Effects of Dry Eye on Higher-Order Aberrations (HOAs) in a Young Population: Association of HOAs with Tear Film Parameters

Document Type : Original Article

Authors

1 Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran. Iran

2 Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran

3 Department of Optometry, School of Rehabilitation and Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Purpose:
Dry eye is a prevalent ocular condition characterized by tear film instability and inflammation of the ocular surface, which may result in visual impairment. This study sought to examine the impact of dry eye on higher-order aberrations (HOAs) within a young population and to explore their relationship with tear film parameters.
Methods:
In this cross-sectional study, 40 young individuals diagnosed with dry eye were compared to 40 healthy subjects matched for age and sex. The criteria for diagnosing dry eye included an Ocular Surface Disease Index (OSDI) score of 13 or higher, accompanied by at least one objective sign such as a tear film break-up time (TBUT) of 10 seconds or less, a Schirmer test score of 5 mm or lower, or corneal staining graded at 1 or above. Higher-order optical aberrations were assessed using a Pentacam device for a 6 mm pupil diameter. Independent samples t-test or Mann-Whitney U test, were employed to assess the differences in HOAs between the dry eye and control groups. Additionally, the relationships between HOAs and tear film parameters were evaluated using Spearman correlation test.
Results:
The average vertical coma (Z3,-1) and spherical (Z4,0) aberrations, along with total HOAs, were significantly elevated in the dry eye group compared to the control group (all P values < 0.05). A significant positive correlation was found between vertical coma and OSDI (0.391, P=0.001), while a significant negative correlation was noted with TBUT (-0.306, P=0.008) and Schirmer score (-0.244, P=0.037). Additionally, a significant positive correlation was identified between spherical aberration and OSDI (0.461, P<0.001), alongside significant negative correlations with TBUT (-0.365, P=0.002) and Schirmer score (-0.280, P=0.017).
Conclusion:
Dry eye in younger individuals is associated with an increase in higher-order aberrations, particularly vertical coma and spherical aberrations. These results suggest that evaluating HOAs may serve as a useful diagnostic tool in the management of dry eye among young populations.

Keywords

References

  1. Messmer EM. Pathophysiology of dry eye disease and novel therapeutic targets. Exp Eye Res 2022; 217:108944.
  2. Kusada N, Yokoi N, Sotozono C. Association between corneal higher-order aberrations evaluated with a Videokeratographer and corneal surface abnormalities in dry eye. Diagnostics 2023; 13(21): 3319.
  3. Suliman A, Rubin A. A review of higher order aberrations of the human eye. Afr Vision Eye Health 2019; 78(1): a501.
  4. Rhee J, Chan TC-Y, Chow SS-W, Di Zazzo A, et al. A systematic review on the association between tear film metrics and higher order aberrations in dry eye disease and treatment. Ophthalmol Ther. 2022; 11(1): 35-67.
  5. McCann P, Abraham AG, Mukhopadhyay A, Panagiotopoulou K, et al. Prevalence and incidence of dry eye and meibomian gland dysfunction in the United States: a systematic review and meta-analysis. JAMA Ophthalmol 2022; 140(12): 1181-1192.
  6. Wróbel-Dudzińska D, Osial N, Stępień PW, Gorecka A, Żarnowski T. Prevalence of dry eye symptoms and associated risk factors among university students in Poland. Int J Environ Res Public Health. 2023; 20(2): 1313.
  7. Stapleton F, Velez FG, Lau C, Wolffsohn JSJ. Dry eye disease in the young: A narrative review. Ocul Surf 2024; 31: 11-20.
  8. Montés-Micó R, Cáliz A, Alió JL. Wavefront analysis of higher order aberrations in dry eye patients. J Refract Surg. 2004;20(3):243-7.
  9. Koh S, Maeda N, Hirohara Y, Mihashi T, et al. Serial measurements of higher-order aberrations after blinking in patients with dry eye. Invest Ophthalmol Vis Sci 2008; 49(1): 133-138.
  10. Wang Y, Xu J, Sun X, Chu R, et al. Dynamic wavefront aberrations and visual acuity in normal and dry eyes. Clin Exp Optom 2009; 92(3): 267-273.
  11. Denoyer A, Rabut G, Baudouin C. Tear film aberration dynamics and vision-related quality of life in patients with dry eye disease. Ophthalmology 2012; 119(9): 1811-1818.
  12. Craig JP, Nichols KK, Akpek EK, Caffery B, et al. TFOS DEWS II definition and classification report. Ocul Surf. 2017; 15(3): 276-283.
  13. Pakdel F, Gohari MR, Jazayeri AS, Amani A, et al. Validation of farsi translation of the ocular surface disease index. J Ophthalmic Vis Res. 2017; 12(3): 301-304.
  14. Bron AJ, Evans VE, Smith JA. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea 2003; 22(7): 640-650.
  15. Kloosterboer A, Dermer HI, Galor A. Diagnostic tests in dry eye. Expert Rev Ophthalmol 2019; 14(4-5): 237-246.
  16. Assadpour M, Nabovati P, Hashemi H, Rafati S, et al. Comparison of corneal higher-order aberrations between miniscleral and hybrid lenses in keratoconus. Optom Vis Sci 2020; 97(9): 749-753.
  17. Jung HH, Ji YS, Oh HJ, Yoon KC. Higher order aberrations of the corneal surface after laser subepithelial keratomileusis. Korean J Ophthalmol 2014; 28(4): 285-291.
  18. Li J, Ma J, Hu M, Yu J, Zhao Y. Assessment of tear film lipid layer thickness in patients with Meibomian gland dysfunction at different ages. BMC Ophthalmol 2020; 20(1): 394.
  19. Montés-Micó R, Alió JL, Muñoz G, Pérez-Santonja JJ, Charman WN. Postblink changes in total and corneal ocular aberrations. Ophthalmology 2004; 111(4): 758-767.
  20. Koh S, Tung CI, Inoue Y, Jhanji V. Effects of tear film dynamics on quality of vision. Br J Ophthalmol 2018; 102(12): 1615-1620.
  21. Tutt R, Bradley A, Begley C, Thibos LN. Optical and visual impact of tear break-up in human eyes. Invest Ophthalmol Vis Sci. 2000; 41(13): 4117-4123.
Journal of Paramedical Sciences & Rehabilitation
Volume 14, Issue 3
November 2025
Pages 7-17

Files

Share

How to cite

Statistics