Single Vision Contact Research Articles

Effect of Combining 0.01% Atropine with Soft Multifocal Contact Lenses on Myopia Progression in Children.

Combining 0.01% atropine with soft multifocal contact lenses (SMCLs) failed to demonstrate better myopia control than SMCLs alone. The Bifocal & Atropine in Myopia (BAM) Study investigated whether combining 0.01% atropine and SMCLs with +2.50-D add power leads to greater slowing of myopia progression and axial elongation than SMCLs alone. Participants of the BAM Study wore SMCLs with +2.50-D add power daily and administered 0.01% atropine eye drops nightly (n = 46). The BAM subjects (bifocal-atropine) were age-matched to 46 participants in the Bifocal Lenses in Nearsighted Kids Study who wore SMCLs with +2.50-D add power (bifocal) and 46 Bifocal Lenses in Nearsighted Kids participants who wore single-vision contact lenses (single vision). The primary outcome was the 3-year change in spherical equivalent refractive error determined by cycloplegic autorefraction, and the 3-year change in axial elongation was also evaluated. Of the total 138 subjects, the mean ± standard deviation age was 10.1 ± 1.2 years, and the mean ± standard deviation spherical equivalent was -2.28 ± 0.89 D. The 3-year adjusted mean myopia progression was -0.52 D for bifocal-atropine, -0.55 D for bifocal, and -1.09 D for single vision. The difference in myopia progression was 0.03 D (95% confidence interval [CI], -0.14 to 0.21 D) for bifocal-atropine versus bifocal and 0.57 D (95% CI, 0.38 to 0.77 D) for bifocal-atropine versus single vision. The 3-year adjusted axial elongation was 0.31 mm for bifocal-atropine, 0.39 mm for bifocal, and 0.68 mm for single vision. The difference in axial elongation was -0.08 mm (95% CI, -0.16 to 0.002 mm) for bifocal-atropine versus bifocal and -0.37 mm (95% CI, -0.46 to -0.28 mm) for bifocal-atropine versus single vision. Adding 0.01% atropine to SMCLs with +2.50-D add power failed to demonstrate better myopia control than SMCLs alone.

Subjective experiences of children switched from single vision to dual focus myopia control daily disposable contact lenses

Purpose: Children (8-15years) were satisfied with dual focus (M1d) and single vision (Proclear® 1 day; P1d) contact lenses (omafilcon A, CooperVision) during the first 3 years of the randomised, controlled MiSight® 1 day study (Chamberlain, OVS 2019). After 3 years, P1d wearers were switched to M1d. This analysis evaluated subjective responses in children (11-16years) new to M1d, having previously worn P1d, compared to those continuing in M1d.

A Clinical Study of the Impact of Soft Contact Lenses on the Progression of Myopia in Young Patients.

PurposeTo assess the impact of soft contact lenses on the progression of myopia in young patients.Patients and MethodsThe observational study included 102 patients divided into 3 groups: MFCL (multifocal contact lenses) group: 15 girls and 9 boys, aged 8–20 (nbar x n= 14.12 ± 2.863) with soft multifocal contact lenses with myopia: nbar x n = −3.12 D ± 1.776 D and mean myopia progression −0.23 ± 0.233D after 2 years; SVCL (single vision contact lenses) group: 30 girls and 5 boys, 11–20 years old (nbar x n=15.5 ± 2.24) with myopia nbar x n = −2.88 ± 2.122 D at admission and mean myopia progression −0.54 ± 0.464 D after 2 years; the spectacle (single vision glasses) group: 25 girls and 18 boys, aged 8–18 years (nbar x n = 13.65 ± 2.448) with single vision glasses with myopia: nbar x n = −1.74 ± 1.412 D at admission and mean myopia progression −0.86 ± 0.489D after 2 years. Medical history and physical examination were performed every 6, 12, 18 and 24 months. Refractive error was examined using the autorefractometry after cycloplegia.ResultsThe analysis of myopia correction after 2 years showed differences between MFCL and spectacle correction. The change in myopia progression after 2 years was statistically significant for MFCL vs SVCL and MFCL vs spectacle correction when the myopia occured before the period of intensive growth. When myopia occurred during the period of intensive growth, difference was noted for MFCL vs spectacle correction and SVCL vs spectacle correction. When myopia occurred after a period of intensive growth, no significant differences between the groups were observed.Conclusion1) Multifocal contact lenses and some single vision contact lenses (Biofinity) may be useful in the control of myopia in younger patients, slowing the progression of nearsightedness; therefore, they can be a therapeutic option in inhibiting the progression of myopia. 2) The best effects of using multifocal contact lenses occur if myopia is diagnosed before the period of intensive growth.

