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

Abstract

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.

Comparison of short‐term light disturbance, optical and visual performance outcomes between a myopia control contact lens and a single‐vision contact lens

“…Soft contact lenses with different refractive profiles may contribute to reduce myopia progression by 30%-50%. 5 However, positive dysphotopsia is often reported by Table 3. Lower-order, higher-order and total aberrations for a pupil diameter of 3 mm and 5 mm in each contact lens patients.…”

“…4 It has been reported that a reduction in myopia progression might be achieved by using a centre-distance, dual-focus (DF) contact lens design through the reduction of off-axis hyperopia. [4][5][6] These new designs are being used clinically for myopia control. 2,3 Even though visual acuity (VA) remains acceptable in the majority of patients, many still complain about insufficient quality of vision and dysphotopsia.…”

Ocular and Corneal Aberrations changes in controlled randomized clinical trial MiSight® Assessment Study Spain (MASS)

“…Dual-focus designed lenses also produced positive SA in 3 mm pupil size, but conversely, in greater pupil sizes of 4 mm, a higher negative value of 4th order SA was found, and even more so in the 5 mm pupil size. These ndings show that the changes in HOA induced by dual-focus designs (such as MiSight) are substantially more pupil-dependent than the center-distance MFCL designs 31,34 and shows the role of SA whose magnitude differently affects the myopia control. 34 Previous MASS studies have also reported an increase on monocular light disturbance perception 28 and near-vision worsening 26 in subjects wearing MiSight (study group) compared with subjects wearing single-vision spectacles (control group).…”

“…These ndings show that the changes in HOA induced by dual-focus designs (such as MiSight) are substantially more pupil-dependent than the center-distance MFCL designs 31,34 and shows the role of SA whose magnitude differently affects the myopia control. 34 Previous MASS studies have also reported an increase on monocular light disturbance perception 28 and near-vision worsening 26 in subjects wearing MiSight (study group) compared with subjects wearing single-vision spectacles (control group). Nevertheless, over 2 years of follow-up there could be seen a signi cant binocular attenuation effect, and a consequent decrease in the monocular light disturbance.…”

“…There have been several previous studies regarding the relation between HOA and refractive error. In a recent review, Hughes et al 34 considered this topic to be controversial and Little et al 12 thought it to be due mainly asymmetries in sample size, differences in subjects' age/ethnicity, or varying methodological procedures, including differences in classi cation of refractive error. Despite this, most studies 37,38 show that HOA values are higher in myopes than emmetropes or hyperopes, and there is a correlation between primary SA (4th order) and refractive error in such a way that value of 4th order SA in the eye becomes less positive with increasing myopia and axial length.…”