Myopia control

Ortho-K vs MiyoSmart, Stellest and the other myopia control options

We fit five different myopia control options at NVISION. Here is how they actually differ — what the child wears, when they wear it, what the evidence says and what each one costs.

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Every option on this page does the same underlying job: slowing how fast a child’s short-sightedness gets worse. They differ in how they do it, what the child has to wear and when, and what it costs.

The reason this matters more than the daily convenience: each additional dioptre of myopia raises the lifetime risk of retinal detachment, glaucoma and macular degeneration. Slowing progression in childhood is about long-term eye health, not just about a thinner lens at the next check-up.

There is no single best option — the right one depends on the child’s prescription, how fast it is moving, their age, and honestly, what they will actually stick with. Below is how the options we fit compare.

The options

What we fit, and how each one works

Ortho-K (orthokeratology)

Worn: Overnight only — nothing worn during the day
How it works: Custom rigid lenses gently reshape the cornea while the child sleeps. They come out in the morning and vision stays clear all day.
Evidence: Peer-reviewed studies, including the SMART and ROMIO trials, show Ortho-K slows the elongation of the eyeball by 36–56% compared with standard glasses or contacts.
Best for: Children with faster-progressing myopia, and anyone who does not want to wear anything during the day — sport, swimming and dusty environments in particular.
Trade-off: Requires a nightly routine and a fitting process with follow-ups. Suitable up to roughly -6.00 dioptres with mild astigmatism.
Cost: $2,275 fitting and lens package; $1,600 per replacement pair

More about Ortho-K

Hoya MiyoSmart lenses

Worn: Glasses, worn during the day
How it works: Spectacle lenses with a treatment zone that provides myopic defocus around a clear central zone, while correcting vision normally.
Evidence: The practice publishes a two-year clinical trial result of an average 59% reduction in myopia progression and 60% reduction in axial eye growth.
Best for: Children who already wear glasses happily, families who want no contact lens handling, and younger children not ready for lens care.
Trade-off: Only works while the glasses are on the face — effectiveness depends on genuinely full-time wear.
Cost: $699 with an NVISION frame, or $899 using your own frame

More about Hoya MiyoSmart lenses

Essilor Stellest lenses

Worn: Glasses, worn during the day
How it works: Spectacle lenses combining a myopia control design with clear central vision, plus blue-light filtering.
Evidence: No trial figure for Stellest is published on this site. Ask us at the assessment and we will go through the current manufacturer evidence with you.
Best for: The same profile as MiyoSmart: an established glasses wearer, no lens handling required.
Trade-off: As with any spectacle option, the benefit stops when the glasses come off.
Cost: Quoted at assessment

More about Essilor Stellest lenses

ACUVUE Abiliti

Worn: Soft contact lenses, worn during the day
How it works: Daily soft contact lenses designed specifically for myopia management, worn in place of glasses.
Evidence: No trial figure for Abiliti is published on this site. Ask us at the assessment and we will go through the current manufacturer evidence with you.
Best for: Older children and teenagers who want to be out of glasses during the day but are not suited to, or not keen on, overnight lenses.
Trade-off: Daytime lens wear carries a higher dry eye and handling burden than overnight wear, and lenses must be worn consistently.
Cost: Quoted at assessment

More about ACUVUE Abiliti

Eyerising Myopia Solution

Worn: A desktop device used at home
How it works: A repeated low-level red-light therapy device used at home on a set schedule, rather than a worn correction.
Evidence: No trial figure for Eyerising is published on this site. Ask us at the assessment and we will go through the current manufacturer evidence with you.
Best for: Families looking for an option that does not depend on the child wearing or handling anything, and who can commit to the treatment schedule.
Trade-off: It does not correct vision — the child still needs their glasses. Requires consistent at-home use.
Cost: Quoted at assessment

How to actually decide

If you want the child in nothing during the day

Ortho-K is the only option here that leaves the child with no glasses and no daytime lenses. For sport, swimming and self-consciousness at school, that is often the deciding factor rather than the clinical data.

If the child is happy in glasses

MiyoSmart or Stellest keep everything familiar — one pair of glasses, worn all day, doing two jobs at once. There is no fitting process, no lens handling and no nightly routine, and for many families that is what makes it stick.

If progression is fast

Faster progression raises the stakes, and Ortho-K is generally the stronger option for it. This is a conversation to have with the measurements in front of you, which is why the myopia control assessment exists.

What about atropine drops?

Low-dose atropine can slow progression but does not correct vision, so the child still needs glasses. It is sometimes used alongside another option rather than instead of one.

The honest answer

The best myopia control option is the one that gets used properly every day. A lens design with a slightly better trial figure that a child resents wearing will underperform a slightly weaker option they are happy with. We would rather fit the second one and actually slow the progression.

Common questions

Myopia control questions

Which is more effective, Ortho-K or MiyoSmart?

The published figures are 36–56% reduction in axial elongation for Ortho-K and an average 59% reduction in progression for MiyoSmart, but they come from different trials with different measures and are not directly comparable. The more useful question is which one your child will wear consistently — and how fast their myopia is currently moving.

Can we switch if it isn’t working?

Yes. Progression is monitored at review appointments, and if the measurements show the current option is not slowing things enough, we change the plan. Ortho-K in particular is fully reversible.

Do myopia control options fix my child’s eyesight?

No. They correct vision and slow how fast the myopia worsens. They do not reverse existing short-sightedness, and the goal is a lower final prescription in adulthood than there would otherwise have been.

What does the assessment cost?

A myopia control assessment is $95 and requires up-to-date eye test results. It establishes the current prescription, how fast it is progressing, and which options are suitable before you commit to any of them.

At what age should we start?

Earlier generally means more benefit, because more of the progression is still ahead. Children as young as six can be fitted for Ortho-K, and spectacle options can start as soon as myopia is diagnosed.

Book a myopia control assessment

$95, and it needs up-to-date eye test results. It tells us how fast things are moving before you choose an option.

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