MiSight® 1 Day:
Patient Selection & Candidacy Criteria

Contact Lens Treatment 6 min read Evidence level: RCT (Chamberlain et al. 2019, 3-year controlled trial)

MiSight® 1 day is FDA-indicated for slowing the progression of myopia in children aged 8–12 at initiation of treatment. But not every myopic child in that age range is the ideal candidate. This page covers exactly who qualifies, what the trial enrolled, and how to handle borderline cases.

FDA Indication

MiSight® 1 day is indicated for: Correction of myopic ametropia and slowing the progression of myopia in children with non-diseased eyes who at initiation of treatment are 8–12 years of age and have a refraction of −0.75 to −4.00 D spherical equivalent with ≤0.75 D of astigmatism.

Clinical Trial Efficacy — What the RCT Actually Shows

59%
Less refractive progression vs controls at 3 years (−0.51D vs −1.24D)
52%
Less axial elongation vs controls (0.30mm vs 0.62mm over 3 years)
6 yr
Follow-up data showing sustained efficacy and high lens preference

These figures are from the ITT population — all enrolled participants regardless of wear time. Children achieving full-time wear (≥10 hours/day, ≥6 days/week) showed results at the upper end of this range. Note: the commonly cited "55% AL reduction" reflects axial elongation reduction; the 52% figure here is from the same trial and reflects mean axial change ratio.

Inclusion Criteria from the Clinical Trial

The 3-year double-masked RCT (Chamberlain et al. 2019) enrolled children meeting all of the following:

Patient Selection: Best vs Borderline Candidates

✅ Best candidates

  • Refraction −0.75D to −4.00D SE
  • Astigmatism ≤0.75D
  • Age 8–12 at initiation
  • Anisometropia <1.00D
  • Motivated child + engaged parent
  • Willing to wear ≥10 hrs/day
  • Healthy anterior segment

⚠️ Borderline — may succeed

  • Astigmatism 0.75–1.00D (off-label)
  • Myopia −4.00D to −6.00D (off-label)
  • Age 13–16 (off-label but clinically supported)
  • Moderate compliance concerns — discuss expectations
  • Higher anisometropia — assess fitting carefully

A note on borderline cases

Clinical experience supports feasibility in children with higher myopia (−4.00 to −6.00D) and older adolescents (13–16 years), though these are off-label uses. Younger onset favours longer benefit windows — earlier fitting allows more years of slowed progression before natural stabilisation. For children outside the RCT parameters, clinical judgment should account for individual risk profile, compliance capacity, and alternative options (orthokeratology, spectacle lenses).

The Compliance Factor

Efficacy is compliance-dependent. The RCT required ≥10 hours/day, ≥6 days/week. Children who wear MiSight for shorter periods each day will achieve proportionally less myopia control benefit. At the fitting appointment, frank discussion with both child and parent about wear expectations is essential — it directly impacts the outcome you can promise.

6-year follow-up finding: In the extended follow-up, children continued achieving full-time lens wear exceeding the minimum 10 hours/day requirement, and showed high preference for soft contact lenses over spectacles regardless of lens design. Compliance was not a significant attrition factor in the long-term cohort.

⚠️ FDA Disclaimer: MiSight® 1 day is FDA-indicated for children 8–12 years of age at initiation. Clinical use beyond these parameters (older age, higher prescription, higher astigmatism) is off-label. CooperVision does not endorse off-label prescribing. Document clinical rationale when prescribing outside indication.

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Chamberlain P et al. A 3-Year Randomized Clinical Trial of MiSight Lenses for Myopia Control. Optom Vis Sci. 2019;96(8):556–567. PMID 31343513 · Arumugam B et al. Sustained Efficacy of Dual-Focus Contact Lens Wear. Optom Vis Sci. 2020;97(8):588–596 · Jones D et al. Six years of wearer experience in children with MiSight® 1 day. Contact Lens Anterior Eye. 2023;46(3):101804 · MiSight® is a registered trademark of The Cooper Companies, Inc. Educational content — not prescribing guidance.