Early experiences with the HOYA MiYOSMART Sun spectacle lenses - Q&A with Marianne Goldwaser and Jagrut Lallu

Myopia is a growing concern worldwide.¹ MiYOSMART spectacle lenses, known for their Defocus Incorporated Multiple Segments (D.I.M.S Technology), have been well-received in managing myopia in children. The latest additions to the MiYOSMART family, the sun range, include the MiYOSMART Chameleon and MiYOSMART Sunbird spectacle lenses. Spending more time outdoors brings many health benefits and may be helpful for slowing down myopia progression:^2,3 these new spectacle lenses provide a comprehensive solution that combines high-efficacy myopia management⁴ with visual comfort and sun protection,* especially for those undergoing combination treatment with atropine.

Last year, HOYA Vision Care (HOYA) initiated an international post-market surveillance study across 10 countries involving 18 Eye Care Professionals (ECPs). This post-market surveillance involved participants aged 3 to 20 years old, with 43% under 10 years, 50% between 10-15 years, and 7% aged 16 years and older.⁵ Participants were geographically distributed with 29% from Europe/UK, 35% from Asia, and 36% from Australia and New Zealand. Among the participants, 77% used MiYOSMART Chameleon lenses and 23% used MiYOSMART Sunbird lenses. Additionally, 21% of the participants combined their lens use with low-dose atropine. Notably, 62% of the children had previously worn MiYOSMART clear spectacle lenses before joining the program.⁵

We spoke to Marianne Goldwaser from HOYA Vision Care and New Zealand Optometrist Jagrut Lallu about experiences with the MiYOSMART sun spectacle lenses, including their performance, adaptability, and wearer satisfaction.

Marianne: The MiYOSMART Chameleon spectacle lenses are photochromic lenses, adapting to changing light conditions with category 2 tinting, designed to provide a multipurpose solution  for vision correction and myopia management.^6,7 The MiYOSMART Sunbird spectacle lenses provide consistent category 3 polarized tinting for sun protection, associated to D.I.M.S Technology , and are designed to be used in addition to the clear MiYOSMART spectacle lenses.^6,8

 Both lenses in the sun range, as well as the original clear lenses, offer 100% UV-A and UV-B protection, addressing the need for effective myopia management combined with sun protection. 

Marianne: HOYA initiated the Early Experience Program (EEP) for the MiYOSMART sun solutions to comprehensively evaluate their acceptance among children of diverse ages and ethnic backgrounds. The program aims to assess several key factors: adaptation, tolerance, satisfaction and compliance of these lenses, particularly focusing on outdoor behaviour and sun protection. Additionally, HOYA intends to investigate hypotheses regarding ease of adaptation compared to clear lenses, visual performance in various environments and activities, and the potential reduction in light sensitivity among atropine users. Furthermore, the program seeks to gather insights into wearers' knowledge of sun protection practices, estimate their outdoor exposure duration, and determine average equipment usage times. By incorporating feedback from Eye Care Professionals and spectacle wearers, HOYA aims to ensure that the MiYOSMART sun solutions align closely with practical needs and preferences, thereby enhancing their relevance and effectiveness in real-world applications.

Jagrut: We have been using MiYOSMART in combination with variable strengths of atropine as combination treatment for some time.^9-11 With certain individuals, there is variable pupil effect with compounded atropine, so when this became an option, all our patients were notified, and many adopted this product. Indications are those that are active both indoors and outdoors as well as those on combination treatment, including MiYOSMART clear lens with atropine.

In the EEP, 28% of my patients were under atropine treatment. These were my findings:

Table 1: Improvement in Light Sensitivity Among Atropine Users in the Early Experience Program. The table illustrates the reduction in light sensitivity among atropine users from dispensing to the 3-month follow-up. 

 Initially, a significant portion of users always or frequently experienced light sensitivity (37.50%). At the 15-day follow-up, a majority reported sometimes or infrequently experiencing sensitivity, but by the 3-month follow-up, the frequency of sensitivity decreased, indicating an overall improvement in light sensitivity over time (89 % never squint).

Jagrut: There was no practical difference which means to me that this is an easily interchangeable solution when moving from clear. We noticed 100 % satisfaction at the 3-month follow-up, with an increase in the percentage of very happy users and a decrease in dissatisfaction over time. While the number of cases I manage is limited and further study is needed, this is a positive indication. We have also used the MiYOSMART Sunbird spectacle lens, a sunglass solution with the same effect on comfort and compliance. 

