Myopia Management

AMERA EDUCATION & PROFESSIONAL SERVICES• FEBRUARY 2021

 On the successful completion of this training, you should be able
to understand:
outcomes
Learning

1 Importance of Myopia Management

2 Myopia Management solutions

3 How to get started in Myopia Management

4 How to effectively communicate Myopia Management to parents

 Importance Of
Myopia Management
Myopia: Rising Global Prevalence

WORLD POPULATION High Myopia Myopia No Myopia

2020 5.2%* 34%* 60.8%*

7.8 billion

2050 10%* 49.8%* 40.2%*

9.5 billion

Half of the Almost 1 billion

world population people will have
will be myopic* high myopia*

1 in 2 people < -5.00 D

*Holden BA, Fricke TR, Wilson DA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036-1042. doi:10.1016/j.ophtha.2016.01.006
Risks Associated With Myopia
Myopia can lead to serious long-term risks, which may even cause vision impairment.

Any level of myopia increases

the risks of the below
mentioned ocular conditions,
compared to emmetropes,
but the risk increases
exponentially once
reaching high myopia5.

MYOPIC MACULAR RETINAL

PRESCRIPTION CATARACT PSC3 GLAUCOMA4
DEGENERATION1 DETACHMENT2

-6.00 to -9.00 40.6 x risk 21.5 5.5 2.46

-3.00 to -6.00 9.7 9.0 3.1 2.46

-1.00 to -3.00
2.2 3.1 2.1 1.65

1. Vongphanit J, Mitchell P, Wang J. Prevalence and progression of myopic retinopathy in an older population. Ophthalmology 2002; 109: 704-711.
2. Ogawa A, Tanaka M. The relationship between refractive errors and retinal detachment--analysis of 1,166 retinal detachment cases. Jpn J Ophthalmol 1988; 32(3):310-5.
3. Lim R, Mitchell P and Cumming R. Refractive association with cataract: the Blue Mountains Eye Study. IOVS 1999, 40(12): 3021-3026
4. Marcus MW, de Vries MM, Jonoy Montolio FG, Jansonius NM. Myopia as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. Ophthalmology 2011, 118(10):1989-1994.
5. https://www.brienholdenvision.org/news/item/95-changing-the-way-optometrists-think-about-myopia.html
Myopia Progress Quickly In Children, So Early Intervention Is Key

-1

Refractive error (D)

• The younger a child becomes myopic,
-2
the faster they will progress, leading
to higher risk of developing high -3
myopia. Intervening at the earliest -4
possible time significantly reduces
-5
the burden.
-6
• Myopia onset at 7 years of age, -7
progression rate is 0.9D/year* 6 8 10 12 14 16
Age
• Myopia onset at 12 years of age,
Onset 11yrs Onset 9yrs Onset 7yrs
progression rate is 0.30D/year*
Predicted progression model for an Asian
child with myopia of -1.00 D with onset at
various ages*

*Sankaridurg P. A less myopia future: what are the prospects? Clin Exp Optom 2015; 98: 494-496.
 Myopia Correction vs. Myopia Management

Myopia Management
Myopia Correction 1
Undercorrection Myopia Correction Myopia Management
▪ May increase myopia progression. ▪ Provides good central vision. ▪ Provides good central vision and
▪ May be due to peripheral and ▪ Process of correcting the slows down myopia progression.
central blur, stimulating axial length refractive error with single vision ▪ Aimed to delay development or
growth. spectacle lenses or single vision slow myopia progression to avoid
▪ Not encouraged as it has not contact lenses. or reduce the risk of potential
shown to be successful in slowing pathologies in later life2.
▪ Does not delay the
down myopia progression. ▪ Includes multiple options over the
development or slow the
⇒ Refractive correction of long term as myopia develops
progression of myopia.
progressing myopes should be
▪ May be modified depending on the
updated regularly
result of the myopia progression

1) Chung K, Mohidin N, O’Leary DJ. Undercorrection of myopia enhances rather than inhibits myopia progression. Vis Res. 2002;42:2555–9.
2) The impact of myopia and high myopia: report of the Joint World Health Organization–Brien Holden Vision Institute, Global Scientific Meeting on Myopia, University of New South Wales, Sydney, Australia, 16–18 March 2015
Why Myopia Management Is Important
Level of Risks linked to Myopia progression

Reducing myopia by 1 D, has the potential to

reduce the risk of myopic maculopathy by
40%*.
Reducing myopia by 1 D, has the potential to
reduce the risk of retinal detachment by
25%*.
Reducing myopia by 1 D, has the potential to
reduce the risk of open angle glaucoma by
20%*.

