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Effect of multifocal spectacle lenses on accommodative errors over time: Possible implications for myopia control.

Saulius R Varnas1,2, Dinesh Kaphle3,4,5, Katrina L Schmid3,6

  • 1Carl Zeiss Vision Australia Holdings Limited, Adelaide, Australia.

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Progressive addition lenses (PALs) initially reduce accommodative lag in young myopes. However, efficacy wanes over time, requiring boosted lens power to maintain benefits.

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Area of Science:

  • Ophthalmology
  • Optometry
  • Vision Science

Background:

  • Accommodative errors, specifically lag, are common in myopia.
  • Multifocal spectacle lenses, such as progressive addition lenses (PALs), are used to manage refractive errors.
  • Understanding the long-term efficacy of PALs in correcting accommodative lag is crucial for visual performance.

Purpose of the Study:

  • To investigate how different progressive addition lens (PAL) designs impact accommodative errors in myopes.
  • To determine if the effect of PALs on accommodative lag changes over a 12-month period.
  • To assess the effectiveness of booster addition powers in maintaining accommodative lag reduction.

Main Methods:

  • Fifty-two young myopes (18-27 years) were randomly assigned to two types of PALs with 1.50 D additions.
  • Accommodative lag was measured using a Grand Seiko autorefractor and a COAS-HD aberrometer at various near distances.
  • Measurements were repeated over 12 months, with additional testing of booster powers (0.25-0.75 D) at the final visit.

Main Results:

  • Both PAL types initially reduced accommodative lag compared to single vision lenses (SVLs).
  • PAL efficacy in reducing lag diminished after 12 months, except at a 40 cm working distance.
  • Booster addition powers of 0.50 D and 0.75 D restored or improved accommodative lag reduction.

Conclusions:

  • PALs can effectively reduce accommodative lag, but optimal performance requires tailored addition power for specific working distances.
  • Lens efficacy decreases over the first year of wear.
  • Boosting PAL addition power by at least 0.50 D after one year is recommended to sustain accommodative lag reduction.