What are higher-order aberrations (HOAs)?

Higher-order aberrations (HOAs) are optical imperfections that can occur in the human eye, causing deviations from ideal vision. In addition to the more well-known lower-order aberrations (LOAs) like nearsightedness (myopia), farsightedness (hyperopia), and astigmatism, higher-order aberrations involve more complex irregularities in the eye's optical system.

While lower-order aberrations can be corrected with glasses or contact lenses, higher-order aberrations are more challenging to correct for and require specialized equipment and materials.

Visual symptoms of HOAs include:

Halos: Concentric circles or rings around bright light sources, such as headlights or streetlights.

Starbursts: Radiating lines or rays extending from bright light sources.

Ghosting: Duplicated or overlapping images.

Coma: Distortion resembling a comet-shaped blur.

Double vision: Seeing two images instead of one.

Irregular astigmatism: Uneven distortion in different directions.

These aberrations can result from factors such as irregularities in the corneal shape, scarring, previous eye surgeries, those with large pupils, or certain medical conditions affecting the eye such as keratoconus or other corneal dystrophies. They can also be induced by the aging process or from changes in the eye's internal structures.

Managing higher-order aberrations (HOAs) with scleral lenses and Wavefront technology

Although custom scleral lenses are able to greatly improve the vision quality of an irregular cornea, there may still be HOAs that distort the vision. For those looking to improve their vision further, we use wavefront-guided technology to optimize and enhance their vision.

In our office, we use the Ovitz aberrometer to measure the optical characteristics of a patient's eye, which includes both the lower-order aberrations as well as the higher order aberrations. This provides us with a detailed map of that particular eye's visual irregularities, which is then used to create a customized wavefront corrective scleral lens. This leads to enhanced visual acuity and reduced blur for patients with complex vision issues.

If you would like to see if you are a Wavefront scleral lens candidate or would like to have your aberrations measured, feel free to reach out to us for a consultation visit.