Reducing myopia by 1 D, has the potential to

reduce the risk of visual impairment by
20%*.
*Bullimore MA, Brennan NA. Myopia Control: Why Each Diopter Matters. Optom Vis Sci 2019;96:463-5
 Global Children’s Myopia Landscape Show Low Myopia Control
Uptake
~1-3 %3 MYOPIA CONTROL
96% of parents are concerned that their child’s ~ 8 %2 CONTACT LENS
myopia is getting worse but …

~ 90% are corrected by single vision lenses

~ Only 1-3% use myopia control solutions ~90 %1 SV LENS

MC: Myopia Control included solutions such Ophthalmic lens, Orthokeratology and Atropine (negligible)
Sources: POPULATION DATA FROM UNITED NATIONS, estimated for year 2018 based on linear progression of population data from year 2015 to year 2020. 6 to 18 years as scientifically school-age myopia starts from 6 years
and stabilizes by late teens around 18 years, from website: https://www.managemyopia.org/all-about-myopia/types-of-myopia/ Include all countries where Essilor has a subsidiary as indicated in Infomarche 2017
BHVI MYOPIA PREVALENCE article: http://www.sciencedirect.com/science/article/pii/S0161642016000257 Hypothesis for estimation: Myopic prevalence for 2018 estimated assuming a linear progression of myopic
prevalence between year 2000 to year 2050. Myopic prevalence for missing countries took reference from similar regions or neighboring countries.
INFOMARCHE 2017 Population with a visual correct for below 18 years old. [1, 2] INFOMARCHE 2017 Correction methods for wearers below 18 years old [3] ESTIMATE, myopia control products contributed approx. 3% in the
kids market in China and China is considered the biggest market for myopia control. The % total could be > 100% because of multi-equipment.
Potential Benefits Of Myopia Management
DUTY OF CARE
• Minimize myopia progression
& its burden
• Chance to change the lives
and vision of your patients
• Enable parents to make
informed decisions
DIFFERENTIATION
• Expand your expertise and
set your practice apart from
others
• Advance professional
knowledge and proficiency
INCREASED PROFITABILITY
• Better profit vs. myopia correction
• Higher patient satisfaction
generates greater loyalty and
more referrals
Myopia Management Solutions
Goal of Myopia Management

+
CORRECT MYOPIA CONTROL MYOPIA
Deliver clear vision Slow down its progression
Interventions For Myopia Management

The progression of myopia may be slowed down with myopia management solutions,
reducing the number of sight-threatening eye diseases in the years to come

Spectacle Lenses Contact Lenses Pharmaceuticals

Progressive lenses/Bifocals Multifocal CL Atropine
Peripheral Defocus lenses Extended Depth of Focus CL
Dual Focus lenses Dual Focus CL
Stellest™ lenses OrthoK
Management Solutions: Advantages And Disadvantages
Spectacle Lens Soft Contact Lens
Advantages Advantages
• Simple • Wider field of vision
• Non-invasive • Excellent cosmesis
• No adverse effects • Ideal for sports
• Easy to wear and • Stable on the eye
prescribe
Disadvantages
Disadvantages • Lower quality vision
• Aesthetics issue in (ghosting)
bifocals • Risk of infection
• Not suitable for dry eyes
• Difficulties in handling
• Parental supervision
required
Orthokeratology
Advantages
• No need to wear correction
during day
• Wider field of view
• Sports
Disadvantages
• Higher risk of microbial
keratitis than daily wear CL
• Limited prescription range
compared to multifocal CL
• Skills and equipment
required by practitioner
• Parental supervision
required
Atropine
Advantages
• Likely to have good VA when
used with SV correction
Disadvantages
• Duration of treatment
• Dosage and long-term
effects are still not known
• Can dilate pupil and reduce
accommodation requiring
near ADD and/or
photochromic spectacles
• Limited availability
• Rebound effects with high
dosage
Myopia Management Solutions: Summary
Efficacy SER%

