Peripheral Refraction and Refractive Error in Singapore Chinese Children

PURPOSE. Peripheral hyperopia was hypothesized to stimulate axial elongation. This study describes peripheral refraction and its associations with central refractive error in young Singapore Chinese children. METHODS. Two hundred fifty children aged 40 months or older recruited from the Strabismus, Amblyopia, and Refractive Error in Young Singapore Children study were included in this analysis. Peripheral refraction was measured after pupil dilation using an infrared autorefractor. A total of five measurements were captured: central visual axis and 15 and 30 eccentricities in the nasal and temporal visual fields. RESULTS. The mean age of the participants recruited was 83 +/- 36 months. There were 37 children with high and moderate myopia (<= -3 D; 14.8%), 81 with low myopia (-2.99 to -0.5 D; 32.4%), 84 with emmetropia (-0.49 to 1.0 D; 33.6%), and 47 with hyperopia (> 1.0 D; 18.8%). Compared with the central axis, children with high and moderate myopia had relative hyperopia at all peripheral eccentricities (P < 0.001), whereas children with low myopia had relative hyperopia only at the temporal and nasal 30 degrees (P < 0.001), but not at the nasal and temporal 15 degrees. Children with emmetropia and hyperopia had peripheral relative myopia at all eccentricities (P < 0.001). A significant correlation between the nasal and temporal refractive error at 30 degrees was noted (Spearson's correlation coefficient = 0.85, P < 0.001). CONCLUSIONS. Young myopic Singapore Chinese children had relative hyperopia in the periphery. This study substantiates previous studies in older children and in Caucasian subjects. (Invest Ophthalmol Vis Sci. 2011; 52:1181-1190) DOI:10.1167/iovs.10-5601