When a parent walks up to my counter and tells me their child's prescription jumped another half dioptre in six months, I can see the worry on their face. They have been googling. They have found terms like "myopia control" and "Stellest vs MiYOSMART" and now they want to know which one actually works. I get this conversation at least a few times a month, and it is one of the most important ones I have in this job.
Both Stellest (by Essilor) and MiYOSMART (by Hoya) are specialty lenses designed to slow the progression of myopia (nearsightedness) in children. They use different technology to achieve a similar goal, and both have solid clinical evidence behind them. Here is what I explain to parents, along with the honest trade-offs.
Why Myopia Progression Matters
Before comparing lenses, it helps to understand why slowing myopia matters in the first place. Myopia is not just about needing thicker glasses. Higher levels of myopia are associated with increased risk of serious eye conditions later in life, including retinal detachment, glaucoma, cataracts, and myopic maculopathy. A child whose prescription reaches -6.00 or beyond faces meaningfully higher lifelong risk compared to a child who stays at -2.00.
The World Health Organization has identified myopia as a growing global health concern. The prevalence has increased dramatically over the past few decades, and researchers estimate that by 2050, roughly half the world's population will be myopic. Genetics play a role, but environmental factors — particularly increased near work and decreased outdoor time — are driving the acceleration.
This is where myopia control comes in. The goal is not to cure myopia. It is to slow its progression during the critical years (roughly ages 6 to 16) so that a child ends up with a lower final prescription and fewer associated risks.
Head-to-Head: Stellest vs MiYOSMART
Both lenses work by manipulating how light focuses on different parts of the retina. Standard single vision lenses correct central vision but allow peripheral light to focus behind the retina, which may stimulate the eye to grow longer (and thus more myopic). Both Stellest and MiYOSMART create a "myopic defocus" signal in the periphery that discourages this elongation.
They just do it differently.
| Feature | Essilor Stellest | Hoya MiYOSMART |
|---|---|---|
| Technology name | H.A.L.T. (Highly Aspherical Lenslet Target) | D.I.M.S. (Defocus Incorporated Multiple Segments) |
| How it works | 1,021 invisible aspherical lenslets arranged in 11 rings around a central clear zone | Hundreds of small defocus segments (+3.50D) embedded across the lens surface |
| Clear vision zone | Central 9mm zone for sharp distance vision | Central 9.4mm zone for sharp distance vision |
| Myopia slowing (2-year data) | 67% slower progression vs standard lenses | ~60% slower progression vs standard lenses |
| Axial length control (2-year data) | 62% slower axial elongation | ~60% slower axial elongation |
| Clinical study | Multi-centre study published in JAMA Ophthalmology (2022) | Published in British Journal of Ophthalmology (2020) |
| Lens material | 1.59 Polycarbonate | 1.60 MR-8 resin |
| Impact resistance | Polycarbonate — high impact resistance, good for active kids | Standard resin — good but not as impact-resistant as polycarbonate |
| UV protection | Built-in UV filter | Built-in UV filter |
| Manufacturer | Essilor (EssilorLuxottica) | Hoya Vision Care |
| Available coatings | Crizal anti-reflective options | Various anti-reflective options |
| Approximate cost (lenses only, Canada) | $400 – $650 | $400 – $700 |
The numbers are close. Both lenses deliver roughly 60% or better slowing of myopia progression, which is significant. A child who might have progressed -1.00D over two years in standard lenses might only progress -0.35 to -0.40D in either of these. Over the full growth period, that difference compounds.
Myopia Progression: What the Numbers Look Like
Parents always ask me: "How much will this actually help?" Here is a simplified look at how myopia progression compares with and without management:
| Scenario | Starting Rx (Age 8) | Annual Progression | Estimated Rx at Age 16 |
|---|---|---|---|
| No myopia management (standard lenses) | -1.00 | -0.50 to -0.75 per year | -5.00 to -7.00 |
| With Stellest or MiYOSMART (~60% slowing) | -1.00 | -0.20 to -0.30 per year | -2.60 to -3.40 |
| With myopia control + lifestyle changes | -1.00 | -0.15 to -0.25 per year | -2.20 to -3.00 |
These are approximations. Every child is different, and progression rates vary. But the pattern is consistent: myopia control lenses can meaningfully reduce where a child ends up. The difference between -3.00 and -7.00 is not just thicker lenses. It is a different risk profile for the rest of their life.
