Challenging Refractions - Summary - MDSpire

Challenging Refractions

Dr. McKinnis describes what to do when visual acuity alone does not fully capture visual quality.

  • By

  • Ryan McKinnis, OD, FAAO

  • May 1, 2026

  • 4 min

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Objective:

To explore the impact of lower- and higher-order aberrations on visual quality and contact lens care.

Approach:
    Key Findings:
    • HOAs significantly affect visual quality, leading to complaints like glare and poor night vision despite 20/20 acuity.
    • Traditional refraction methods are often insensitive to HOAs, complicating patient care.
    • Rigid gas permeable and scleral lenses can effectively reduce corneal HOAs and improve visual outcomes.
    • Incorporating HOA-correcting optics into lens designs can enhance patient satisfaction.
    Interpretation:

    Recognizing the role of HOAs in visual dissatisfaction is crucial for clinicians to improve patient outcomes and satisfaction.

    Limitations:
    • Wavefront aberrometry is not routinely used in clinical practice.
    • Treatment options for HOAs can be complex and are not always straightforward.
    Conclusion:

    A comprehensive understanding of both LOAs and HOAs is essential for effective patient management and improved visual quality.

    Sources:

Original Source(s)

Challenging Refractions

  • by Ryan McKinnis, OD, FAAO

  • May 1, 2026

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