Ophthalmic lens for myopia control

Abstract

An ophthalmic lens for slowing or preventing myopia progression has a lens center, a shape defined by a lens peripheral edge, and an optical zone surrounding the lens center and having an outer periphery. The optical zone has a central optical zone surrounding the lens center and defined by a central optical zone radius and a peripheral optical zone surrounding the central optical zone and extending to an outer periphery of the optical zone. The lens comprises a plurality of myopic defocus zones each located at a predetermined radial distance from the center of the lens and each introducing a predetermined ADD power that increases as the radial distance from the center of the lens increases up to a radius of at least 4 mm. At least a first myopic defocus zone is located within the central optical zone, and at least a first myopic defocus zone and a second myopic defocus zone are located in the peripheral optical zone.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims priority to U.S. Provisional Application No. 63 / 434,819, filed on December 22, 2022, and U.S. Provisional Application No. 63 / 548,432, filed on November 14, 2023. Technical Field

[0003] The present invention relates to an ophthalmic lens designed to prevent or reduce myopia progression in a patient. More particularly, the present invention relates to lens designs and methods for lens design that induce a predetermined peripheral blur orientation at the retinal plane or otherwise increase the average peripheral blur anisotropy value. Background Art

[0004] Common conditions that lead to decreased visual acuity include myopia and hyperopia, for which corrective lenses in the form of glasses, rigid or soft contact lenses are required. These conditions are generally described as an imbalance between the length of the eye and the focusing of the optics of the eye. Myopia focuses light from distant objects in front of the retinal plane, and unaccommodated hyperopia focuses light from distant objects behind the retinal plane. Myopia usually develops because the axial length of the eye grows longer than the focal length of the optics of the eye, that is, the eye grows too long. Hyperopia usually develops because the axial length of the eye is too short compared to the focal length of the optics of the eye.

[0005] Myopia has a high prevalence in many parts of the world. The most concerning aspect of this condition is its potential to develop into high myopia, for example, greater than five (5) or six (6) diopters, which significantly affects a person's ability to function without optical aids. High myopia is also associated with an increased risk of retinal diseases, cataracts, glaucoma and myopic macular degeneration (MMD, also known as myopic retinopathy), and may become the leading cause of permanent blindness worldwide. MMD has been associated with refractive error (RE) to the point where it is no longer possible to clearly distinguish between pathological myopia and physiological myopia, and therefore there is no "safe" level of myopia.

[0006] Corrective lenses are used to change the overall focus of the eye so that a sharper image is formed at the retinal plane by shifting focus from the front of the plane to correct myopia or from the back of the plane to correct hyperopia, respectively. However, the corrective approaches to these conditions do not address the cause but are merely repair or aimed at treating the symptoms.

[0007] Most eyes are not simply nearsighted or farsighted, but also have myopic astigmatism or hyperopic astigmatism. Astigmatic errors in focus cause the image of a point light source to form two perpendicular lines at different focal lengths. In the following discussion, the terms nearsighted and farsighted are used to encompass both simple nearsightedness and myopic astigmatism, and simple hyperopia and hyperopic astigmatism, respectively.

[0008] Emmetropia describes a state of clear vision in which objects at infinity are in relatively sharp focus when no optical correction is required and the lens is relaxed. In a normal or emmetropic adult eye, light from distant and near objects passing through the central or paraxial region of the aperture or pupil is focused by the lens into the eye near the plane of the retina where an inverted image is sensed. However, it has been observed that most normal eyes exhibit positive longitudinal spherical aberration, which means that light passing through the aperture or pupil at its periphery is focused in front of the plane of the retina when the eye is focused to infinity. As used herein, the measure D is dioptric power, which is defined as the reciprocal of the focal length of a lens or optical system, expressed in meters.

[0009] The spherical aberration of a normal eye is not constant. For example, accommodation (a change in the refractive power of the eye, primarily by changing the internal lens) causes the spherical aberration to change from positive to negative.

[0010] As noted, myopia typically occurs due to excessive axial growth or elongation of the eye. It is now generally accepted that the focus and quality of the retinal image can affect axial eye growth, and that altering the retinal image can cause consistent and predictable changes in eye growth.

[0011] Known methods of attempting to eliminate or reduce axial elongation of the eye, particularly in children, include the use of ophthalmic lenses that intentionally introduce myopic defocus into the visual field. Myopic defocus introduces a 'stopping' stimulus to the eye that produces a restriction in eye growth. This was initially observed as thickening of the choroid. Animal studies have shown that changes in eye growth in response to retinal image defocus are largely mediated through local retinal mechanisms, because changes in eye length still occur when the optic nerve is damaged, and because applying defocus to a localized retinal area has been shown to result in changes in eye growth that are confined to that specific retinal area.

[0012] Ophthalmic lenses with a concentric ring design have been shown to slow the progression of myopia. These ophthalmic lenses include the Johnson & Johnson Vision Care, Inc. Bifocal lenses and CooperVision, Inc. Contact lenses. These lenses have certain annular zones containing optics that correct myopia, while others introduce myopic defocus. Light from distant objects along the optical axis that passes through a given annulus comes into focus essentially at a point on the optical axis; on the retina for the myopia correction annulus and in front of the retina for the myopic defocus annulus, respectively.

[0013] U.S. Patent No. 10,901,237, which is incorporated herein by reference in its entirety, describes various other lens designs for myopia control, particularly for use in soft contact lenses. These lenses also have a concentric annular design in which certain annular segments include optics that focus on the retina. For patients requiring myopia correction, these annular segments may include optics that redirect the focus onto the retina. For patients who do not require myopia correction, these annular segments may not provide optical correction. The myopic defocus annular segment, which is not centrally positioned, contains optics that focus light passing therethrough in front of the retina, rather than a point focus on the optical axis, which forms a non-coaxial annular focus. In some disclosed embodiments, the central portion of the lens contains an add optical power that causes myopic defocus but along the optical axis.

[0014] Lens designs such as these tend to emphasize on-axis optics for light rays originating from objects along the optical axis, and more specifically produce a focus relative to the central region. Furthermore, these lens designs focus on design principles based on central vision, and incorporate optical elements into the central vision region to generate myopic defocus. In addition to central vision, it has been shown that peripheral refractive error can have a substantial impact on central refractive progression, and myopic defocus in the near periphery can slow axial growth. (See Smith, Vision Reg., Sept. 2009; 49(19): 2386-2392).

