Clinical Scorecard: Practice Pearls: Is HOA Correction the Real Deal?
At a Glance
| Category | Detail |
|---|---|
| Condition | Higher-Order Aberrations (HOAs) |
| Key Mechanisms | Disrupt the path of light through the eye, not correctable by standard lenses. |
| Target Population | Patients with corneal irregularities, ectasia, surgical history, trauma, or high ametropia. |
| Care Setting | Ophthalmology and optometry practices. |
Key Highlights
- HOAs affect nearly all patients to some degree.
- Symptoms include glare, halos, starbursts, ghosting, and blurred vision.
- Quantification of HOAs relies on aberrometer data.
- Patient selection is crucial for successful HOA correction.
- Wavefront-guided lenses can significantly improve vision performance.
Guideline-Based Recommendations
Diagnosis
- Identify significant HOAs through patient conversation and aberrometry.
Management
- Utilize wavefront-guided contact lenses for HOA correction.
Monitoring & Follow-up
- Assess for neural adaptation and monitor for cataract development.
Risks
- Consider ocular surface disease and other uncontrollable factors.
Patient & Prescribing Data
Individuals seeking enhanced visual performance or correction of bothersome HOAs.
HOA correction can be life-changing for appropriate candidates.
Clinical Best Practices
- Conduct high-quality scans in dark rooms with stable lens fit.
- Underpromise and overdeliver in patient expectations.
- Stay informed on advancements in HOA measurement and correction.
References
- Howland B, Howland HC. Subjective measurement of high-order aberrations of the eye.
- Liang J, et al. Objective measurement of wave aberrations of the human eye.
- McCormick GJ, et al. Higher-order aberrations in eyes with irregular corneas.
- Martínez-Pérez C, et al. Corneal higher-order aberrations in different types of irregular cornea.
- Erdinest N, et al. Higher order aberrations in keratoconus.
- Hastings GD, et al. Avoiding penetrating keratoplasty in severe keratoconus.
- Gelles JD, et al. Ocular impression-based scleral lens with wavefront-guided optics.
- Gelles JD, et al. Visual improvement with wavefront-guided scleral lenses.
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