Optical aberrations and alignment of the eye with age

We explored the relative changes in ocular, corneal, and internal aberrations associated with normal aging with special emphasis in the role of ocular alignment and lens shape factor in the balance of aberrations. Ocular and corneal aberrations together with the angle kappa were measured for a 5-mm pupil diameter in 46 eyes with low refractive errors and ages ranging between 20 and 77 years. The root mean square (RMS) of the higher order ocular and corneal aberrations increased with age at a rate of 0.0032 mu m/year and 0.0015 mu m/year, respectively. While in young eyes the partial compensation of aberrations by the internal surfaces was clear, no significant difference was found between corneal and ocular RMS in the older group. The ocular spherical aberration (0.0011 mu m/year) and horizontal coma (0.0017 mu m/year) increased moderately with age. This is not due to changes in the optical alignment, since angle kappa did not vary significantly with age. Age-related variations in the radii of curvature of the crystalline lens modify slightly its shape factor, reducing the compensation of lateral coma. This suggests that geometrical changes in the crystalline lens with age contribute to modify its aberration structure, reducing the compensation mechanism and explaining most of the measured increment of ocular aberrations with age.