Scleral Lenses With Wavefront-Guided Optics Boost Visual Quality in Keratoconus

Wavefront-guided scleral lenses can improve vision and quality of life in patients with keratoconus.

Scleral lenses with wavefront-guided optics can correct residual higher order aberrations (HOAs) in patients with keratoconus, improving both vision and quality of life, according to a poster presented at the 2023 American Optometric Association (AOA) ePosters event in Washington, DC. 

Clark Chang, OD, from Wills Eye Hospital and Jenny Wong, OD, from the Contact Lens Institute of Nevada detailed a case report of a patient (man; age, 31 years) fit with the study lenses who previously experienced persistent photic disturbances with scleral lens wear. Previous scleral lens overrefraction yielded a best corrected visual acuity of 20/25, but with persistent glare and ghosting. After undergoing aberrometry measurements, significant residual HOA with root-mean-square (RMS) of 0.64 μm, which was captured over a 7 mm pupil diameter, was noted in the right eye. The primary HOAs included both spherical aberration and coma.

Wavefront-guided scleral lenses can be utilized to correct residual HOA, which improve patients’ visual outcomes and quality of life.

The patient underwent fitting with wavefront-guided scleral lenses with an optic zone of 9.5 mm, and a set of orientation dot markings enabled better alignment between the wavefront correction profile and the patient’s visual axis. The scleral lenses with wavefront-guided optics reduced RMS to 0.49 μm, best corrected visual acuity improved to 20/15, and the patient reported a comfortable wearing experience and a resolution of subjective visual disturbances in both photopic and scotopic conditions.

“Despite gas permeable lens wear, significant residual higher order aberrations (HOA) may persist and cannot be corrected with a traditional sphero-cylindrical treatment approach,” the poster presenters explain. “Wavefront-guided scleral lenses can be utilized to correct residual HOA, which improve patients’ visual outcomes and quality of life.”

Disclosure: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


Chang C, Brown N, Wong J. Reducing visual disturbances with wavefront-guided optics in a keratoconus patient who failed conventional scleral lenses. Poster presented at: American Optometric Association 2023 ePosters Virtual Event; June 13-14, 2023; Washington, DC.