[0015] Additional aberrations arise in peripheral vision, which may further contribute to the development of myopia. In an astigmatic eye, the refraction of the eye is not spherical or rotationally uniform, but because of the elliptical or "football" shape of the eye, the refractive power along one meridian is different from the refractive power along the vertical meridian, so that the focal lines along the two meridians are at different distances. Regular astigmatism is generally classified as "with the rule," "against the rule," or "oblique." For individuals with "with the rule" astigmatism (the most common), the vertical meridian has the strongest optical power or steepest curvature compared to the horizontal meridian. Oblique astigmatism occurs when the strongest optical power or steepest curvature does not fall on the vertical or horizontal meridian.

[0016] In addition to the possible presence of astigmatism in central vision, it is well known that peripheral astigmatism is produced by light rays striking the refractive surfaces of the cornea and lens at oblique incidence. This astigmatism and other wavefront aberrations result in highly anisotropic optical blur in the peripheral retina. Blur anisotropy is defined herein as the logarithm (base 10) of the ratio of the area under the modulation transfer function (MTF) along the vertical meridian (superior-inferior meridian) divided by the area under the MTF along the horizontal meridian (temporal-nasal meridian), i.e., blur anisotropy = log[(area)] 竖直 / (area) 水平 ]. Thus, when an image (or point spread function) has primarily vertically oriented blur, the blur anisotropy is negative, and when an image has primarily horizontally oriented blur, the blur anisotropy is positive. The human nervous system is more sensitive to horizontally oriented visual stimuli than to vertically oriented stimuli. Furthermore, the orientation of the blur pattern produced by astigmatism changes from horizontal to vertical around the periphery of the retina, a principle known as the meridian effect.

[0017] Figure 2 An exemplary illustration of peripheral blur anisotropy is shown in , where the blur at the retinal plane has an asymmetric pattern such that the blur pattern is longer in one direction (i.e., along the y-axis) than in the perpendicular direction. Figure 2 In the example above, the optical resolution along the x-axis will be finer than the optical resolution along the y-axis. As described above, the orientation of the peripheral blur will change around the periphery of the retina.

[0018] Peripheral vision can also be used to introduce myopia control effects. In a recent publication titled “Eccentricity-Dependent Effects of Simultaneous Competing Defocus on Emmetropization in Infant Rhesus Monkeys” (Vision Research 177 (2020) 32-40), the authors showed that myopic defocus of about 20° from the fovea can significantly affect the development of central refraction in primates. In another publication, it is hypothesized that the orientation sensitivity of the nervous system is consistent with the habitual blur orientation, and that this blur orientation may be a trigger for eye growth. Zhelenznyak et al. (2016), “Optical and Neural Ansiotropy in Peripheral Vision”, Journal of Vision, 16 (5): 1, 1-11.

[0019] Recently, Ji et al. used modeling techniques to evaluate certain bifocal and multifocal contact lenses that were suitable for incorporating an additional optical power for inducing myopic defocus, compared to monofocal lenses, to assess the effects of the lenses on peripheral vision at various eccentricities. Ji et al., "Through-focus Optical Characteristics of Monofocal and Bifocal Soft Contact Lenses Across the Peripheral Visual Field", Ophthalmic & Physiological Optics, 38 (2018) 326-336. The results of the study indicated that when compared to single-vision lenses, the former two lenses exhibited a reduction in the anisotropy of peripheral optical blur and an increase in depth of focus. From this, the authors hypothesized that the mechanism of myopia control with bifocal and multifocal lenses is the reduction in the anisotropy of peripheral optical blur and the increase in depth of focus.

[0020] U.S. Patent Publication No. 2022 / 0252901 to Yoon (“Yoon”) describes an optical lens for myopia control that intentionally introduces peripheral aberrations to manipulate peripheral blur to make it more radially symmetric. In other words, building on the earlier assumption in Ji’s paper that anisotropy of peripheral optical blur is desirable, the application describes intentionally minimizing the anisotropy in the peripheral region to a point where the anisotropy is radially symmetric, e.g., Figure 1 In other words, the lenses described in Yoon preferably have a circle of least confusion at the patient's retina. This means one focal line is behind the retina and one focal line is in front of the retina. In contrast, the lenses described herein preferably have both tangential and sagittal focal lines in front of the retina or have adjusted blur anisotropy values ​​oriented in the positive direction.

[0021] The present inventors have discovered that, contrary to the teachings of Yoon and Ji, lenses designed to have high blur anisotropy oriented opposite to that of peripheral hyperopia exhibit better myopia control treatment efficacy. Utilizing these findings, lens designs incorporating peripheral optics that increase the average peripheral blur anisotropy value (towards the positive direction) will also improve efficacy. The present disclosure relates to such lens designs and methods for designing such lenses. Summary of the Invention

[0022] An ophthalmic lens for at least one of slowing down or preventing the progression of myopia is provided. The lens comprises: a lens center and a shape defined by a peripheral edge of the lens; an optical zone surrounding the lens center and having an optical zone outer periphery, wherein the optical zone further comprises a central optical zone surrounding the lens center and defined by a central optical zone radius, and a peripheral optical zone surrounding the central optical zone and extending to the optical zone outer periphery. The lens further comprises a plurality of myopic defocus zones, each located at a predetermined radial distance from the lens center and each incorporating a predetermined ADD power, wherein the predetermined ADD power for the plurality of myopic defocus zones increases with increasing radial distance from the lens center, up to a radius of at least 4 mm, and wherein at least a first myopic defocus zone is located within the central optical zone, and at least a first myopic defocus zone and a second myopic defocus zone are located in the peripheral optical zone.

[0023] In an alternative embodiment, the central optical zone radius may be between 4 mm and 5 mm, and / or the at least one myopic defocus zone within the central optical zone may be located at a radial distance greater than 1.2 mm from the center of the lens. The at least one myopic defocus zone in the central optical zone may further have an ADD power of at least 1.5 D.

[0024] In another embodiment, the first myopic defocus zone and the second myopic defocus zone in the peripheral optical zone can be positioned at radial distances of at least about 2.25 mm and 3.0 mm, respectively, from the center of the lens and can further have ADD powers of about 3.0 and 4.0, respectively.

[0025] In yet another embodiment, the lens further comprises a fourth myopic defocus zone and a fifth myopic defocus zone located in the peripheral optical zone, and the fourth myopic defocus zone may be located at a radial distance of at least 3.75 mm from the center of the lens, and the fifth myopic defocus zone may be located at a radial distance of at least 4.5 mm from the center of the lens. The fourth myopic defocus zone may have an ADD power of at least about 5D, and the fifth myopic defocus zone may have an ADD power of at least 6D.

[0026] In yet another embodiment, the myopic defocus zones in the central optical zone and the peripheral optical zone can each generate a non-coaxial myopic annular defocus for light passing through the myopic defocus zone.

