title: Wavefront analysis of eye with monocular diplopia and cortical cataract.
abstract: OBJECTIVE
  To determine whether higher-order aberrations can explain the monocular diplopia reported by a patient.
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  A patient complaining of monocular diplopia was examined with the Hartmann-Shack aberrometer to determine if the higher-order wavefront aberrations could account for the diplopia. The patient had a mild cortical cataract, and measurements were made before and after lensectomy. In addition, the retinal image was simulated using Zernike polynomials.
  
  
  RESULTS
  Spherical aberration (0.20 microm for 4-mm pupil) and secondary astigmatism (-0.12 microm) were increased in the eye. The simulated retinal image had a double configuration that was approximately the same as the subjective image reported by the patient. After cataract surgery, the diplopia disappeared, and the spherical aberrations and secondary astigmatism were considerably decreased.
  
  
  CONCLUSIONS
  The monocular diplopia probably stemmed from the combined effects of spherical aberration and secondary astigmatism caused by the cortical cataract.
authors.affiliation: Department of Applied Visual Science, Osaka University Graduate School of Medicine, Technical Research Institute, Tokyo, Japan. fujikado@ophtal.med.osaka-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujikado
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimojyo
authors.forename: Jun
authors.initials: J
authors.lastname: Hosohata
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hirohara
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Mihashi
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Maeda
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Tano
mesh_terms: D000328:Adult; D001251:Astigmatism / Q000175:diagnosis / Q000209:etiology; D002386:Cataract / Q000150:complications / Q000175:diagnosis*; D002387:Cataract Extraction; D003315:Cornea / Q000473:pathology*; D019781:Corneal Topography; D004172:Diplopia / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D012030:Refractive Errors / Q000175:diagnosis / Q000209:etiology