This episode is sponsored by Contamac.
The US data on Essilor Stellest is finally in a peer-reviewed journal. A new paper in JAMA Ophthalmology followed 159 children ages 6 to 12 across nine US sites. Over 24 months, Stellest slowed myopia progression by 71% and axial elongation by 53% compared with single-vision lenses.
That’s a big deal for US doctors. But our panel noticed something right away: 71% and 53% are not the same number.
Dr. Leah Johnson and Dr. Cary Herzberg are back to break down the study. Leah likes what she sees: a well-designed trial, a diverse US population instead of a 95–99% Asian cohort, and strong wear time. She also reminds us that relative percentages can flatter a result, and that the absolute axial length benefit lands about where our other modalities already do. In her words, it’s another lifestyle option, and a good one.
Cary zeroes in on the gap between refraction and axial length. If the two measures can be that far apart, he asks, how can anyone tell doctors they don’t need a biometer? That question takes over the episode.
Leah compares it to glaucoma. You can manage glaucoma with a pressure-lowering drop and no OCT, but nobody would call that specialty care today. At the same time, she doesn’t want a missing biometer to be the reason a myopic kid ends up in single-vision glasses. Matt brings a lesson from his time as executive director of the AAOMC: when the myopia community came at the rest of optometry too aggressively, it pushed doctors away. His bigger worry is follow-up care, parent education, and the “Stellest is a scam, just go to Target” posts on social media.
The panel also covers what happens when kids look through their full distance prescription at near all day, why the 20-20-20 rule may be too short, atropine’s effect on accommodation, and Cary’s story of the $60,000 topographer that paid for itself,
This week’s sponsor is Contamac.
Learn more about Optimum Infinite Ortho-K from Contamac →