[0027] In an alternative embodiment, at least one myopic defocus zone within the central optical zone is positioned at least at a radial distance greater than 1.2 mm from the center of the lens and may further have an ADD power of at least 3D.

[0028] In this embodiment, at least the first myopic defocus zone and the second myopic defocus zone in the peripheral optical zone can be positioned at radial distances of at least about 2.56 mm and 3.22 mm, respectively, from the center of the lens and can further have ADD optical powers of about 8D and 9.8D, respectively.

[0029] This lens may also include a fourth myopic defocus zone and a fifth myopic defocus zone located in the peripheral optical zone, the fourth myopic defocus zone and the fifth myopic defocus zone may be located at a radial distance of at least about 3.87 mm from the center of the lens and at least about 4.53 from the center of the lens, and the fourth myopic defocus zone and the fifth myopic defocus zone may each further have an ADD optical focal length of at least 12D.

[0030] The lens may further include a second myopic defocus zone located at least partially within the central optical zone, the second myopic defocus zone may be located at a radial distance of at least about 1.91 mm from the center of the lens and may have an ADD optical power of at least about 5.9D.

[0031] The myopic defocus zones in the central optical zone and the peripheral optical zone may each generate a non-coaxial myopic annular defocus for light passing through the myopic defocus zone.

[0032] An ophthalmic lens for at least one of slowing down or preventing the progression of myopia is also provided, the ophthalmic lens comprising: a lens center and a shape defined by a peripheral edge of the lens; an optical zone surrounding the lens center and having an optical zone outer periphery, wherein the optical zone further comprises a central optical zone and a peripheral optical zone, the central optical zone surrounding the lens center and defined by a central optical zone radius, the peripheral optical zone surrounding the central optical zone and extending to the optical zone outer periphery. The lens further comprises a plurality of myopic defocus zones, each of the plurality of myopic defocus zones being located at a predetermined radial distance from the lens center and each introducing a predetermined ADD power, wherein each of at least a first myopic defocus zone and a second myopic defocus zone located in the peripheral optical zone has a greater ADD power than at least the first myopic defocus zone located in the central optical zone.

[0033] In one embodiment, the central optical zone in this lens has a radius between 4 mm and 5 mm, and at least one myopic defocus zone located within the central optical zone can be positioned at a radial distance of at least 1.2 mm from the center of the lens and can have an ADD optical power of at least 1.5D.

[0034] In another embodiment, the first myopic defocus zone and the second myopic defocus zone in the peripheral optical zone may be positioned at radial distances of at least approximately 2.25 mm and 3.0 mm, respectively, from the center of the lens and may further have ADD powers of approximately 3.0D and 4.0D, respectively.

[0035] In yet another embodiment, the lens further comprises a fourth myopic defocus zone and a fifth myopic defocus zone in the peripheral optical zone, the fourth myopic defocus zone and the fifth myopic defocus zone may be located at radial distances of at least 3.75 mm and 4.5 mm, respectively, from the center of the lens, and may have ADD optical powers of at least about 5D and at least 6D, respectively.

[0036] The myopic defocus zones in the central optical zone and the peripheral optical zone may each generate a non-coaxial myopic annular defocus for light passing through the myopic defocus zone.

[0037] In yet another embodiment, at least one myopic defocus zone within the central optical zone may be positioned at least at a radial distance greater than 1.2 mm from the center of the lens and may further have an ADD power of at least 3 D. At least the first and second myopic defocus zones within the peripheral optical zone may be positioned at radial distances of at least approximately 2.56 mm and 3.22 mm, respectively, from the center of the lens and may further have ADD powers of approximately 8 D and 9.8 D, respectively.

[0038] In yet another embodiment, the lens further comprises a fourth myopic defocus zone and a fifth myopic defocus zone in the peripheral optical zone, and the fourth myopic defocus zone may be located at a radial distance of at least about 3.87 mm from the center of the lens, and the fifth myopic defocus zone may be located at a radial distance of at least about 4.53 from the center of the lens, and the fourth myopic defocus zone and the fifth myopic defocus zone may further have an ADD optical power of at least 12D.

[0039] In yet another embodiment, the lens further comprises a second myopic defocus zone at least partially within the central optical zone, which second myopic defocus zone may be located at a radial distance of at least about 1.91 mm from the center of the lens and may further have an ADD optical power of at least about 5.9D.

[0040] The myopic defocus zones in the central optical zone and the peripheral optical zone may each generate a non-coaxial myopic annular defocus for light passing through the myopic defocus zone. BRIEF DESCRIPTION OF THE DRAWINGS

[0041] The foregoing and other features and advantages of the invention will be apparent from the following more particular description of preferred embodiments of the invention, as illustrated in the accompanying drawings.

[0042] Figure 1 An anisotropic peripheral blur pattern is illustrated; where the illustrated pattern is generated by ray tracing through a model eye, where each cross represents the intersection of a ray with the retina, and where rays originating from a point source are uniformly distributed throughout the pupil.

[0043] Figure 2An anisotropic peripheral blur pattern is illustrated, where the illustrated pattern was generated by ray tracing through a model eye, where each cross represents the intersection of a ray with the retina, and where rays originating from a point source are uniformly distributed throughout the pupil.

[0044] Figure 3 An eye model for simulating central and peripheral vision is illustrated;

[0045] Figures 4(a) to 4(d) illustrate blur anisotropy values ​​for various lenses;

[0046] Figure 5 illustrates a toric power profile for a lens according to the present invention;

[0047] Figure 6 Illustrated for Figure 5 The blur anisotropy value of the lens;

[0048] Figure 7 4 and Figure 5 The myopia control efficacy value of the lens;

[0049] Figure 8 The lower limbal ray position relative to the center of the eye is illustrated for various pupil sizes;

[0050] Figure 9 illustrates a toric power profile for an alternative lens according to the present invention;

[0051] Figure 10 Exemplary lenses to which the present invention may be applied are illustrated;

[0052] Figure 11 illustrates a power profile for a lens incorporating peripheral optical features according to the present disclosure;

[0053] Figures 12a and 12b illustrate the results of the experiment under the condition of 4 mm pupil size. Figure 11 The fuzzy anisotropy value of the implementation scheme;

[0054] Figures 13a and 13b illustrate the results of the experiment under the condition of 5 mm pupil size. Figure 11 The fuzzy anisotropy value of the embodiment of ; and

[0055] 14a and 14b illustrate blur anisotropy values ​​for the lenses of FIG. 4b and FIG. 4d at a 5 mm pupil size. DETAILED DESCRIPTION

[0056] The present disclosure relates to ophthalmic lens designs and methods for ophthalmic lens designs that induce directional peripheral blur to increase myopia control efficacy. The present disclosure also relates to ophthalmic lens designs and methods for lens designs that introduce optical elements or features that increase the average peripheral blur anisotropy value into the peripheral optical zone, thereby increasing myopia control efficacy or otherwise providing a better balance of efficacy and visual acuity. Ophthalmic lenses to which the present disclosure is applicable include, but are not limited to, contact lenses, spectacle lenses, and implantable ophthalmic lenses, such as intraocular lenses and phakic lenses, that are worn on the eyes of a person or wearer.