Spectacle Lenses1 -3% to 67%

Multifocal soft CL2

18% to 67%

Orthokeratology3 Not measurable

Low-dose atropine4 59% to 75%

-10 0 10 20 30 40 50 60 70 80

1) Sources in annex (slides 31-33)

2) Sources in annex (slides 34-36)
3) Sources in annex (slides 37-39)
4) Low Dose Atropine (0.5%, 0.1%, 0.01%). Results from Atropine 1% were not taken into consideration because of the strong rebound effect observed after cessation of the treatment with such concentration. Sources in annex (Slides 40-42).
Myopia Management Solutions: Summary
Efficacy AL%

Spectacle Lenses1 -6% to 60%

Multifocal soft CL2 22% to 53%

Orthokeratology3 32% to 52%

Low-dose atropine4 -8% to 29%

-20 -10 0 10 20 30 40 50 60 70

1) Sources in annex (slides 31-33)

2) Sources in annex (slides 34-36)
3) Sources in annex (slides 37-39)
4) Low Dose Atropine (0.5%, 0.1%, 0.01%). Results from Atropine 1% were not taken into consideration because of the strong rebound effect observed after cessation of the treatment with such concentration. Sources in annex (Slides 40-42).
 Spectacle Lens Solutions For Myopia Management: Summary
Efficacy SER%

1st Generation (1a)* Progressive addition lenses 11% to 27%

Bifocals: 27% to 38%

1st Generation (1b)* Bifocals and prismatic bifocals 27% to 54% Prismatic Bifocals: 54%

2nd Generation* Peripheral defocus lenses -3% to 14%

3rd Generation* Dual focus lenses 59%

4th Generation* Stellest™ lenses 55% to 67%

-10 0 10 20 30 40 50 60 70 80

*Sources in annex (slides 31-33)

 Spectacle Lens Solutions For Myopia Management: Summary
Efficacy AL%

1st Generation (1a)* Progressive addition lenses 3% to 15%

1st Generation (1b)* Bifocals and prismatic bifocals 34%

2nd Generation* Peripheral defocus lenses -6% to 13%

3rd Generation* Dual focus lenses 60%

4th Generation* Stellest™ lenses 51% to 60%

-10 0 10 20 30 40 50 60 70

*Sources in annex (slides 31-33)

 How To Implement
Myopia Management Into
Your Practice
Scope of Myopia Management

IDENTIFY THE RISK FACTORS PROVIDE ADVICE ON VISUAL PRESCRIBE OPTICAL

OF MYOPIA DEVELOPMENT ENVIRONMENT TREATMENTS TO SLOW DOWN
PROGRESSION
5 Steps Of The Myopia Management Best Practice

INTERVIEW
1 Ask questions to fully assess and manage risk
factors for onset of myopia or myopia progression

EXAMINATION
2 Conduct comprehensive examination to ensure
the best outcome for your management plan

DIAGNOSIS
3 Effective communication of the outcomes of
the examination in a format that the child
and their parents can easily understand

RECOMMENDATION
4 Provide useful advice on visual environment changes
and recommend the most suitable solution

FOLLOW-UP
5 Offer a holistic standard of care to ensure that
myopia progression is always closely monitored
Step 1: Interview

What is your child’s current age?

If your child is already myopic, at what
age did he or she start wearing glasses?

Do you have myopia?

What is the ethnicity of your child?

How many hours does your

child spend outdoors?

Aside from school hours, how much time

does your child spend on close work?
Myopia Risk Factors

RISK FACTOR LOW RISK MEDIUM RISK HIGH RISK

Current age of Child1-4 16 years old or older 8 to 16 years old 7 years old or younger
1
Age of myopia onset1-4 16 years old or older 8 to 16 years old 7 years old or younger

2 Family history of myopia1,5 No parents myopic One parent myopic Both parents myopic

East Asian living in

western countries.
3 Ethnicity4, 6-8 African + Rural East Asian + Urban
Other Asian, European &
Latino living anywhere

4 Time spent outdoors1,5,9,10 > 2.5 hours / day 1.5 to 2.5 hours / day 0 to 1.5 hours / day

Time spent on near work1,9,11

5 0 to 2 hours / day 2 to 3 hours / day > 3 hours / day
(outside of school hours)

