Novel applications of an adaptive optics visual simulator in the clinical setting

Purpose: To evaluate the clinical benefit of using an adaptive optics visual simulator (AOVS) and its impact in different clinical settings. Methods: An adaptive optics visual simulator performed the experimental procedure and was used to optically introduce aberrations in 9 normal eyes for visual acuity (VA) change, and in 10 cyclopleged eyes for enhancing depth of focus (DoF). AOVS was also used to correct 20 highly aberrated eyes. Results: The correction/induction of high order aberrations (HOA) alters the best-corrected visual acuity (BCVA) by a mean of ~1 to 1.5 lines compared to the best spectacle correction. The depth of focus (DoF) was most enhanced (~2.0 D) with the introduction of negative and positive spherical aberration of 0.6 μm magnitude. The correction of HOAs in highly aberrated eyes improved BCVA by a mean of ~1.5 to 2 lines in two groups of pathological eyes. Conclusions: Aberrations have differing effects according to their clinical use. The AOVS defines the clinical response of HOAs on VA, visual perceptions and DoF.