Accommodation and Phoria in Children Wearing Multifocal Contact Lenses

Gong, Celia; Troilo, David; Richdale, Kathryn

doi:10.1097/opx.0000000000001044

Cited by 57 publications

(79 citation statements)

References 39 publications

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“…This suggests that the concentric, alternating power profile of the Clinical and Experimental Optometry 103.1 January 2020 lenses causes changes in HOAs that are markedly pupil-dependent. Multifocal contact lenses have been shown to affect the accommodation response; 187,188 however, the change in HOAs during accommodation with multifocal contact lens wear is yet to be examined. Future studies examining the change in HOAs during accommodation while wearing dual-focus and multifocal contact lenses may provide valuable insights into accommodative function during lens wear and potential mechanisms for myopia control.…”

Section: Soft Contact Lenses: Multifocal and Dual-focusmentioning

confidence: 99%

Higher order aberrations, refractive error development and myopia control: a review

Hughes

Vincent

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et al. 2020

Clinical and Experimental Optometry

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Evidence from animal and human studies suggests that ocular growth is influenced by visual experience. Reduced retinal image quality and imposed optical defocus result in predictable changes in axial eye growth. Higher order aberrations are optical imperfections of the eye that alter retinal image quality despite optimal correction of spherical defocus and astigmatism. Since higher order aberrations reduce retinal image quality and produce variations in optical vergence across the entrance pupil of the eye, they may provide optical signals that contribute to the regulation and modulation of eye growth and refractive error development. The magnitude and type of higher order aberrations vary with age, refractive error, and during near work and accommodation. Furthermore, distinctive changes in higher order aberrations occur with various myopia control treatments, including atropine, near addition spectacle lenses, orthokeratology and soft multifocal and dual‐focus contact lenses. Several plausible mechanisms have been proposed by which higher order aberrations may influence axial eye growth, the development of refractive error, and the treatment effect of myopia control interventions. Future studies of higher order aberrations, particularly during childhood, accommodation, and treatment with myopia control interventions are required to further our understanding of their potential role in refractive error development and eye growth.

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Section: Soft Contact Lenses: Multifocal and Dual-focusmentioning

confidence: 99%

Higher order aberrations, refractive error development and myopia control: a review

Hughes

Vincent

Read

et al. 2020

Clinical and Experimental Optometry

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“…Studies of accommodation in young adults (non‐presbyopic) wearing multifocal lenses reveal either normal or reduced gain behaviour beyond the far point of the near add . Similarly, diverse accommodative gains have been observed in children (aged 7–16 years) viewing with multifocal lenses with some exhibiting normal, and some reduced, gain …”

Section: Introductionmentioning

confidence: 99%

Accommodation and its role in myopia progression and control with soft contact lenses

Cheng

Brennan

2019

Ophthalmic Physiologic Optic

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Purpose To examine the impact of contact lens optical design on accommodative behaviour of children and the correlation between myopia progression and the accommodative response of the eye while wearing a contact lens designed for myopia control. Methods A post‐hoc analysis was conducted on data from a previously published myopia control trial. A total of 109 subjects (aged 8 to 11 years, myopia: −0.75 to −4.00 D) wore either a Control (single‐vision, n = 57) or a Test (with positive spherical aberration, +SA, n = 52) soft contact lens, binocularly for 1 year. Accommodative response was measured as the subject observed targets at −1.00 to −4.00 D vergence using the Grand Seiko WAM‐5500 open‐field autorefractor (http://www.grandseiko.com). Slope of accommodative response (SAR) as well as distance and near phoria and stimulus accommodative convergence/accommodation (AC/A) were compared between each group at baseline without study lenses and at 1‐week and 1‐year visits with study lenses. The SAR was also compared to changes in axial length (AL) and spherical equivalent cycloplegic auto refraction (SECAR). Results At baseline, there was no significant difference in SAR between the two study groups (ΔSAR = −0.039, p = 0.84). At 1 week, mean SAR of the Test group was significantly less than for the Control group (ΔSAR = −0.203, p < 0.0001), an effect that persisted to 1 year (ΔSAR = −0.129, p < 0.0001). In the Test group, greater SAR was associated with less change in AL (regression coefficient: −0.59 mm, p < 0.0001) and SECAR (regression coefficient: 1.12 D, p = 0.006) at 1 year. In the Control group, associations between SAR and change in AL and SECAR were not statistically significant. Compared to the Control group, eyes of the Test group appeared to be more exophoric with study lenses, however, the difference between the two groups was only significant at 1 week for distance phoria and 1 year for near phoria. Conclusion The soft contact lens with +SA for controlling myopia progression resulted in an apparent decrease in mean accommodation. Within the Test group, reduced accommodative response correlated with greater myopia progression, suggesting some subjects in the Test group utilised the +SA for near viewing, inducing hyperopic defocus at the retina. Accordingly, the potential impact of a lens optics on accommodative function should be considered during design of myopia control lenses.

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“…Visual performance with bi-and multifocal soft contact lenses was previously investigated in pre-presbyopic subjects with respect to the quality of vision [12][13][14] and changes in the accommodation behaviour 7,[15][16][17][18][19][20][21][22] . A recent investigation by Gong et al 23 showed that children fitted with centre-distance multifocal soft contact lenses with a positive addition of +2.5 D (Biofinity, comfilcon A, Cooper Vision) used the lenses' addition power during near vision to relax their accommodation. This underaccommodation at near could increase the peripheral hyperopic defocus and thus possibly counteract the contact lenses' therapeutic effect during near vision tasks 23 .…”

mentioning

confidence: 99%

Changing accommodation behaviour during multifocal soft contact lens wear using auditory biofeedback training

Wagner

Schaeffel

Troilo

2020

Sci Rep

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Biofeedback training has been used to access autonomically-controlled body functions through visual or acoustic signals to manage conditions like anxiety and hyperactivity. Here we examined the use of auditory biofeedback to improve accommodative responses to near visual stimuli in patients wearing single vision (SV) and multifocal soft contact lenses (MfcL). MfcLs are one evidence-based treatment shown to be effective in slowing myopia progression in children. However, previous research found that the positive addition relaxed accommodation at near, possibly reducing the therapeutic benefit. Accommodation accuracy was examined in 18 emmetropes and 19 myopes while wearing SVCLs and MfcLs (centre-distance). Short periods of auditory biofeedback training to improve the response (reduce the lag of accommodation) was performed and accommodation re-assessed while patients wore the SVCLs and MFCLs. Significantly larger accommodative lags were measured with MFCLs compared to SV. Biofeedback training effectively reduced the lag by ≥0.3D in individuals of both groups with SVCL and MFCL wear. The training was more effective in myopes wearing their habitual SVCLs. This study shows that accommodation can be changed with short biofeedback training independent of the refractive state. With this proof-of-concept, we hypothesize that biofeedback training in myopic children wearing MFCLs might improve the treatment effectiveness.

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Accommodation and Phoria in Children Wearing Multifocal Contact Lenses

Cited by 57 publications

References 39 publications

Higher order aberrations, refractive error development and myopia control: a review

Higher order aberrations, refractive error development and myopia control: a review

Accommodation and its role in myopia progression and control with soft contact lenses

Changing accommodation behaviour during multifocal soft contact lens wear using auditory biofeedback training

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