Retinal Peripheral Defocus and Peripheral Refractive Measurement Techniques: A Review

The theory of retinal peripheral defocus currently represents the prevailing paradigm for myopia prevention and control. Research studies on peripheral refraction indicate that peripheral defocus is significantly associated with the management and progression of myopia. A series of animal and clinical studies conducted over the last century have substantiated this theory. Accurate and rapid measurement and evaluation of peripheral refractive states using appropriate techniques form the foundation for investigating this theory. Research based on technologies for measuring retinal peripheral refractive errors continues to evolve, with precise detection holding substantial significance in ophthalmology, particularly within optometry. This paper provides a comprehensive overview of the principles underlying the most commonly employed methods for measuring peripheral refraction, addressing their current status in both clinical and commercial contexts, and ranging from subjective to objective measurements, as well as analyzing and comparing various methodologies along with their respective advantages and disadvantages. Special emphasis is placed on widely utilized open automatic optometry systems and Hartmann–Shack wavefront aberration techniques, while also introducing a newly developed measurement method grounded in refractive compensation technology for optical imaging—multispectral refractive topography. Based on these measurement techniques, future directions for research and technological advancements concerning peripheral refractive error are proposed.