Wearing time results from the EEP of my patients wearing the Chameleon MiYOSMART spectacle lenses:

Table 2: Average Wearing Time of MiYOSMART Chameleon Lenses During Weekdays. This table shows the mean, maximum, and minimum wearing times of the lenses at the time of dispensing, after 15 days, and after 3 months. The data indicates a gradual increase in the average wearing time over the three-month period.

Marianne: We were interested in several metrics when analysing the Early Experience Program such as the overall performance and patient satisfaction with MiYOSMART Chameleon spectacle lenses.  From our analysis of the in the EEP, we discovered that:

• Adaptability: 80% of participants adapted to MiYOSMART Chameleon spectacle lenses within one day.¹² Specifically, 49% adapted instantly, 31% within a few hours. The adaptation duration showed no significant differences between teenagers and young children. This indicates a high and rapid adaptation rate across different age groups.¹²
• Subjective visual performance: all participants reported satisfaction with their visual performance while wearing MiYOSMART Chameleon spectacle lenses in various outdoor conditions.¹² Additionally, 100% of participants were satisfied with their vision in indoor activities. Most participants (86%) did not notice any lens coloration indoors. Both new users and those transitioning from MiYOSMART clear spectacle lenses to Chameleon spectacle lenses experienced similar high-quality vision, indicating consistent satisfaction among all users.¹²
• Colour fading experience: all participants were comfortable with the fading feature of the MiYOSMART Chameleon spectacle lenses.¹² The comfort levels with the fading feature were consistent across different regions, including Europe, Asia, Australia and New Zealand.
• Atropine users can experience light sensitivity due to mydriasis.¹³ In order to combat this, sunglasses and/or photochromic spectacle lenses can be worn; however, no myopia management spectacle lenses with multiple segments had incorporated this feature until the development of MiYOSMART Chameleon and Sunbird lenses, which offer both myopia management  and adaptive sun protection.

It was found that the MiYOSMART Chameleon spectacle lenses significantly alleviated light sensitivity in those also undergoing atropine treatment. The results indicate an improvement in light sensitivity management. See figure 1 for a visual representation of the completed data set. 

We also looked at how users rated their overall experience with the MiYOSMART Chameleon spectacle lenses, and found that the vast majority reported positive experiences, with a combined 98% expressing satisfaction (either happy or very happy) at the 3-month follow-up mark (see Figure 2). This high satisfaction rate demonstrates user acceptance of the MiYOSMART Chameleon spectacle lenses. 

Based on the various elements described, we observed a 98% overall satisfaction at the 3-month follow-up for MiYOSMART Chameleon spectacle lenses.¹⁴

The benefits of time outdoors for myopia management have been well-established in the literature, especially for myopia onset prevention.^{2, 15,16} However, a significant number of children do not spend sufficient time outdoors, with weekdays seeing even less outdoor activity than weekends. Data indicates that 35% of children with MiYOSMART Chameleon and Sunbird spectacle lenses spend no more than 2 hours/day outdoors on weekdays. On weekends, this drops to 23% for Chameleon and 9% for Sunbird users,¹⁷ indicating room for improvement. Furthermore, there is a notable lack of awareness and practice of sun protection among children using MiYOSMART clear spectacle lenses. The majority of children (81%) do not switch to sunglasses, 87% never use clip-on sunglasses, and only 11% always wear a hat for sun protection.

Jagrut: I found that there was still a knowledge gap when it came to spending time outdoors. In the EEP, the results from my patients highlighted this issue. On average, patients spent 3.18 hours per day outdoors. However, this varied considerably, with the maximum outdoor time reported being 8 hours per day and the minimum being just 1 hour per day. These findings underscore the need to actively promote outdoor activities among children to ensure they receive the benefits of adequate time spent outdoors. Increasing awareness and encouraging more outdoor play can help bridge this knowledge gap and improve overall patient outcomes.

We are working to actively promote balance in life with equal time indoors and outdoors in the summer. We also now have this resource that has been worked on to promote education about outdoors through our government departments. I use the recommendations and guidelines developed by the Paediatric Society of New Zealand, which you can access here or on their website. 

The introduction of the MiYOSMART Chameleon and Sunbird spectacle lenses represent a significant step forward in integrating myopia management with sun protection, offering a well-rounded approach to managing childhood myopia. The inclusion of photochromic and polarized spectacle lens solutions ensures that children can benefit from adaptive light management, especially those undergoing combination treatment with atropine. As more data become available, these innovations are likely to play a pivotal role in shaping future myopia management protocols.

PRODUCT DISCLAIMER - MiYOSMART has not been approved for myopia managemen in all countries, including the U.S., and is not currently available for sale in all countries, including the U.S.