The Long-Term Patient Journey with DIMS Spectacle Lenses: A Mixed-Methods Study of Satisfaction, Adherence and Socioeconomic Barriers.

PURPOSE: While defocus incorporated multiple segments (DIMS) spectacle lenses are clinically proven effective in slowing myopia progression, the long-term, real-world patient experience is poorly understood. This study aimed to provide both quantitative and qualitative analyses of the wearer experience in a long-term cohort of DIMS wearers. METHODS: This retrospective, convergent parallel mixed-methods study included 63 former child participants (now aged 17-23 years) who participated in the previous DIMS spectacle lenses clinical trial 8-10 years earlier. Data were collected 2 years after the final clinical trial concluded. A quantitative online questionnaire assessed wearer experience, while in-depth, semi-structured phone interviews explored the lived wearer journey. Predictors of satisfaction were identified using multiple linear regression and qualitative transcripts were analysed using a systematic thematic approach. RESULTS: Quantitative analysis revealed high satisfaction, with 88.9% of wearers satisfied or very satisfied and 90.4% believing in the efficacy of DIMS spectacle lenses. Regression analysis identified Maintenance and Durability as the strongest predictors of long-term satisfaction, alongside positive perceptions of appearance (adjusted R2 = 0.50, p < 0.001). Qualitative analysis revealed a patient journey defined by parent-driven initiation, a manageable sensory adaptation period and strong perceived efficacy based on personal experience. However, only one-third of participants had continued DIMS use; a decision driven overwhelmingly by the high cost of the spectacles. CONCLUSION: DIMS spectacle lenses provide a highly positive long-term wearer experience. However, the high cost of the spectacles creates a dominant socioeconomic barrier to treatment continuity, highlighting a critical gap between clinical success and access outside the trial setting.