Higher order aberrations in keratoconus‏

Nir Erdinest, Naomi London, David Landau, Ramez Barbara, Adel Barbara, Shehzad A Naroo

Research output: Contribution to journalReview articlepeer-review


Introduction: Keratoconus is a progressive disorder of the cornea that causes thinning (Sedaghat et al. in Sci Rep 11(1):11971, 2021), ectasia, and irregular astigmatism, resulting in poor visual acuity that cannot be corrected with standard sphero-cylindrical spectacle lenses. One feature distinguishing keratoconic corneas is ocular aberrations, manifesting up to five or six times the amount of higher-order aberrations than a normal, healthy eye. These aberrations can cause visual disturbances even at the very early stages of the disease. Methods: In the past, a diagnosis was derived from clinical symptoms, but technological advances have revealed multiple pre-clinical features, allowing for the differentiation between keratoconic and normal eyes at a much earlier stage. These include anterior and posterior corneal surface elevations, the corneal pachymetry profile, corneal epithelial patterns, wavefront aberration metrics, and corneal biomechanics (Sedaghat et al. in Sci Rep 11(1):11971, 2021).This review discusses the aberrations associated with keratoconus, how to measure them, and treatment methods to minimize their negative influence. Conclusions: Early diagnosis can lead to early treatment and may allow for arresting progression, thereby improving the long-term prognosis. With the acceleration of refractive surgery, it is important to identify patients with keratoconus, as they are usually contraindicated for refractive surgery.

Original languageEnglish
Article number172
Number of pages16
JournalInternational Ophthalmology
Issue number1
Early online date10 Apr 2024
Publication statusPublished - 10 Apr 2024

Bibliographical note

Copyright © 2024. The Author(s), under exclusive licence to Springer Nature B.V. This version of the article has been accepted for publication, after peer review and is subject to Springer Nature’s AM terms of use [https://www.springernature.com/gp/open-research/policies/accepted-manuscript-terms], but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/[DOI here when available]


  • Visual disturbance
  • Ectasia
  • Keratoconus
  • Keratoconus - diagnosis - etiology - therapy
  • Humans
  • Wavefront
  • Corneal Topography - methods
  • Vision Disorders
  • Astigmatism - diagnosis
  • Early detection
  • Higher order aberrations
  • Cornea


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