title: Postblink changes in total and corneal ocular aberrations.
abstract: OBJECTIVE
  The purpose of this study was to determine objectively the changes in optical aberrations induced by the progressive tear film irregularity after a blink and their effects on retinal image quality.
  
  
  METHODS
  Prospective, consecutive, nonrandomized comparative trial (self-controlled).
  
  
  METHODS
  Twenty healthy subjects.
  
  
  METHODS
  Corneal and total ocular aberrations were determined in 20 subjects at various time intervals (approximately 0, 10, and 20 seconds) after a blink. Corneal and total aberrations were measured with an Orbscan II topographer (Orbtek Inc, Salt Lake City, UT) and a Zywave aberrometer (Bausch & Lomb, Irvine, CA), respectively. All data were decomposed using Zernike polynomials to yield the root mean square wavefront deviations, in micrometers (microm), for different pupil diameters (3.5, 4.5, 5.5, and 6.5 mm). A merit function (Mf), defined as the volume under the 2-dimensional modulation transfer function as computed from the total wavefront error, was taken as the image quality metric.
  
  
  RESULTS
  Both corneal and total aberrations (third order and higher) showed a statistically significant increase with time after the blink for all pupil diameters except 3.5 mm. The magnitude of the increase was greater at larger pupil diameters. For a 6.5-mm pupil, the aberrations increased on average by a factor of 2.5 (total) and 2.5 (corneal). Increases in total aberration were related closely to increases in corneal aberration (P<0.0001). For a 6.5-mm pupil, after 20 seconds, the reduction in optical quality (Mf) among the subjects studied was 21+/-8%.
  
  
  CONCLUSIONS
  After a blink, the gradual increase in optical aberration associated with the increasingly irregular tear film may cause a progressive reduction in the optical quality of the eye. These changes in aberration with time may partly limit the improvements in visual performance that are achievable by customized corneal ablation.
authors.affiliation: Department of Research, Development and Innovation, Instituto Oftalmológico de Alicante, Medical School, Miguel Hernández University, Avda. Denia 111, 03015 Alicante, Spain. roberto.montes@uv.es
authors.forename: Robert
authors.initials: R
authors.lastname: Montés-Micó
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Alió
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Muñoz
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Pérez-Santonja
authors.forename: W Neil
authors.initials: WN
authors.lastname: Charman
mesh_terms: D000328:Adult; D001767:Blinking / Q000502:physiology*; D003315:Cornea / Q000378:metabolism*; D019781:Corneal Topography; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000378:metabolism*; D013666:Tears / Q000378:metabolism