A Systematic Review on the Association Between Tear Film Metrics and Higher Order Aberrations in Dry Eye Disease and Treatment

Abstract

We systematically reviewed published research on dry eye disease and its association with higher order aberrations (HOAs). The purpose of this review was to first determine if an association between tear film metrics and HOAs exists and second to determine if the treatment of dry eyes can improve tear film metrics and HOAs together. A search was conducted in Entrez PubMed on 25 April 2021 using the keywords “higher order aberrations” and “dry eye”. The initial search yielded 61 articles. After publications were restricted to only original articles measuring HOA outcomes in patients with dry eye, the final yield was 27 relevant articles. Of these 27 papers, 12 directly looked at associations and correlations between dry eyes and HOA parameters. The remaining 15 studies looked at dry eye interventions and HOA outcomes and parameters. There is clear evidence demonstrating that dry eyes and HOAs have an association, and that the tear film is one of the most important factors in this relationship. There is also a direct correlation between tear film metrics and HOAs. Improvements in HOAs with dry eye interventions provide further evidence to support the intricate relationship between the two. Despite the clear association between HOAs and dry eye disease, further research is still required in the realm of clinical application as dry eye interventions vary depending on many factors, including patient severity and eye drop viscosity.

Changes in visual function and optical and tear film quality in computer users

“…There is evidence that dry eye and HOAs are associated, and that tear film metrics are correlated with HOAs 38 . However, in the present study, the reduction in tear film quality observed in computer workers throughout the working day was not accompanied by significant changes in ocular HOAs or the Strehl ratio.…”

Correlations between Quality of Vision, Higher Order Aberrations and Non-Invasive Keratographic Tear Film Break-Up Time in Pseudophakic Eyes after Uncomplicated Phacoemulsification

“…Inverse correlation between tear film break-up and higher HOA was plausible and was consistent with previous study [14]. Tear film is the outermost refractive surface of the eye, which is also key in stabilising HOA [15]. Irregular optical surface due to tear film break-up involving central cornea has been speculated to increase HOA [16].…”

Analysis of the Changes and Possible Reasons in Aberrations before and after Surgery in Patients with Concomitant Exotropia

“…HOAs, being an optical defect, cannot be corrected by any reliable method at present. e integrity of tear film can affect higher-order aberration, and the unsmooth anterior corneal surface induced by tear film destruction is the key factor leading to the increase of HOAs [20][21][22][23][24]. Pupil diameter changes [25][26][27][28] and adjustments [29][30][31][32][33] can also cause changes in HOAs.…”