Utilising a visual image quality metric to optimise spectacle prescriptions for eyes with keratoconus

Purpose To compare optical performance, visual performance, and patient‐perceived quality of vision with: (1) spectacles determined using subjective refraction and (2) spectacles determined using an objective optimisation method based on wavefront aberration data for eyes with keratoconus. Methods T...

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Bibliographic Details
Published inOphthalmic & physiological optics Vol. 43; no. 5; pp. 1007 - 1015
Main Authors Bell, Elizabeth L. S., Hastings, Gareth D., Nguyen, Lan Chi, Applegate, Raymond A., Marsack, Jason D.
Format Journal Article
LanguageEnglish
Published England Wiley Subscription Services, Inc 01.09.2023
Subjects
Acuity
Eye
Eyeglasses
Humans
Keratoconus
Keratoconus - diagnosis
Keratoconus - therapy
objective refraction
Prescriptions
Refraction
Refraction, Ocular
subjective refraction
Visual Acuity
visual image quality
subjective refraction
visual image quality
keratoconus
objective refraction
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Summary:Purpose To compare optical performance, visual performance, and patient‐perceived quality of vision with: (1) spectacles determined using subjective refraction and (2) spectacles determined using an objective optimisation method based on wavefront aberration data for eyes with keratoconus. Methods Thirty‐seven eyes (20 subjects) with keratoconus underwent both subjective refraction and uncorrected wavefront aberration measurement. Wavefront aberration data were used to objectively identify a sphero‐cylindrical refraction that optimised the visual image quality metric visual Strehl ratio (VSX). The two refractions were assembled in trial frames and worn by the subject in a random order. High‐contrast visual acuity (VA), letter contrast sensitivity (CS), and the patient's short‐term subjective preference were recorded for each prescription. Results Median magnitude of the dioptric difference (a measure of similarity between the subjective and objective refractions) was 2.77 D (range = 0.21–20.44 D, first quartile = 1.02 D, third quartile = 4.36 D). Sixty‐eight per cent of eyes had better VA with the objective refraction and 32% of eyes gained more than one line of VA. Monocularly, objective refraction was preferred 68% of the time when looking at a distant acuity chart and 76% of the time when viewing a real‐world dynamic scene. Conclusions Objective refraction based on visual image quality derived from wavefront aberration data can be valuable in the determination of monocular spectacle refractions for individuals with keratoconus.
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Bell, Elizabeth: Conceptualization (Equal), Data curation (Equal), Formal analysis (Equal), Investigation (Equal), Methodology (Equal), Project administration (Equal), Software (Equal), Visualization (Equal), Writing – original draft (Lead), Writing – review & editing (Equal)
Applegate, Raymond A: Conceptualization (Equal), Formal analysis (Equal), Funding acquisition (Equal), Investigation (Equal), Methodology (Equal), Resources (Equal), Supervision (Equal), Writing – original draft (Equal), Writing – review & editing (Equal)
Nguyen, Lan Chi: Conceptualization (Equal), Formal analysis (Equal), Investigation (Equal), Methodology (Equal), Project administration (Equal), Resources (Equal), Supervision (Equal), Writing – original draft (Equal), Writing – review & editing (Equal)
Marsack, Jason: (Corresponding Author) Conceptualization (Equal), Data curation (Equal), Formal analysis (Equal), Funding acquisition (Equal), Investigation (Equal), Methodology (Equal), Project administration (Equal), Resources (Equal), Software (Equal), Supervision (Equal), Validation (Equal)Visualization (Equal), Writing – original draft (Equal), Writing – review & editing (Equal)
Author Contributions
Hastings, Gareth Dudley: Conceptualization (Equal), Formal analysis (Equal), Investigation (Equal), Methodology (Equal), Project administration (Equal), Supervision (Equal), Validation (Equal), Writing – original draft (Equal), Writing – review & editing (Equal)
ISSN:0275-5408
1475-1313
1475-1313
DOI:10.1111/opo.13166