MiSight® 1 day study: helping kids thrive over 7 years - Q&A with Professor Debbie Jones

Professor Debbie Jones: Being part of this seven-year journey has been incredibly meaningful, both personally and professionally. When we first enrolled the children, even committing to three years felt daunting — we were working with eight- to twelve-year-olds, many of whom were newly diagnosed with myopia and experiencing vision correction for the first time. To be able to offer them contact lenses at that age was also quite remarkable because it wasn’t the typical thing to do. At that time in our journey of myopia, we just thought myopia was corrected with spectacles, as the concept of myopia management was relatively new then. So, we had this opportunity to get them in contact lenses right from the start, which was exciting, but also to see these children grow with us. Initially, we had some shy eight and nine-year-olds, who flourished through puberty to become self-confident individuals. We even had twins in the study - twin boys – and they started off quite similar, and then we saw their personalities change as the years went by. To be involved in something that became so life-changing for these children, and not even realizing it at the beginning, has been incredibly meaningful.

Debbie: The children themselves had very few issues throughout the study — they adapted well to contact lens wear and were comfortable attending visits. We worked hard to remain flexible with appointment times and to support families in a way that felt practical and collaborative.

Parents played a huge role in engagement. They could see that their children were being closely monitored and very well cared for. Because this was a clinical study, we provided a little more than routine clinical care — more detailed assessments, more explanations, and more time spent helping families understand what we were measuring and why. I think the parents realized they were part of something that was beneficial to their child. They also saw their children grow in confidence. 

The children wearing MiSight® 1 day showed very little change in prescription. Even though we were masked, we began to notice that something was happening— some children weren't showing the usual progression, while others followed the expected pattern of around a 0.25 D change every six months. Parents of the children whose prescriptions remained stable noticed this as well and were happy with the positive outcome.

Debbie: There’s a real contrast between what myopia control represents now and what it meant back then. At the time, it was a new concept—we didn’t really know if it would work. But going through a clinical study with MiSight® 1 day and seeing its impact on young children gave us that confidence. We now have extensively published data that clearly demonstrates efficacy. The work has been done, the evidence is there, and clinicians can trust the results.

This has shifted how we practise. We know that myopia control is the right thing to do, and we now have multiple options to offer to patients and their families. 

Another major change is the strength of evidence supporting contact lens wear in young children. It’s much easier to say—to both practitioners and parents—that this is safe and achievable.1  Many children have gone before them. Where we once hesitated and felt the need to wait until a child was older or more mature, we now have strong evidence of safety in daily disposable soft contact lenses. We can now say, ‘This is the right approach, and we’re confident it will work.’ For children, this means access to effective vision correction that fits their lifestyle, supports their confidence, and addresses myopia progression at the same time. 

Debbie: Myopia management should be considered the standard of care — regardless of whether it is formally defined as the standard of care in your jurisdiction. We have strong evidence, we have multiple treatment options, and we have a responsibility to act in our patients’ best interests.

We used to hesitate and assume children needed to be older or more mature, but I would encourage clinicians not to underestimate what children are capable of. Working in this study refined my own skills at contact lens handling instruction, and demonstrated to me how well children can manage lenses when given proper guidance. In fact, younger children often do exceptionally well because they listen, they follow instructions, and once they learn the skills, they become very capable. It may not happen immediately for every child, but with good instruction and support, they can get there.

We have daily disposable contact lenses, as well as spectacle and pharmaceutical options* for myopia management, and this allows us to tailor management to the child and their lifestyle. For an active child—whether they dance, play sport, or simply prefer not to wear glasses—contact lenses can be truly life-changing.

So my message to colleagues is simple: don’t hesitate, and don’t make assumptions for your patients. Have the conversation with families, offer them the options, and give it a go. You may be surprised just how capable—and compliant—your youngest patients can be.

Debbie: One of the most memorable aspects for me was seeing the growth in confidence among the children. Many started out shy and quiet—partly because they were young, and partly because they were still getting comfortable with us—but there was a noticeable shift once they began wearing contact lenses. Anyone who is myopic probably remembers that first ‘wow’ moment of wearing contact lenses. The children had that same ‘aha’ moment, especially when they successfully removed a contact lens from their own eye for the first time. I always started with removal, because I found it easier. We would complete all the vision measurements with the contact lenses in, and then I’d say, “Okay, now I’m going to get you to take them out.” That moment—when they realized they could do it—was incredibly exciting for them. 

What made this experience even more special was the length of the study. Over seven years, we watched these children grow into young adults. Some began the study at the upper age limit of 12 years —one child was recruited only a week before his 13th birthday. We saw the progression from parents sitting in the room—sometimes very much “helicopter parents”—to parents waiting outside, to eventually dropping their children off, and finally to the participants driving themselves to appointments.

The conversations evolved too. Early on, we talked about school, homework, favourite video games, and what they wanted for Christmas. Later, it was about starting high school, university applications, and career aspirations. To follow a child long enough to move from “How much homework do you have?” to “What are you going to do with the rest of your life?”—within the same study—was incredibly meaningful. It was also genuinely fun. Seeing the same participants every six months, year after year, created a strong sense of continuity and care. During the first three years, only half of the participants received the myopia control intervention,2  but in the second half of the study, everyone did.3  There was a real sense of excitement in being able to switch all participants over, knowing that every child would benefit during that next phase. That period then extended even further with the rebound study, bringing the total follow-up to seven years.4

Debbie: I’ve always seen myself as a clinician first, and that hasn’t changed—even while taking on the role of a research clinician. What this study gave me was confidence: to offer myopia control to every child who is eligible, knowing that it works and that the evidence supports it.

It also significantly strengthened my confidence in fitting contact lenses for children. Just last week, I saw a young patient—eight or nine years old—with high hyperopia and significant astigmatism, who asked if he could wear contact lenses. I said, “Absolutely.” His mother was surprised, but the answer was very clear to me. If a child wants to wear contact lenses, and there are no contraindications, we shouldn’t deny them that opportunity. Our role is to offer the option and help parents understand that contact lens wear can be safe and successful for children.

On the myopia control side, our understanding has evolved enormously. When this study was underway initially in 2012 we were still in the early stages of the evidence-base. There were genuine light-bulb moments for me and the other co-investigators, as we began to see differences emerge and realized that these interventions were truly having an effect. To witness myopia control working in real time—more than a decade ago—has shaped how I practise today.

Now, with robust, long-term data behind us, we know myopia control works, and we know it’s the right thing to do. Whether or not it is formally defined in your country as “standard of care,” it has to be your own standard of care. That’s why I feel confident speaking with colleagues who are still hesitant or just starting out. When they ask, “Does it really work?” or “Should I be doing this?” my answer is simple: yes, it does—and yes, you should.

*Availability of interventions with regulatory indications and approval to slow progression of myopia varies by country.