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Related Experiment Video

Updated: Jun 10, 2025

Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
05:46

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Non-orthogonal spectacle correction for irregular astigmatism.

Adela Hulpus1,2, Ritchie Henry1, Lynn White3

  • 1St Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.

Ophthalmic & Physiological Optics : the Journal of the British College of Ophthalmic Opticians (Optometrists)
|October 13, 2024
PubMed
Summary
This summary is machine-generated.

Non-orthogonal correction (NOC) lenses improved visual acuity and subjective image quality for most keratoconus patients. This novel spectacle correction offers potential benefits for vision and quality of life in individuals with irregular astigmatism.

Keywords:
astigmatismcorneanon‐orthogonal astigmatismoptical power

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Area of Science:

  • Ophthalmology
  • Optometry
  • Biomedical Engineering

Background:

  • Keratoconus is a progressive eye condition characterized by irregular astigmatism.
  • Standard spectacle correction may not fully address the visual challenges posed by irregular astigmatism in keratoconus.
  • Non-orthogonal correction (NOC) offers a novel approach to spectacle lens design.

Purpose of the Study:

  • To evaluate the effectiveness of non-orthogonal correction (NOC) cylinder trial lenses in improving visual acuity and subjective image quality in keratoconus patients.
  • To compare NOC lenses with standard orthogonal correction for visual performance.

Main Methods:

  • 18 participants with keratoconus (23 eyes) were refracted using standard orthogonal cylinder lenses and then NOC cylinder lenses.
  • Corneal elevation data were analyzed using Pentacam Scheimpflug imaging and MATLAB.
  • Participants underwent subjective refraction, visual acuity testing (BCVA, logMAR), and completed questionnaires on image clarity and ghosting.

Main Results:

  • 61% of eyes showed improved best-corrected visual acuity (BCVA) with NOC lenses compared to orthogonal correction.
  • 87% and 79% of participants reported increased letter clarity and reduced ghosting, respectively, independent of BCVA changes.
  • NOC allowed for finer adjustments of cylinder and axis, with most participants interested in trying NOC spectacles.

Conclusions:

  • Non-orthogonal spectacle correction may enhance visual acuity and subjective visual quality in keratoconus patients.
  • NOC lenses can improve letter clarity and reduce ghosting, potentially leading to better quality of life for individuals with irregular astigmatism.
  • This innovative correction method shows promise for managing the visual complexities of keratoconus.