Visual field performance of the novel DIMS TED spectacle lens compared with DIMS and single-vision spectacle lenses

Purpose To evaluate the visual field performance of DIMS TED spectacle lens, an enhanced Defocus Incorporated Multiple Segments (DIMS) spectacle lens design featuring more defocus segments closer to the geometric center, higher defocus power and extended defocus treatment zone, compared with DIMS and single vision (SV) spectacle lenses. Methods Children aged 9 to 14 years with cycloplegic spherical equivalent refractive error (SER) ranged from −1.00 to −6.00D were recruited. Visual field performance was assessed using an automated static perimeter (Zeiss, Humphrey Visual Field HFA 750i) with SITA Fast 30–2 protocol. A Goldmann size III (0.43 o ) green flashing stimulus of varying luminance levels was presented at 76 random test points within 30 o visual field. Each participant underwent testing for all three lens types in a pre-generated random order. Results Sixteen myopic children (mean age 12.09 ± 1.82 years; mean cycloplegic spherical equivalent refraction −3.04 ± 1.14D) completed reliable visual field testing. Mean visual sensitivity was 27.94 ± 1.54 decibels (dB), 29.21 ± 1.16 dB and 29.16 ± 1.44 dB for DIMS TED, DIMS and SV spectacle lenses, respectively. Across the 76 test points, mean sensitivity differences between the DIMS TED and SV ranged from −4.63 ± 9.45 dB to 1.25 ± 4.67 dB, while differences between DIMS TED and DIMS lenses ranged from −4.69 ± 7.70 dB to 0.63 ± 4.83 dB. Omnibus Friedman tests at each test point corrected with the Benjamini–Hochberg (BH) procedure, identified a significant overall effect of lens condition at seven test points (raw p value from 0.00007 to 0.004, and corresponded BH value from 0.005 to 0.006, false discovery rate q = 0.05). Post hoc pairwise showed DIMS TED had significantly lower sensitivity with DIMS at six test points and with SV at four test points after Bonferroni correction ( p < 0.017). Conclusion The DIMS TED spectacle lens was associated with no clinically meaningful reduction in visual field sensitivity within the central 30° compared with DIMS and SV spectacle lenses in myopic children. This finding supports the visual tolerability of this intensified defocus design for childhood myopia management. Future studies incorporating larger cohorts and broader age ranges are warranted.