Chris A. Smiley
LAS VEGAS – The use of aberrometry can provide peace of mind when patients do not see 20/20, according to a speaker here at Vision Expo West.
“The biggest thing an aberrometer helps us with is an objective measure of vision quality,” Chris A. Smiley, OD, said at the Global Contact Lens Forum
“In optometry school we were taught if a patient doesn’t see 20/20, we have to refer it to figure out why,” he said. “We can use aberrometry to help us figure this out.”
He shared a case of a 65-year-old patient with diabetes and a cataract that he initially diagnosed due to unilateral higher-order aberrations.
“That’s where aberrometry helped show me what was going on and indicated that it might be time to have the cataract removed,” Smiley said.
He said he commonly uses his aberrometer for overrefracting contact lens patients. The instrument provides “quick, objective data” and will indicate whether a manual overrefraction is necessary, he said.
“You might find that a patient who can’t see right has a higher-order aberration and might benefit from a gas permeable or semi scleral lens,” Smiley said. “An aberrometer can really help you hone down the correct cylinder for the patient.”
He recommended using aberrometry to detect keratoconus, latent hyperopia in a child, when doing orthokeratology or post-LASIK aberrations.
Smiley said he would like to see “truly custom, higher-order aberration-correcting lenses to offer the most precise vision possible. That might be a future use of aberrometry in our practice.”
Other potential uses include evaluating the difference between the pupillary axis and line of sight.
“We may start to see some multifocal contact lenses that have decentered optics, and we might need to measure angle kappa a little better,” he said.
Without the use of aberrometry, typically, if a patient complains of blur, the clinician can consider coma; if they complain of glare, haloes and night myopia, they probably have spherical aberration; and if they have starburst, they probably have trefoil, Smiley said.
He noted that aberrometry is done on every patient in his practice.
“It saves time, and you’ll be a lot more accurate,” he said. “One of our labs told us we have the lowest remake rate in the region. I attribute that to staff training and use of aberrometry.”
Smiley also noted that he performs overrefractions on every contact lens patient.
“One of the requirements of vision plans is that you must do a contact lens overrefraction or you didn’t complete the exam,” he said. – by Nancy Hemphill, ELS, FAAO
Quinn T, et al. Effective and efficient use of technology in practice. Presented at: Vision Expo West; Las Vegas; September 18-21, 2019.
Disclosure: Smiley reports financial interests in Alcon, Alden, Allergan, Bausch + Lomb, Blanchard Contact Lens, CooperVision, Johnson & Johnson Vision Care, Sun Pharmaceuticals and Synergeyes.