MiYOSMART vs Stellest vs Ortho-K: Which Suits Your Child?

Your child’s myopia is changing. Therefore, you want to do more than update their standard glasses each year.

During your research, you may find three common options:

• HOYA MiYOSMART spectacle lenses
• Essilor Stellest spectacle lenses
• Orthokeratology, also called Ortho-K

All three options aim to help manage childhood myopia. However, they work in different ways.

MiYOSMART and Stellest are specialised spectacle lenses. Your child wears them during the day.

Ortho-K uses custom contact lenses that your child wears while sleeping. They remove the lenses after waking.

So, which option is better?

There is no single answer for every child. The choice should depend on the prescription, eye health, age, lifestyle and ability to follow the care plan.

This MiYOSMART vs Stellest vs Ortho-K guide explains the practical differences. It can also help you prepare questions for your child’s optometrist.

Why Does Childhood Myopia Need More Than Clearer Vision?

Myopia, or short-sightedness, makes distant objects appear blurry.

Standard single-vision glasses can correct this blur. However, they are not specifically designed to slow myopia progression.

Myopia often progresses as the eye grows longer from front to back. This change is called axial elongation.

Specialised myopia management options aim to slow the rate of progression. However, they cannot guarantee that myopia will stop.

The optometrist may monitor:

• The glasses prescription
• Axial length
• Visual clarity
• Eye health
• Treatment use
• Comfort
• Lifestyle needs
• Changes between appointments

Eye Philosophy provides information about its available myopia control spectacle lenses, including MiYOSMART and Stellest. The page explains that both designs combine central vision correction with specialised optical zones.

What Is MiYOSMART?

MiYOSMART is a spectacle lens developed by HOYA.

It uses Defocus Incorporated Multiple Segments technology. This is commonly shortened to DIMS.

The lens contains two main areas:

1. A central zone that corrects the child’s distance vision
2. A surrounding treatment area made of small lens segments

These segments create a different optical signal around the central correction.

The child wears MiYOSMART lenses like normal glasses. However, consistent wear remains important.

A two-year randomised clinical trial studied DIMS lenses in 183 children aged 8 to 13. The researchers compared the lenses with standard single-vision glasses and found slower average myopia progression and axial elongation in the DIMS group. However, results varied between children, and the study population should be considered when applying the findings to an individual child. Read the DIMS spectacle lens clinical trial.

Possible Advantages of MiYOSMART

MiYOSMART may suit families who prefer glasses because:

• No contact lens insertion is required
• No overnight lens wear is needed
• The lenses can correct vision throughout the day
• The child may already feel comfortable wearing glasses
• The care routine is similar to normal spectacle care
• The lenses use an impact-resistant material
• Parents can easily see whether the child is wearing them

However, the child must wear the glasses consistently. Broken, lost or poorly fitting frames may interrupt the treatment plan.

What Is Stellest?

Stellest is a specialised spectacle lens developed by Essilor.

It uses Highly Aspherical Lenslet Target technology. This is commonly shortened to H.A.L.T.

Like MiYOSMART, Stellest includes a central area for clear distance vision. It also includes a surrounding treatment zone.

The treatment zone contains highly aspherical lenslets. These lenslets create a volume of myopic defocus in front of the retina.

The design differs from MiYOSMART. However, both lenses aim to provide clear central vision while delivering a myopia management signal.

A one-year randomised clinical trial compared spectacle lenses with highly aspherical lenslets against other lens designs and standard single-vision lenses. Children wearing the highly aspherical lenslet design showed less average myopia progression and axial elongation than the single-vision group. Again, individual outcomes varied. Read the highly aspherical lenslet clinical trial.

Possible Advantages of Stellest

Stellest may appeal to families because:

• It is a spectacle-based option
• It does not require contact lens handling
• It corrects distance vision during daily wear
• The child can follow a familiar glasses routine
• Parents can monitor whether the glasses are being worn
• It may suit children who are not ready for contact lenses

However, the lenses must sit correctly in front of the child’s eyes.

A loose or poorly fitted frame may affect comfort and lens positioning. Therefore, frame selection and professional measurements matter.

What Is Ortho-K?

Ortho-K uses custom rigid gas-permeable contact lenses.