Myopia control with soft multifocal contact lenses: 18-month follow-up.

PURPOSE:The study aimed to establish the outcome of multifocal contact lenses (MFCL) (Multistage + 1.50D and Proclear + 3.00D) on myopia progression and axial length elongation over an 18-month period.METHODS:Thirty myopic schoolchildren (5 males and 25 females) aged between 13 and 15 years were randomly assigned to wear either single vision contact lens (SVCL), Multistage MFCL + 1.50D, or Proclear +3.00D MFCL for 1½ years using a double-masked design. Cycloplegic refraction, corneal curvature, and axial length were measured.RESULTS:Myopia progression was controlled by 38.6% and 66.6% in children wearing Multistage + 1.50D and Proclear +3.00D MFCL, respectively, in comparison to children wearing SVCL over an 18-month period. In terms of axial elongation, this study found a 31.1% and 63.2% control in axial elongation over 18 months of treatment in comparison to the SVCL group. No statistical significant difference in corneal curvature was found between initial and last visits for all the three groups (SVCL, P = 0.90; Multistage + 1.50 MFCL, P = 0.78, and Proclear + 3.00 MFCL, P = 0.05).CONCLUSION:Proclear +3.00D MFCL was revealed to cause slow development of myopia and axial elongation among myopic schoolchildren. MFCL with higher add powers could be more effective on myopia progression in comparison with moderate add powers.

Associations between Binocular Vision Disorders and Contact Lens Dissatisfaction.

These data demonstrate that binocular vision disorders (BVDs) contribute to contact lens (CL) dissatisfaction independently of CL discomfort (CLD) in myopic, pre-presbyopic, adult, single-vision CL wearers. This study aimed to determine whether BVDs contribute to CL dissatisfaction and whether this contribution is independent of CLD. Participants attended one clinical visit while wearing their habitual CLs. Symptoms from CLD and BVDs were measured with the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) and Convergence Insufficiency Syndrome Survey (CISS), respectively. A comprehensive binocular vision (BV) assessment was performed. The Ocular Surface Disease Index (OSDI) was used to measure CL dissatisfaction from CLD and BVDs based on reported correlations between the CLDEQ-8 and the CISS with the OSDI. Participants were categorized according to their CL comfort status (CLD [≥12 on CLDEQ-8] or non-CLD [<12 on CLDEQ-8]) and BV status (BVD or non-BVD). Seventy-six participants completed the trial, and 19 (25%) were diagnosed with BVD. Those diagnosed with BVD scored higher than did those diagnosed with non-BVD for the OSDI (25.1 ± 12.7 vs. 10.7 ± 7.3, P < .001) and CISS (18.7 ± 7.7 vs. 11.9 ± 5.9, P = .001), but not the CLDEQ-8 (P = .25). Those categorized as having CLD scored higher than did those categorized as having non-CLD for the OSDI (19.0 ± 12.3 vs. 9.3 ± 5.9, P = .003) and CISS (16.1 ± 6.8 vs. 11.0 ± 6.2, P = .001). There were no significant interactions between BV status and CL comfort status for any questionnaire (P > .08). Higher scores for OSDI in those with CLD or BVD indicate that both conditions contribute to CL dissatisfaction. Higher scores for the CISS in those with CLD suggest a degree of overlap for some BVD symptoms. Nonsignificant differences between BVD and non-BVD for the CLDEQ-8 suggest that BVDs contribute to CL dissatisfaction independently of CLD.

