Recent findings from a first-of-its-kind clinical study evaluated the efficacy of HOYA Vision Care’s Defocus Incorporated Multiple Segments (DIMS) spectacle lenses among pre-myopic, preschool-aged pediatric patients.
The data was presented during the 2025 Association for Research and Vision in Ophthalmology (ARVO) earlier this month.
Before we get to this research, refresh me on DIMS.
DIMS is a HOYA-patented, non-invasive technology utilized in the company’s MiYOSOMART spectacle lenses.
- The intent: To correct myopia refractive error and provide clear vision for pediatric patients.
How it works: The lens technology uses a honeycomb-shaped segment treatment area (the defocus zone) to slow myopia progression as well as a clear zone (the focus zone) with a patient’s prescription.
- What this does: The focus zone enables clear vision while the defocus zone simultaneously manages myopia—see here for a more detailed, visual explanation.
Now for these spectacle lenses.
Notably: The MiYOSMART spectacles can be fitted to a pediatric patient in a similar manner to that of single-vision lenses.
The design: Includes a highly impact-resistant and thin, lightweight lens material (for ultraviolet protection and optical clarity) as well as:
- Anti-reflective coating to minimize lens scratches
- Water-repellant properties to prevent water stains
And the clinical data on them?
Check out the plethora of supporting research.
Included in this: 8-year data evaluating the MiYOSMART spectacles with DIMS tech for long-term myopia control among patients aged 16 to 21. Read our coverage.
- And in recent news: Earlier this year, HOYA introduced an expanded power range for the MiYOSMART, accommodating both high myopia and astigmatism.
- See here for those details.
Alrighty, now to this latest research.
We’ll start with the basics: Investigators conducted a pilot study at the National Yang Ming Chiao Tung University Hospital in Yilan, Taiwan.
The participants: 24 pre-myopic patients (aged 5 to 6) with cycloplegic refraction from +0.75 diopters (DED) to –0.50 D.
- Among the criteria:
- Cycloplegic spherical equivalent (SE) < +1.00 D and > -0.50 D in the more ametropic eye
- Astigmatism of ≤1.50D in both eyes
- Anisometropia of ≤1.50D
And the setup?
Participants were instructed to wear photochromic DIMS spectacle lenses with a plano central zone for 9 months.
- To note: Spectacle lens wear was initially only on a part-time basis—such as during near-work activities at home, on the weekends, and holidays.
As for monitoring: Patients were evaluated at baseline and monitored every 3 months, with most entering elementary school by the 9-month visit of the study.
- Throughout: If SE increased to ≤ -1.00D in either eye, lenses were re-prescribed to maintain 6/7.5 or better visual acuity (VA).
What was measured at these visits?
Primary and secondary outcomes were the 9-month change in cycloplegic SE and axial length (AL), respectively.
Exploratory outcome measures included the change in:
- Subfoveal choroidal thickness (CCT)
- Near-work behavior
- Outdoor activity
And how was compliance tracked?
Patients’ caregivers (parents) logged their adherence to the required wearing in daily diaries, with a ≥52.4% adherence considered “good compliance.”
Was there a control cohort to compare against?
Indeed. A total of 378 pre-myopic pediatric patients (aged 5 to 7; mean age: 5.4) were enrolled in a comparable cohort.
- Note: These participants were from a separate longitudinal study with an annual SE change of –0.15 D/year.
Now to the findings.
Over the 9-month study period, investigators reported the average SER remained stable, with just a slight shift observed that equated to +0.06 D per year:
- Average SER at baseline: +0.375 D (±0.319 D)
- Average SER at 9 months: +0.432D (±0.33 D)
- p = 0.471
Interestingly: Three patients whose SE progressed faster than others had one or both parents with high myopia—suggesting a potential genetic predisposition as well as an emphasis on the need for intervening early in similar patient cases.
How did this compare to the control group?
By contrast, the average SER for these patients equated to –0.15 D per year.
Next: Talk axial length.
Among those 24 pre-myopic patients, their AL increased significantly.
- Baseline: 22.48 mm (±0.61 mm)
- 9 months: 22.64 mm (±0.63 mm)
- p < 0.01
And CCT?
This remained stable throughout the 9-month period:
- Baseline: 351.3 μm ±55.9 μm
- 9 months: 348.2 μm ±50.7 μm
- p = 0.726
So how was overall spectacle lens adherence?
The study authors reported adherence to be “high,” with an average wearing rate of 74%.
- Remember: Their target rate was just 52%.
Further: Patients’ caregivers reported "minimal visual complaints" in their daily compliance tracking.
Did any patients become myopic, even after wearing the spectacles?
Just one—accounting for 4.2% of the 24 participants.
What may have influenced this: Investigators noted that this patient had already started elementary school at the start of the study, potentially suggesting that an increase in near-work demands and a decrease in time spent outdoors may have contributed to the accelerated progression of myopia.
- Why this is significant: The authors reasoned that the +95% of patients who did not become myopic underscores the potential of the DIMS spectacles to “delay or prevent myopia onset in high-risk children.”
Compare this to prior research on another form of myopia control: atropine.
While not a direct match in terms of study design and setup, myopia incidence was much lower for this study (4.2%) versus the 2023 LAMP2 study (28.4%).
- Quick refresh: The LAMP2 study evaluated the use of low-concentration (0.05%) atropine drops in affecting the incidence of myopia among pediatric patients (aged 4 to 9; mean age: 6.8).
The inferred takeaway: DIMS spectacle lenses may be more effective as a less invasive option (and alternative to atropine) for pre-myopic pediatric patients.
Interesting … and were there any limitations from this study?
Three key drawbacks of the study were noted.
- Small sample size
- For the future: A larger study size is needed to confirm the preliminary data from this research—as well as to apply it for a broader population size
- Short follow-up
- For the future: Further research with longer-term outcomes beyond 9 months is needed, particularly on outcomes after patients are enrolled in school
- Lack of direct randomized control
- For the future: A randomized trial with a matching control (instead of a matched historical control, as used in this trial) would result in more accurate and precise findings
And overall?
In general, the study authors determined that the average stability in SE among pre-myopic patients suggested a “protective effect of DIMS spectacle lenses on refractive status.”
- Plus: The high adherence in spectacle lens wear further supported the lenses’ effectiveness in preventing myopia-related symptoms.
And as lead researcher Dr. Hsin-Yu Yang (Lisa) told Glance:
- “For the first time, we have clinical evidence suggesting that DIMS spectacle lenses may prevent the onset of myopia in pre-myopic preschoolers, marking a significant advancement in the field of preventing this condition.”
Product Disclaimer: *MiYOSMART spectacle lenses have not been approved for myopia management in all countries, including the United States, and are not currently available for sale in all countries.
Editor's note: This article was updated on May 16, 2025.