Pillar 04 · Myopia Control
Myopia Control Specialist Seattle · The Carlson family practice's longest-running specialty
PSEC has fit children with myopia control modalities since Paragon CRT received FDA approval in June 2002 — the longest continuous myopia control program at a single Seattle address. Matt Carlson personally leads the program since 2013. Four FDA-evidenced modalities. Axial length tracked at every visit. Quarterly progression reviews with parents.
Why progressive myopia matters
Why does my child's myopia level matter beyond the prescription?
67%
Increase in lifetime risk of myopic maculopathy per additional 1.00 D of myopia.[1]
2-4×
Glaucoma risk in high myopia (≥ −6.00 D) versus emmetropic adults.[2]
50%
Of world population projected to be myopic by 2050.[3]
36-50%
Slowing of axial elongation with FDA-evidenced myopia control modalities in pediatric clinical trials.[4]
“Refraction tells you what corrects today. Axial length tells you what the eye is going to look like at 40. Every kid in our program gets axial length measured at every visit — that's the metric that maps to the lifetime retinal-detachment, glaucoma, and maculopathy risk we're actually trying to flatten.”
The Carlson family lineage
22-23 years of continuous family-practice myopia care at one Seattle address
June 2002: Paragon CRT receives FDA approval. The Carlson family practice begins fitting Ortho-K patients in Seattle from that point forward.
2013: Dr. Matt Carlson takes over the myopia control + pediatric vision practice from his father.
2019: CooperVision MiSight receives FDA approval. PSEC adds MiSight.
September 2025: Essilor Stellest receives FDA approval. PSEC dispenses Stellest.
2026: Four FDA-evidenced modalities running simultaneously. Combination therapies for higher-progression cases. Axial length tracking at every visit. Quarterly parent reviews.
The four FDA-evidenced modalities
PSEC fits all four · plus combination therapies
Modality 01
Stellest Spectacle Lenses
Essilor · FDA-approved September 2025
The only FDA-approved myopia control spectacle lens for US retail. H.A.L.T. microlenslets create peripheral myopic defocus that slows axial elongation. 92% compliance — the highest of any modality (kids wear glasses simply).
Year 1: $700-$1,100
Note: MiYOSMART (Hoya) is NOT FDA-approved in the US. Stellest is the only legal US option.
Modality 02
Orthokeratology (Ortho-K)
Paragon CRT · FDA-approved June 2002
Custom-fit rigid lenses worn overnight reshape the cornea while your child sleeps. Wakes up with corrected vision. Wears nothing during the day. The Carlson family practice has fit Paragon CRT continuously since FDA approval.
Year 1: $2,000-$2,800
Best for kids 8-15 wanting freedom from daytime correction.
Modality 03
MiSight Daily Soft Contact Lens
CooperVision · FDA-approved November 2019
Daily disposable soft contact lens with multifocal myopia-control zones. Corrects vision + slows progression simultaneously. Real-time corrective vision in daily wear.
Year 1: $1,500-$2,500
Best for kids 8+ ready for daily contact lens wearing.
Modality 04
Low-Dose Atropine Drops
Compounded · 0.01% / 0.025% / 0.05%
One drop per day at bedtime. Pharmacologically slows axial elongation. Mechanism affects retinal-scleral signaling. Doesn't change vision correction (kids still need glasses or contacts for clarity).
Year 1: $300-$600
Often combined with another modality for compounded effect.
Why we measure axial length
Why does axial length matter more than the prescription?
Most optometry practices track myopia by refraction (the prescription). PSEC tracks axial length — the actual physical length of the eyeball — at every visit. Axial length is the underlying biological progression metric, and the lifetime risks (retinal detachment, glaucoma, maculopathy) correlate with axial length, not refraction.[1]You'll see your child's axial length plotted on a normative growth chart — and know whether the modality is actually working in biological terms.
Primary-source evidence
Sources cited on this page
- [1]Bullimore MA, Brennan NA. Myopia Control: Why Each Diopter Matters. Optometry and Vision Science, 2019;96(6):463-465. View source →
- [2]Marcus MW, et al. Myopia as a risk factor for open-angle glaucoma: a systematic review and meta-analysis. Ophthalmology 2011;118(10):1989-94.e2. View source →
- [3]Holden BA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology 2016;123(5):1036-1042. View source →
- [4]Wildsoet CF, et al. IMI – Interventions Myopia Institute: Interventions for Controlling Myopia Onset and Progression Report. Invest Ophthalmol Vis Sci 2019;60(3):M106-M131. View source →
- [5]FDA 510(k) Premarket Notification K013690 — Paragon Vision Sciences Paragon CRT Lenses (June 2002). View source →
- [6]FDA P180005 — CooperVision MiSight 1 day soft contact lens approval (November 2019). The first FDA-approved contact lens indicated to slow progression of myopia in children. View source →
FAQ
Parent questions
When should we start myopia control for our child?
As soon as myopia is first diagnosed and progression is documented. Many programs start at age 6-8 because progression is typically fastest in elementary school years. Some children with strong genetic risk benefit from pre-myopia counseling even before they're myopic.
My pediatrician hasn't mentioned myopia control. Should I push?
Pediatricians are increasingly aware of myopia control evidence, but some haven't been formally briefed. Current AAP guidance recommends evidence-based myopia management for progressive myopia. If your child's prescription is getting worse year over year, that's the indication. We're happy to talk to your pediatrician directly.
Which modality is best?
No single 'best' — depends on your child's age, refraction, axial length, daytime activity, and family routine. The decision is made jointly between Matt and the parents at the initial consult. Sometimes the best answer is a combination.
Will myopia control fully stop my child's myopia from getting worse?
No modality fully stops progression. Clinical data shows 50-67% slowing on average. That's the difference between (say) a final Rx of -6.00 vs -2.50 by age 18 — significant for lifetime retinal/glaucoma/maculopathy risk.
My child is 14. Is it too late to start myopia control?
Not necessarily. Progression often continues into the late teens and early 20s for kids with rapid progression. We assess case-by-case. Some 14-year-olds benefit from Ortho-K + atropine combination; some have already stabilized.
What's the difference between Stellest and MiYOSMART?
Stellest (Essilor) is the only FDA-approved myopia control spectacle lens in the US as of 2026 (approved September 2025). MiYOSMART (Hoya) is used in Europe and Asia but is NOT FDA-approved in the United States. PSEC dispenses FDA-approved options only.
Is myopia control covered by insurance?
Most vision plans treat myopia control as out-of-pocket as of 2026. HSA, FSA, and CareCredit financing all apply. Some plans are beginning to cover Stellest specifically; we verify your plan before dispensing.
Does PSEC accept new myopia control patients?
Yes — at both Wallingford and Bellevue Eastgate offices. Initial consultations are 60-90 minutes and include axial length measurement, refraction, binocular vision assessment, and modality consultation.