Peripheral Refractive Error With Spherical, Multifocal, and Orthokeratology Correction

Abstract

Purpose:: Peripheral refractive error has been hypothesized to be a stimulus for myopia progression. We have shown that when the central vision of a myope is corrected with soft contact lenses, the peripheral refractive error tends towards hyperopia which may be the stimulus for local compensatory eye growth. Hence, it is important to understand the effects of various corrective devices on the peripheral refractive error. The purpose of this study is to determine the effect of currently available corrective methods on central and peripheral refraction along the horizontal visual field.

Methods:: 8 subjects with refractive error in the range of -1.00 to -5.00 participated in this investigation. The Hartmann-Shack technique was used to measure the central and peripheral refractive error at 5° intervals out to ±35° in the nasal and temporal periphery along the horizontal meridian in uncorrected and corrected eyes. Corneal topographical data was collected before, with and after lens wear. The refractive and corneal topographical data was collected with spherical contact lenses, back surface aspheric multifocal contact lenses, and after orthokeratology treatment.

Results:: Central and peripheral refractive error at baseline and with the spherical contact lenses was consistent with previous results showing a tendency to higher degree of hyperopic refractive error in the periphery for myopes. Multifocal contact lenses showed a mild myopic shift in refractive error between 15° temporal and nasal, but returned to baseline further into the periphery. Peripheral refractive error showed a decrease in hyperopia and increase in myopia following orthokeratology treatment. Corneal topography showed a correlation with changes noted in peripheral refractive changes up to 15° temporal and nasal.

Conclusions:: Contact lenses show a potential for correcting peripheral refractive error. Back surface aspheric multifocal contact lenses show a potential for peripheral correction, but may not adequately correct peripheral refractive error at this time. Orthokeratology was better at correction of the periphery. Corneal topography offers a potential way to monitor changes in the peripheral refractive error which may be improved with off axis topography.

Keywords: myopia • optical properties • refractive error development