Correcting Higher Order Aberrations (HOAs) with Scleral Lenses

Scleral lenses are life changing devices for people with irregular corneas from conditions like  keratoconus, corneal transplants, failed LASIK, corneal scarring and dry eye disease.  They offer significant improvements in visual acuity and can give patents with these conditions the ability to see and function normally with comfort and consistency.  They act as a prosthetic that can be worn during the day to greatly reduce blur, glare, and light sensitivity.  

Patients with these conditions suffer from excessive amounts of what are known as higher order aberrations (HOAs).  Aberrations exist in virtually every eye.  Typical aberrations (lower order aberrations) include myopia (near sightedness), hyperopia (far-sightedness) and astigmatism, can be easily corrected with glasses and soft contact lenses.  People with eye diseases like keratoconus have additional higher order aberrations (trefoil, coma, etc) that cause significant blur, glare at night, star-bursting, haloes, and “ghosting” of letters and images.  These HOAs cannot be corrected with typical vision correction devices like glasses and soft contact lenses.  

Rigid lenses like traditional scleral lenses and corneal gas permeable lenses can correct a significant amount of HOAs and greatly improve vision for these individuals, but often there are still residual HOAs that can persist and prevent clarity. 

Kirkwood Eye Associates is now the first and only practice in Missouri with the ability to detect these residual HOAs with the help of the XWAVE system from OVITZ, and the ability to incorporate the proper correction onto a number of scleral lens platforms.   The process involves using the XWAVE aberrometer to measure the amount of HOAs present in an eye wearing a traditional scleral lens.  The measurements can then be used to design a wavefront guided optic zone on a scleral lens to further reduce presence of HOAs and improve visual acuity and clarity.  

This process requires perfect scleral lens stability to properly align the optics to correct these imperfections in the visual system.  The scleral lens experts at Kirkwood Eye Associates utilize cutting edge technologies like scleral mapping and impression scleral molding to design lenses with the optimal fit necessary to align these precision optical corrections.  

It is important to note that likely every human eye has some detectable level of HOAs and it is impossible to get that level to zero with current technology, but the OVITZ software can often help people with corneal disease bring their HOAs to a level at or below what we would expect in a non-diseased eye.  

HOA correction is not currently covered by any vision or medical insurance.  If you do have a plan with “medically necessary” coverage, please note that HOA correction will still be an out-of-pocket add-on feature.  

Contact Kirkwood Eye Associates today to see if HOA-correcting scleral lenses can help improve your vision.