Effect of Small Angle Misalignments on Ocular Wavefront Zernike Coefficients

Abstract

Purpose: To assess the possible impact of minor changes in fixation on wavefront measurements as a potential constraint in detecting subtle temporal variations in ocular wavefront error. Methods: Twelve healthy subjects with an average age of 36.3 ± 8.8 were instructed to put their heads in the aberrometer’s chin-rest and look at a fixation target that was embedded in the device. The fixation targets were readily observable to the participants without accommodation, thanks to the aberrometer’s Badal system. When each eye was staring at the target, its wavefront aberration was recorded three times and then averaged for further analysis. The averaged Zernike coefficients were rescaled to the smallest value of the maximum round pupil found among all eyes (4.41 mm), and this procedure was repeated for each target. Results: Alteration of the fixation targets caused changes to the Zernike coefficients of defocus (C(2,0)), vertical trefoil (C(3,–3)), vertical coma (C(3,–1)), horizontal coma (C(3,1)), oblique trefoil (C(3,3)), primary spherical aberration (C(4,0)), and secondary spherical aberration (C(6,0)), but the changes were not statistically significant. Nevertheless, an alteration in the target’s size and shape exhibited a significant correlation across all of the aforementioned coefficients in both eyes (p < 0.05). The total RMS of aberrations and the RMS of the spherical-like aberrations were both lowest while choosing the larger Maltese cross, and the bigger E-letter minimized the RMS of HOA and comatic aberrations. Conclusion: The aberrometric changes occur as a consequence of altering the fixational gaze and are within the range of the changes found after performing a near-vision task, so they might potentially act as a confounding factor when attempting to identify such small variations in the ocular wavefront. Using a smaller E-letter (5 arcmin) as an internal fixation target resulted in the least standard deviation of measurements, fixational stability, and higher accuracy in ocular wavefront measurements.