Myopia Control Options Compared: A Guide for Markham & Toronto Families

Your eyes are getting worse every year—or you're watching this happen to your child. You've done the research and know that myopia control treatments exist—but now you're facing a confusing array of options. Ortho-K. MiSight. Atropine. Specialty glasses. What's the difference? Which one is right for you?

At Elevate Vision Care in Markham, we see this every week — families across Markham, Unionville, and the broader Toronto area navigating a confusing array of myopia control options. This guide breaks down each treatment available at our clinic so you can make a confident, informed decision.

Why Myopia Control Matters

First, let's address why this matters at all.

Myopia isn't just about needing stronger glasses. As myopia increases, so does the risk of serious eye diseases later in life:

Every diopter of myopia prevented is meaningful. Keeping your child at -3.00 instead of -6.00 isn't just about thinner glasses—it's about substantially lower lifetime risk of vision-threatening conditions.

This is why myopia control isn't optional for anyone with progressive myopia. It's proactive healthcare.

The Four Main Options

Let's look at each treatment category in depth.

Option 1: Orthokeratology (Ortho-K)

What It Is

Ortho-K uses specially designed hard contact lenses worn overnight to temporarily reshape the cornea. You wake up with clear vision and go through the day without glasses or contacts.

How It Works

The lenses gently flatten the central cornea during sleep. This corrects myopia and creates optical changes across the retina that signal the eye to slow its growth. When the lenses are removed in the morning, the reshaping effect lasts throughout the day.

Effectiveness

Research shows Ortho-K slows myopia progression by 40-60% compared to regular glasses, according to reviews by the International Myopia Institute(opens in new tab). Some studies show even greater effect in certain populations.

The Experience

Nightly routine:

1. Insert lenses 15-20 minutes before bed

2. Sleep with lenses in place (6-8 hours minimum)

3. Remove lenses in the morning

4. Clean and store lenses for next night

5. Enjoy glasses-free vision all day

Adaptation period: Most patients adapt within 1-2 weeks. The first few nights may involve some lens awareness, and morning removal takes practice.

Cost in Markham/Toronto

• First year: ~$2,500 (fitting, lenses, follow-ups)

• Ongoing years: ~$1,200 (replacement lenses, monitoring)

Best For

• Anyone who wants freedom from daytime glasses/contacts

• Active individuals involved in sports, swimming, or dance

• Patients aged 6+ with moderate myopia (-1.00 to -6.00 D)

• Those committed to a consistent nightly routine

• Children and teens with progressive myopia (excellent for slowing progression)

Not Ideal For

• Patients with certain corneal conditions

• Those who can't commit to the nightly routine

Pros and Cons

Option 2: MiSight Contact Lenses

What It Is

MiSight lenses are daily disposable soft contact lenses designed specifically for myopia control. They look and feel like regular soft contacts but have a special optical design that slows eye growth.

How It Works

MiSight uses "ActivControl" technology—concentric ring zones that create myopic defocus on the peripheral retina. This signals the eye to slow its elongation while still providing clear central vision for daily activities.

Effectiveness

A 3-year randomized clinical trial(opens in new tab) published in Optometry and Vision Science showed MiSight slows myopia progression by 59% compared to single-vision lenses. Six-year follow-up data(opens in new tab) confirms the effect is sustained with continued wear.

The Experience

Daily routine:

1. Insert fresh lenses each morning

2. Wear throughout the day

3. Remove and discard in the evening

4. No cleaning or overnight storage

Adaptation period: Similar to regular soft contacts. Most patients adapt within days.

Cost in Markham/Toronto

• Annual cost: $1,000-$1,200 (includes lenses, fitting, follow-ups)

• Cost remains consistent year over year

Best For

• Patients already comfortable with contact lenses

• Those who prefer daytime lens wear

• Anyone who may forget overnight Ortho-K or sleeps irregularly

• Simpler routine preference

Not Ideal For

• Patients with dry eyes or allergies affecting contact lens comfort

• Those who want to avoid all daytime lenses (prefer glasses-free)

Pros and Cons

Option 3: Low-Dose Atropine Eye Drops

What It Is

Atropine is a medication that, at very low concentrations (0.01%-0.05%), slows the elongation of the eye that causes myopia progression. It's administered as one drop in each eye at bedtime.

How It Works

The exact mechanism isn't fully understood, but atropine appears to act on receptors in the retina and sclera to slow eye growth. It doesn't correct vision—you still wear glasses or contacts—but it reduces how quickly your prescription changes.

Effectiveness

Studies show low-dose atropine slows progression by 30-50% depending on concentration. The ATOM2 study(opens in new tab) in Singapore and the LAMP study(opens in new tab) in Hong Kong provide the strongest evidence:

• 0.01%: ~30% reduction, minimal side effects

• 0.05%: ~50% reduction, mild side effects

The Experience

Daily routine:

1. One drop in each eye at bedtime

2. Continue wearing regular glasses or contacts during the day

3. That's it

Adaptation: Virtually no adaptation needed. Some patients notice mild light sensitivity with higher concentrations.

Cost in Markham/Toronto

• Annual cost: ~$500 (compounded drops plus monitoring visits)

• Must be obtained from a compounding pharmacy

Best For

• Anyone seeking the lowest-cost option

• Patients who can't tolerate contact lenses

• Adults with progressing myopia who want a simple solution

• Add-on treatment to boost other myopia control methods

Not Ideal For

• Those wanting vision correction included (atropine doesn't correct vision)

• Anyone extremely sensitive to light

• Cases where contact-based treatments are more suitable

Pros and Cons

Option 4: Myopia Control Spectacle Lenses

What It Is

Several specialty glasses lenses have been developed for myopia control, including:

• DIMS lenses (Defocus Incorporated Multiple Segments)

• HALT lenses (Highly Aspherical Lenslet Target)

• DOT (Diffusion Optics Technology)

These look like regular glasses but incorporate optical zones that create peripheral defocus to slow eye growth.

