determine whether bifocal and prismatic bifocal spectacles could control myopia in children with high rates of myopic progression. They enrolled 135 (73 girls and 62 boys) myopic Chinese Canadian children with myopic progression of at least 0.50 diopters (D) in the preceding year. Children were randomly assigned to 1 of 3 treatments: (1) single-vision lenses (n = 41), (2) +1.50-D executive bifocals (n = 48), or (3) +1.50-D executive bifocals with a 3-prism diopters base-in prism in the near segment of each lens (n = 46).

They found: “Of the 135 children (mean age, 10.29 years, mean visual acuity, -3.08 D), 131 (97%) completed the trial after 24 months. Myopic progression averaged -1.55 D for those who wore single-vision lenses, -0.96 D for those who wore bifocals, and -0.70 D for those who wore prismatic bifocals. Axial length increased an average of 0.62 mm, 0.41 mm, and 0.41 mm, respectively. The treatment effect of bifocals (0.59 D) and prismatic bifocals (0.85 D) was significant and both bifocal groups had less axial elongation (0.21 mm) than the single-vision lens group.”

The authors concluded: ”Bifocal lenses can moderately slow myopic progression in children with high rates of progression after 24 months.”

Don’t be surprised if you start seeing some children wearing bifocals.

For the full abstract, click here.

Arch Ophthalmol 128(1):12-19, January 2010. © 2010 To the American Medical Association.
Randomized Trial of Effect of Bifocal and Prismatic Bifocal Spectacles on Myopic Progression-Two-Year Results. Desmond Cheng, Katrina L. Schmid, George C. Woo, Bjorn Drobe. Correspondence to Dr. Cheng: [email protected]

Category F. Eye. Keywords: children, myopia, bifocal lenses, randomized controlled trial
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 27 January 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.