Optical disks are read out by focusing a beam of high numerical aperture (NA) through the substrate. Deviations of the thickness from the nominal value result in spherical aberration; tilting the substrate results in coma. Exact analytical expressions for the rms aberration per micrometer thickness mismatch (for spherical aberration) and per degree tilt (for coma) are derived. The paraxial estimates for these sensitivities proportional to NA4 (spherical aberration) and NA3 (coma) underestimate the exact values by a factor of approximately 2 for the value NA = 0.85, corresponding to the new Blu-ray disk format. Expansion of the aberration function in Zernike aberrations shows that the exact aberration functions are well described by the lowest-order Zernike spherical aberration (A40) and coma (A31) term for all but the very highest NA values.