The child wears them overnight. The lenses temporarily reshape the front surface of the eye, called the cornea.

The child removes the lenses in the morning. They may then experience clearer vision during the day without glasses or daytime contact lenses.

The effect is temporary. Therefore, the child must continue wearing the lenses as prescribed to maintain the vision correction.

Ortho-K may also create an optical effect that helps slow axial elongation in some children.

In the randomised ROMIO study, researchers compared children using Ortho-K with children wearing single-vision spectacles. The Ortho-K group showed less average axial elongation over two years. However, some participants stopped the treatment, and Ortho-K still requires careful fitting, hygiene and regular monitoring. Read the ROMIO Ortho-K clinical trial.

Parents can learn more about Eye Philosophy’s Orthokeratology service in Melbourne, including assessment, corneal mapping and follow-up care.

Possible Advantages of Ortho-K

Ortho-K may interest families because it can:

• Reduce dependence on glasses during the day
• Avoid daytime soft contact lens wear
• Support active sports routines
• Remove frames during dance or gymnastics
• Make helmets and protective equipment easier to wear
• Provide a non-surgical and reversible form of vision correction
• Form part of a myopia management plan for suitable children

However, Ortho-K requires more daily responsibility than spectacle lenses.

The child and parent must follow the cleaning, insertion and removal instructions carefully.

MiYOSMART vs Stellest vs Ortho-K at a Glance

This table provides a general comparison only. It does not determine which option suits your child.

MiYOSMART vs Stellest: What Is the Main Difference?

MiYOSMART and Stellest are both spectacle lenses. Therefore, their daily routines are similar.

The main difference lies in the optical design.

MiYOSMART uses multiple defocus segments arranged around the central correction.

Stellest uses highly aspherical lenslets arranged in rings around the central zone.

Parents may focus heavily on which technology reports a higher percentage in a study. However, percentages from separate studies should not be compared as though the studies were identical.

The studies may differ in:

• The ages of the children
• The starting prescriptions
• The location of the research
• The number of participants
• Wearing time
• Study length
• Methods used
• The comparison group
• The way results were calculated

Therefore, a published percentage does not predict an individual child’s outcome.

The better practical question is:

Which lens can your child wear correctly and consistently?

Which Spectacle Lens Is Better for an Active Child?

An active child can still use MiYOSMART or Stellest.

However, parents should consider the activity.

Running and General Play

A secure, well-fitted frame may work well. Sports straps can also help prevent slipping.

Contact Sports

Standard frames may not provide suitable eye protection.

The child may need sport-specific protective eyewear. Parents should ask whether the required protective frame can accommodate the specialised lens design.

Dance and Gymnastics

Some children wear glasses comfortably. Others find that frames move during turns, jumps or floor routines.

Cycling

Glasses can provide clear vision. However, the child may also need suitable protective eyewear.

Swimming

Children should not swim while wearing Ortho-K lenses.

Ortho-K lenses are removed in the morning. Therefore, a suitable wearer may enter the pool without a contact lens on the eye.

However, swimming still involves eye health risks. Goggles remain important because pool water can irritate the eyes and carry microorganisms.

A child using MiYOSMART or Stellest may need prescription swimming goggles if they cannot see clearly without their glasses.

Which Option May Suit a Child Who Loses or Breaks Glasses?

A child who regularly loses glasses may find spectacle-based treatment difficult to follow.

Still, this does not automatically make Ortho-K the better choice.

Ask why the glasses are being lost.

For example:

• Does the frame feel uncomfortable?
• Does it slip down?
• Is the child embarrassed to wear it?
• Do they remove it for sport?
• Does the prescription feel wrong?
• Is the frame too fragile?
• Does the child have trouble remembering their belongings?

A better-fitting frame may solve some problems.

On the other hand, a child who cannot manage glasses may also struggle with the detailed hygiene routine required for Ortho-K.

Therefore, parents should assess overall responsibility rather than one behaviour.

Which Option May Suit a Child Who Dislikes Contact Lenses?

MiYOSMART or Stellest may provide a simpler starting point for a child who fears anything touching their eyes.

The child can wear the lenses as ordinary glasses. They do not need to learn insertion and removal.

However, attitudes can change.

