New readout at Academy ’25 adds weight to contrast-modulating spectacle lenses
SightGlass Vision (San Ramon, CA, United States) brought fresh data to Boston, reporting 18-month interim results from the CATHAY randomized study.1 Children wearing its Diffusion Optics Technology (DOT) spectacle lenses were far more likely to hold their ground against myopia progression than those in single-vision lenses.
At the American Academy of Optometry 2025 (Academy ‘25 Boston), investigators shared that 57% of DOT wearers showed no clinically meaningful progression (compared with 15% in controls) along with 0.34 mm less axial elongation and 0.70 D less cycloplegic SER change.2
What makes DOT different
Each DOT lens hides thousands of microscopic light-scattering elements that gently reduce retinal image contrast. The idea is to soften the visual “growth cues” that drive axial elongation while keeping everyday vision crystal clear.
Earlier results from the randomized CYPRESS trial showed the same trend: less myopic shift and less axial growth than single-vision lenses at 12 months, with benefits holding through four years.3 Think of it as turning the retinal volume down from shout to whisper, so the eye doesn’t over-grow its cue.
DOT lenses are still investigational in the U.S. (with FDA Breakthrough Device designation) but are now commercially available in Canada, China, Israel, the Netherlands, Spain and the United Kingdom.
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Key outcomes at 18 months
Presented by Dr. Jennifer Hill, the 18-month analysis covered children across five Chinese hospitals and confirmed earlier findings:
- No clinically meaningful progression: 57% (DOT) vs 15% (single-vision)
- Axial length: 0.34 mm less elongation (DOT vs control)
- Cycloplegic SER: 0.70 D less progression (DOT vs control)
The pattern mirrors CYPRESS and its four-year follow-up, reinforcing that contrast modulation can sustainably slow eye growth.3, 5
Real-world practice data and astigmatism
Outside the trial setting, Dr. Kylvin Ho shared a two-year, real-world analysis from a Canadian clinic. On average, DOT lenses slowed myopia progression by ≥ 50%. Stable refraction (≤ 0.50 D change) occurred in 52% of children aged 6-7 and 62% aged 8-10.4
As for astigmatism, which is a common question with patterned optics, Dr. Debbie Laughton reported no downside. In new 12-month data she presented, DOT lenses slowed myopic progression without increasing astigmatism compared with controls in both North American and Chinese pediatric cohorts. The proportion of children with astigmatism shifted from 87% to 92% in North America and from 91% to 88% in China, with no differences versus controls.5
READ MORE: Myopia Care in The Modern Age – COOKIE
Where DOT fits in
Myopia management is now a four-lane highway, featuring spectacles, ortho-K, low-dose atropine and soft contact lenses. DOT drives in the contrast-management lane, not the defocus one.
For families who prefer glasses, or for children not suited to contact lenses or pharmacologic therapy, a spectacle option with documented effects on axial length offers another route to the same destination: slower eye growth over time.
From a workflow perspective, DOT fits the familiar cadence of spectacles, with full-time wear and routine follow-up. Counseling still matters. Set expectations around consistent wear, environmental habits and regular measurement of axial length and refraction. That combination is where clinic and lens design meet to deliver impact.
Market momentum
SightGlass Vision estimates over one million children have now worn DOT lenses worldwide. The company is a joint venture between CooperVision (California, USA) and Essilor International (Charenton-le-Pont, France) and continues phased market rollouts and professional education.
In the broader context: myopia prevalence keeps climbing so clinicians need scalable, kid-friendly solutions that blend easily into school life. Evidence like CATHAY helps anchor those options in randomized science.
READ MORE: Game-Changers in Myopia Management – COOKIE
What to watch next
The DOT story is now unfolding on two fronts: randomized data and real-world results. The Chinese cohort strengthens durability, the Canadian data show practicality and the astigmatism findings ease a common concern.
Next up are longer-term outcomes, regional comparisons and continued tracking of axial length, which is the clearest growth marker we have. DOT may not be flash and fireworks, rather clever optics: a subtle shift in contrast that keeps young eyes growing a little slower and seeing better for longer.
Editor’s Note: This content is intended exclusively for healthcare professionals. It is not intended for the general public. Products or therapies discussed may not be registered or approved in all jurisdictions, including Singapore.
References
- SightGlass Vision, Inc. Assessment of DOT Spectacles in Chinese Children Extension (CATHAY Ext). ClinicalTrials.gov. Available from: https://clinicaltrials.gov/study/NCT07008001 Accessed on October 9, 2025
- Hill J, et al. Control of myopia using contrast modulation spectacle lenses in a Chinese population: 18-month results [conference presentation]. American Academy of Optometry Annual Meeting; 2025 Oct 9; Boston, MA.
- Rappon J, Chung C, Young G, et al. Control of myopia using diffusion optics spectacle lenses: 12-month results of a randomised controlled, efficacy and safety study (CYPRESS). Br J Ophthalmol. 2023;107(11):1709-15.
- Ho K, et al. Two-year real-world effectiveness of myopia control contrast modulation spectacle lenses in a Canadian practice [conference presentation]. Am Acad Optom Annu Meet; 2025 Oct 9; Boston, MA.
- Laughton D, Hill JS, McParland M, Tasso V, Woods J, Zhu X, et al. Control of myopia using diffusion optics spectacle lenses: 4-year results of a multicentre randomised controlled, efficacy and safety study (CYPRESS). BMJ Open Ophthalmol. 2024;9(1):e001790.