To evaluate the changes of higher order aberration according to tear-film instability measured serially by KR-1W wavefront every second for 10 seconds. The present study also analyzed the relationship between higher order aberration and the tear-film break-up time, Schirmer test, and superficial punctate keratitis.

The 228 eyes of 114 patients randomly selected from patients who visited hospital were measured once every second for 10 seconds after eye blinking by continuous measurement using wavefront.

Higher order aberration increased overtime, and the higher order aberration value measured at the tenth second subtracted from the value of the first second was statistically significant ( p = 0.004). In addition, the increment in higher order aberration between 9 seconds and 10 seconds was statistically significant ( p = 0.01). The group of patients with a tear-film break-up time less than 6 seconds showed the greatest changes when measuring the higher order aberration difference value between the tenth and first seconds, which was statistically significant ( p = 0.002). The group of patients where the Schirmer test results were longer than 10 millimeters and who had superficial punctate keratitis showed the greatest statistically significant changes when measuring the difference in higher order aberration values between the tenth and first seconds ( p = 0.008, p = 0.005, respectively).

Analysis of higher order aberration by wavefront could be useful in cases of decreased optical quality, diagnosis and evaluation of treatment in dry eye syndrome.