Retinal image simulation by PSF analyzer on the eye with higher-order aberrations due to the crystalline lens

Abstract

We report a 42-year-old woman with acute-onset monocular multiplopia in a vertical direction. The corneal topography showed irregular corneal aberrations and the wavefront sensor showed both corneal and total-ocular higher-order aberrations. However, when the corneal aberrations were corrected with a hard contact lens (HCL), the patient reported even more marked subjective multiplopia, which suggested that the distorted vision was caused by the presumed irregular aberrations in the crystalline lens. The results of wavefront analysis of the eye with the HCL did not coincide well with the patients subjective report of vertical multiplopia, which suggested that the lens aberrations seemed to be too complex for the algorithm of the sensing procedure to analyze. Simulated retinal images obtained using the point spread function (PSF) analyzer showed multiple images vertically, which were more clearly depicted in the eye with the HCL, and which coincided precisely with the patients subjective complaint. We speculated that distortion of the shape of the crystalline lens occurred early during the aging process. Retinal-image simulation using the PSF analyzer is clinically useful to estimate the quality of vision even in eyes with highly complicated aberrations that are beyond the measurable range of the wavefront sensor.