Important: Myopia control lenses are not a cure. They slow progression, not stop it. Your child will still need regular eye exams (typically every 6 to 12 months) to monitor changes. The optometrist managing myopia will adjust the treatment plan as needed.
Age Suitability and When to Start
Both Stellest and MiYOSMART are designed for children, typically ages 6 through 16. This is the window when myopia progresses most aggressively, particularly between ages 8 and 12.
The general consensus among optometrists who specialise in myopia management is: the earlier you start, the more benefit over time. If your child's prescription is increasing by -0.50D or more per year, that is a signal to discuss myopia management with their eye doctor. Waiting until the prescription is already high means you have missed years of potential slowing.
Some parents ask about using these lenses for teenagers over 16. At that point, myopia progression typically slows naturally as the eye finishes growing. Your optometrist may suggest transitioning back to standard lenses, or they may recommend continuing if progression is still active. It is a case-by-case decision.
The Adjustment Period
This is one of the first questions parents ask: "Will my kid find these uncomfortable?" The honest answer is that most children adapt remarkably quickly.
Both Stellest and MiYOSMART have a central clear zone that provides sharp, undistorted vision straight ahead. The peripheral treatment zones can create a subtle difference in side vision that some children notice initially. It is not blurriness exactly. More like a slight softening at the edges. Most kids stop noticing within three to five days.
In the Stellest clinical trials, over 91% of children reported satisfactory vision within the first week. MiYOSMART reports similar adaptation rates. Children tend to adapt faster than adults because their visual system is more plastic and flexible.
My advice to parents: commit to a full week before making any judgments. If your child is still uncomfortable after 7 to 10 days, go back to the prescribing optometrist for a recheck. It is rare, but occasionally the fitting needs adjustment.
The Screen Time Question
Parents almost always bring up screen time, and rightfully so. Research has consistently linked increased near work (including screen time) and decreased outdoor time with faster myopia progression. This is why kids spending more time on devices is a concern beyond just eye strain.
The current evidence-based recommendations are:
- Outdoor time: At least 90 to 120 minutes per day. Sunlight exposure appears to have a protective effect against myopia progression, independent of physical activity.
- Near work breaks: Follow the 20-20-20 rule. Every 20 minutes, look at something 20 feet away for 20 seconds.
- Working distance: Hold devices and books at least 30cm (12 inches) from the eyes.
- Screen-free time before bed: At least 30 to 60 minutes.
Myopia control lenses are most effective when combined with lifestyle modifications. The lenses alone do excellent work, but adding outdoor time and near-work management creates the best outcome.
Other Myopia Control Options
Stellest and MiYOSMART are the two most prominent spectacle lens options, but they are not the only myopia management tools available:
- Orthokeratology (ortho-K): Hard contact lenses worn overnight that temporarily reshape the cornea. Good efficacy data, but requires compliant kids comfortable with contact lens wear.
- Low-dose atropine drops: Pharmaceutical approach using diluted atropine eye drops (typically 0.01% to 0.05%). Prescribed by the optometrist, used nightly. Moderate efficacy with minimal side effects at low doses.
- Soft multifocal contact lenses: Specialty soft contacts with peripheral defocus zones, similar in concept to Stellest and MiYOSMART but in contact lens form. Suitable for older children comfortable with contacts.
Some optometrists use combination therapy (for example, myopia control lenses plus low-dose atropine) for children with very aggressive progression. This is a clinical decision made by the managing optometrist based on the individual child's pattern.