Refractive error12 < +0.75D

– –
(risk of myopia onset) (6 - 7 years of age)
6
Progression over
< 0.50 -0.50 to < -1.00 ≥ -1.00
the last year1,13
*References in annex (slides 47)
Myopia risk factor categorization is utilized under license from Myopia Profile Pty Ltd
 Step 2: Examination

Unaided Vision + VA
Refractive Assessment:
o Auto Refraction / Retinoscopy
o Subjective refraction / Baseline cycloplegic refraction (where possible)
Binocular Vision Assessment:
o Phorias + Fusional reserves + NPC
o Amplitude of accommodation + Lag of accommodation
o AC/A

Best Corrected VA
Ocular Health:
o Anterior eye
o Posterior eye – retinal assessment
Additional Diagnostic Assessment (if available)
o Corneal topography (Ortho-K)
o Axial length (with high accuracy)

Gifford KL, Richdale K, Kang P, Aller TA, Lam CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report.
Invest Ophthalmol Vis Sci. 2019;60:M184-M203.

Adapted from the IMI Clinical Mangement Guidelines.

Did You Know
REFRACTIVE ASSESSMENT
It is important that the unaided vision matches the
degree of myopia to avoid overcorrection.

Remember every 0.25D should improve VA by one line.

BV ASSESSMENT
Myopia has been long associated with inaccurate BV – including
near esophoria, accommodative lag, high AC/A ratios and intermittent exotropia.

It allows us to pick up signs of pre-myopes. For myopes, BV

abnormalities can influence the decision of the best solution for the patient.

AXIAL LENGTH MEASUREMENT

It is considered the gold standard to evaluate and monitor myopia
management success, but it is not a requirement to practice myopia
management.
Step 3: Diagnosis

1 2 3
PRE MYOPIA
NO MYOPIA PRESENT MYOPIA
PRESENT INCLUDING PRESENT
& MINIMAL RISK MEDIUM OR HIGH -0.50D OR MORE
FACTORS RISK FACTORS

Myopia
≥+0.75D to >-0.50D in
-0.50D or more
children where a combination
spherical equivalent
of baseline refraction, age
and risk factors provide a
High Myopia
likelihood of the future
-5.00D or more
development of myopia
spherical equivalent
 Tips On How To Identify The Pre-Myope

FAMILY One myopic parent increases risk by three-fold, while two myopic
HISTORY parents doubles this risk again.1

VISUAL Less than 90 minutes a day spent outdoors increases risk,

especially if combined with more than 3 hours a day spent on near
ENVIRONMENT work activities (outside of school time).2

Children with higher accommodative convergence (AC/A) ratios,

BINOCULAR typically seen with esophoria, have an increased risk of myopia
VISION development within one year of over 20 times.3 Intermittent
exotropia has also been associated with onset of myopia.4

CURRENT The most significant risk factor of this lot for future myopia is if a
child is +0.50 or less of hyperopia at age 6-7, independent of all
REFRACTION other factors.
(1) Jones L, Sinnott L, Mutti D, Mitchell G, Moeschberger M. Parental history of myopia, sports and outdoor activities, and future myopia. Invest Ophthalmol Vis Sci 2007; 48(8): 3524-3532.
(2) Rose KA, Morgan IG, Ip J, Kifley A, Huynh S, Smith W, Mitchell P. Outdoor Activity Reduces the Prevalence of Myopia in Children. Ophthalmol. 2008;115:1279-1285.
(3) Mutti DO, Jones LA, Moeschberger ML, Zadnik K. AC/A Ratio, Age, and Refractive Error in Children. Invest Ophthalmol Vis Sci. 2000;41:2469-2478.
(4) Mutti DO, Mitchell GL, Hayes JR et al. (CLEERE Study Group) Accommodative Lag before and after the Onset of Myopia. Invest Ophthalmol Vis Sci 2006;47:837-846.
(5) Zadnik K, Sinnott LT, Cotter SA, Jones-Jordan LA, Kleinstein RN, Manny RE, Twelker JD, Mutti DO, Collaborative Longitudinal Evaluation of E, Refractive Error Study Group. Prediction of Juvenile-Onset Myopia. JAMA Ophthalmol.
2015;133:683-689.Chua SY, Sabanayagam C, Cheung YB, Chia A, Valenzuela RK, Tan D, Wong TY, Cheng CY, Saw SM. Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children. Ophthalmic
Physiol Opt. 2016;36:388-394.

