The Joint Position Statement on contact lenses for myopia management – Q&A with Tacy Song

As myopia management becomes a standard component of pediatric eye care, there remains considerable variability in how treatment is implemented across clinical practice. The Joint Position Statement on the clinical use of contact lenses for myopia control in the Asia-Pacific region was developed to help address this challenge by providing practical, evidence-based guidance informed by both ophthalmology and optometry perspectives. 

In this Q&A, we speak with Tacy Song (pictured bottom, 2nd to the right), Head of Professional Affairs, Myopia, APAC at CooperVision and co-author of the statement, about the key recommendations, areas of clinical debate, and how the guidance aims to support more consistent and confident myopia management in everyday practice.

Tacy Song: The Joint Position Statement is a consensus-driven guidance developed by a panel of ophthalmologists and optometrists across the Asia-Pacific region to standardize the clinical use of contact lenses for myopia control. It focuses on two key evidence-based interventions—myopia control soft contact lenses (MCSCLs) and orthokeratology (ortho-k)—and provides practical recommendations for their integration into everyday clinical practice.

The statement was built on both real-world clinical insights and expert deliberation, combining survey findings from eye care professionals (ECPs) with structured roundtable discussions. Its purpose is to bridge variation in clinical practice by providing clear, actionable guidance on patient selection, lens fitting, monitoring protocols, treatment outcomes, and when to discontinue therapy.

Ultimately, it serves as a pragmatic framework to help ECPs deliver consistent, evidence-informed care, with the goal of improving myopia control outcomes and long-term ocular health in children across diverse practice settings in the region.

Tacy Song: Despite the growing body of evidence supporting myopia control interventions, their adoption in clinical practice remains inconsistent. Many ECPs continue to rely on traditional approaches such as single-vision spectacles, often due to familiarity, lack of standardized guidance, or variability between professional disciplines.¹ 

In the Asia-Pacific region, this variability is further amplified by differences in healthcare systems, training backgrounds, and access to treatments. Without a shared framework, clinical decisions—such as when to initiate treatment, how to monitor progression, or when to stop therapy—can differ significantly between practitioners. 

A consensus was therefore needed to align ophthalmology and optometry perspectives, reduce variability, and provide confidence in clinical decision-making. By standardizing key elements of patient care, the position statement helps ensure that children receive optimal and consistent myopia management regardless of where care is delivered.

Importantly, this consensus recognizes the role of contact lenses as a practical, real-world solution for myopia management – combining proven efficacy with strong compliance and consistent wear,²  while also improving visual quality, quality of life, and children’s confidence, participation in daily activities, and overall self-perception.^3,4 

Tacy Song: The key findings for the clinical use of contact lenses in myopia management across the patient journey were:

• Patient selection: Myopia control contact lenses can be initiated from as young as 5 years old and continued into early adulthood, depending on clinical need.
• Fitting protocols: For MCSCLs, trial lens fitting is recommended, with slit-lamp examination and over-refraction as key assessments. For ortho-k, multiple fitting approaches are acceptable (trial lenses, empirical methods, or software), with slit-lamp examination, corneal topography, and fluorescein evaluation as key assessments.
• Visual outcomes: Acceptable visual acuity is ≥6/9, with a target of achieving 6/6 where possible.
• Monitoring and follow-up: Regular follow-up is essential, particularly at 3, 6, and 12 months in the first year. Key parameters include refraction, axial length, vision, ocular health, adaptation, and compliance. Follow-up schedules differ slightly between MCSCL and ortho-k but emphasize structured, ongoing monitoring.
• Treatment outcomes: Target: ≤0.50 D progression per year. Axial length benchmarks are age-dependent (stricter in older children).
• Treatment cessation: Typically considered from ≥18 years old. Based on stable refraction (0.00–0.25 D/year) and minimal axial elongation (≤0.10 mm/year).
• Combination therapy: Low-dose atropine (0.01%–0.05%) may be used alongside contact lenses where appropriate.

Tacy Song: One of the key challenges during the consensus process was reconciling differences between ideal clinical standards, published evidence, and real-world practice patterns across the region. Variability existed in areas such as visual outcome expectations, fitting assessments, and monitoring approaches.

A clear example was the discussion around acceptable visual acuity outcomes. While achieving 6/6 vision is the clinical goal as all children in the MiSight® 1 day clinical trial had 6/6 vision, the panel recognized that this may not always be consistently achievable in myopia control practice with the different types of contact lens for myopia management. Through discussion, the group agreed that 6/9 or better represents an acceptable and pragmatic outcome, while still maintaining 6/6 as the aspirational target. This reflects a balance between ideal clinical outcomes and what is realistically achievable in routine care. 

Another area of debate was the role of fluorescein pattern evaluation in orthokeratology fitting. Although some evidence suggests limited benefit for fitting accuracy, it remains widely used across the region. The panel ultimately agreed to retain fluorescein assessment as a key parameter, acknowledging its practical value and familiarity among clinicians. 

These challenges were addressed through structured, evidence-informed dialogue, supported by survey data and consensus polling. The discussions were led by Dr. Foo, Head of the Myopia Centre at Singapore National Eye Centre, and supported by Dr. Kate Gifford, Chair of the International Myopia Institute, who brought global clinical guidance into the conversation. This combination ensured that the final recommendations were both grounded in regional real-world practice and aligned with international standards.

Tacy Song: This position statement aims to shift the conversation from “whether” to treat myopia to “how” to treat it effectively and consistently. 

It also highlights the importance of collaboration between optometrists and ophthalmologists, encouraging a more integrated approach to patient care. Aligning clinical practices across professions helps build confidence among ECPs and supports clearer communication with patients and their families. 

Importantly, the statement brings real-world practice into the conversation, demonstrating that evidence-based interventions can be successfully implemented in everyday settings. This helps bridge the gap between clinical trials and daily practice, ultimately supporting broader adoption of myopia control strategies.

Tacy Song: The next step is to translate these recommendations into practical tools that support day-to-day clinical implementation. This includes simplified clinical algorithms, decision aids, and training programs that enable eye care professionals to apply the guidance confidently and consistently in practice.

Education will also be critical—not only for practitioners, but equally for patients and parents. Clear communication around the importance of early intervention, treatment adherence, and realistic expectations will be key to driving meaningful engagement and improving long-term outcomes.

Importantly, local adaptation is already beginning to take shape. Given the variation in regulatory environments and treatment availability, these recommendations need to be contextualized at a country level. In markets such as Singapore and Taiwan, the position statement has already been used as a foundation for the development of country-specific consensus guidelines, helping to translate regional recommendations into locally relevant practice.

Notably, the strength of this initiative lies in its broad regional representation, with contributing authors from Singapore, Malaysia, Hong Kong, Australia, Japan, Korea, and Taiwan. This diversity has enabled the recommendations to reflect real-world practice across Asia-Pacific, and the authors have collectively played an active role in amplifying the guidance through education, clinical engagement, and professional platforms.

Finally, continued research and the generation of real-world evidence will be essential to further refine and evolve these recommendations, ensuring they remain aligned with emerging data and the realities of clinical practice.