Peripheral optical errors and their change with accommodation differ between emmetropic and myopic eyes.

The progression of myopia is thought to be controlled by the retinal image quality, but its triggering factors are not yet well known. The differences between the peripheral optics in emmetropic and myopic eyes might explain why some eyes become myopic. The present study further investigates peripheral optical quality and how it is affected by accommodation. The refraction and aberrations of the right eyes of five emmetropes and five myopes were measured using a laboratory Hartmann-Shack wave front sensor, specially designed for peripheral measurements with an open field of view. The off-axis optical quality was assessed in steps of 10 degrees out to +/-40 degrees horizontally and +/-20 degrees vertically for two different states of accommodation (targets at 0.5 D and 4.0 D). As expected, the emmetropes had a higher relative peripheral myopia, that is, more positive c(2)(0) coefficient, than the myopes. The new results of this study are that this well-known difference was found to be asymmetric over the visual field and that it increased with accommodation. This increase was because the relative peripheral defocus profile of the myopes did not show a consistent change between far and near vision, whereas the emmetropes became relatively more myopic in the periphery with accommodation. These findings may indicate a difference between emmetropic and myopic eyes that could be an important clue to understand myopia progression.