[0057] Variable toric design

[0058] As described above, typical human vision provides a focused image in the central vision area and provides increasingly anisotropic blurred images towards the periphery of the eye. For individuals who need correction (nearsightedness or farsightedness), ophthalmic lenses focus on correction of central vision, which is typically within about 10 degrees of the visual field. Figure 3 An eye model showing a field of view (FOV) ranging from 0 degrees to 40 degrees is illustrated. This eye model used herein to evaluate peripheral blur is similar to the model described in detail by Navarro et al. in the publication J.Opt.Soc.Am.A 16, 1881-1891 (1999), which is incorporated herein by reference. Based on the use of actual biometric data, the model has been modified to include only slight variations in the corneal and lens surfaces of the model. The eye model is constructed to represent the average optical and mechanical properties of the eye of the general population, including wavefront aberrations, corneal anterior curvature, etc. The eye model is also used for visual interference (scattering) simulation, as described by Chen in the publication "Evaluating the Effects of Scattering on Retinal Image Quality", Proc.SPIE 11941, Ophthalmic Technologies XXXII, 119410B (4 March 2022).

[0059] As is known to those skilled in the art, in a typical eye, blur increases at larger peripheral FOV angles. Further known from the meridian effect, the orientation of the blur pattern changes around the periphery. Furthermore, along the horizontal meridian, when compared to central vision viewing a substantially similar image, higher FOV angles for horizontal gratings perform better than higher FOV angles for vertical gratings.

[0060] As also mentioned above, Ji hypothesized that eliminating or minimizing peripheral blur orientation (producing an isotropic blur pattern) would improve myopia control efficacy in a lens. Contrary to this teaching, the inventors herein have discovered that inducing an anisotropic blur pattern formed by myopic astigmatism is desirable and more effective.

[0061] To quantitatively assess peripheral image blur orientation, several myopia control lenses, including the 4 mm myopia control lenses from Johnson & Johnson Vision Care, Inc., were evaluated using the model described above at a 4 mm pupil. Abiliti TM Figures 4a-4b illustrate the blur anisotropy of these lenses as evaluated, with a single vision lens ("Lens 1") shown in Figure 4a, Abiliti TM The lens ("Lens 4") is shown in Figure 4d and is similar to Abiliti TM 4b ("Lens 2"), and a second bifocal test lens with dual coaxial foci is shown in FIG4c ("Lens 3"). The blur anisotropy is negative when the image has a vertical orientation and positive when the image has a horizontal orientation. Within each figure, the blur anisotropy at 0, 10, 20, 30, and 40 degree FOVs is shown by reference numerals 400, 410, 420, 430, and 440, respectively. For each figure, the vertical line at x=0 represents the retinal plane or zero defocus, and the horizontal axis indicates defocus in front of (positive) or behind (negative) the retina. As shown in these figures, the blur anisotropy at the retinal plane is negative for all degrees of FOV except zero, for all lenses, except for the lens of FIG4d at 10 degree FOV.

[0062] As shown in Figures 4a to 4d, in the peripheral field of view, blur anisotropy exhibits maxima and minima both in front of and behind the retina, corresponding to the focal line of astigmatism. For the single vision lens shown in Figure 4a, the size and position of the focal line at the retina vary significantly, and are -0.13, -0.35, -0.41, and -0.89 for 10, 20, 30, and 40 degrees FOV, respectively. The FOV-averaged blur orientation value at the retinal plane is -0.44 (calculated without including foveal vision at a 0-degree FOV). The FOV-averaged blur anisotropy values ​​for the myopia control lenses of Figures 4b, 4c, and 4d have higher values ​​of -0.16, -0.18, and -0.11, respectively. Figures 14a and 14b illustrate the blur anisotropy values ​​for the lenses of Figures 4b and 4d at a pupil size of 5 mm.

[0063] These increasingly positive FOV average blur anisotropy values ​​are associated with increased myopia control efficacy, as demonstrated in clinical studies using these same lenses. The clinical study results are summarized below, where the single vision lens (SV) corresponds to lens 1, the "concentric ring bifocal" lens (DF) corresponds to lens 3, the test lens EE (enhanced efficacy) corresponds to lens 4, and the test lens EV (enhanced vision) corresponds to lens 2. This clinical study is a multinational, prospective, randomized, controlled, double-blind, stratified, myopia-controlled clinical trial (NCT03408444). The purpose of the study was to compare the efficacy and visual acuity of the four lenses. A total of 185 patients completed the study. All study participants were aged 7-12 years, and each participant had a spherical error ranging from -0.75D to -4.50D, astigmatism <=1.00D, and anisometropia <1.5D. As shown in the table below, there were no statistically significant differences in baseline characteristics between the study participants.

[0064]

[0065] Lens efficacy was determined by measuring axial length (using the LENSTAR system) and assessing ciliary muscle paralysis spherical equivalent autorefraction (SECAR) using a Grand Seiko WAM-5500 device, with five replicates, each being the average of three consecutive readings.

[0066] The study concluded that all three study lenses were effective in slowing axial elongation of the eye compared to SV. The efficacy results of this study are shown below.

[0067]

[0068] Figure 2 Unadjusted mean ± standard error of the mean (SE) changes in (A) axial length (AL) and (B) spherical equivalent ciliary muscle paralysis autorefraction (SECAR) over time by lens type. The two measurements of AL at 26 weeks represent the non-cycloplegic measurement (dark gray) and the post-cycloplegic measurement (black).

[0069] D = diopters; EE = enhanced efficacy lens group; EV = enhanced vision lens group; DF = dual focus lens group; SV = single vision lens group.

[0070] In the above Figure 2 In A, the top row represents single vision (SV) lenses, the next row represents bifocal (DF) lenses, the next row represents EV, and the bottom row represents EE lenses. Figure 2 In B, the top row is lens EE, the next row is lens DF, the next row is lens EV, and the bottom row is lens SV.

