the "S.M.A.R.T." study is an ongoing myopia control study done by a group of Optometrists using accelerated orthokeratology (the Euclid Systems "Emerald" orthokeratology lens, which is the lens we use in our office). S.M.A.R.T. stands for "Stabilization of Myopia by Accelerated Reshaping Technique" & is a 5-year longitudinal study with the stated purpose of "To determine if the wearing of overnight corneal reshaping lenses influences the progression of myopia in children".

(info taken from their website: http://www.facebook.com/pages/Deerfield-IL/SMART-Clinical-Trial/72558518387#/pages/Deerfield-IL/SMART-Clinical-Trial/72558518387?v=app_2347471856&viewas=725575092):

SMART One Year Results
Refractive Outcomes
At 1-Year the change in “best sphere” (= sph. eqv.) for the control group was significantly more myopic than for the test group (p <0.0001) (Test OD +0.02D, OS +0.03D vs. Control OD -0.37D, OS -0.35D)

here's what that means in English: the kids wearing the Emerald ortho-k retainers at night did not get more nearsighted at all. the "control" group who are wearing glasses GOT MORE NEARSIGHTED by an average of -0.4 diopters. so if we catch a kid who is -1.00 diopters at age 10 and put him in ortho-k...

age 11: -1.00, uncorrected vision 20/40 (approx)
age 12: -1.00, uncorrected vision 20/40
age 13: -1.00, uncorrected vision 20/40
age 14: -1.00, uncorrected vision 20/40
age 15: -1.00, uncorrected vision 20/40
age 16: -1.00, uncorrected vision 20/40
age 17: -1.00, uncorrected vision 20/40
age 18: -1.00, uncorrected vision 20/40

if we choose to just go with regular glasses or soft contacts, and we use the data from the year-1 SMART study to extrapolate:

age 11: -1.40, uncorrected vision 20/70 (approx)
age 12: -1.80, uncorrected vision 20/100
age 13: -2.20, uncorrected vision 20/150
age 14: -2.60, uncorrected vision 20/200
age 15: -3.00, uncorrected vision 20/250
age 16: -3.40, uncorrected vision 20/300
age 17: -3.80, uncorrected vision 20/350
age 18: -4.20, uncorrected vision 20/400 ("the big E")

this is why i'm such a big fan of ortho-k in children. yes, its expensive (about $1000-$1500 for both eyes, $500-$750 per eye). but most people will agree that there is a SIGNIFICANT difference in vision between being 20/40 vs 20/400, as well a SIGNIFICANTLY higher dependence on vision correction between being -1.00 and -4.25. if a 20/40 person loses their glasses they can still function. they can still legally drive. a 20/400 person absolutely cannot function in daily life w/o vision correction.


  1. -1.00 to -4.00 is 4 times RX in 7 years

    but 20/40 to 20/400 is *TEN TIMES WORSE* VISION in 7 years


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