Metrics of optical quality derived from wave aberrations predict visual performance

Wavefront-guided refractive surgery and custom optical corrections have reduced the residual root mean squared (RMS) wavefront error in the eye to relatively low levels (typically on the order of 0.25 mum or less over a 6-mm pupil, a dioptric equivalent of 0.19 D). It has been shown that experimental variation of the distribution of 0.25 pm of wavefront error across the pupil can cause variation in visual acuity of two lines on a standard logMAR acuity chart. This result demonstrates the need for single-value metrics other than RMS wavefront error to quantify the effects of low levels of aberration on acuity. In this work, we present the correlation of 31 single-value metrics of optical quality to high-contrast visual acuity for 34 conditions where the RMS wavefront error was equal to 0.25 mum over a 6-mm pupil. The best metric, called the visual Strehl ratio, accounts for 81% of the variance in high-contrast logMAR acuity.