Peripheral higher order aberrations (HOA) of 646 children at 30° temporal, nasal and inferior visual field were measured under cycloplegia (5 mm pupil diameter) using a commercially available Shack-Hartmann aberrometer in the Sydney Myopia Study [age, 12.7 ± 0.4 years (mean ± standard deviation)] and five years later in the Sydney Adolescent Vascular and Eye Study. At baseline, 176 eyes were emmetropic, 95 were myopic and 375 were hyperopic. Coma, 3rd order and RMS of coma increased with eccentricity for all eyes and no difference was observed for 4th order and RMS of C(4,0) among refractive error groups. More positive C(4,0) was observed for hyperopic eyes at periphery. At follow up, 26% had 'myopic change' and 70% had 'no change' in refractive error. At follow-up, horizontal coma became more negative at nasal field and more positive at temporal field for all eyes. More positive C(4,0) for hyperopic eyes at baseline may indicate variation in optical characteristics of peripheral cornea and crystalline lens. An increase in horizontal coma with time, irrespective of refractive error change, may be attributed to variation in the shape factor of peripheral cornea and crystalline lens and/or misalignment of optical surfaces/components relative to the visual axis (angle kappa) as the eye grows in axial length.