Effect of peripheral defocus on axial growth and modulation of refractive error in children with anisohyperopia

Ian G. Beasley, Leon N. Davies, Nicola S. Logan*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To establish whether axial growth and refractive error can be modulated in anisohyperopic children by imposing relative peripheral hyperopic defocus (RPHD) using multifocal soft contact lenses. Methods: This study is a prospective, controlled paired‐eye study with anisohyperopic children. Axial growth and refractive error were observed without intervention for the first 6 months of the 3‐year trial with participants wearing single vision spectacles. Then, participants wore a centre‐near, multifocal, soft contact lens (+2.00 D add) in their more hyperopic eye for 2 years, with a single vision contact lens worn in the fellow eye if required. The ‘centre‐near’ portion of the contact lens in the more hyperopic eye corrected distance refractive error while the ‘distance’ portion imposed hyperopic defocus in the peripheral retina. Participants reverted to single vision spectacles for the final 6 months. Results: Eleven participants, mean age of 10.56 years (SD 1.43; range 8.25–13.42), completed the trial. No increase in axial length (AL) was found during the first 6 months in either eye (p > 0.99). Axial growth across the 2‐year intervention period was 0.11 mm (SEM 0.03; p = 0.06) in the test eye versus 0.15 mm (SEM 0.03; p = 0.003) in the control eye. AL was invariant during the final 6 months in both eyes (p > 0.99). Refractive error was stable during the first 6 months in both eyes (p = 0.71). Refractive error change across the 2‐year intervention period was −0.23 D (SEM 0.14; p = 0.32) in the test eye versus −0.30 D (SEM 0.14; p = 0.61) in the control eye. Neither eye demonstrated a change in refractive error during the final 6 months (p > 0.99). Conclusions: Imposing RPHD using the centre‐near, multifocal, contact lens specified here did not accelerate axial growth nor reduce refractive error in anisohyperopic children.
Original languageEnglish
Pages (from-to)805-814
Number of pages10
JournalOphthalmic and Physiological Optics
Issue number4
Early online date7 Apr 2023
Publication statusE-pub ahead of print - 7 Apr 2023

Bibliographical note

Copyright © 2023 The Authors. Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Funding Information:
This research was funded by a postgraduate scholarship from the College of Optometrists.


  • anisometropia
  • axial growth
  • contact lenses
  • hyperopia
  • peripheral defocus
  • refractive error


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