Estimating visual quality from wavefront aberration measurements

PURPOSE: Root mean square (RMS) wavefront error may not be the best metric for predicting a patient's visual function; other metrics should be considered. We describe the most important metrics of optical quality, which are being investigated to predict vision quality and visual performance. METHODS: Optical quality can be described in two different ways. Pupil plane metrics describe variability of the wavefront error at the pupillary plane (eg, RMS wavefront error). Image plane metrics describe the retinal image and do so for either a point source of light (eg, point-spread function [PSF]) or sinusoidal gratings (optical transfer function [OTF]). Visual quality metrics, however, must also consider neural processing and subjective perception. RESULTS: Since vision is more sensitive to rays coming from the center of the pupil, "pupil fraction" appears to be a better predictor of visual acuity (r(2) = 0.50) than RMS error (r(2) = 0.13). However, image plane metrics, such as the visual Strehl ratio (r(2) = 0.62) and the volume between the optical transfer function and neural contrast sensitivity function. (r(2) = 0.80) appear to be even better. CONCLUSION: Visual perception is highly subjective and involves many aspects of image quality. A single metric to describe all aspects of image quality may be unrealistic. Nevertheless, improved visual quality metrics need further investigation and will likely involve preferential weighing of light passing through the central area of the pupil and/or incorporating neural factors into image quality computation.