Research summary credit to Myopia Profile Pty Ltd

Step 4: Recommendation
1 2 3
DIAGNOSIS DIAGNOSIS DIAGNOSIS

NO MYOPIA PRE MYOPIA MYOPIA

PRESENT & PRESENT PRESENT
MINIMAL RISK INCLUDING -0.50D OR
FACTORS MEDIUM OR MORE
HIGH • Prescribe Myopia
RISK FACTORS Management
Solutions

Review yearly or in line 6 monthly review

• Review schedule
with local guidelines
based on myopia
management schedule
Always Offer Environmental Advice For Every Child

Spend at least 2 hours

a day outdoors

Limit amount of leisure near work to 20-20-20 rule:

less than 2 hours (outside school Every 20 minutes of screen time,
time) look 20 feet away for 20 secs

Adequate lighting in the room Practice good reading distance

(elbow rule)
Myopia Management Solutions

MODALITY ADVANTAGES DISADVANTAGES

• Simple
• Non-invasive • Aesthetics issue (bifocals)
Spectacle Lens • No adverse effects
• Easy to wear and prescribe

• Wider field of view • Lower quality vision (ghosting)

• Excellent cosmesis • Risk of infection
Soft Contact Lens • Ideal for sports • Not suitable for dry eyes
• Stable on the eye • Difficulties in handling
• Parental supervision required

• No need to wear correction during day time • Higher risk of microbial keratitis than daily wear contact lens
Ortho- • Wider field of view • More limited prescription range compared to multifocal CL
• Suitable for Sports • Skills and equipment required by practitioner
keratology • Parental supervision required

• Duration of treatment
• Dosage and long term effects are still not known
Atropine • Can dilate pupil and reduce accommodation with higher
• Likely to have good VA when used with SV correction concentrations requiring near ADD and/or photochromic
spectacles
• Limited availability
• Rebound effects with high dosage
What’s The Solution You Should Prescribe?

• Anything more than a single vision correction

• It suits the child:

o The child’s ability to handle the solution
o Interest and motivation of child and parent
o Cost of the overall program

• It fits your scope of practice

o Access to solution
o Local regulations
When Is The Best Time To Start Or Stop Myopia Management?

• Time to start:
o Myopia progression is greatest at onset and the
younger a child develops myopia, the faster it will
progress.
o So ideally myopia management should start as
soon as possible for the greatest impact on
slowing myopia progression.

• Time to stop:
o Studies show that 90% of myopes stabilize by
age of 21, so we should manage myopia until
early 20s or when it appears to have stabilized.

COMET group 2013, Bullimore et al 2002, Parssinen 2014

Step 5: Follow-Up

1 2 3
DIAGNOSIS
DIAGNOSIS
PRE MYOPIA DIAGNOSIS
NO MYOPIA MYOPIA
PRESENT
PRESENT
INCLUDEING PRESENT
& MINIMAL
RISK
MEDIUM OR 0.50D OR
HIGH MORE
FACTORS
RISK FACTORS

REVIEW FREQUENCY REVIEW FREQUENCY REVIEW FREQUENCY

Review yearly or in line 6 monthly review Dependent on

with local guidelines Myopia Control
Option

REFER TO NEXT SLIDE

Review Process

• Review symptoms

• Confirm behavioral changes are in place

• Unaided / aided vision

• Subjective and/or objective refraction

• Binocular vision assessment

• Eye health examination

Step 5: Follow-Up

Spectacle Lens

Soft Contact Lens

Orthokeratology

Atropine

1 DAY 4–7 DAYS 1 MONTH 3 MONTHS 6 MONTHLY

CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci. 2019;60:M184-M203.
Adapted from IMI Clinical Management Guidelines
How To Effectively Communicate
Myopia Management To Parents
 Tip 1: Just Get Started

83% of parents showed an interest to purchase once

they understand the benefits of Myopia Management.

Most do not even realize that myopia can be controlled.

