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Assessment of Clinical Trials for Devices Intended to Control Myopia Progression in Children
Marc W Robboy1, Gene Hilmantel, Michelle E Tarver
1Office of Device Evaluation, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD.
Insights
Research is exploring ways to slow myopia progression in children, a growing vision problem. Future studies need better designs to confirm if treatments like contact lenses are safe and effective for myopia control.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Clinical Research Design
Background:
- Myopia (nearsightedness) prevalence is increasing globally, posing risks for serious vision impairment.
- Childhood myopia progression is a key concern, driving research into effective interventions.
- Current treatments like pharmacological agents, multifocal spectacles, and contact lenses show potential but require further validation.
Purpose of the Study:
- To review existing studies on myopia control treatments in children.
- To identify limitations in previous clinical trial designs for myopia control.
- To discuss essential study design and regulatory considerations for future research.
Main Methods:
- Review of key published clinical trials on myopia control.
- Analysis of common limitations in study methodologies (e.g., follow-up duration, randomization, masking).
- Discussion of best practices for designing robust clinical trials.
Main Results:
- Previous myopia control studies, particularly those using contact lenses, often suffer from methodological weaknesses.
- Short follow-up times, inadequate randomization, and incomplete masking limit the reliability of past findings.
- A need exists for well-designed studies to establish safety and efficacy of myopia control interventions.
Conclusions:
- Robust clinical study designs are crucial for accurately assessing myopia control treatments.
- Future trials must address methodological limitations to provide reliable evidence on the efficacy and safety of interventions like contact lenses.
- Improved study designs will facilitate regulatory approval and clinical adoption of effective myopia management strategies.
Abstract:
The increased prevalence of myopia in the United States and other regions of the world, and the sight-threatening problems associated with higher levels of myopia have led to great interest in research designed to reduce these rates. As most of the progression of myopia occurs in childhood, these investigations have been directed toward slowing the progression of myopia in children. Treatments described to potentially slow the progression of myopia have included pharmacological interventions, multifocal spectacles, and multifocal correction created by contact lenses. Although some contact lens clinical trials have demonstrated promising results in slowing the progression of myopia, many of these studies have significant limitations, including only short follow-up times, limited randomization, and incomplete masking. Such limitations have underscored the need to develop a more robust clinical study design, so that future studies can demonstrate whether contact lenses, as well as other medical devices, can be used in a safe and effective manner to control myopia progression. We review previous key studies and discuss study design and regulatory issues relevant to future clinical trials.
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