The Role of Frame Size in Myopia Management: Insights from Recent Research
Originally presented as a poster at the 2024 International Myopia Conference in Hainan, China.
The Role of Frame Size in Myopia Management: Insights from Recent Research
Originally presented as a poster at the 2024 International Myopia Conference in Hainan, China.
Myopia, commonly known as nearsightedness, is on the rise among children worldwide. This condition can lead to a higher risk of severe vision issues, such as retinal detachment or glaucoma, in adulthood. Fortunately, new innovations in lens technology, like those with Myopic Peripheral Defocus Lenses (MPDL), are showing promise in slowing down the progression of myopia.
MPDL lenses feature a central clear vision zone surrounded by a specialized treatment area designed to control the eye's growth. These lenses create a positive peripheral defocus that increases progressively from the center to the peripheral area of the lens, allowing for more precise control over myopia progression.
In a recent study we presented at the International Myopia Conference, my colleagues and I explored an interesting question: Does the size of a child’s glasses frame influence the effectiveness of MPDL lenses in controlling myopia?
Does frame size matter in Myopia control?
Why frame size could be important
When prescribing glasses for myopia management, optometrists usually focus on fitting the child with a comfortable frame that keeps the lenses positioned correctly. But could the frame’s dimensions—how wide or tall it is and how far the lenses are from the child’s eyes—affect the treatment’s success?
The primary goal of this study was to explore whether the size of a spectacle frame—its horizontal and vertical dimensions and the distances from the pupil to the frame edges—affects the myopia control effects in children wearing MPDL lenses. Understanding this relationship can help eye care professionals (ECPs) make more informed decisions when prescribing myopia management lenses for children, ensuring that they maximize the therapeutic benefits of these advanced lenses.
Figure 1. Fitting characteristics of 2 participants of the study with extremely different face physiognomies, indicating distances from the pupil to the nasal, temporal, superior, and inferior sides of the edge of the frame. (a) Seven-year-old participant wearing a frame with horizontal size of 41 mm, vertical size of 37 mm, and bridge of 18 mm. (b) Eleven-yearold participant wearing a frame with horizontal size of 55 mm, vertical size of 47 mm, and bridge of 14mm
How the study was conducted
Understanding the experiment
The study involved 39 children aged 5 to 12, all diagnosed with myopia. The participants were part of a one-year randomized controlled trial (RCT) to assess the impact of MPDL lenses on axial length growth—a key measure of myopia progression. Over the course of a year, our researchers tracked the children’s eye growth, focusing specifically on the right eye. Eye growth is an important indicator because it helps measure the progression of myopia. The study examined six key frame measurements:
- Horizontal frame size (HBOX): How wide the frame is.
- Vertical frame size (VBOX): How tall the frame is.
- Distances from the pupil to the frame’s edges:
- Nasal (Size-N)
- Temporal (Size-T)
- Upper (Size-U)
- Lower (Size-L)
Spearman's rank correlation coefficient was used to assess the relationships between these frame parameters and the changes in the children’s axial length, a crucial factor in understanding how quickly myopia is progressing. A p-value of less than 0.05 was considered statistically significant for identifying meaningful correlations.
What did the study find?
Figure 2. Frame characteristics variables correlated with axial length growth after 12 months of follow
up: horizontal frame size (HBOX), vertical frame size (VBOX) and distances from pupil position to the
frame edge at the nasal (Size-N), temporal (Size-T), upper (Size-U) and lower (Size-L) sides
Results at a glance
The results were clear: none of the frame parameters significantly correlated with changes in axial length over the 12-month period. Specifically, the statistical analysis showed no meaningful relationship between the frame's horizontal or vertical dimensions and the progression of myopia in the children wearing MPDL lenses. For example, the correlation between axial length growth and HBOX had a Spearman’s rank correlation coefficient of -0.222 (p = 0.171), indicating a weak and non-significant relationship.
These findings suggest that the therapeutic effect of MPDL lenses remains consistent regardless of frame size. It underscores that the focus during prescription should be on ensuring a comfortable and well-fitted frame for children rather than prioritizing larger or specific frame dimensions for treatment efficacy.
In short, the size of the frame doesn’t seem to affect how well MPDL lenses work to slow down the progression of myopia.
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Figure 3. Dispersion graphs representing the distribution of values within the dataset: Relationship between axial length growth after 12 months of follow up and frame characteristics: horizontal frame size (HBOX),
vertical frame size (VBOX) and distances from pupil position to the frame edge at the nasal (Size-N), temporal (Size-T), upper (Size-U) and lower (Size-L) sides
What this means for parents and optometrists
Focus on fit and comfort, not frame size
So what does this mean for optometrists and parents selecting frames for children undergoing myopia management? It’s simple: you don’t need to worry about choosing a specific frame size to improve the effectiveness of myopia management lenses. Instead, the focus should be on finding a frame that fits comfortably and ensures the lenses stay correctly positioned on the child’s face, supporting both comfort and compliance.
Well-fitting frames help make sure the lenses are doing their job and encourage children to wear them regularly—both key factors in managing myopia effectively. Choosing a frame that is too large or uncomfortable may reduce compliance, which is a crucial part of successful treatment.
The bigger picture: Myopia management today
Looking beyond frame size
As myopia becomes a growing concern worldwide, understanding the factors that contribute to successful treatment is key to managing this condition effectively. While advanced lens designs like MPDL can significantly slow myopia progression, their effectiveness is not dependent on frame size. The priority should always be ensuring a good fit and comfortable wear for the child so they stick with the treatment long term.
Therefore, rather than focusing on the dimensions of the frame, it is essential to consider the comfort and long-term compliance of the child wearing the lenses. A frame that fits well and stays securely in place will help ensure consistent use, which is vital for effective myopia management.
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