Cost and Insurance in Canada
Let me be upfront about cost because it matters. Myopia control lenses are more expensive than standard single vision lenses. In Canada, you can expect to pay $400 to $700 for the lenses alone, plus the cost of the frame. Standard single vision lenses typically run $150 to $300 for comparison.
Insurance coverage is inconsistent. Most plans cover glasses for children, but many do not specifically distinguish between standard and myopia management lenses. Some plans have a flat dollar amount for lenses ($150 to $250 is common), which helps offset but does not fully cover the cost. Check your plan details or call your insurer before committing.
Is it worth the extra cost? I think so, but I understand it is a significant investment. When you factor in the potential for lower final prescriptions, reduced need for high-index lenses over a lifetime, and the decreased risk of myopia-related eye disease, the value proposition is strong. But every family has a different financial reality, and there is no judgment in choosing standard lenses while implementing lifestyle changes instead.
Frequently Asked Questions
Which is better, Stellest or MiYOSMART?
Neither is objectively better. Both have strong clinical data showing roughly 60% slowing of myopia progression compared to standard single vision lenses. The efficacy numbers are close enough that the difference is not clinically meaningful. The choice often comes down to which lens lab your optical works with, availability in your area, and your child's specific prescription needs. Both are excellent options, and your optometrist can help determine which one makes more sense for your child.
At what age should a child start myopia control lenses?
Both Stellest and MiYOSMART are designed for children aged 6 to 16, the years when myopia progresses most rapidly. Starting earlier generally provides more cumulative benefit because you are slowing progression over a longer period. If your child's prescription is increasing by -0.50D or more per year, bring it up with their optometrist at the next exam. Waiting until the prescription is already high means missing the window where these lenses provide the most value.
How much do Stellest and MiYOSMART lenses cost in Canada?
In Canada, expect to pay between $400 and $700 for the lenses, depending on the prescription strength and coating options. This is on top of the frame cost. Standard single vision lenses typically run $150 to $300 by comparison. Insurance may cover a portion, but many plans do not specifically account for myopia management lenses. It is worth calling your insurer to ask what your plan covers before placing an order.
Do myopia control lenses actually work?
Yes. Both Stellest and MiYOSMART have been validated in peer-reviewed clinical trials published in reputable journals. Stellest showed 67% slowing of myopia progression over two years in a study published in JAMA Ophthalmology. MiYOSMART showed approximately 60% slowing over two years in a study published in the British Journal of Ophthalmology. These results are among the strongest of any non-pharmaceutical myopia control intervention.
Can adults use Stellest or MiYOSMART lenses?
These lenses are designed and tested for children and adolescents whose myopia is actively progressing. By adulthood, myopia typically stabilizes as the eye stops growing. There is no clinical evidence supporting their use for adults, and no benefit to wearing peripheral defocus lenses when the eye is no longer elongating. Adults with high myopia should discuss their options with their eye care provider, which may include surgical or contact lens solutions.
Is there an adjustment period with myopia control lenses?
Most children adapt within a few days to one week. The peripheral treatment zones may cause a slight difference in side vision initially, but the brain adapts quickly. In clinical trials, over 90% of children wearing both Stellest and MiYOSMART reported satisfactory vision within the first week. Children adjust faster than adults in general. Give it a solid week before making any judgments, and if discomfort persists beyond 10 days, return for a recheck.
Does screen time make myopia worse in kids?
Research strongly suggests that prolonged near work (including but not limited to screen time) and insufficient outdoor time are associated with faster myopia progression. The exact biological mechanism is still being studied, but the epidemiological correlation is well-established across multiple large studies. Current guidelines recommend at least 90 to 120 minutes of outdoor time daily for children and regular breaks from near work following the 20-20-20 rule (every 20 minutes, look 20 feet away, for 20 seconds).
This article is for informational purposes only and does not constitute medical advice. Myopia management is a clinical decision that should be made in consultation with your child's optometrist, who can assess progression patterns and recommend the most appropriate treatment plan.