March 3, 2025
By Dwight Akerman, OD, MBA, FAAO, Dipl AAO, FBCLA, FIACLE
Photo Credit: Getty Images
In the study by Meyer et al. (2025), the authors investigate the effect of dual focus (DF) myopia control contact lenses on the accommodative behavior and retinal defocus in individuals with high myopia, defined as exceeding 6.00D. The purpose of this research was to evaluate how these specialized lenses influence both myopic and hyperopic defocus at the retina, particularly in younger populations experiencing significant levels of myopia.
The study involved thirteen participants, aged 13 to 32 years, all of whom had spherical equivalent refractive errors ranging from −6.50D to −9.25D. Each participant was fitted bilaterally with DF lenses designed to simulate the optical profile of a CooperVision MiSight 1 day lens alongside a standard single vision lens. Measurements were obtained using a pyramidal aberrometer, focusing on wavefront aberrations along the primary line of sight and across the central horizontal retina at various target vergences.
Results indicated that the treatment optic zone of the DF lenses effectively shifted retinal defocus by approximately −2.00D, with a mean difference of −2.21D noted when compared to the single vision lens. The study found no significant impact on the accommodative accuracy of the participants due to the inclusion of the DF optic (p = 0.51). However, it was noted that larger accommodative lags were present at nearer viewing distances, increasing by about 0.30D for each additional diopter of spherical equivalent refractive error.
Furthermore, the research revealed that while the DF lens’s treatment zones generated a combined effect of reducing hyperopic defocus and introducing myopic defocus, the increased accommodative lag and the structure of the more prolate retinas in highly myopic eyes resulted in a lesser degree of myopic defocus than anticipated. Specifically, measured defocus at various retinal points showed a consistent trend toward approximately −2.00D at the foveal center, with slight reductions observed toward the temporal side.
In conclusion, the findings of this study suggest that dual focus myopia control lenses can potentially alter the retinal defocus characteristics in highly myopic youth, thereby influencing their visual experience. However, the unique accommodative challenges posed by higher myopia merit further investigation to optimize lens designs and therapies aimed at controlling myopia progression in this demographic.
Abstract
Accommodative Behavior and Retinal Defocus in Highly Myopic Eyes Fitted with a Dual Focus Myopia Control Contact Lens
Dawn Meyer, Javier Gantes-Nuñez, Martin Rickert, Nitya Murthy, Paul Chamberlain, Arthur Bradley, Pete Kollbaum
Purpose: To evaluate the myopic and hyperopic defocus delivered to the retina by a dual focus (DF) myopia control contact lens when myopia exceeds 6.00 D.
Methods: Individuals with high myopia were fitted bilaterally with high-powered DF lenses containing power profiles matching a CooperVision MiSight 1 day contact lens (omafilcon A) and a CooperVision Proclear 1 day single vision (SV) lens. Wavefront measurements along the primary line of sight and across the central ±20° of the horizontal retina were acquired using a pyramidal aberrometer, while subjects accommodated to high-contrast letter stimuli (6/12 equivalent) at six target vergences (−0.25 and −1.00 to −5.00 D). Linear mixed-effects regression models explored the relationship between the spherical equivalent refractive error (SERE) and induced defocus.
Results: Thirteen teenagers and young adults (ages 13–32 years, mean [standard deviation, SD] age = 22.8 [4.9] years) with high myopia (SERE −6.50 to −9.25 D) were tested. The treatment optic zone of the DF lens shifted retinal defocus by the expected −2.00 D, with a mean (SD) difference (DF–SV) of −2.21 (0.18) D for the inner treatment ring. Inclusion of the treatment optic had no significant impact on accommodative accuracy (p = 0.51). Accommodative lags were larger at the nearer viewing distances, with lag increasing by approximately 0.30 D for every additional dioptre of SERE. Measured retinal defocus within the annular treatment zone was approximately −2.00 D at the foveal centre, 10° nasal and temporal and 20° nasal and reduced to −1.90 (0.57) D at 20° temporal.
Conclusions: Relative to eyes with lower levels of myopia, the increased accommodative lags and more prolate retinas of highly myopic eyes reduced the myopic retinal defocus from the DF myopia control lens, while the treatment optical zones generated the combined effect of reducing hyperopic and introducing myopic retinal defocus relative to an SV correction.
Meyer, D., Gantes‐Nuñez, J., Rickert, M., Murthy, N., Chamberlain, P., Bradley, A., & Kollbaum, P. (2025). Accommodative behaviour and retinal defocus in highly myopic eyes fitted with a dual focus myopia control contact lens. Ophthalmic and Physiological Optics, 45(1), 189-199.
DOI: https://doi.org/10.1111/opo.13420
MiSight 1 Day soft contact lenses are FDA-approved for the correction of myopic ametropia and for slowing the progression of myopia in children with non-diseased eyes who, at the initiation of treatment, are 8-12 years of age and have a refraction of -0.75 to -4.00 diopters (spherical equivalent) with less than or equal to 0.75 diopters of astigmatism.
