Related Experiment Video
Updated: Aug 3, 2025
Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients
Published on: March 29, 2022
Effect of peripheral defocus on axial growth and modulation of refractive error in children with anisohyperopia
Ian G Beasley1, Leon N Davies1, Nicola S Logan1
1School of Optometry, Aston University, Birmingham, UK.
Insights
Multifocal contact lenses did not alter axial growth or refractive error in children with anisohyperopia. This study found no significant modulation of eye growth or vision changes with relative peripheral hyperopic defocus (RPHD) treatment.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Myopia Control Research
Background:
- Anisohyperopia, a condition with unequal hyperopia between eyes, presents challenges in visual development for children.
- Understanding factors that modulate axial growth and refractive error is crucial for myopia control strategies.
- Relative peripheral hyperopic defocus (RPHD) has been investigated as a potential method to influence eye growth.
Purpose of the Study:
- To determine if relative peripheral hyperopic defocus (RPHD) can modulate axial growth and refractive error in children diagnosed with anisohyperopia.
- To assess the efficacy of center-near multifocal soft contact lenses in managing refractive development in this specific pediatric population.
Main Methods:
- A prospective, controlled, paired-eye study was conducted over 3 years with anisohyperopic children.
- Participants initially wore single vision spectacles, followed by 2 years of multifocal contact lens wear in the more hyperopic eye (imposing RPHD) and single vision contact lens in the fellow eye.
- Axial length and refractive error were monitored throughout the trial, including a final 6-month period with single vision spectacles.
Main Results:
- No significant increase in axial length was observed during the initial 6-month period or the final 6-month period in either eye.
- Over the 2-year intervention, axial growth was 0.11 mm in the test eye versus 0.15 mm in the control eye, with no statistically significant difference (p=0.06).
- Refractive error remained stable throughout the study, with no significant changes observed in either the test or control eyes during the intervention or follow-up periods.
Conclusions:
- The application of RPHD using the specified center-near multifocal contact lenses did not accelerate axial growth in anisohyperopic children.
- This treatment approach did not demonstrate a significant reduction in refractive error in the studied pediatric cohort.
- The findings suggest that this particular multifocal contact lens design and RPHD strategy may not be effective for modulating eye growth or refractive error in anisohyperopia.
Purpose:
To establish whether axial growth and refractive error can be modulated in anisohyperopic children by imposing relative peripheral hyperopic defocus (RPHD) using multifocal soft contact lenses.
Methods:
This study is a prospective, controlled paired-eye study with anisohyperopic children. Axial growth and refractive error were observed without intervention for the first 6 months of the 3-year trial with participants wearing single vision spectacles. Then, participants wore a centre-near, multifocal, soft contact lens (+2.00 D add) in their more hyperopic eye for 2 years, with a single vision contact lens worn in the fellow eye if required. The 'centre-near' portion of the contact lens in the more hyperopic eye corrected distance refractive error while the 'distance' portion imposed hyperopic defocus in the peripheral retina. Participants reverted to single vision spectacles for the final 6 months.
Results:
Eleven participants, mean age of 10.56 years (SD 1.43; range 8.25-13.42), completed the trial. No increase in axial length (AL) was found during the first 6 months in either eye (p > 0.99). Axial growth across the 2-year intervention period was 0.11 mm (SEM 0.03; p = 0.06) in the test eye versus 0.15 mm (SEM 0.03; p = 0.003) in the control eye. AL was invariant during the final 6 months in both eyes (p > 0.99). Refractive error was stable during the first 6 months in both eyes (p = 0.71). Refractive error change across the 2-year intervention period was -0.23 D (SEM 0.14; p = 0.32) in the test eye versus -0.30 D (SEM 0.14; p = 0.61) in the control eye. Neither eye demonstrated a change in refractive error during the final 6 months (p > 0.99).
Conclusions:
Imposing RPHD using the centre-near, multifocal, contact lens specified here did not accelerate axial growth nor reduce refractive error in anisohyperopic children.
Related Concept Videos
01:16Focusing of Light in the Eye
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:28Angle Closure Glaucoma: Treatment
01:26Influence of Earth's Curvature and Atmospheric Refraction on Leveling