The efficacy of multifocal soft contact lenses for the alleviation of asthenopic symptoms in myopes with accommodative lag

PurposeTo evaluate the efficacy of multifocal soft contact lenses to reduce asthenopic symptoms in myopes with accommodative lag. MethodsTwenty-four myopic participants, aged 18–35 years, with mean spherical equivalent (MSE) of ≤ -0.75D, were recruited in a randomised, double-blind crossover study. All participants were existing contact lens wearer with near orthophoria or esophoria, presenting with subjective asthenopic symptoms at baseline [Convergence Insufficiency Symptom Survey (CISS) score ≥ 21] and a lag of accommodation ≥ +0.75 D. All participants were initially fitted with single vision contact lenses for a one month period. Participants were then randomly assigned 1:1 to wear low add or high add multifocal soft contact lenses for a further month. After this period, the groups were reversed. Data were collected at baseline and following one month’s wear of each lens. Change in CISS score was evaluated as the primary outcome measure, while secondary outcome measures were changes in accommodative lag and heterophoria status. ResultsBaseline CISS score was (mean ± SD) 25.04 ± 4.58. Post-intervention scores were as follows: single vision: 24.46 ± 4.59, low add: 12.17 ± 6.89, high add: 13.71 ± 7.23. Both low add and high add multifocal soft contact lens wear was associated with an improvement in CISS score compared to baseline CISS and single vision (all p < 0.01). No significant difference was found between the CISS score for the baseline CISS and single vision (p = 1.00). No significant difference was found in lag of accommodation between lens conditions (all p > 0.05), however, there was an exophoric shift in near heterophoria between single vision and both multifocal contact lenses (low add: (mean difference 1.33 Δ, p = 0.02; high add: mean difference 1.23 Δ, p = 0.02) but not between habitual spectacle or any other modality (all p > 0.05). ConclusionsThe use of multifocal soft contact lenses for a one-month period was associated with reduced severity of asthenopic symptoms in pre-presbyopic myopes with accommodative lag. Whilst improvement of symptoms does not appear to be mediated by a significant reduction in accommodative lag, changes in heterophoria may play a role in reducing asthenopic symptoms.

Comparison of visual performance between extended depth of focus contact lens and single-vision contact lens in eyes with monofocal intraocular lens.

To assess the visual performance of extended depth of focus (EDF) contact lenses (CL) in eyes that had undergone monofocal intraocular lens (IOL) implantation, and compare that between EDF and single-vision (SV) contact lenses. Prospective, randomized, crossover study METHODS: Seventeen patients implanted with monofocal IOLs were enrolled. The study was conducted using 1dayPure EDOF as a test CL and 1dayPure moisture (both SEED Co., Ltd.) as a control CL. Binocular visual acuity from far to near distances, photopic and mesopic contrast sensitivity (with and without glare), and stereopsis were evaluated after wearing the two kinds of CLs in random order. The obtained results were compared between the EDF and SV CLs. Binocular visual acuity at 0.3, 0.4, 0.7, 1, and 5m was 0.24 ± 0.12, 0.07 ± 0.09, - 0.02 ± 0.08, - 0.02 ± 0.08, and - 0.06 ± 0.07 logMAR during the EDF CL wear, respectively, and 0.39 ± 0.17, 0.26 ± 0.15, 0.04 ± 0.12, - 0.02 ± 0.08, and - 0.09 ± 0.09 during the SV CL wear, respectively. The EDF CL showed better results than the SV CL at 0.3, 0.4, and 0.7m (p < 0.05). There were no significant differences in contrast sensitivity between the EDF and SV CLs at 1.5 cycles per degree under all conditions; however, the sensitivity of the EDF CL was generally worse than that of the SV CL from the middle to high spatial frequencies. Stereopsis at 40cm was significantly better in the EDF CL wear than in the SV CL wear (p < 0.05). The EDF CL substantially improved visual acuity at near to intermediate distances in IOL-implanted eyes. However, far visual acuity decreased under low-contrast conditions, and contrast sensitivity slightly declined at the middle to high spatial frequencies.

