The effects of entrance pupil centration and coma aberrations on myopic progression following orthokeratology

Jacinto Santodomingo-Rubido*, César Villa-Collar, Bernard Gilmartin, Ramón Gutiérrez-Ortega, Asaki Suzaki

*Corresponding author for this work

Research output: Contribution to journalArticle


Background: The aim was to assess the potential association between entrance pupil location relative to the coaxially sighted corneal light reflex (CSCLR) and the progression of myopia in children fitted with orthokeratology (OK) contact lenses. Additionally, whether coma aberration induced by decentration of the entrance pupil centre relative to the CSCLR, as well as following OK treatment, is correlated with the progression of myopia, was also investigated.

Methods: Twenty-nine subjects aged six to 12years and with myopia of -0.75 to -4.00 DS and astigmatism up to 1.00DC were fitted with OK contact lenses. Measurements of axial length and corneal topography were taken at six-month intervals over a two-year period. Additionally, baseline and three-month topographic outputs were taken as representative of the pre- and post-orthokeratology treatment status. Pupil centration relative to the CSCLR and magnitude of associated corneal coma were derived from corneal topographic data at baseline and after three months of lens wear.

Results: The centre of the entrance pupil was located superio-temporally to the CSCLR both pre- (0.09±0.14 and -0.10±0.15mm, respectively) and post-orthokeratology (0.12±0.18 and -0.09±0.15mm, respectively) (p>0.05). Entrance pupil location pre- and post-orthokeratology lens wear was not significantly associated with the two-year change in axial length (p>0.05). Significantly greater coma was found at the entrance pupil centre compared with CSCLR both pre- and post-orthokeratology lens wear (both p<0.05). A significant increase in vertical coma was found with OK lens wear compared to baseline (p<0.001) but total root mean square (RMS) coma was not associated with the change in axial length (all p>0.05).

Conclusion: Entrance pupil location relative to the CSCLR was not significantly affected by either OK lens wear or an increase in axial length. Greater magnitude coma aberrations found at the entrance pupil centre in comparison to the CSCLR might be attributed to centration of orthokeratological treatments at the CSCLR.

Original languageEnglish
Pages (from-to)534-540
Number of pages7
JournalClinical and Experimental Optometry
Issue number6
Early online date17 Aug 2015
Publication statusPublished - Nov 2015

Bibliographical note

This is the peer reviewed version of the following article: Santodomingo-Rubido, J., Villa-Collar, C., Gilmartin, B., Gutiérrez-Ortega, R., & Suzaki, A. (2015). The effects of entrance pupil centration and coma aberrations on myopic progression following orthokeratology. Clinical and experimental optometry, Early view, which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.


  • coma
  • decentration
  • myopic progression
  • orthokeratology
  • pupil centration

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