Introduction: This study performs optical aberration assessment in patients using a novel ultra-high-resolution device. The objective of this study is to analyze optical aberrations, especially the very high order wavefront (more than 10th order of Zernike coefficients), and compare between keratoconus and healthy patients. Methods: In this cross-sectional study, we analyzed 43 eyes from 25 healthy patients and 43 eyes from 27 patients with keratoconus using corneal tomography and a very high-resolution (8.55 lm) aberrometer prototype (T-eyede) outfitted with a sensor originally developed for use in the field of astrophysics. Corneal aberration values were assessed using an optical model built with Zemax optical software, while ocular aberrations were assessed using T-eyede. In addition, image-processing analysis was performed of the wavefront phase, creating a highpass filter map. Results: We found lower values for ocular aberrations than corneal aberrations in both groups (p \ 0.001). Specifically, we found a reduction in primary astigmatism (0.145 lm) and primary coma (0.017 lm). Also, the keratoconus group showed significantly higher wavefront aberration values compared with controls (p \ 0.001). An analysis of the highpass filter map revealed 2 contrasting results: one smooth or clear, while the other presented a banding pattern. Almost all in the control group (95%) showed the first pattern, while 77% of the keratoconus group showed a banding pattern on the filtered map (chi-squared test, p \ 0.001). Conclusion: This device provides reliable, precise measurements of ocular aberrations that correlate well with corneal aberrations. Furthermore, the extraordinary high-resolution measurements revealed unprecedented micro changes in the wavefront phase of patients with keratoconus that varied with disease stage. These findings could lead to new screening or follow-up methods.

We present a method for evaluating the quality of optical glass using a high-resolution wavefront sensor, the wavefront phase imaging (WFPI) sensor. As shadowgraphy is a widely used method for inspecting striae in optical glass, it does not provide a quantitative metric that represents the potential optical quality of the glass and should be based on the operator’s experience. We compare the proposed method in two experiments. First, we compare it with the results obtained by shadowgraphy on a variety of samples. Second, we compare the results of a single-point chromatic confocal profilometer on a calibrated sample. The WFPI shows results comparable to the reference method in both cases but provides more information than shadowgraphy and avoids the human factor in the measurement.