Lenses and Spectacles to Prevent Myopia Worsening in Children

&#x0D; A total of 5 relevant systematic reviews and 7 randomized controlled trials (RCTs) were identified.&#x0D; Myopia progression and axial length elongation was less with omafilcon A (MiSight) contact lenses compared to single-vision lenses (1 RCT; statistical significance of difference was not reported).&#x0D; Myopia progression and axial length elongation was less with defocus incorporated multiple segments spectacle lenses compared to single-vision spectacle lenses (1 RCT; the between-group difference was statistically significant).&#x0D; Myopia progression was less with orthokeratology contact lenses compared to single-vision contact lenses or single-vision lenses (2 systematic reviews and 2 RCTs; between-group difference was statistically significant or statistical significance was not reported) and axial length elongation was less (5 systematic reviews and 2 RCTs; between-group difference was statistically significant or statistical significance was not reported).&#x0D; Myopia progression and axial length elongation was less with multifocal lenses compared with single-vision contact lenses (1 systematic review and 2 RCTs; between-group difference was statistically significant).&#x0D; Findings need to be interpreted in the light of limitations, such as limited quantity and quality of the included primary studies, limited information regarding adverse events, and lack of long-term data.&#x0D; No economic evaluations reporting on the cost-effectiveness of these interventions were identified.&#x0D;

Visual Performance of Center-distance Multifocal Contact Lenses Fit Using a Myopia Control Paradigm.

The purpose of this study was to examine the visual performance of center-distance MFCLs in nonpresbyopic adults under different illumination and contrast conditions compared with a single-vision contact lens (SVCL). Twenty-five adult subjects were fit with three different lenses (CooperVision Biofinity D MFCL +2.50 add, Visioneering Technologies NaturalVue MFCL, CooperVision Biofinity sphere). Acuity and reading performance were evaluated. A statistically significant difference in high-contrast distance acuity was observed (Biofinity, -0.18 ± 0.06; Biofinity MFCL, -0.14 ± 0.08; NaturalVue MFCL, -0.15 ± 0.03; repeated-measures [RM] ANOVA, P = .02). Under mesopic, high-contrast conditions, MFCLs performed worse than SVCLs (Biofinity, -0.05 ± 0.091; Biofinity MFCL, +0.03 ± 0.09; NaturalVue MFCL, +0.05 ± 0.091; RM-ANOVA, P < .0001). Under low-contrast conditions, MFCLs performed one line worse in photopic lighting and two lines worse under mesopic conditions (RM-ANOVA, P < .0001). Glare reduced acuity by 0.5 logMAR for all lenses (RM-ANOVA, P < .001). A statistically significant difference in near acuity was observed (RM-ANOVA, P = .02), but all lenses achieved acuity better than -0.1 logMAR (Biofinity, -0.16 ± 0.06; Biofinity MFCL, -0.17 ± 0.04; NaturalVue MFCL, -0.13 ± 0.08). Reading performance in words per minute (wpm) was worse with MFCLs (Biofinity MFCL, 144 ± 22 wpm; NaturalVue MFCL, 150 ± 28 wpm) than with SVCLs (156 ± 23 wpm; RM-ANOVA, P = .02) regardless of letter size (RM-ANOVA, P = .13). No difference in acuity between the MFCLs was detected (RM-ANOVA: all, P > .05). Multifocal contact lenses perform similarly to SVCLs for high-contrast targets and display reduced low-contrast acuity and reading speed. Practitioners should recognize that high-contrast acuity alone does not describe MFCL visual performance.

The effect of simultaneous dual-focus integration on the global flash multifocal electroretinogram in the human eye.

