Effect of higher-order aberrations and intraocular scatter on contrast sensitivity measured with a single instrument

Higher-order aberrations (HOAs) and intraocular scatter lead to the degradation of image quality on the retina, and consequently deteriorate subjective visual performance. In this article, we modified an adaptive optics double-pass system to combine objective and subjective visual testing capabilities. Employing the modified DP system, we investigated the effects of HOAs and intraocular scatter on contrast sensitivity. Contrast sensitivity measurements were performed with HOAs either retained or corrected by adaptive optics, and with scatter either remaining at the natural eye-induced level or further enhanced by a set of three different scatter filters. Contrast sensitivity was found to be worse when HOAs were uncorrected or scatter increased. Quantitative analysis indicated that the joint effect of HOAs and scatter on contrast sensitivity was not a simple summation of each contributing factor, suggesting a potential compensatory mechanism between HOAs and intraocular scatter on contrast sensitivity.