When a child’s glasses prescription goes up every year, most parents end up asking the same question: can this be slowed down? That is what myopia control lenses are for. They do not cure short-sightedness or take it away, but they can slow how quickly it gets worse. Three options come up again and again: Ortho-K, Stellest lenses and DIMS lenses. At Vasudeva Vision in Delhi, our optometrists fit ortho k night lenses, and this guide sets all three options side by side so you can compare them fairly.
Ortho-K, Stellest and DIMS in brief
Ortho-K: a custom contact lens worn overnight that temporarily reshapes the front of the eye. Many children see clearly the next day without glasses, but the routine demands strict hygiene.
Stellest: a spectacle lens worn through the day. There is no contact lens to handle, but it only helps when it is actually worn.
DIMS: the optical design behind MiYOSMART spectacle lenses. Daily wear is much like Stellest, with a different lens pattern.
In trials, all three slowed progression compared with standard single-vision correction. None stops it completely, and results differ from child to child.
Why myopia management matters
Myopia usually develops because the eye grows too long from front to back. Ordinary glasses fix the blur but leave that growth untouched. Higher levels of myopia carry a greater risk of later eye problems, including retinal detachment and myopic maculopathy, so slowing progression in childhood is considered worthwhile. The aim is a lower final prescription, not a promise that myopia will stop.
Ortho-K: reshaping the cornea overnight
How orthokeratology contact lenses work
Orthokeratology contact lenses, often called contact lens ortho k, are custom rigid lenses worn during sleep. These cornea reshaping lenses gently flatten the centre of the cornea, the clear front surface of the eye. The effect is temporary. That is why the lenses must be worn as instructed, and why the cornea slowly returns to its original shape if wear stops.
Researchers believe the new corneal shape also creates focusing signals at the edge of the retina that slow eye growth. A meta-analysis of studies lasting two years found about 0.25 mm less eye elongation in Ortho-K wearers than in control groups. A more recent review also found that eye growth rebounded in children who stopped treatment.
The main Ortho-K risk
Reviews suggest the risk is similar to other overnight lens wear. It is linked to poor hygiene, tap water exposure and missed follow-up visits. A red or painful eye needs urgent professional attention.
Stellest lenses: spectacles with lenslets
Stellest lenses have a clear central zone for distance vision, surrounded by rings of tiny aspherical lenslets. These create a zone of defocused light in front of the retina, which is meant to slow eye elongation while the child sees clearly through the centre.
In a two-year randomised trial of children aged 8 to 13 in China, lenses with highly aspherical lenslets slowed progression by about 0.80 D, roughly 50%, compared with single-vision lenses. Longer daily wear was linked to better results. The trial was run through a joint university and manufacturer research centre, which is worth remembering when you read the findings.
DIMS lenses and MiYOSMART lenses
DIMS stands for Defocus Incorporated Multiple Segments. It is the optical technology, while MiYOSMART lenses are a commercial spectacle lens built on it. DIMS lenses have a central zone for clear distance vision, surrounded by many small segments with added plus power that create myopic defocus.
In a two-year randomised trial of 183 Chinese children aged 8 to 13, myopia progressed 52% more slowly and eye elongation was 62% lower than with single-vision lenses. About one in five DIMS wearers (21.5%) showed no progression over two years, against 7.4% of controls, so most children still progress to some degree. Later follow-up reports extended the observation period beyond two years.
Ortho-K vs Stellest vs DIMS at a glance
Comparison factor | Ortho-K | Stellest | DIMS / MiYOSMART |
Treatment type | Overnight corneal reshaping contact lenses | Specialised spectacle lenses | Specialised spectacle lenses |
How it works | Temporarily flattens the central cornea and is thought to create peripheral defocus that slows eye growth | Clear central zone with rings of aspherical lenslets that create defocus in front of the retina | Clear central zone with multiple plus-power segments that combine clear vision with myopic defocus |
Wearing schedule | Overnight, as instructed | Waking hours, with longer daily wear linked to better results | Waking hours, worn consistently as prescribed |
Daytime vision | Clear without glasses, though the effect fades if lenses are skipped | Spectacles correct vision while worn | Spectacles correct vision while worn |
Care and maintenance | Strict lens and case hygiene, no tap water, regular aftercare and lens replacement | Routine spectacle care and regular review | Routine spectacle care and regular review |
Safety considerations | Risk of infection, so hygiene and prompt review of a red or painful eye are essential | Correct fit, adaptation and professional monitoring | Correct fit, adaptation and professional monitoring |
Suitability | Individual assessment required | Individual assessment required | Individual assessment required |
Comparing effectiveness fairly
Percentages from different trials should not be lined up side by side. Studies vary in children’s ages, starting prescriptions, ethnicity, length of follow-up, control groups and outcome measures such as refraction or eye length. Most spectacle trials have also been run in East Asian children. A retrospective real-world study of 212 Chinese children found broadly similar one-year results for Ortho-K and myopia control glasses, but retrospective designs are weaker than randomised trials. The evidence does not support calling any one option better for every child.
Comfort, convenience and cost
Myopia control glasses slot easily into daily life and need no lens handling. The catch is that they only work while they are on, so a child who keeps taking them off, for sport for example, may get less benefit. Ortho-K frees children from glasses by day, which many families value for sport and water activities. It does need a nightly routine, usually with a parent supervising, and a pair of backup glasses for travel.
It helps to talk about cost early. Ortho-K typically involves custom lenses, solutions, replacements and frequent aftercare visits. Spectacle options involve the lenses themselves, replacements if the prescription changes or the lenses get damaged, and regular reviews. Often the best treatment is simply the one a child can stick with.
Safety, suitability and monitoring
An eye-care professional may look at age, prescription, astigmatism, corneal shape, eye health, family history, how fast myopia is progressing, and whether the child and family can manage the routine. Monitoring usually includes measuring eye length and refraction every few months. Spectacle options avoid the infection risk of contact lenses, but they still need a good fit and consistent wear, and some children need a short adaptation period. If progression continues despite treatment, the plan can be reviewed.
Atropine eye drops and other options
Atropine eye drops for myopia are low-dose drops put in both eyes, usually at bedtime. Randomised trials such as the LAMP study found they slowed progression in a concentration-dependent way, with higher concentrations tending to cause more light sensitivity and near blur. The concentration and regimen are a clinical decision, and long-term effects are still being studied. Atropine is sometimes used alongside optical treatment, although the evidence on combined approaches is still developing. Soft multifocal contact lenses are another option, and more time outdoors is widely recommended. Whichever myopia lens or treatment is chosen, it works best as part of an overall plan.
Questions to ask your eye-care professional
Is my child a suitable candidate, and why?
How will you measure whether treatment is working?
What results can we realistically expect, and what are the limits of the evidence?
What are the risks, and which symptoms mean we should call straight away?
What does the daily routine involve, and who will supervise it?
What are the first-year and ongoing costs?
What happens if progression continues or my child stops treatment?
Conclusion
There is no single best choice among myopia control lenses. Ortho-K, Stellest and DIMS each have evidence of slowing progression for many children, and each fits differently with age, prescription, lifestyle and family routine. The right decision comes from a thorough eye examination and regular monitoring. If your child’s myopia is changing, book an assessment with a qualified optometrist to talk through the options. You can reach our team at Vasudeva Vision by call or WhatsApp.
