How a moment of inspiration on public transport led to a breakthrough in myopia control

The seed of an idea for an innovative myopia control method was sown one day during an unassuming bus journey.

At the time, Hong Kong academics, Professors Carly Lam and To Chi-ho, had reached an impasse in their research.

They had established through a clinical trial that contact lenses incorporating both myopic defocus and vision correction could slow down myopia progression in children.

However, there were issues with teaching children to safely insert and remove contact lenses, as well as the problem of allergic reactions and dry eyes in some children.

“We seemed to be stuck,” Professor Lam told OT.

“We knew a contact lens could work but for young children it was not the ideal optical appliance,” she shared.

Professor Lam recounted how Professor To was travelling on a bus one day when he had a moment of inspiration.

“On the window, part of the surface was a meshwork of dots which formed advertising pictures on the outside of the bus. It suddenly came to him that one could have small circles of myopic defocus on the spectacle lens and achieve vision correction,” Professor Lam shared.

"For all researchers, it takes a certain type of luck to allow you to get the right result"

Promising technology

The resulting technology displayed promising results in a two-year randomised, double-blind clinical trial involving 160 Chinese children.

Spectacles with defocus incorporated multiple segments (DIMS) lenses slowed myopia progression in 60% of participants and stopped myopia progression in 21.5% of children.

In collaboration with optical lens company, Hoya, here are plans to launch the spectacles in Hong Kong and China this year before rolling out the technology to Japan, Europe, Australia and the US next year.

Professor Lam emphasised that the partnership with Hoya was a positive one.

“For all researchers, it takes a certain type of luck to allow you to get the right result,” she shared.

“Hoya has the technology and the manufacturing capacity. With the research done, we can have this available in a very short time. It is a very good illustration of how research can be translated into practice with the right partners,” Professor Lam elaborated.

Recognition

The DIMS spectacle lens received the Grand Prize at this year’s International Exhibition of Inventions of Geneva.

Professor Lam said that the accolade prompted a lot of interest in the research.

“People were very excited and thought it was a wonderful but simple idea,” she shared.

“But for us, it is 13 years of hard work engaging in the topic and understanding the processes,” Professor Lam observed.

The Hong Kong academic completed her undergraduate and Master’s degrees in the UK before returning to Hong Kong to work.

She noticed that the proportion of people with myopia was very high in Hong Kong compared to the UK, with a survey of optometry students revealing a prevalence of 70%.

“We started going to schools and rest homes to look at a whole spectrum of ages, from the very young to the very old,” Professor Lam shared.

Professor Lam and colleagues were surprised by the number of myopes who were in a younger age group, suggesting that the increase in myopia was a recent trend.

“From that set of work there were more questions that we wanted to answer. What were the factors affecting myopia incidence and progression? Were they related to genetics or environment?”

"So many kids are wearing glasses and contact lenses so young."

A growing problem

A series of studies conducted by Professor Lam suggested that the education system in Hong Kong tended to drive young children to become myopic.

This pattern was also seen in Taiwan and Singapore, Professor Lam added.

She emphasised that myopia is not just an inconvenience, but can affect vision quality and result in retinal pathology.

“So many kids are wearing glasses and contact lenses so young. They have an extra inconvenience every morning and in many activities during the day,” she added.

“I wanted to study myopia because it is a topic where we can prevent harm and help future generations,” Professor Lam concluded.