[0071] These results indicate that higher blur anisotropy values ​​are associated with better myopia control efficacy. The lenses described herein are designed to generate positive FOV-averaged blur anisotropy values, rather than the negative values ​​exhibited in known myopia control (and spherical) lens designs, and in contrast to the near-zero blur anisotropy targets in the lenses described in the Yoon patent publication.

[0072] At its most general level, the lenses of the present application are able to achieve improved myopia control efficacy in single vision lenses by simply introducing variable toric power into the lens. The term toric here is not used in the more commonly used sense of optical devices used to correct central refractive astigmatism. In one embodiment, the variable toricity is described in the spatial domain by introducing aspheric surfaces to increase the amount away from the center of the optical device, and the variable toricity can generate changes in the oblique astigmatism typically generated in such devices. In another embodiment, the variable toricity is described in the angular / FOV domain by introducing aspheric surfaces to increase the amount away from the central FOV, and the variable toricity can generate changes in the oblique astigmatism typically generated in such devices. It is the toric power profile itself that introduces the myopia control effect. Therefore, the lenses of the present invention achieve a level of myopia control efficacy using a lens design that is less complex than currently available myopia control lenses.

[0073] One lens design according to the present invention includes different curvatures in sagittal and tangential orientations to generate a variable toric power across the lens. For clarity, "variable toric power," as used herein with respect to an ophthalmic lens, means a lens having a toric power that varies radially from the center of the lens outward across the optic zone of the lens, or at least a portion of the optic zone, according to a predetermined toric power profile. The variable toric power can be applied to either the anterior or posterior surface of the lens as a continuously variable toric power, or can be applied discontinuously at certain radial locations, as will be further described below.

[0074] The principles described herein can be readily applied to various types of ophthalmic lenses. In the case of contact lenses, Figure 10is shown in FIG. A contact lens 1000 includes a lens center 1002 and a shape defined by a peripheral edge 1003, and an optical zone 1004 surrounding the lens center and having an optical zone outer periphery 1006. The optical zone of a lens is generally considered to be the portion of the lens through which the wearer will see during the normal course of wearing the lens to receive the intended vision correction. For example, for a myopic patient, the optical zone may have a -3D optical power to correct the patient's myopic vision. The optical zone may have a circular configuration defined by a radius (r) from the center of the lens. Alternatively, the optical zone may take any other suitable shape, such as may be specifically suitable for spectacle lenses rather than contact lenses. The optical zone may be a single vision optical zone (having a single diopter), or the optical zone may include other areas within the optical zone, such as a specific myopia treatment zone as described further below. Although the diameter may vary, the optical zone in contact lenses is generally designed to be as large as possible without compromising mechanical properties (including handling and comfort), and the diameter is typically in the range of 6 mm to 10 mm.

[0075] In the case of myopia control lenses, the optical zone may also optionally include one or more additional myopia treatment areas 1010, such as a high ADD power area at the very center of the lens. While not necessary for myopia control as described further below, such an area can increase the efficacy of the lens because the relative ADD power induces myopic blurring so that the focus falls in front of the retina and, as will be readily understood by those skilled in the art, provides a stimulus to move the retina toward the point of myopic defocus. This, in turn, provides a counter-signal to counteract further elongation of the eye or progression of myopia.

[0076] Although the above-described embodiments include a high ADD power zone at the center of the lens, any suitable configuration or positioning of one or more additional myopia treatment zones may be used, whether centrally positioned or not, and whether on-axis (the point of myopic defocus falls on the optical axis but in front of the retina) or off-axis (the point of myopic defocus is in front of the retina but not coincident with the optical axis).

[0077] In one embodiment, the contact lens has an aspheric back curvature with a radius of 7.85 and a conic constant of -0.26. The front surface has a biconical structure that is specifically designed so that the toric power increases steadily from zero at the center of the lens radially outward to the edge of the lens, as shown in FIG. Figure 5 Notably, for this exemplary embodiment, the toric power of the lens is increased in a predetermined manner such that the blur anisotropy at or in front of the retina becomes positive. Figure 5 The illustrated variable toric power profile is given by the equation Toric Power = 0.0642(r) 3 –0.1063(r) 2–0.018(r) definition, where r is equal to the radius from the center of the lens.

[0078] When the blur anisotropy values ​​of the lens described above at 0, 10, 20, 30, and 40 degree FOVs are modeled in the same manner as described above for the lens of Figures 4a-4d, the results are Figure 6 4a to 4d (lines 600, 610, 620, 630 and 640, respectively). As shown, the blur anisotropy values ​​at the retinal plane (x=0) are all positive compared to the lens shown in FIG. 4a to 4d, demonstrating that this lens induces an opposite blur orientation relative to the comparison lens.

[0079] The efficacy of a positive blur inducing lens according to the present invention was mathematically tested using the peripheral blur model described above, compared to the lens discussed in conjunction with Figures 4a to 4d. "Lens 5" is a lens of the present invention that is identical to Lens 1 (a single vision (SV) lens with -3D power) discussed above, but with the variable toric power profile described above applied to the lens. The metric used to define myopia treatment efficacy is the FOV-averaged blur anisotropy values ​​at zero defocus across 10, 20, 30, and 40 degree FOVs. These averages are shown below:

[0080] Lens 5 (variable toric lens) 0.38 Lens 1 (single vision) -0.44 Lens 2 (EV lens) -0.16 Lens 3 (bifocal) -0.18 Lens 4 (Acuvue Abiliti) -0.11

[0081] These results are plotted in Figure 7 From this figure, it is readily apparent that the single vision spherical lens (Lens 1) has the lowest myopia control efficacy expected. Lenses 2, 3, and 4 also each have lower myopia control efficacy values ​​than the inventive lens described herein (Lens 5).

[0082] It is noteworthy that the lens with the highest myopia control efficacy is still the single vision lens (Lens 5, a variable toric lens as described above), where the only difference between the two single vision lenses 5 and Lens 1 (the least effective) is that Lens 5 is a single vision toric lens with a variable toric power profile, while the single vision lens of Lens 1 is a spherical lens. Therefore, the lens of the present invention has the surprising result of achieving increased myopia control efficacy using a single vision but toric lens. In this embodiment, no additional "myopia control" zone is required, thereby simplifying the design and manufacture of the lens.

