By Jaclyn Chang, OD

I recently had the chance to discuss how myopic control can benefit our patients with contact lens residency trained optometrist, Dr. Rosa Yang.

Here is the conversation.

Dr. Rosa Yang

Dr. Yang pursued a post-graduate residency program in Cornea and Contact Lenses at the University of Waterloo.

She is the recipient of the Sheldon Wechsler Contact Lens Residency Award from the American Academy of Optometry and was awarded First Place in Clinical Poster from the Global Specialty Lens Symposium.

Dr. Yang has particular interests in myopia control (including ortho-K), dry eye and corneal disease management.


Jaclyn:  What myopia control options are available?

Rosa:  There are several options including the MiYOSMART spectacle lenses by Hoya, MiSight soft contact lenses or off-label use of soft multifocals, Atropine, and ortho-K.

As a clinician, I think it is good to be aware of all the options so you can choose the most appropriate option for your patient.

Jaclyn: How do you choose one myopia control option over another for a patient? Is it very individual to that patient’s comfort level and particular case?  

Rosa: I don’t want to oversimplify, but, yes, there are selection criteria where we weigh one option over another. These include prescription, the parents’ budget, and the underlying eye condition.

A big factor is also how comfortable the patient is with handling contact lenses. Do they want to handle the contacts themselves or is it something that the parents might want to be more involved with? For the latter, ortho-K might be the better option because it’s mainly done at home at night.

For a patient who doesn’t want to wear hard contact lenses or glasses, and if the parents are hesitant about putting their kids on a medication (Atropine), soft contact lenses are the option we would be considering.

The only FDA approved soft contact lens for myopia control is MiSight, but it is limited by the fact that it is not available with astigmatism. In patients who have astigmatism, multifocal soft contact lenses can be used to implement the peripheral defocus effects.

Jaclyn: Under what circumstances might you select specifically designed spectacle lenses (like  MiYOSMART) for the patient?

Rosa: Some patients have been wearing spectacles and would like to continue wearing them. For them, it makes sense to keep them in myopia control lenses like MiYOSMART.

There are also patients who are uncomfortable pursuing contact lenses (i.e. they have trouble handling CLs, they are poor CL candidates) or the parents are uncomfortable having their kids on long-term atropine drops, then we would consider spectacles.

MiyoSmart lenses may also have larger prescription ranges than the contact lenses.

Jaclyn: When would you initiate myopia control treatment? Do you monitor until you see progression or initiate at the onset of myopia?

Rosa: Currently there is no consensus amongst clinicians, but when I see evidence of fast progression, then I initiate myopia control. Average progression is -0.50D per year, so anything above that might urge me to start myopia control; sometimes you may want to monitor a little bit more to see.

There are also clinicians that see myopia control as a preventative treatment that should be used more widely, especially considering the global myopia pandemic, so it’s a grey area.

Jaclyn: Are there certain things that we can say to our patients to help them better understand the importance and benefit of myopia control treatment? How can we help them understand the health implications associated with myopia?

Rosa: This is a very good question, because this is a topic that I discuss with every parent when we talk about myopia control. I tell them that the reason we pursue myopia control is not just the high prescription itself, it’s not just the inconvenience of having really thick glasses, it’s the ocular health implication.

“When you have a high prescription, the eyeball is usually more elongated, which means that the tissues in the eyeball get stretched out and are thinner; this predisposes them to certain ocular health complications, some of which are vision threatening. There is a higher risk of retinal detachment, maculopathy, and glaucoma.”

When I emphasize this, parents usually understand. With myopia control, it’s very important that parents understand what you’re doing, why you’re doing it, and how you’re doing it.

Jaclyn: Thanks for that – hearing the way that other doctors counsel always helps me with how I counsel my patients. Education makes such a big difference to patient care. 

Rosa: Yes, exactly, with myopia control, sometimes parents wonder why their child’s prescription still increases. That’s why with myopia control, it’s very important to have a consultation.

The management we’re doing is not to stop myopia, it’s to slow down the progression of myopia; regardless, the child is still going to progress.

Another thing to realize, for example, with ortho-K, is that some parents may think that once you wear the ortho-K lenses, that the prescription is completely gone, so explaining the process and treatment is very important.

Jaclyn: Thank you so much Dr. Yang! This gives our audience some things to think about and implement into everyday practice. 

Previous discussions with Dr. Rosa Yang: 
Pursuing a Contact Lens Residency: 



Dr. Jaclyn Chang graduated from the University of Waterloo (UW) with an Honours Bachelor of Science in Biomedical Sciences before continuing at Waterloo to complete her Doctor of Optometry degree. She is currently a practicing optometrist in Toronto.

