Measurement of the peripheral aberrations of human eyes:A comprehensive review

It has been nearly 50 years since the first glimpse of the relationship between myopia and peripheral refractive errors. According to experiments on both animals and humans, the eyes with hyperopic peripheral vision appear to be at higher risk of developing myopia than those with myopic peripheral refractive errors. Despite the first measurement of peripheral refraction being achieved by a modified manual optometer, the concept of emmetropization triggered a rapidly increasing number of studies on peripheral aberrations. Not only the horizontal off-axis aberrations but also the meridional aberrations at different angles are measured by researchers during the development of peripheral aberrations measuring techniques. According to the differences among the working principles, a variety of techniques have been adopted for performing such measurements. The methods developed to realize the high-performance measurement involve the subject cooperating actively by rotating the head or eyes, the rotation of the whole optical path, and the combination of measurements of many light paths. This paper provides a review of the peripheral aberrations measuring techniques and their current status. This article also highlights the development trend of the measuring techniques of peripheral aberrations and practical applications of peripheral aberration measurements, such as the control of the accommodation, the measuring time, and the dynamic range problem of the wavefront sensor. Although wavefront sensing peripheral measurement is widely recognized for its capability to reveal both lower-order aberrations and higher-order aberrations, the efficiency of an autorefractometer is incomparable. The current study reveals that the most widely used peripheral aberration measurement methods are the use of an open field autorefractometer and Hartman-shack wavefront sensor-based techniques.

Evaluation of patient visual comfort and repeatability of refractive values in non-presbyopic healthy eyes

AIMTo evaluate the intra-operator repeatability in healthy subjects using the WAM-5500 auto-kerato/refractometer and the iTrace aberrometer, to compare the refractive values and the subjective refraction obtained with both devices and to determine which of these three spherocylindrical corrections allows the subject to achieve the best visual comfort.METHODSForty-two non-presbyopic healthy eyes of 42 subjects were enrolled in this prospective study. Refractive values were compared, evaluating the repeatability, the relationship between the methods and the best visual comfort obtained.RESULTSSphere, cylinder and axis results showed good intraclass correlation coefficients (ICC); the highest ICC was obtained using the spherical refraction with the autorefractometer and the aberrometer, achieving levels of 0.999 and 0.998, respectively. The power vector (PV) was calculated for each refraction method, and the results indicated that there were no statistically significant differences between them (P>0.05). Direct comparison of PV measurements using the three methods showed that aberrometer refraction gave the highest values, followed by the subjective values; the autorefractometer gave the lowest values. The subjective method correction was most frequently chosen as the first selection. Equal values were found for the autorefractometer and the aberrometer as the second selection.CONCLUSIONThe iTrace aberrometer and the WAM-5500 auto-kerato/refractometer showed high levels of repeatability in healthy eyes. Refractive corrections with the aberrometer, the autorefractometer and subjective methods presented similar results, but spherocylindrical subjective correction was the most frequently selected option. These technologies can be used as complements in refractive evaluation, but they should not replace subjective refraction.