Wavefront analysis of an eye with monocular triplopia and nuclear cataract

Abstract Purpose To determine whether higher-order aberrations explain patient-reported monocular triplopia. Design Observational case report. Method A patient complaining of monocular triplopia was examined with a Hartmann-Shack aberrometer to determine whether higher-order wavefront aberrations could account for the triplopia. The patient had a mild nuclear cataract; measurements were made before and after lensectomy. The retinal image was simulated using the Zernike polynomials. Result Spherical aberration (−0.18 μm, 4 mm pupil) and trefoil aberration (−0.16 μm) were increased. The simulated retinal image had a triple configuration similar to the subjective image reported by the patient. After cataract surgery, the subjective triplopia disappeared; spherical, and trefoil aberrations were markedly decreased. Conclusion The monocular triplopia probably stemmed from combined effects of spherical and trefoil aberrations caused by the nuclear cataract.