Some children become open to contact lenses as they grow older. Others gain confidence after a careful contact lens teaching session.

Do not force a frightened child to use Ortho-K. Anxiety may affect safe lens handling and treatment consistency.

Which Option Requires the Most Parent Involvement?

Ortho-K usually requires the highest level of daily parent involvement, especially at the beginning.

Parents may need to:

• Supervise handwashing
• Check lens cleaning
• Help with insertion
• Help with removal
• Inspect the lens case
• Replace care products
• Watch for redness or discomfort
• Attend follow-up appointments
• Ensure the child never rinses lenses with tap water
• Contact the clinic if a problem develops

MiYOSMART and Stellest require less complex daily care. However, parents still need to:

• Encourage full-time wear as advised
• Clean the lenses correctly
• Check the frame fit
• Arrange repairs quickly
• Keep backup glasses where appropriate
• Attend regular myopia reviews

No treatment works well when the family cannot follow the recommended routine.

What Are the Safety Considerations?

MiYOSMART and Stellest Safety Considerations

Spectacle lenses do not carry the same infection risk as contact lenses.

However, possible concerns may include:

• Adaptation to the optical design
• Peripheral visual awareness
• Headaches or visual discomfort
• Incorrect lens centration
• Poorly fitted frames
• Scratched lenses
• Broken frames
• Inconsistent wear

Children should report any ongoing visual discomfort.

The optometrist should also check that the frame remains correctly positioned.

Ortho-K Safety Considerations

Ortho-K involves overnight contact lens wear. Therefore, it carries contact lens-related risks.

These may include:

• Corneal infection
• Corneal inflammation
• Redness
• Pain
• Light sensitivity
• Corneal staining
• Lens binding
• Fluctuating vision
• Glare or haloes
• Poor lens positioning
• Reduced vision if wear becomes inconsistent

Good hygiene can reduce avoidable risk. However, it cannot remove every risk.

Children should stop wearing the lenses and seek prompt professional advice if they develop pain, increasing redness, discharge, strong light sensitivity or reduced vision.

Does Ortho-K Provide Better Myopia Control Than Spectacle Lenses?

You cannot determine the best option from a simple online ranking.

Research supports several myopia management treatments. However, the response varies between children.

For example, one child may respond well to a spectacle lens. Another may continue to progress despite good wear.

Likewise, Ortho-K may work well for one child but provide a less suitable visual result for another.

The optometrist may consider:

• The child’s age
• The current prescription
• The rate of change
• Axial length
• Corneal shape
• Astigmatism
• Pupil size
• Eye health
• Family history
• Previous treatments
• Wearing habits
• Lifestyle
• Treatment preference

Therefore, the treatment with the strongest published average is not automatically the best treatment for your child.

Can a Child Switch From MiYOSMART or Stellest to Ortho-K?

Yes, a child may be reassessed for another option.

For example, a family may consider switching because:

• The child’s lifestyle has changed
• Glasses interfere with sport
• The frame is frequently damaged
• The child now feels ready for contact lenses
• Progression continues despite good spectacle wear
• The child prefers glasses-free daytime vision
• The current treatment is difficult to maintain

However, the optometrist should first confirm that Ortho-K is clinically suitable.

The child may need:

• A new eye examination
• Corneal topography
• Tear-film assessment
• Axial length measurement
• A review of the current progression rate
• Contact lens handling instruction
• A discussion about risk and cost

The child should continue using their existing correction until the optometrist gives different instructions.

Can a Child Switch From Ortho-K to Spectacle Lenses?

Yes.

Ortho-K creates a temporary corneal change. Therefore, the cornea gradually returns toward its previous shape after treatment stops.

However, the prescription may fluctuate during this transition.

The optometrist may need to monitor the child before finalising new spectacle lenses.

Parents should not stop Ortho-K immediately before ordering expensive glasses without discussing the timing with the practitioner.

Can Treatments Be Combined?

In selected cases, an optometrist may discuss combined myopia management.

For example, a child may use an optical treatment alongside prescription atropine eye drops.

However, combining treatments does not guarantee a better result for every child.

It may also add:

• More cost
• More appointments
• More side-effect considerations
• A more complex routine
• Greater responsibility for the family

The optometrist should explain why a combined approach is being considered.

