The view from France: providing myopia management in clinical practice

The Europe, Middle East, and Africa Miyosmart Case Study Contest took place in Riga, Latvia on 15 May.

The event saw eye care professionals from 30 countries submit case studies outlining their use of Miyosmart spectacle lenses in clinical practice.

Marion Wolff, head of the orthoptics team at Dr Jérôme Harquel’s ophthalmology practices in Obernai and Barr, was selected as the winner of the contest after presenting her case study alongside fellow finalists, Dr Stephanie Kearney, of the UK, and Dr Vitaliya Zhurba, of Kazakhstan.

OT spoke with Wolff about the competition and daily myopia management practice in France.

Could you tell OT about your professional background?

I am a French orthoptist specialising in myopia management. I’ve been working alongside Dr Jérôme Harquel, an ophthalmologist, for the past 15 years in the east of France. Over the years, we have progressively implemented different myopia control strategies, including orthokeratology, defocus contact lenses, and defocus spectacle lenses, such as Miyosmart. In addition to my clinical practice, I teach at the Orthoptics School of Strasbourg. I’m also involved in clinical research projects and professional education, because I believe that sharing knowledge is essential to improve patient care.

What was it like to be involved in the Miyosmart Case Study Contest?

The Miyosmart Case Study Contest [held in Riga, Latvia on 15 May] was a great opportunity to share real-life clinical experiences with colleagues from different countries. Each finalist presented a clinical case related to myopia management, which led to very interesting discussions about treatment strategies and patient outcomes. It was inspiring to meet professionals who share the same interest in myopia management and learn from their experiences. The contest showed me that despite very different healthcare systems from one country to another, clinicians are always looking for ways to improve patient care. We share the same goal – preserving children’s future eye health.

Can you tell me about the case study you presented?

The case study I described related to Eva – a young girl with a strong family history of myopia. Her mother is myopic and her older brother developed myopia at an early age. She presented with several risk factors for myopia onset, including decreasing hyperopia and a long axial length for her age.

Together with the family, we decided to start plano Miyosmart spectacle lenses as an early preventative strategy. I followed her for four and a half years from the age of eight. The outcome was very encouraging – her refraction remained stable, her axial length growth followed an emmetropic growth pattern and she did not develop myopia during the follow-up period. A single case cannot prove that myopia was prevented, but it raises an interesting question about the role of early intervention in pre-myopic children.

The contest showed me that despite very different healthcare systems from one country to another, clinicians are always looking for ways to improve patient care. We share the same goal – preserving children’s future eye health.

What opportunities are presented by the new Hoya myopia management spectacle lens, Miyosmart iQ?

I find it very exciting because of the potential to help children whose myopia has progressed despite treatment. It’s a simple and accessible solution and the initial studies are very promising. In France, we have been prescribing Miyosmart iQ since April. I’m looking forward to seeing the first results coming through in my practice over the coming months

More generally, innovation is crucial for addressing progressive myopia. As clinicians, we always look for personalised solutions that combine effectiveness, comfort, ease of use, and accessibility for children and their families.

Can you tell me about the myopia management options you have available to you in your clinical practice in France?

We have used orthokeratology since 2016 – that was the first myopia management option that became available in France. Next came defocus contact lenses in 2019 followed by Miyosmart spectacle lenses in 2020. We also use low concentration atropine eye drops.

Since June 2025, the French national health insurance has funded Miyosmart spectacle lenses for children who meet certain criteria. It is estimated that there are around 500,000 children in France who are eligible for reimbursement. That was very revolutionary because it meant that children could wear Miyosmart without their families worrying about the cost.

How do you tailor myopia management to the child in front of you as a clinician?

There is no single solution that fits everyone – it depends on age, family history, lifestyle, progression of refraction and axial length. The ability to comply with treatment and cost are also important considerations for families. I would say the best treatment is the one that is both effective and realistic for the family.

An aggressive treatment strategy is recommended for young myopic children, especially if they have a family history of high myopia. In that case, we would prescribe defocus spectacle lenses combined with low concentration atropine treatment. In other cases, when the child is older with moderate myopia and enjoys sports, we might start with orthokeratology contact lenses. The goal is always to provide personalised care rather than apply the same strategy to every patient.