[0083] It should be noted that increasing the toric power across the lens may affect image quality, particularly when present in the central vision area. If desired, the negative impact on visual quality can be further balanced with the increased efficacy. Figure 8The positioning relative to the center of the lens through which light rays enter at various FOVs (0, 10, 20, 30, 40) is illustrated for various pupil sizes (3mm, 4mm, 5mm, and 6mm). At a 0-degree FOV, for example, paraxial rays pass through the entire 4mm to enter the 4mm pupil. However, at a 10-degree FOV, rays enter the 4mm pupil at a radial distance of up to 2.436mm from the center of the lens. The adverse effect on vision quality can be balanced with myopia control efficacy by utilizing variable toric power to induce positive peripheral blur outside the central vision zone for a given pupil size. For a 4mm pupil size, the variable toric power can be applied outside the 4mm central optical zone to capture only peripheral rays that are completely outside the central vision zone.

[0084] Figure 9 903 .

[0085] Although the ophthalmic lenses described in detail herein are contact lenses, the principles described and invented can be applied to any ophthalmic lens used for myopia control. For example, the optical devices described can be applied to spectacle lenses. Furthermore, these principles can also be applied to implantable lenses, such as intraocular lenses or phakic lenses.

[0086] Peripheral optics design

[0087] As described above, the results described above indicate that higher blur anisotropy values ​​are associated with better myopia control efficacy. The lenses described above introduce variable toric power to increase blur anisotropy, but blur anisotropy can also be introduced through peripheral optical elements or features as further described below. These designs can be further customized to provide a desired balance of efficacy and visual acuity.

[0088] It is well known that the central vision zone of an ophthalmic lens (which is the central viewing area of ​​the lens within the pupil diameter) is most important for visual acuity. Optical elements or aberrations that disrupt central vision will have a greater impact on visual acuity than optical elements or aberrations outside the central vision zone. Although pupil size may vary across the population, for relatively young children and adolescents who would benefit most from myopia control lenses, pupil size typically ranges from 2.5 mm to 6 mm in diameter under different lighting conditions, with 4.3 mm generally considered the population average for age subgroups and typical room lighting conditions.

[0089] Currently available myopia control contact lenses introduce areas or zones of myopic defocus into the central viewing area of ​​the lens. While such myopic defocus zones in the central optical zone may provide better efficacy, they also degrade visual acuity. For myopia control lenses, when defocus is introduced into the central vision zone, the design must balance this degradation in visual acuity with efficacy. The present embodiment utilizes the principles related to blur anisotropy described above to design myopia control lenses with a better balance of efficacy and visual acuity by introducing myopic defocus optics in a selected manner into the peripheral areas of the optical zone.

[0090] Return Reference Figure 10 As an exemplary lens 1000 to which the design features described herein may be applied, lens 1000 includes a lens center 1002 having a shape defined by a lens peripheral edge 1003, and an optic zone 1004 surrounding the lens center and having an optic zone outer periphery 1006. As previously described, the optic zone of a lens is generally considered to be the portion of the lens through which a wearer will see during the normal course of wearing the lens to receive the intended vision correction. The optic zone may have a circular configuration defined by a radius (r) from the lens center. Alternatively, the optic zone may take any other suitable shape, such as may be particularly suitable for eyeglass lenses rather than contact lenses. While the diameter may vary, the optic zone in contact lenses is generally designed to be as large as possible without compromising mechanical properties (including handling and comfort), and typically has a diameter in the range of 6 mm to 10 mm. For the purposes of describing this embodiment, the optic zone is further divided into a central optic zone 1010 surrounding the lens center and a peripheral optic zone 1020 surrounding the central optic zone. The central optical zone 1010 is designed to have a diameter that substantially matches the wearer's pupil diameter or the typical average pupil size for the population, which typically ranges from 2.5 mm to 6 mm, with the population average being approximately 4.3 mm.

[0091] Figure 11The power profiles of two lens designs P1 and P2 that balance myopia control treatment efficacy and visual acuity compared to known lenses that incorporate only a central optical element for myopia control effects are illustrated. The efficacy and visual acuity of these designs were evaluated assuming pupil diameters of 4 mm and 5 mm. Figure 11 It is apparent that each design comprises a continuous circumferential ring having an optical design that introduces myopic defocus to wearers of different ADD powers and at different radial locations, as indicated in the following table:

[0092] Lens P1

[0093] district 1 2 3 4 5 Radial distance (mm) 1.5-1.64 2.25-2.4 3.0-3.15 3.75-3.9 4.5-4.65 ADD power(D) 1.5 3.01 4.02 4.99 6.01

[0094] Lens P2

[0095] district 1 2 3 4 5 6 Radial distance (mm) 1.2-1.51 1.91-2.16 2.56-2.82 3.22-3.47 3.87-4.13 4.53-4.78 ADD power(D) 3.0 5.92 8.01 9.84 12.0 12.0

[0096] As used herein, the phrase ADD power reflects the degree of myopic defocus introduced relative to the base power of the lens (in diopters). For example, Figure 11 The base power of the -3D correction is reflected, and the first myopic defocus zone of lens P1 has an ADD power of approximately 1.5D relative to the -3D baseline correction. For embodiments P1 and P2, each concentric ring having an ADD power that causes myopic defocus generates myopic defocus as an annular focus around the optical axis, rather than as a point focus on the optical axis. Optical designs that generate myopic defocus as an annulus around the optical axis or non-coaxial myopic annular defocus are described in detail in U.S. Patent No. 10,901,237, which is incorporated herein by reference in its entirety.

[0097] Referring first to the lens design for a 4 mm pupil diameter, lens design P1 has only a single circumferential zone 1101 within the central optical zone with an ADD power that introduces myopic defocus for the wearer. This ADD power segment is a relatively low power of 1.5 D. Outside the central optical zone (within the peripheral optical zone) is a continuous circumferential zone that increases in ADD power with increasing radial distance from the center of the lens. In the illustrated embodiment, there are four additional continuous rings (a second ring 1102, a third ring 1103, a fourth ring 1104, and a fifth ring 1105), each with the following ADD powers: 3.01, 4.02, 4.99, and 6.01, respectively. With a 5 mm pupil diameter, the second 1102 ring would also be within the central optical zone of the lens, and only the continuous third, fourth, and fifth rings would be located in the peripheral optical zone or zone.

[0098] Referring to the second lens design P2, under the condition of a pupil diameter of 4 mm or 5 mm, this lens design has at least a first 1110 myopic defocus ring located in the central optical zone, and at least a first 1113 myopic defocus ring and a second 1114 myopic defocus ring located in the peripheral optical zone. This embodiment may also include a second myopic defocus ring 1111 located at least partially in the central optical zone, and may also include a third 1114 myopic defocus ring and a fourth 1115 myopic defocus ring located in the peripheral optical zone.

