Purpose To determine the between-visit repeatability of peripheral autorefraction measurements using the Grand Seiko WAM-5500 in normal eyes. Methods Cycloplegic autorefraction of the right eye was measured on 25 myopic young adults using a modified Grand Seiko autorefractor. Measurements were made centrally (along the line of sight) and ±20°, ±30°, and ±40° from the line of sight in the horizontal meridian at two visits separated by 1 to 15 days. Five autorefraction measurements at each location were converted to vector space and averaged. Relative peripheral refraction (RPR) was calculated as the difference between the peripheral and central spherical equivalent (SE). Between-visit repeatability was evaluated by plotting the difference versus the mean of the measurements at the two visits (bias) and by calculating the 95% limits of agreement (LoA). Results The mean (±SD) age and SE refractive error centrally (at visit 1) were 24.0 ± 1.3 years and −3.45 ± 1.42 D, respectively. There was no significant between-visit bias for any refractive component evaluated (M, J0, J45, and RPR) at any location measured (all p>0.05). The 95% LoA of defocus (M) was ±0.21 D centrally and increased with increasing eccentricity to ±0.73 D and ±0.88 D at 40° nasally and temporally on the retina, respectively. The 95% LoA of RPR increased with increasing eccentricity to ±0.67 D and ±0.82 D at 40° nasally and temporally on the retina, respectively. Conclusions In normal eyes, the repeatability of cycloplegic autorefraction was best centrally and decreased as eccentricity increased; however, repeatability in the far periphery was still better than previously reported between-visit repeatability for foveal cycloplegic subjective refraction. With clear knowledge of the repeatability of on- and off-axis cycloplegic autorefraction with the Grand Seiko, peripheral measurements can be properly interpreted in longitudinal studies.

Purpose Peripheral retinal defocus has been implicated in myopia progression. The effect of commercially-available spherical soft contact lenses (SCLs) on peripheral defocus of adult myopic eyes was investigated. Methods Twenty-five young adults with spherical equivalent (SE) refractions between −0.50 D and −6.00 D were enrolled. Cycloplegic autorefraction (right eye) was measured centrally and ±20°, ±30°, and ±40° from the line of sight along the horizontal meridian using an autorefractor. Four commercially-available spherical SCLs (Biofinity, Acuvue2, PureVision2, and Air Optix Night & Day Aqua) were evaluated. SE defocus (M) was used to calculate relative peripheral defocus (RPD) while wearing each SCL and relative peripheral refraction (RPR) of the uncorrected eye. Spherical aberration (SA) changes due to each SCL were measured along the line of sight by aberrometry. Peripheral defocus was analyzed using repeated-measures analyses of variance (RM-ANOVA). The association between changes in axial SA and the change in peripheral defocus was evaluated using linear mixed models. Results The mean age (±SD) and central SE refractive error were 24.0 ± 1.3 years and −3.45 ± 1.42 D, respectively. PureVision2 did not change RPD (p=0.33). Significant myopic shifts on the temporal retina were found with three lenses: Acuvue 2 (−0.29 D at 30°; −0.80 D at 40°; both p≤0.01), Biofinity (−1.21 D at 40°; p=0.02), and Air Optix Night & Day Aqua (−0.23 D at 20°, −0.48 D at 30°, and −1.50 D at 40°; all p<0.004). All SCLs caused a negative change in SA. SCLs inducing less negative (more positive) SA changes were associated with a less hyperopic change in RPD. Conclusions Spherical SCL design can influence the peripheral defocus profile experienced by a myopic eye. Several, but not all, SCLs reduced peripheral hyperopia. Differences in how SCL types influence peripheral defocus may have implications for myopia progression.