What is wavefront aberrometry and what might it tell me?

(posted apr 2003)

At the risk of being considered a heretic, I really don’t see what the big deal is about Wavefront analysis. Sure, I believe it is a Good Thing — in fact, it’s a very important thing and I urge all of you to make sure you get it done as soon as possible. But to me, the details of it don’t matter so I’ve never bothered to learn them and you will find me woefully undereducated about what the differences are between spherical aberrations and coma and trefoil and all the other goodies.

Why? Because, in my humble opinion:

The bottom line is that if you have trashy vision in one form or another, the chances are that when you get Wavefront scans there will be some magical numbers on them in the categories for "higher order aberrations" (which seems to be a kind of holy grail amongst the post-operative community in the USA) which magically demonstrate beyond a shadow of a doubt that, YES, THERE REALLY MIGHT BE SOMETHING WRONG WITH YOUR VISION! (Some of which really is visible on your topographies, of course, but we won’t clutter up this section with a repetition of the chip on our shoulders about that.)

Can you believe it? YOU REALLY HAVEN’T BEEN HALLUCINATING OR LYING SHAMELESSLY TO GET ATTENTION.

"Hold on just a minute," you counter, "I already knew that."

Of course you did. But your eye doctor didn’t, so this is for his benefit. Broadly speaking, it tells him that your peripheral cornea, and probably some of your central cornea too, is not as pretty and smooth and shapely as it ought to be, and that as a result you really might be justified in being unhappy with your vision. (Though of course we reserve the right to think that you’re just picky.)

So. It’s official. There Really Is Something Wrong With My Vision. And it has some nice fancy names and numbers to prove it.

Now that I know that, what do I do?

The answers haven’t changed. You can get rigid gas permeable contacts (or similar), or you can be a guinea pig for a Wavefront-guided laser surgery. Alternatively, you can cobble together other partial solutions and crutches.

If, however, you are seriously considering pursuing a Wavefront-guided laser surgery, Wavefront analysis suddenly becomes very important indeed and you ought to learn to know your coma from your trefoil. Wavefront-guided laser surgery means that the laser fires off an ablation pattern based on the information from the Wavefront scanner; this can be done with either PRK (surface ablation) or LASIK (re-lifting the flap). We invite you to use the Links Library to do some research on this. The only further comment we will make here is that NOT ALL WAVEFRONT SCANNERS ARE EQUAL. Some are higher resolution than others. The higher the better, as any photographer with a digital camera will tell you. (You want your vision to be like a glossy and not like what a 2.0 megapixel camera will give you on a low res printer, right?). And, we all know the old adage GARBAGE IN GARBAGE OUT. Bottom line, the resolution of the wavefront scanner will be a key factor in a good result.