HAL spectacle lenses slow myopia progression and axial elongation in Indian children and adolescents

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medRxiv Published April 16, 2026 Medically reviewed April 25, 2026 Study authors: Saxena, R.; Jethani, J.; Roy, L.; Matalia, J.; Verkicharla, P. K.; Ganesh, S.; Parthasarathy, A.; Na… DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Consider HAL lenses for myopia control in Indian children, but note retrospective design and limited follow-up.

This retrospective study evaluated the efficacy of Highly Aspherical Lenslets (HAL) spectacle lenses for myopia control in 372 Indian children and adolescents aged 4–16 years across 10 ophthalmic centers in India. The intervention involved HAL spectacle wear compared to an untreated year, with follow-up ranging from 6 to 24 months after prescription. Primary outcomes were myopia progression and axial elongation.

Main results showed that annual myopia progression was -0.72 ± 0.47 D/year during the untreated period, reducing to -0.11 ± 0.29 D/year with HAL spectacle wear, indicating a treatment effect of 0.54 D/year. Axial elongation was 0.11 ± 0.16 mm/year with HAL lens wear, representing approximately 62% relative slowing of elongation compared to the untreated period. Secondary outcomes included comparison with published meta-regression models, but specific results were not detailed.

Safety and tolerability data, including adverse events, serious adverse events, and discontinuations, were not reported. Key limitations include the retrospective design and limited follow-up period, which may introduce bias and restrict long-term conclusions. Funding and conflicts of interest were also not reported.

In practice, this study supports HAL lenses as a potential myopia control intervention in this population, but clinicians should consider the observational nature and lack of safety data when making decisions. Further prospective studies are needed to confirm efficacy and assess tolerability.

Study Details

EvidenceLevel 5

PublishedApr 2026

View Original Abstract ↓

Objective: The study aims to evaluate the real-world effectiveness of Highly Aspherical Lenslets spectacle (HAL; Essilor(R) Stellest(R)) in slowing myopia progression among Indian children and adolescents aged between 4 and 16 years. Methods and analysis: This was a multicentre retrospective study conducted across 10 leading ophthalmic centers. The study participants comprised children aged between 4 and 16 years who were prescribed HAL spectacles (Essilor(R) Stellest(R)). Data were extracted from electronic medical records at three time points: T1: One year prior to intervention; T2: Baseline at HAL spectacle prescription; T3: 6 to 24 months after prescription. The primary endpoint was the myopia progression and axial elongation in the year following prescription, compared with the untreated year and with published meta-regression models. Only data from the right eye were analysed, with the expected physiological progression estimated based on the individual progression trajectory after adjusting for age-related slowing as reported in published meta-regression models. Results: A total of 372 myopic children were included in the study. The annual myopia progression was -0.72 {+/-} 0.47 D/year during the untreated period, reducing to -0.11 {+/-} 0.29 D/year with HAL spectacle wear. The expected progression without treatment was -0.65 D/year, based on trajectory-adjusted modelling, indicating a treatment effect of 0.54 D/years and an estimated 83% slowing in myopia progression compared to expected progression. The expected axial elongation under physiological conditions was 0.29 mm/year, estimated using age-adjusted meta-regression models; with HAL lens wear, axial elongation was 0.11 {+/-} 0.16 mm/year, corresponding to a [~]62% relative slowing of elongation. Conclusion: The present study demonstrates the real-world evidence validating the efficacy of HAL lenses as an effective myopia control intervention in Indian children and adolescents. The retrospective design and limited follow-up period warrant future prospective, long-term studies to validate these findings.