Clinical applications of ocular aberrometry in ophthalmology: A comprehensive review with a focus on ray-tracing devices

Modern ophthalmology increasingly emphasizes visual quality in addition to visual acuity. Visual quality is influenced by lower-order aberrations – such as myopia, hyperopia, and astigmatism – as well as higher-order aberrations, which can significantly degrade vision, especially under mesopic or scotopic conditions. Aberrometry provides a quantitative assessment of these optical imperfections, offering insights that go beyond standard refraction. Various technologies are employed to measure ocular aberrations, including Hartmann–Shack, Tscherning, and ray-tracing principles, each with distinct clinical applications. Ray-tracing aberrometry, as implemented in devices like iTrace, enables detailed analysis of both corneal and internal optics by separating total aberrations into their respective components. This facilitates the objective evaluation of dysfunctional lenses, guides selection and customization of premium intraocular lenses, and enhances surgical planning and postoperative assessment in cataract and refractive procedures. The integration of aberrometry into routine ophthalmic care enables clinicians to deliver more precise, individualized treatment, ultimately improving patient outcomes and satisfaction. This review provides an overview of the principles, device types, and clinical applications of aberrometry, with a focused discussion on the capabilities of ray-tracing systems.