[0099] The peripheral FOV model described above, applied to the P1 and P2 lens designs, generates the blur anisotropy values ​​shown in Figures 12a and 12b, respectively, for a 4 mm pupil size condition, and in Figures 13a and 13b, respectively, for a 5 mm pupil size condition (in each figure, reference numerals 1200, 1210, 1220, 1230, and 1240 correspond to 0, 10, 20, 30, and 40 degree FOVs, respectively). For the 4 mm pupil size condition, the size and position of the focal line at the retina are reflected in the following table:

[0100] Degree FOV P1 value P2 value 0 0 0 10 -0.0454 -0.1291 20 -0.2949 -0.1612 30 -0.1592 -0.1661 40 -0.0027 -0.18978

[0101] The average blur anisotropy value for the P1 lens was -0.1255, and the average blur anisotropy value for the P2 lens was -0.1615. The average blur anisotropy values ​​for the known lenses described above in conjunction with the toric design (for a 4 mm pupil size) are reproduced below. The lenses with non-coaxial annular focus are Lens 4 and Lens 6, which is identical to Lens 4 but lacks a small, high ADD power annulus at the exact center of the lens that converges on the coaxial focus in front of the retina.

[0102] Lens 5 (Variable ToricLens) 0.38 Lens 1 (single vision) -0.44 Lens 6 -0.16 Lens 3 (bifocal) -0.18 Lens 4 (Acuvue Abiliti) -0.11

[0103] It can be easily seen that the P1 lens, with an average blur anisotropy of -0.1255, has very similar myopia control efficacy to lens 4 (-0.11), and better efficacy than lens 6 (-0.16). The P2 lens efficacy is comparable to lens 6, but slightly worse than lenses 5, 3, and 4.

[0104] For myopia control lenses, it is desirable to provide the best possible balance between efficacy and visual acuity. Based on visual acuity modeling assuming a 4 mm diameter pupil condition, projected visual acuity has been established for lenses P1 and P2, as well as the existing lenses described above with the highest myopia control efficacy (Lens 4 and Lens 6), and is set forth in the table below:

[0105] Lens design VA (-10logMAR) Lens 4 -2.4 Lens 6 -0.9 Lens 5 0.04 P1 0 P2 -1.0

[0106] Lens P1 has improved visual acuity over both Lens 4 and Lens 6, while Lens P2 exhibits visual acuity that is better than Lens 4 and substantially similar to Lens 6. For the lenses discussed above, the table below shows efficacy and visual acuity values ​​for each lens for ease of reference.

[0107] lens effect VA Lens 4 -0.11 -2.4 Lens 6 -0.16 -0.9 Lens 5 0.38 0.04 P1 -0.1255 0 P2 -0.1615 -1.0

[0108] In summary, lens P1 has an efficacy level close to that of lens 4, but has significantly improved visual acuity (almost 2.5 lines of improvement). Lens P1 also has an efficacy that is better than lens 6 and an almost full line improvement in visual acuity. Lens P2 has slightly worse efficacy than lens 4, but has an almost 1.5 line improvement in visual acuity, and has efficacy and visual acuity that are substantially similar to lens 6.

[0109] For a 5 mm pupil size condition, blur anisotropy values ​​are shown in Figures 13a and 13b. For comparison purposes, blur anisotropy values ​​for lenses 6 and 4 described above, assuming a 5 mm pupil size condition, are shown in Figures 14a and 14b, respectively. For a 5 mm pupil size condition, the size and position of the focal line at the retina for P1, P2, and lens 4 are reflected in the table below.

[0110]

[0111]

[0112] According to the above table, the average blur anisotropy of lens P1 is -0.0812, the average blur anisotropy of lens P2 is -0.0931, and the average blur anisotropy of lens 4 is -0.1177. Therefore, both P1 and P2 show higher efficacy than lens 4.

[0113] Based on visual acuity modeling assuming a 5 mm diameter pupil condition, projected visual acuity has been established for lenses P1 and P2, as well as the existing lenses described above with the highest myopia control efficacy (Lens 4 and Lens 6), and is set forth in the table below:

[0114] Lens design VA (-10logMAR) Lens 4 -2.12 Lens 6 -0.76 Lens 5 -0.28 5 P1 -0.21 P2 -1.21

[0115] Lens P1 similarly has improved visual acuity over both Lens 2 and Lens 4, while Lens P2 has the improved visual acuity of Lens 4 and has a visual acuity about half a line worse than Lens P1. For the lenses discussed above, the table below shows the efficacy and visual acuity values ​​for each lens for ease of reference.

[0116] lens effect VA Lens 4 -0.1177 -2.12 Lens 6 -0.1327 -0.76 Lens 5 0.38 -0.28 P1 0.0264 -0.21 P2 -0.0649 -1.21

[0117] In summary, lens P1 has improved efficacy over both lens 6 and lens 4, with significantly improved visual acuity (almost 2 lines) over lens 4 and visual acuity substantially similar to that of lens 6. Lens P2 also has improved efficacy over both lens 6 and lens 4, with improved visual acuity (almost 1 line) over lens 4 and visual acuity that is approximately 0.5 lines worse than lens 6. The embodiments described above are directed to the purpose of increasing positive blur anisotropy, which assumes horizontal peripheral field of view. While the foregoing is directed to embodiments of the present invention, other and further embodiments of the invention may be devised without departing from the basic scope of the invention, which is limited only by the scope of the claims set forth below. For example, the present invention contemplates that any feature shown in any embodiment described herein may be combined with any feature shown in any other embodiment described herein or incorporated by reference herein and still fall within the scope of the invention.

Claims

1. An ophthalmic lens for at least one of slowing down or preventing the progression of myopia, comprising: The center of the lens and the shape defined by the peripheral edge of the lens; an optical zone surrounding the lens center and having an optical zone outer periphery, the optical zone further comprising a central optical zone surrounding the lens center and defined by a central optical zone radius and a peripheral optical zone surrounding the central optical zone and extending to the optical zone outer periphery; and a plurality of myopic defocus zones, each of the plurality of myopic defocus zones being located at a predetermined radial distance from the center of the lens and each introducing a predetermined ADD optical power, wherein the predetermined ADD optical power of the plurality of myopic defocus zones increases with increasing radial distance from the center of the lens, up to a radius of at least 4 mm; Wherein at least a first myopic defocus zone is located within the central optical zone, and at least a first myopic defocus zone and a second myopic defocus zone are located in the peripheral optical zone.

2. The lens of claim 1, wherein the central optical zone radius is between 4 mm and 5 mm.

3. The lens of claim 1 , wherein at least one myopic defocus zone within the central optical zone is positioned at least at a radial distance greater than 1.2 mm from the center of the lens.

4. The lens of claim 3, wherein the at least one myopic defocus zone in the central optical zone has an ADD optical power of at least 1.5D.