Effectiveness

Clinical studies show these specialty lenses slow progression by 50-67%—comparable to or better than contact lens options. A 2-year trial of DIMS lenses(opens in new tab) (MiYOSMART) published in the British Journal of Ophthalmology showed 59% reduction. Stellest HALT lenses showed up to 67% reduction in full-time wearers(opens in new tab) according to results published in JAMA Ophthalmology.

The Experience

Daily routine:

• Wear glasses normally throughout the day

• No special handling or care beyond regular glasses

Adaptation: Minimal. Most children adapt immediately.

Cost in Markham/Toronto

• Per pair: $600-$800

• Need new lenses as prescription changes (typically annually)

• Annual cost: $600-$800

Best For

• Anyone who prefers glasses over contacts

• Younger children not ready for contact lenses

• Those wanting the simplest possible routine

• Patients with dry eyes or allergies that limit contact lens options

Not Ideal For

• Active individuals who find glasses limiting for sports

• Those who want to be glasses-free

• Anyone who frequently loses or breaks glasses

Pros and Cons

Side-by-Side Comparison

Efficacy data from peer-reviewed clinical trials.

Making the Decision: A Framework

Consider Age

Children Ages 4-7:

• Atropine is typically the first option for pre-myopia if indicated

• Specialty glasses if available and affordable

• May transition to contacts later

Children & Teens Ages 6-17:

• All options available

• Match to lifestyle and preferences

• Often the ideal age to start contact lens options

Adults 18+:

• If myopia is still progressing, any option may help

• Ortho-K excellent for vision correction + control

• Atropine simplest add-on to existing glasses

Consider Lifestyle

Very active in sports:

• Ortho-K provides the most freedom (glasses-free during all activities)

• MiSight requires removal for swimming/water sports

• Glasses limit certain sports

Irregular sleep schedule:

• MiSight or atropine + glasses better choices

• Ortho-K needs consistent 6-8 hours of wear

Anxious about eye touching:

• Start with atropine + glasses or specialty lenses

• May warm up to contacts over time

Consider Your Priorities

Lowest cost:

• Atropine

• Specialty glasses

Simplest routine:

• Specialty glasses (just wear them)

• Atropine (one drop at bedtime)

Most freedom:

• Ortho-K (glasses-free days)

Consider Progression Rate

Rapid progression (>1.00 D/year):

• Consider combination therapy (e.g., atropine + Ortho-K)

• More aggressive approach justified

Moderate progression:

• Single treatment usually sufficient

• Monitor and adjust if needed

Combination Therapy: When One Isn't Enough

For patients with aggressive myopia—high prescription, rapid progression, strong family history—we sometimes combine treatments:

Atropine + Ortho-K:

• Atropine addresses biochemical pathway

• Ortho-K provides optical defocus

• May provide greater control than either alone

Atropine + MiSight:

• Same dual-mechanism principle

• Often used when single treatment shows insufficient control

Atropine + Specialty Glasses:

• Lowest-effort combination

• Good for anyone who can't wear contacts

Combination therapy adds cost but may be worthwhile for high-risk cases. We typically try single treatments first and escalate if progression continues.

What Doesn't Work

Let's be clear about what doesn't control myopia:

Regular glasses: Correct vision but do nothing to slow progression. Your child's prescription will continue to worsen.

Regular contact lenses: Same as glasses—vision correction only.

Under-correction: Some old theories suggested prescribing weaker glasses. Research shows(opens in new tab) this actually worsens progression. Don't do it.

Getting Started

If myopia is progressing—whether in you or your child—here's the path forward:

Step 1: Comprehensive Myopia Assessment

We'll evaluate:

• Current prescription

• Rate of progression (comparing to previous exams)

• Axial length (eye length measurement)

• Corneal shape and health

• Lifestyle and preferences

Step 2: Review Options Together

We'll discuss:

• Which treatments suit your child's profile

• Realistic expectations for each

• Costs and insurance considerations

• Your family's priorities

Step 3: Begin Treatment

Once you've chosen a path:

• For Ortho-K: Fitting appointments and training

• For MiSight: Fitting and lens supply

• For Atropine: Prescription to compounding pharmacy

• For Specialty Glasses: Lens ordering and fitting

Step 4: Monitor and Adjust

Ongoing monitoring includes:

• Regular progression checks

• Axial length measurements

• Treatment adjustments as needed

The Bottom Line

There's no single "best" myopia control treatment—only the best treatment for your situation. The right choice depends on age, prescription, lifestyle, and personal preferences.

What matters most is starting treatment. Every year of uncontrolled progression adds to lifetime myopia and associated risks. The research is clear: myopia control works, and earlier intervention provides the most benefit.

For children and teens: Early intervention is key—the sooner treatment starts, the more progression we can potentially prevent.

For adults: If your myopia is still changing, you're not "too old" for myopia control. The same treatments that work for children can help slow your progression too.

At Elevate Vision Care, we offer all major myopia control options and will help you find the right fit. If you're in Markham, Unionville, Scarborough, Richmond Hill, or the Toronto area, our team can help you find the right myopia control treatment for your child. Book your consultation(opens in new tab) to learn which approach makes the most sense for you.