Manipulation of Ocular Aberrations in Myopes

Abstract: Myopia is a major cause of vision loss throughout the world. High myopia is associated with severe eye diseases like maculopathy, retinal detachment and glaucoma. The prevalence of myopia is increasing, and varies by country and by ethnic group. In some Asian populations the prevalence is 70%-80%. This thesis includes five experiments. In experiment I we investigated the effects of added positive and negative spherical aberration on accommodative response accuracy. We found that the accommodative response can be altered by modulating the spherical aberration of the eye with soft contact lenses. There was an improvement in the accommodative response slopes and a decrease in the lag of accommodation with the negative spherical aberration lenses compared to positive spherical aberration lenses. In experiment II we investigated whether the negative spherical aberration in contact lenses could be tolerated visually in terms of wearability and comfort. We found that all the subjects were satisfied with the contact lens comfort, distance and near vision and the stability of the vision with the lenses. The accommodative response was stable through out the treatment period.In experiment III we investigated the efficacy of a novel dual treatment for the improvement of accommodative accuracy and dynamics in myopes. The spherical aberration of the eye was effectively altered to negative in the treatment group as predicted. In the control group as expected there was no significant change in the spherical aberration of the eye with and without contact lenses. The treatment lenses decreased the lag of accommodation and increased the accommodative response slope at 3 months.In the experiment IV we investigated the effect of the treatment lenses used in the previous experiment on high and low contrast visual acuities after a one year treatment period. The results showed a significant improvement in both high and low contrast visual acuities after the one year period in the treatment group compared to the control group, even though it was not clinically significant.In experiment V we investigated the intrasession repeatability of peripheral aberrations using COAS-HD VR aberrometer and also reported the distribution of higher order aberrations in a group of young emmetropes. There was no significant difference in the variance of total higher-order RMS between on- and off-axis measurements. There was a significant change in the horizontal coma, spherical aberration and higher-order RMS with off-axis angle along the horizontal visual field. We demonstrated that fast, repeatable and valid peripheral aberration measurements can be obtained with this instrument.This thesis contributes new results in this field of myopia, aberration and accommodation.