Impact of Peripheral Refractive Errors in Mobility Performance

Visual Psychophysics and Physiological Optics
Clara García-Pedreño, Juan Tabernero, Antonio Benito, and Pablo Artal

PURPOSE. The purpose of this study was to investigate the functional effects of peripheral refractive errors on mobility performance through a stair negotiation task.
METHODS. Twenty-one young, normal sighted subjects navigated through an obstacle with steps, wearing spectacles that altered only their peripheral refraction. Lenses were used to induce positive defocus (+2 diopters [D] and +4 D), negative defocus (−2 D and −4 D), or astigmatism (+1.75 D and −3.75 D, axis 45 degrees) in the periphery. Feet trajectories were analyzed, and several gait assessment parameters were obtained. Statistical tests were conducted to determine significant performance differences between the lenses. Peripheral refraction in each subject was measured using a scanning Hartmann-Shack wavefront sensor to assess the impact of intrinsic peripheral refraction on the experiment.
RESULTS. Statistically significant differences in performance appeared when peripheral errors were superimposed. Crossing time with respect to plano lenses increased by 6.2%, 7.6%, 19.2%, and 29.6% for the −2 D, +2 D, −4 D, and +4 D lenses, respectively (P < 0.05 in the last 3 cases). Subjects exhibited slower walking speeds, increased step count, and adopted precautionary measures. High-power positive defocus lenses had the biggest impact on performance, and differences were observed in distance to steps between induced positive and negative defocus.
CONCLUSIONS. In this laboratory-based study without an adaptation period, peripheral refractive errors affected stair negotiation, causing cautious behavior in subjects. Performance differences among types of peripheral defocus may result from magnification effects and intrinsic peripheral refraction. These results highlight the importance of understanding the effects of induced peripheral errors by myopia control and intraocular lenses.