To investigate the effect of simultaneous dual-focus (DF) on retinal activities measured by global flash multifocal electroretinogram (mfERG). Thirty adults were recruited for mfERG measurement under three conditions: in-focus (i.e., no defocus), +2.50D DF and +7.50D DF, administered using single vision contact lenses and DF lenses. The direct component (DC) and the induced component (IC) of the mfERG were pooled into central macular (0-8°), para-macular (8-18°) and peri-macular (18-30°) regions, and then compared across the three conditions using two-way, repeated measures ANOVA. Simultaneous DF had a significant effect on the IC amplitude, which was significantly stronger under +7.50 D DF (p<0.01) than for the in-focus condition, which was mostly derived from the central and para-macular regions. No significant effect was observed for the +2.50 D DF condition. Under the effect of relatively strong simultaneous DF integration, the retina showed an enhanced retinal response, which originated from the inner retina. Compared with the peri-macular region, central and para-macular responses appeared to be enhanced.

Effect of High Add Power, Medium Add Power, or Single-Vision Contact Lenses on Myopia Progression in Children

Slowing myopia progression could decrease the risk of sight-threatening complications. To determine whether soft multifocal contact lenses slow myopia progression in children, and whether high add power (+2.50 D) slows myopia progression more than medium (+1.50 D) add power lenses. A double-masked randomized clinical trial that took place at 2 optometry schools located in Columbus, Ohio, and Houston, Texas. A total of 294 consecutive eligible children aged 7 to 11 years with -0.75 D to -5.00 D of spherical component myopia and less than 1.00 D astigmatism were enrolled between September 22, 2014, and June 20, 2016. Follow-up was completed June 24, 2019. Participants were randomly assigned to wear high add power (n = 98), medium add power (n = 98), or single-vision (n = 98) contact lenses. The primary outcome was the 3-year change in cycloplegic spherical equivalent autorefraction, as measured by the mean of 10 autorefraction readings. There were 11 secondary end points, 4 of which were analyzed for this study, including 3-year eye growth. Among 294 randomized participants, 292 (99%) were included in the analyses (mean [SD] age, 10.3 [1.2] years; 177 [60.2%] were female; mean [SD] spherical equivalent refractive error, -2.39 [1.00] D). Adjusted 3-year myopia progression was -0.60 D for high add power, -0.89 D for medium add power, and -1.05 D for single-vision contact lenses. The difference in progression was 0.46 D (95% CI, 0.29-0.63) for high add power vs single vision, 0.30 D (95% CI, 0.13-0.47) for high add vs medium add power, and 0.16 D (95% CI, -0.01 to 0.33) for medium add power vs single vision. Of the 4 secondary end points, there were no statistically significant differences between the groups for 3 of the end points. Adjusted mean eye growth was 0.42 mm for high add power, 0.58 mm for medium add power, and 0.66 mm for single vision. The difference in eye growth was -0.23 mm (95% CI, -0.30 to -0.17) for high add power vs single vision, -0.16 mm (95% CI, -0.23 to -0.09) for high add vs medium add power, and -0.07 mm (95% CI, -0.14 to -0.01) for medium add power vs single vision. Among children with myopia, treatment with high add power multifocal contact lenses significantly reduced the rate of myopia progression over 3 years compared with medium add power multifocal and single-vision contact lenses. However, further research is needed to understand the clinical importance of the observed differences. ClinicalTrials.gov Identifier: NCT02255474.

