title: Dynamics of ocular aberrations in keratoconus.
abstract: BACKGROUND
  The aim was to investigate the fluctuations in monochromatic ocular aberrations with accommodation and tear-film changes in moderate keratoconic eyes.
  
  
  METHODS
  We measured the changes in ocular higher-order aberrations in 10 moderate keratoconic and 10 visually normal eyes to accommodative stimuli ranging from zero to 5.00 DS using a Hartmann-Shack aberrometer. In addition, the changes in ocular higher-order aberrations were measured for up to 15 seconds after a blink in eight keratoconic and eight visually normal eyes.
  
  
  RESULTS
  These results show that ocular spherical (p = 0.68) and coma-like (p = 0.71) aberrations did not change significantly with accommodation from zero to 5.00 DS in keratoconic eyes. In contrast to normal eyes, the ocular higher-order RMS error tended to decrease in magnitude after a blink in keratoconic eyes. Vertical coma became less negative with time after a blink in the keratoconic group, therefore, reducing the manifest ocular higher order RMS error by counteracting the negative vertical coma of the cornea.
  
  
  CONCLUSIONS
  Compared to the manifest monochromatic higher-order aberrations, any dynamic fluctuations in ocular aberrations with accommodation and tear film changes are relatively small in moderate keratoconic eyes. This implies that the correction of monochromatic higher-order aberrations in keratoconus using customised soft contact lenses will not be significantly hindered by such dynamic aberrational changes.
authors.affiliation: Faculty of Life Sciences, Moffat Building, University of Manchester, Manchester, United Kingdom. hema.radhakrishnan@manchester.ac.uk
authors.forename: Hema
authors.initials: H
authors.lastname: Radhakrishnan
authors.forename: Amit
authors.initials: A
authors.lastname: Jinabhai
authors.forename: Clare
authors.initials: C
authors.lastname: O'Donnell
mesh_terms: D000065:Accommodation, Ocular; D000328:Adult; D001767:Blinking; D016022:Case-Control Studies; D003315:Cornea / Q000473:pathology; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000473:pathology*; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D012029:Refraction, Ocular; D013666:Tears / Q000378:metabolism*; D014792:Visual Acuity