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Summary

Higher-order wavefront error (HO-WFE) in healthy eyes is typically below 0.5 μm. Ocular conditions significantly increase HO-WFE, but treatments can effectively minimize it.

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Area of Science:

  • Ophthalmology
  • Optometry
  • Vision Science

Background:

  • Higher-order wavefront error (HO-WFE) describes complex aberrations in the eye's optical system beyond standard refractive errors.
  • Understanding normative HO-WFE ranges is crucial for diagnosing and managing visual dysfunction.
  • Existing studies often use artificial pupil sizes, potentially limiting applicability to natural viewing conditions.

Purpose of the Study:

  • To establish normative reference ranges for higher-order wavefront error (HO-WFE).
  • To compare HO-WFE values in healthy eyes versus those with common ocular pathologies.
  • To evaluate the efficacy of treatments for reducing HO-WFE.

Main Methods:

  • A comprehensive review of 17 studies encompassing 31,605 subjects was conducted.
  • Normative HO-WFE upper limits (95% CI) were calculated for healthy individuals aged 20-80 years.
  • HO-WFE was analyzed for pupil diameters ranging from 3 to 7 mm, and effects of pathologies like keratoconus, pterygium, cataract, and dry eye were reviewed.

Main Results:

  • The upper limit of normal HO-WFE (95% CI) for a 35-year-old with a 6 mm pupil is estimated at 0.471 μm.
  • HO-WFE generally increases with age, though the impact of age-related pupil miosis requires further investigation.
  • Pathologies significantly elevate HO-WFE: keratoconus can exceed 3.0 μm (coma-dominant), while cataracts and pterygia induce coma and trefoil, or negative spherical HO-WFE.

Conclusions:

  • Normal physiological HO-WFE is approximately 0.5 μm at physiological pupil sizes.
  • Ocular pathologies can increase HO-WFE beyond 1.0 μm, but various treatments demonstrate high effectiveness.
  • Future research should utilize natural pupil sizes to refine normative HO-WFE reference ranges.