Accommodative Changes with Center-Near Multifocal Contact Lenses in Young Adults with Accommodative Infacility

Purpose : To evaluate changes in accommodative function after near works in young myopes with accommodative infacility fitted with center-near multifocal soft contact lenses. Methods : Thirty-one soft contact lens wearers were participated and divided into the accommodative infacility group and normal group according to the accommodative facility. Subjects were fitted with single vision contact lenses (SVCLs) and center-near mid-add multifocal soft contact lenses (MFCLs). In case of MFCLs wearing, accommodative functions were measured after more than 7 days of adaptation. The amplitude of accommodation, near point of convergence, accommodative facility and vergence facility were measured after watching video using a smartphone for inducing accommodative burden for 30 minutes. Results : Among the subjects, twenty-four were normal in accommodative facility and seven were accommodative infacility. In young adults group with accommodative infacility, the near point of accommodation after watching video, was significantly increased with SVCLs(p=0.012) and no difference with MFCLs compared with before watching video. And the near point of convergence with MFCLs after watching video was significantly shorter than that with SVCLs, and shorter than before watching video(p=0.009), and accommodative facility with MFCLs was statistically significant increased compared with SVCLs, and higher than that of before video watching(p=0.004). Conclusion : The med-add center-near MFCLs enhance accommodative function that could be effective to alleviated accommodative burden for the young adults with accommodative infacility.

Wpływ miękkich multifokalnych soczewek kontaktowych z wysokimi addycjami na koordynację wzrokowo-ruchową

The aim of the present study was to assess whether soft multifocal contact lens (SMFCLs) with high addition powers, designed for myopia control, may have an impact on eye movements and eye–hand coordination. A total of 24 young adults used SMFCLs (Relax, SwissLens) with high additions: +2D (Add2) and +4D (Add4). Single vision (Add0) contact lenses were used as controls (Orbis, SwissLens). In the eye–hand coordination task, the study participants were asked to point out the small circle displayed on a touch screen. Reaction time and accuracy of pointing, as well as latency of eye movements were measured. Results showed that SMFCLs had no significant impact on the latency of eye movements (135, 136, 139 ms, for Add0, Add2 and Add4, p = 0.171), reaction time (732, 730, 727 ms for Add0, Add2 and Add4, p = 0.932) or percent error (17%, 13%, 18% for Add0, Add2 and Add4, p = 0.386).

The influence of power profiles on lens power of single vision and multifocal soft contact lenses

The influence of power profiles on lens power of single vision and multifocal soft contact lenses

Vision Performance and Accommodative/Binocular Function in Children Wearing Prototype Extended Depth-of-Focus Contact Lenses.

To assess two prototype contact lenses (CLs) that extend depth of focus through deliberate manipulation of multiple spherical aberration terms (extended depth-of-focus [EDOF]) for visual performance, accommodative and binocular function, and objective static near refraction against a single-vision (SV) CL. This was a prospective, randomized, cross-over, single-masked (participant) clinical trial in which 16 myopic children wore 2 prototype CLs (EDOFL/EDOFH) designed for presbyopes and a SV CL, each for one week. Measurements comprised monocular and binocular high-contrast visual acuity (HCVA: 6 m, 40 cm), binocular low-contrast visual acuity (LCVA: 6 m), contrast sensitivity (CS: 6 m), phorias (3 m, 33 cm), monocular-accommodative facility (33 cm), and objective static refraction (spherical equivalent M) at zero, -3, and -5 D vergences. Measurements were taken 10 min after lens insertion. Subjective response was assessed using take-home questionnaires comprising vision clarity (distance/intermediate/near), vision quality (haloes at night/ghosting), vision stability when moving (playing sport/using stairs), and comfort. Single vision was significantly better than both EDOF CLs for monocular HCVA, LCVA, and CS (6 m); vision clarity (distance), ghosting (P≤0.040), and EDOFL for binocular HCVA (6 m, P=0.047). M was significantly closer to the ideal objective static refraction at -3 and -5 D vergences (P≤0.004) with both EDOF compared with SV CLs. There were no differences between CLs for any other variable (P≥0.169). Extended depth-of-focus CLs caused minimal disruption to the accommodative and binocular system compared with SV CLs when worn by myopic children. Future EDOF designs for children should reduce the difference between SV for distance vision and vision quality while maintaining the same performance for intermediate and near.

Epidemiology of myopia and prevention of myopia progression in children in East Asia: a review.

