ABSTRACT
This chapter explores the highly aberrated eye, discusses the state of the art associated with custom contact lens correction for the highly aberrated eye, and examines the challenges that limit the widespread availability of these custom lenses. In the context of contact lens correction, there are several conditions of the eye that tend to be frequently associated with high levels of optical aberration. The benefits associated with targeting higher-order aberration for correction in a custom contact lens have been demonstrated in a variety of forms on highly aberrated eyes. Widespread implementation of wavefront-guided corrections will be predicated on an ability to quantify the aberrations present in an eye. To reduce the impact of lens movement and flexure and to provide a more stable platform for customization, investigators began placing wavefront-guided optics in scleral contact lenses. When designing a wavefront-guided contact lens, it is important to first consider which aberrations will be integrated into the correcting optics.