5. The lens of claim 4, wherein the first and second myopic defocus zones in the peripheral optical zone are positioned at least at radial distances of approximately 2.25 mm and 3.0 mm, respectively, from a center of the lens.

6. The lens of claim 5, wherein the first and second myopic defocus zones in the peripheral optical zone have ADD powers of approximately 3.0 and 4.0, respectively.

7. The lens of claim 6, further comprising a fourth myopic defocus zone and a fifth myopic defocus zone located in the peripheral optical zone.

8. The lens of claim 7, wherein the fourth myopic defocus zone is located at a radial distance of at least 3.75 mm from the center of the lens, and the fifth myopic defocus zone is located at a radial distance of at least 4.5 mm from the center of the lens.

9. The lens of claim 8, wherein the fourth myopic defocus zone has an ADD power of at least about 5D.

10. The lens of claim 9, wherein the fifth myopic defocus zone has an ADD power of at least 6D.

11. The lens of claim 6, wherein the myopic defocus zones in the central optical zone and the peripheral optical zone each generate a non-coaxial myopic annular defocus for light passing through the myopic defocus zones.

12. The lens of claim 1, wherein the at least one myopic defocus zone within the central optical zone is positioned at least at a radial distance greater than 1.2 mm from the center of the lens.

13. The lens of claim 12, wherein the at least one myopic defocus zone in the central optical zone has an ADD power of at least 3D.

14. The lens of claim 13, wherein at least the first and second myopic defocus zones in the peripheral optical zone are positioned at radial distances of at least approximately 2.56 mm and 3.22 mm, respectively, from a center of the lens.

15. The lens of claim 14, wherein the first and second myopic defocus zones in the peripheral optical zone have ADD optical powers of approximately 8D and 9.8D, respectively.

16. The lens of claim 15, further comprising a fourth myopic defocus zone and a fifth myopic defocus zone located in the peripheral optical zone.

17. The lens of claim 16, wherein the fourth myopic defocus zone is located at a radial distance of at least about 3.87 mm from the center of the lens, and the fifth myopic defocus zone is located at a radial distance of at least about 4.53 from the center of the lens.

18. The lens of claim 17, wherein the fourth myopic defocus zone and the fifth myopic defocus zone have an ADD optical power of at least 12D.

19. The lens of claim 18, further comprising a second myopic defocus zone at least partially located within the central optical zone.

20. The lens of claim 19, wherein the second myopic defocus zone located at least partially within the central optical zone is located at a radial distance of at least about 1.91 mm from the center of the lens and has an ADD optical power of at least about 5.9D.

21. The lens of claim 1, wherein the myopic defocus zones in the central optical zone and the peripheral optical zone each generate a non-coaxial myopic annular defocus for light passing through the myopic defocus zones.

22. An ophthalmic lens for at least one of slowing down or preventing the progression of myopia, comprising: The center of the lens and the shape defined by the peripheral edge of the lens; an optical zone surrounding the lens center and having an optical zone outer periphery, the optical zone further comprising a central optical zone surrounding the lens center and defined by a central optical zone radius and a peripheral optical zone surrounding the central optical zone and extending to the optical zone outer periphery; and a plurality of myopic defocus zones, each of the plurality of myopic defocus zones being located at a predetermined radial distance from the center of the lens and each introducing a predetermined ADD optical power, Wherein each of at least the first myopic defocus zone and the second myopic defocus zone located in the peripheral optical zone has a greater ADD optical power than at least the first myopic defocus zone located in the central optical zone.

23. The lens of claim 22, wherein the central optical zone radius is between 4 mm and 5 mm.

24. The lens of claim 22, wherein the at least one myopic defocus zone within the central optical zone is positioned at least at a radial distance greater than 1.2 mm from the center of the lens.

25. The lens of claim 24, wherein the at least one myopic defocus zone in the central optical zone has an ADD power of at least 1.5D.

26. The lens of claim 25, wherein the first and second myopic defocus zones in the peripheral optical zone are located at least at radial distances of approximately 2.25 mm and 3.0 mm, respectively, from a center of the lens.

27. The lens of claim 25, wherein the first and second myopic defocus zones in the peripheral optical zone have ADD powers of approximately 3.0D and 4.0D, respectively.

28. The lens of claim 27, further comprising fourth and fifth myopic defocus zones located in the peripheral optical zone.

29. The lens of claim 28, wherein the fourth myopic defocus zone is located at a radial distance of at least 3.75 mm from the center of the lens, and the fifth myopic defocus zone is located at a radial distance of at least 4.5 mm from the center of the lens.

30. The lens of claim 29, wherein the fourth myopic defocus zone has an ADD power of at least about 5D.

31. The lens of claim 30, wherein the fifth myopic defocus zone has an ADD power of at least 6D.

32. The lens of claim 22, wherein the myopic defocus zones in the central optical zone and the peripheral optical zone each generate a non-coaxial myopic annular defocus for light passing through the myopic defocus zones.

33. The lens of claim 22, wherein the at least one myopic defocus zone within the central optical zone is positioned at least at a radial distance greater than 1.2 mm from the center of the lens.

34. A lens according to claim 33, wherein the at least one myopic defocus zone in the central optical zone has an ADD optical power of at least 3D.

35. The lens of claim 33, wherein at least the first and second myopic defocus zones in the peripheral optical zone are positioned at radial distances of at least approximately 2.56 mm and 3.22 mm, respectively, from a center of the lens.

36. The lens of claim 35, wherein the first and second myopic defocus zones in the peripheral optical zone have ADD powers of approximately 8D and 9.8D, respectively.

37. The lens of claim 36, further comprising a fourth myopic defocus zone and a fifth myopic defocus zone located in the peripheral optical zone.

38. The lens of claim 37, wherein the fourth myopic defocus zone is located at a radial distance of at least about 3.87 mm from the center of the lens, and the fifth myopic defocus zone is located at a radial distance of at least about 4.53 from the center of the lens.

39. The lens of claim 38, wherein the fourth myopic defocus zone and the fifth myopic defocus zone have an ADD optical power of at least 12D.

40. The lens of claim 39, further comprising a second myopic defocus zone at least partially located within the central optical zone.

41. A lens according to claim 40, wherein the second myopic defocus zone located at least partially within the central optical zone is located at a radial distance of at least about 1.91 mm from the center of the lens and has an ADD optical power of at least about 5.9D.

42. The lens of claim 22, wherein the myopic defocus zones in the central optical zone and the peripheral optical zone each generate a non-coaxial myopic annular defocus for light passing through the myopic defocus zones.

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