Myopia (short-sightedness) exhibits high prevalence in East Asia. Methods to mitigate myopia progression are important in preventing the vision-threatening complications associated with high myopia. In this review, we examine the regional epidemiology of myopia and provide updated evidence regarding interventions to slow myopia progression in children. We performed a literature search using PubMed from the date of inception through 25 June 2018. Studies involving myopia epidemiology and control of myopia progression were selected; only studies published in English were reviewed. Preference was given to prospective studies, as well as those conducted in Hong Kong or East Asia. Atropine eye drops and pirenzepine eye gel are highly effective for controlling myopia progression in children. Orthokeratology, peripheral defocus contact lenses, bifocal or progressive addition spectacles, and increased involvement in outdoor activities are also effective for controlling myopia progression; however, myopia undercorrection and single vision contact lenses are ineffective. Although various methods are effective for controlling myopia progression in children, no curative remedy exists for myopia. Health care professionals should be aware of the available methods, as well as their risks and benefits. Treatment should be individualised and based on the preferences of the patient's family, after full discussion of the risks and benefits of each modality.

The effect of the optical design of multifocal contact lenses on choroidal thickness.

Studies have found reduced myopia progression with multifocal contact lenses, albeit with an unclear mechanism behind their protective effect. It is hypothesized that the induced myopic defocus of the addition zones of the multifocal contact lenses leads to choroidal thickening and therefore inhibits eye growth. In the current study, the effect of the optical design of multifocal contact lenses on choroidal thickness was investigated. Eighteen myopic participants wore four different contact lenses ((1) single-vision lenses corrected for distance, (2) single-vision lenses with +2.50 D full-field defocus, (3) Multifocal center-distance design, (4) Multifocal center-near design, both with addition power +2.50 D) for 30 min each on their right eye. Automated analysis of the macular choroidal thickness and vitreous chamber depth were performed before and after the wear of each of the contact lenses. Peripheral refraction profiles in primary gaze were obtained using eccentric photorefraction prior to contact lens wear. Choroidal thickness and vitreous chamber depth showed no significant differences to baseline with any of the contact lenses (all p > 0.05). Choroidal thickness increased by +2.1 ± 11.1 μm with the Multifocal center-distance design, by +2.0 ± 11.1 μm with the full-field defocus lens, followed by the Multifocal center-near design with +1.6 ± 11.3 μm and the single-vision contact lens correcting for distance with +0.9 ± 11.2 μm. Multifocal contact lenses have no significant influence on choroidal thickness after short-term wear. Therefore, changes in choroidal thickness might not be the main contributor to the protective effect of multifocal contact lenses in myopia control.

Effect of Peripheral Defocus on Axial Eye Growth and Modulation of Refractive Error in Hyperopes: Protocol for a Nonrandomized Clinical Trial.

BackgroundHyperopia occurs due to insufficient ocular growth and a failure to emmetropize in childhood. In anisohyperopia, it is unclear why one eye may remain hyperopic while the fellow eye grows toward an emmetropic state. Animal studies have shown that manipulating peripheral defocus through optical means while simultaneously providing correct axial focus can either discourage or encourage axial eye growth to effectively treat myopia or hyperopia, respectively. Myopia progression and axial eye growth can be significantly reduced in children and adolescents through the use of multifocal contact lenses. These contact lenses correct distance central myopia while simultaneously imposing relative peripheral myopic defocus. The effect of correcting distance central hyperopia while simultaneously imposing relative peripheral hyperopic defocus is yet to be elucidated in humans.ObjectiveThe objective of our study is to understand the natural progression of axial eye growth and refractive error in hyperopes and anisohyperopes and to establish whether axial eye growth and refractive error can be modified using multifocal contact lenses in hyperopes and anisohyperopes.MethodsThere are 3 elements to the program of research. First, the natural progression of axial eye growth and refractive error will be measured in spectacle-wearing hyperopic and anisohyperopic subjects aged between 5 and <20 years. In other words, the natural growth of the eye will be followed without any intervention. Second, as a paired-eye control study, anisohyperopes aged between 8 and <16 years will be fitted with a center-near multifocal design contact lens in their more hyperopic eye and a single-vision contact lens in the fellow eye if required. The progression of axial eye growth and refractive error will be measured and compared. Third, subjects aged between 8 and <16 years with similar levels of hyperopia in each eye will be fitted with center-near multifocal design contact lenses in each eye; the progression of axial eye growth and refractive error in these subjects will be measured and compared with those of subjects in the natural progression study.ResultsRecruitment commenced on 6 June 2016 and was completed on 8 April 2017. We estimate the data collection to be completed by April 2020.ConclusionsThis trial will establish whether axial eye growth can be accelerated in children with hyperopia by imposing relative peripheral hyperopic defocus using center-near multifocal contact lenses.Trial RegistrationClinicalTrials.gov NCT02686879; https://clinicaltrials.gov/ct2/show/NCT02686879 (Archived by Webcite at http://www.webcitation.org/71o5p3fD2)Registered Report IdentifierRR1-10.2196/9320

