Relevance. Cataract is the leading cause of visual impairment worldwide. Even in the early stages of cataract development, when the maximum visual acuity often remains high, patients complain of a decrease in image quality (light scattering, diplopia), which is expressed in the difficulty of performing daily and professional activities. The cause of this condition in most cases is internal aberrations of a higher order. One of the topical issues of modern ophthalmology is the definition of indications for surgery of primary cataracts with high visual acuity. Purpose. The purpose of this literature review was to describe the current state of the problem of wavefront changes in patients with various types of initial lens opacity. Material and methods. A systematic analysis of scientific publications of domestic and foreign authors on the resources PubMed, Medline from 2000 to 2022, devoted to the currently existing methods for assessing the quality of vision of patients with initial opacification of the lens, was carried out. Results. Our literature review showed the great importance of assessing wavefront aberrations in patients with initial cataracts and high visual acuity. With the advent of modern diagnostic systems – aberrometers with the possibility of an isolated assessment of internal aberrations, doctors have the opportunity to interpret data on the effect of lens changes on the quality of vision. Conclusion. Visual acuity in patients with initial cataract is not a unique evaluation criterion for determining the timing of surgical intervention. Analysis of wavefront aberrations to a greater extent describe visual impairments and can be used as objective criteria for prescribing surgical treatment. The study of aberrations of the human eye makes it possible to give an objective and quantitative assessment of the optical functions of the eye, which expands the possibilities for diagnosis and for the formation of surgical approaches for initial lens opacities in patients with high visual acuity. Key words: higher-order wavefront aberrations, cataract