Parents should also understand what will be monitored and when the plan will be reviewed.

How Important Is Consistent Wear?

Consistency matters for all three options.

MiYOSMART

The child generally needs to wear the glasses as directed throughout the day. Removing them for long periods may reduce the intended treatment exposure.

Stellest

Likewise, consistent daily wear supports the prescribed plan.

Ortho-K

The child usually needs to wear the lenses during sleep according to the schedule provided by the optometrist. Missed nights may cause daytime vision to fluctuate.

However, perfect adherence does not guarantee a specific result.

The child may still show some progression even when the family follows every instruction.

Myopia management aims to slow change. It does not promise to stop it.

How Does Frame Choice Affect MiYOSMART and Stellest?

Frame choice is more than a fashion decision.

The frame must hold the lenses in the correct position.

A suitable frame should:

• Fit the child’s face securely
• Avoid constant slipping
• Sit comfortably behind the ears
• Rest correctly on the nose
• Provide suitable lens depth
• Keep the optical centre aligned
• Remain stable during normal activity
• Encourage the child to wear it

A frame that looks good but constantly slips may not support consistent, correctly positioned wear.

Children also grow quickly. Therefore, the frame fit may change before the next annual eye test.

Parents should return for an adjustment when the glasses become loose.

What Happens During a Myopia Management Assessment?

A myopia management assessment should look beyond the current prescription.

The optometrist may assess:

• Distance and near vision
• The glasses prescription
• Eye coordination
• Focusing ability
• Corneal shape
• Axial length
• General eye health
• Family history
• Previous prescription changes
• Outdoor time
• Near-work habits
• Sports and hobbies
• Treatment preferences
• The family’s ability to manage care

For Ortho-K, the practitioner will also assess whether the corneal shape and eye surface suit overnight lens wear.

Eye Philosophy provides children’s eye tests and myopia management in Melbourne at its Williamstown and Doncaster clinics. The optometrist may recommend further testing based on the child’s clinical needs.

Questions to Ask Before Choosing

Bring a list of questions to the appointment.

You may ask:

• How quickly has my child’s myopia changed?
• Has their axial length increased?
• Which options suit their prescription?
• Why do you recommend this option?
• What evidence supports it?
• What are the risks?
• What can we realistically expect?
• How many hours should the treatment be used?
• How often will reviews occur?
• How will you assess whether it is helping?
• What happens if progression continues?
• Can we change treatment later?
• What are the initial and ongoing costs?
• Will my child need backup glasses?
• What should we do if a lens is lost or damaged?

The practitioner should explain the choices without pressuring you.

Myopia Management in Williamstown and Doncaster

Eye Philosophy Optometrists provides children’s eye examinations and myopia management at two Melbourne locations.

Williamstown Clinic

28 Douglas Parade
Williamstown VIC 3016
Phone: (03) 9397 5895

Doncaster Clinic

700 Doncaster Road
Doncaster VIC 3108
Phone: (03) 9042 0977

Both clinics provide access to myopia assessments and treatment discussions. However, appointment times and service availability may change. Confirm the current details when booking.

Final Thoughts on MiYOSMART vs Stellest vs Ortho-K

MiYOSMART, Stellest and Ortho-K can all form part of childhood myopia management.

MiYOSMART and Stellest may suit children who prefer the simplicity of glasses.

Ortho-K may suit some children who want clearer daytime vision without frames. It may also appeal to active children. However, it requires careful contact lens hygiene and regular follow-up care.

No option can guarantee that myopia will stop.

Therefore, focus on four questions:

1. Is the treatment clinically suitable?
2. Can the child use it safely?
3. Can the family follow the routine?
4. Can the optometrist monitor the result over time?

The best option is not always the most advanced one. Instead, it is the option that meets the child’s needs and can be followed consistently.

The next article focuses closely on the differences between the two spectacle lens designs. It is useful for parents who prefer a glasses-based myopia management option but remain unsure which lens to discuss.

Read our next blog about “MiYOSMART vs Stellest: Which One Actually Helps Slow Your Child’s Myopia?” here: Read the related Eye Philosophy blog.

Book your appointment here: https://eyephilosophy.com.au/contact-us/