Changes in Visual Function According to the Addition of Center-near Designed Multifocals and Utilization as Contact Lenses for Fatigue

Purpose: To compare changes in visual function according to single vision and additions of center-near simultaneous vision multifocal contact lenses and investigate the use as a functional contact lens for fatigue. Methods: Twenty young adult subjects(40 eyes, 26.63±4.36 years) participated in this study. Mean spherical refractive errors were–3.38±2.57 D, mean cylinderical errors were–0.46±0.31 D and mean spherical equivalent errors were -3.61±2.64 D. Subjects visited four times and wore single vision, multifocal LOW, MID, and HIGH addition lenses for each visit. They were asked to watch a video with subtitles on a cell phone (4.7 inches) at 40 cm for 60 minutes in order to induce accommodation. After that, MEM, distance and near contrast visual acuity (100% and 10%), near range of clear vision, near point of accommodation, near point of convergence, accommodative facility and stereoacuity were measured and subjective satisfaction was evaluated. Results: As the addition increased, MEM tended to increase and near point of accommodation decreased(p 0.05). Satisfaction with distance vision showed the highest score in single vision contact lenses. Conclusion: As the addition increases, an increase in MEM and a decrease in near point of accommodation are verified. However, differences in the other tests were mostly not significant. Therefore, in order to use the multifocal contact lenses as functional contact lenses, it may be necessary to trance changes in visual function after wearing for a longer period of time.

Effects of relative negative spherical aberration in single vision contact lens visual performance.

ObjectiveThe study aimed to compare the visual performance of contact lenses with and without negative spherical aberration (SA) over 5 days of wear.MethodsAt baseline, 32 myopic participants (aged 18–33 years) were fitted in a randomized order with two lenses (test lens with minimal or no SA and 1-Day Acuvue Moist designed with negative SA) for 5 days (minimum 6 hours wear/day). Participants returned for a follow-up visit. This consisted of on-axis SA measurements; high- and low-contrast visual acuities at 6 m; high-contrast acuities at 70 and 40 cm; low-illumination, low-contrast acuity at 6 m; stereopsis at 40 cm; horizontal phorias at 3 m and 33 cm; and ±2.00 D monocular accommodative facility at 33 cm. Participants also rated (1–10 scale) vision quality (clarity and lack of ghosting for distance, intermediate, near, driving vision and vision stability during day- and night-time), overall vision satisfaction, ocular comfort, and willingness to purchase (yes/no response).Results1-Day Acuvue Moist induced significantly (p<0.05) more negative SA at distance (Δ=0.078 μm) and near (Δ=0.064 μm) compared to the test lens, for a 6 mm pupil. There were no significant differences (p>0.05) in acuity, binocular vision, and all subjective metrics except vision stability between lenses where the test lens was rated to provide more stable vision (p<0.05).ConclusionContrary to expectations, incorporating negative SA in single vision soft contact lenses did not improve visual performance in non-presbyopic adult myopes.