So start by making it a habit to introduce that there are

solutions which can correct and also control myopia.

It should start as early as possible for the biggest impact!

Tip 2: Focus On Both Short- And
Long-term Benefits

Long term avoidable eye-health risks are important

but likely to be less urgent / relevant to parents.

Explaining short term impacts of controlling

progressive myopia is a good place to start:

1. Less frequent prescription changes

2. Less time between eye exams that their child

spends with blurry vision

3. Less risk of high myopia which reduces quality

of life and often more costly to correct
Tip 3: Summarize Your Message In 3 Explanatory Steps

The “what” of myopia

1
It’s important to simplify your language
when speaking to patients and their
families to maximise understanding.
The “why” of myopia

2 Example:
X Axial Elongation
√ The eye is growing longer than it
should

The “how” of myopia

3
Tip 4: Set Realistic Expectations From The Beginning

It’s important to set realistic

expectation about treatment benefits
to ensure long-term commitment and
avoid dissatisfaction.

• We cannot reverse myopia.

But we can help slow down its progression.
• There can be variability in results from
patient to patient.
• Explain what’s included in the fees.
• Stress the need for long term and
compliance.
Tip 5: Be Ready To Handle Common Parental Objections
MYTH
Myopia will not cause blindness.
My child should not wear glasses because
that will cause myopia to increase.
Myopia can be treated easily with glasses
or contact lenses.
Even if my child becomes highly myopic, there is
always refractive surgery such as Lasik to reverse it.
If my child suffers from myopia, I can’t do anything
to stop its progression.
TRUTH SOURCES
Myopia, particularly high myopia, is a complex condition that is
associated with major eye diseases that require early Bullimore MA, Brennan NA. Myopia Control: Why
management. Each Diopter Matters. Optom Vis Sci 2019;96:463-5.
Haarman AEG, Enthoven CA, Tideman JWL, et al.
The presence of myopia increases the risk of sight-threatening The Complications of Myopia: A Review and Meta-
complications. Furthermore, each additional dioptre increases Analysis. Invest Ophthalmol Vis Sci 2020;61:49.
the risk of these conditions by 20 to 67%.
Not wearing correction will not stop myopia from increasing. Logan NS, Wolffsohn JS. Role of Un-Correction,
It may even cause your child’s myopia to worsen more rapidly. under-Correction and over-Correction of Myopia as a
Strategy for Slowing Myopic Progression. Clin Exp
He would also be disadvantaged due to poor vision. Optom 2020;103:133-7.
Standard glasses (single vision lenses) correct myopia but they Hu Y, Ding X, Guo X, et al. Association of Age at
do not slow down its progression. This means that as children Myopia Onset with Risk of High Myopia in Adulthood
grow, their myopia may progress, requiring stronger in a 12-Year Follow-up of a Chinese Cohort. JAMA
prescriptions, and increasing risk of becoming high myopic. Ophthalmology 2020.
Refractive surgery only correct myopia by changing the front
parts of your eyes, hence, your eyes are still longer than normal.
Your risks of myopia complications are the same as somebody
with your degrees who has not gone through the surgery.
There are a number of ways to help slow the progression of
myopia. Some recent spectacle lenses are available to
effectively slow down myopia progression while providing clear
vision.
Key Takeaway

 More children are becoming myopic at an earlier age, which typically progress quickly in their childhood.

 No level of myopia is safe, as every diopter in myopia progression means an additional lifelong risk of
vision impairment.

 Despite 96% of parents concerned about their child’s myopia getting worse, only est. 1-3% are using
myopia control solution. Many are not aware that there are solutions to help slow down myopia
progression.

 There are different modalities of myopia management with their own advantages and disadvantages.
The solution should be chosen based on what suits the child and the practice.

 It is important to always start with a conversation about myopia – its typical childhood progression, its
impact on function in the short-term and the increased lifelong risk of vision impairments.

 As eye care practitioners, the right thing to do is to always recommend more than a single-vision to a
progressing myope.
TO SEE MORE
TO PLAY MORE
TO LEARN MORE
TO BECOME MORE
“Children do not make up 100% of our
population today, but they do make up
100% of our future”
THANK YOU
KEEP THE ESSILOR EXPERIENCE GOING…