What question did this study set out to answer?

This study aims to understand how scleral lenses affect both pupil responses and optical aberrations in keratoconus patients.

April 23, 2026

Do Scleral Contact Lenses Affect Pupillary Light Response in Patients With Keratoconus?

Key Points

This study aims to understand how scleral lenses affect both pupil responses and optical aberrations in keratoconus patients.
Measured ocular aberrations using Pentacam AXL wave before and after scleral lens application.
Conducted automated pupillometry to assess static and dynamic pupil functions in patients.
Compared changes in visual acuity and ocular metrics pre- and post-lens wear.
Significant improvements in best-corrected visual acuity after wearing scleral lenses (P < 0.05).
Noted decreases in various pupil diameters (high photopic, low photopic, mesopic, and scotopic) and contraction/dilation velocities (P < 0.001).
Correlations were established between changes in visual acuity and specific ocular aberrations.

Abstract

Objectives: To investigate the effects of scleral lenses on ocular aberrations, static and dynamic pupil functions in patients with keratoconus. Methods: Thirty-nine eyes from 31 patients diagnosed with moderate to severe keratoconus. Ocular aberration measurements (Pentacam AXL wave) and pupillometry measurements using automated pupillometry were recorded for all patients, both before and after the wearing of scleral lenses. Results: After the application of scleral lenses, considerable improvements were noted in best-corrected visual acuity (BCVA), lower-order aberration (LOA), higher-order aberration (HOA), vertical coma, horizontal coma, and spherical aberration values in ocular aberration ( P <0.05). In static and dynamic pupillometry, significant decreases were observed in high photopic pupil diameter (PD), low photopic PD, mesopic PD, scotopic PD, contraction velocity, and dilation velocity ( P =0.039, P <0.001, P <0.001, P =0.023, P =0.001, and P =0.016, respectively). The change in BCVA after scleral lenses correlated with the change in LOA, HOA, vertical coma, spherical aberration, low photopic PD, and mesopic PD values ( P <0.05). Conclusions: Scleral lenses cause notable changes in static and dynamic pupil functions. Besides neutralizing LOA and HOA, the decrease in low-photopic and mesopic PD might contribute to improved BCVA and enhanced visual quality after the use of scleral lenses.

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