Dr. Chang is committed to sharing information and bringing new resources to her colleagues. As a student, she sat on the Board of Trustees for the American Optometric Student Association, organizing events to connect students with industry. She was the Co-Founder/Co-President of the award-winning UW Advancement of Independent Optometry Club, the first club at UW dedicated to private practice optometry. Dr. Chang is also a passionate writer, who aims to make information accessible and easily digestible to her colleagues. She has published in Optometry & Vision Science and Foresight magazine and contributed to Optik magazine. She is excited to bring valuable resources to Canada’s next generation of optometrists with


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Dr. Devan Trischuk was born and raised in Yorkton, Saskatchewan

Interest in optometry started from a young age with yearly visits to his OD for stronger glasses due to rapidly progressing myopia

Lectures across Canada to other ODs and health care professionals on myopia management

Dr. Devan Trischuk

Doctorate of Optometry from the University Of Waterloo.

He received the Michael Gutwein Memorial Award for his graduating class at Waterloo (2011)

Selected as one of the top “40 Under 40” optometrists in Canada by Johnson and Johnson Vision (2018)


Why did you choose your field?

I was a young, rapidly progressing myope. From age 7 I needed a bump in Rx every ~6 months before eventually plateau-ing in my early 20’s. My childhood optometrist, Dr. Ron Rogoza, always brought such positive energy, laughter and smiles to my appointments that I always looked forward to them. (I also looked forward to more minus, like all good myopes 😉 )

These fond memories paired with an interest in math/science/healthcare directed me towards optometry as a career.

What changes to eye care do you see coming down the pipe?

I see myopia management becoming the standard of care for myopic children. I look forward to the day when the awareness in the general population of this specialty area results in parents/guardians expecting myopia management for their child.

Hopefully this increased awareness also results in preventative measures being taken – time outdoors, appropriate amounts of near work, future preventative treatments (?) – so that there is an improvement in the global projections of increasing myopia and severity.

What is something you have done in your practice to set you apart.

Offering a wide range of myopia treatment options.
The ability to tailor a treatment plan to each child’s exam findings/visual needs/family dynamic coupled with the constantly increasing number of evidence-based, effective treatment options has allowed more families to access myopia management than ever before.

What business books would you recommend other ECPs read?

‘How to Win Friends and Influence People’ – Dale Carnegie.
A great book for anyone to read – improve your work and personal life.

What advice would you give a new grad today?

Shadow more senior practitioners – there is an immense amount that can be learned from observing those years of experience in action.

Last time you laughed?

Being a human jungle gym for my kids.
Listening to my 4.5 year old daughter describe her perception of the world around her.

What’s your Favorite food?

My wife’s Prime Rib with a nice red wine.

Favorite past-time/hobby?

Previously it was taking in outdoors/sports for my own enjoyment, but it has now shifted to instilling (forcing?) a love of outdoors/active lifestyle in my children.

You can listen to Dr. Trischuk discuss his perspective on myopia control on our Eyes Wide Open Podcast. 


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Dr. Devan Trischuk, OD shares his perspective on myopia control with host Dr. Glen Chiasson. In particular, they discuss the place for a truly effective new spectacle lens option, MiyoSmart, as part of the myopia management kit tool.

About the Guest

Dr. Devan Trischuk’s interest in optometry started from a young age with yearly visits to his optometrist for stronger glasses due to his rapidly progressing myopia. He was born and raised in Yorkton, SK, completed his Bachelor of Science – Honours Physiology degree at the University of Alberta in 2007 and his Doctor of Optometry at the University of Waterloo in 2011. He received the Michael Gutwein Memorial Award for his graduating class at Waterloo.

Dr. Trischuk has taken his interest in Myopia Management a step further and has begun lecturing across Canada to other optometrists and health care professionals on this topic. He is in private practice in Saskatoon.


Episode Notes

Dr. Devan Trischuk discusses his personal motivation to pursue help for young myopes and improve their quality of life.

He shares information on the evolution of spectacle lenses in the treatment of myopia and the reasons he is impressed with the the most recent addition to the tool kit – MiyoSmart lenses from Hoya.

Dr. Trischuk deems this new option as effective as the best conventional myopia management options available based upon the results of clinical trials. He outlines why and when he considers the spectacle lens as a first choice treatment option and discusses how his patient follow up plans have evolved with experience.

Dr. Trichuk provides an overview of the D.I.M.S mechanism of action to slow down axial growth.

Finally, Dr. Trichuk discusses how to address, or preempt, the pricing discussion with patients’ given the differential between standard single vision lenses and this specialty lens option.




Dr. Glen Chiasson

Dr. Glen Chiasson

Dr. Glen Chiasson is a 1995 graduate of the University of Waterloo School of Optometry. He owns and manages two practices in Toronto. In 2009, he co-hosted a podcast produced for colleagues in eye care, the “International Optometry Podcast”. He is a moderator of the Canadian Optometry Group, an email forum for Canadian optometrists. As  a host of  “Eyes Wide Open”, Glenn  looks forward to exploring new new technologies and services for eye care professionals.

Dr. Chiasson enjoys tennis, hockey, and reading. He lives in Toronto with his wife and two sons.

Dr. Chiasson splits EWO podcast hosting duties with Roxanne Arnal.


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