The 2010 National Education Technology Plan steadily replaces paper textbooks with study materials on computers. One risk of increased computer usage is increased Computer Vision Syndrome (CVS) symptoms. I researched multiple studies to analyze the effects of computer use on dry eye and eye strain and how these symptoms can progress to musculoskeletal pain, headaches, decreased quality of life, loss of confidence and even anxiety and depression. Currently, there is not much data on tablet use so I propose two future experiments to determine if tablets can also cause CVS ocular symptoms.

The reduction in visual performance typically found in keratoconic patients is believed to be associated with large magnitudes of uncorrected irregular astigmatism and higher-order aberrations (HOAs). Previous studies indicate that correcting HOAs in keratoconus patients may result in an improvement in visual performance. This thesis explores the correction of HOAs using standard sphero-cylindrical and customised aberration-controlling soft contact lenses in 22 patients with keratoconus. The findings of this work may be useful from a clinical perspective, as some keratoconic patients cannot tolerate rigid gas-permeable (RGP) contact lenses and have few alternatives, excluding surgical intervention, for vision correction. This thesis firstly describes a series of preliminary studies conducted to improve our current understanding of the HOAs manifested in keratoconus. The results of these investigations suggested that alterations in aberrations, due to changes in accommodation or variations in the pre-corneal tear film post-blink, were unlikely to hinder the correction of HOAs for keratoconic patients. Equally, it was ascertained that subjective refraction data provided significantly better visual acuity compared to objective, aberrometry-derived refractions for patients with keratoconus. The findings also show that both lower-order aberrations (LOAs) and HOAs displayed a larger degree of variability in keratoconic eyes compared to those previously reported for visually-normal subjects. Furthermore, significant increases in 3rd-order coma root mean square aberrations were found after temporarily suspending RGP contact lens wear for 16 keratoconic patients. The results of two clinical studies suggested that standard sphero-cylindrical soft lenses can, to some extent, mask HOAs in keratoconic patients; however, the visual performances achieved were found to be poorer compared to RGP lenses. Equally, the results showed that RGP lenses provide superior visual performances compared to customised, aberration-controlling lenses, in spite of the customised lenses providing comparable reductions in uncorrected HOAs. The inducement of superfluous HOAs and LOAs, through customised contact lens translations and rotations, were modelled using MatLab (version 7.6.0.324; The Mathworks, Natick, MA, US). The results confirmed that minimising the decentration of aberration-controlling contact lenses, to less than 5 degrees of rotation and less than 0.50 mm of translation, will help to achieve an optimal correction of HOAs. However, more stringent criteria were required for LOAs, where rotational displacements should be reduced to less than 3 degrees and translational displacements should be limited to less than 0.10 mm. In conclusion, the correction of HOAs for patients with keratoconus is possible using customised, aberration-controlling soft contact lenses; however, several factors will govern their success, including the repeatability and accuracy of HOA measurements for these irregular corneas, and the stability of the customised lenses on-eye.

L’amélioration des matériaux et des technologies de lentilles de contact a permis le recours de plus en plus fréquent à un type de lentille de contact à grand diamètre reposant sur la sclère : la lentille sclérale (SL). Celle-ci est majoritairement utilisée pour la réadaptation visuelle de patient vivant avec divers types de déformations cornéennes, mais également pour le traitement de maladie de surface oculaire et la correction optique de la simple erreur de réfraction lorsque les autres modalités de lentilles ne peuvent être tolérées. Ce mémoire a pour objectif d’évaluer l’influence de l’asphéricité des surfaces antérieure (ASA) et postérieure (ASP) sur la performance visuelle d’un porteur de SL chez deux groupes distincts : une cohorte de 12 participants sans anomalie cornéenne et une cohorte de 9 participants ayant un diagnostic de kératocône (KC). Lors de l’expérience, quatre différentes SL ayant différents profils d’asphéricité ont été étudiées sur l’œil droit seulement. Pour chaque SL, les mesures d’acuité visuelle à haut contraste (AVHC), l’acuité visuelle à bas contraste (AVHC) et les valeurs moyennes quadratiques (root-mean-square ou RMS) des différents coefficients d’aberrations d’ordres supérieurs (AOS) ont été compilées pour chacun de ces designs aux diamètres pupillaires 3, 4, 5 et 6 mm. Les résultats obtenus suggèrent que l’augmentation de l’ASA d’une SL portée à l’œil droit génère une augmentation de l’aberration sphérique négative, de la coma verticale et horizontale négative chez les deux groupes. L’augmentation de l’ASA entraîne toutefois une augmentation de l’AOS totale et du trèfle total chez les participants sans anomalie cornéenne. Chez le groupe de participants atteint de KC, l’augmentation de l’ASA entraîne une diminution non significative des AOS totales et une augmentation non significative de l’aberration trèfle total. Bien que des études supplémentaires soient nécessaires pour bien comprendre l’influence de l’asphéricité sur les AOS chez les participants atteints de KC, la manipulation de celle-ci permettrait de réduire l’amplitude de certains types d’AOS dans certains cas particuliers. / Improvements in materials and technology have led to the increased use of a large diameter contact lens that rests on the sclera: the scleral lens (SL). These lenses are mainly used for visual rehabilitation of patients with various types of corneal ectasia, for the treatment of ocular surface disease and also for the optical correction of simple refractive error when other lens modalities are not tolerated. The purpose of this dissertation is to evaluate the influence of anterior surface asphericity (ASA) and posterior surface asphericity (ASP) on the visual performance of a SL wearer in two distinct groups: a cohort of 12 participants with no corneal abnormalities and a cohort of 9 participants with a diagnosis of keratoconus (KC). Four different SLs with different aspheric profiles were studied on the right eye only. For each SL, high-contrast visual acuity (HCVA), low contrast visual acuity (LCVA) measurements were measured. The root-mean-square (RMS) values of the higher-order aberration (HOA) Zernike coefficients were also measured for each of these designs for a pupil diameter of 3, 4, 5 and 6 mm. The results of this study suggest that increasing the anterior asphericity of a SL worn on the right eye generates an increase in negative spherical aberration, negative vertical and horizontal coma in both groups. Increasing anterior asphericity leads to an increase in total HOA and total trefoil in participants without corneal anomalies. In the group of participants with KC, increasing asphericity results in a non-significant decrease in total HOA and a non-significant increase in total trefoil aberration. Although additional studies are needed to understand the influence of asphericity on HOA in participants with KC, the manipulation of the anterior asphericity could reduce the amplitude of some types of HOA in some cases.

No description available.