Evidence map›Paper›PMID 39396112›Full record

ArticleOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)2025

Non-orthogonal spectacle correction for irregular astigmatism.

Adela Hulpus, Ritchie Henry, Lynn White, Bernardo T Lopes, Vito Romano, Ahmed Abass

Abstract read
In one paragraph

Article in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Principles of a Non-orthogonal Optical Surface with Potential for Correction of Irregular Astigmatism.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026
    Article
  2. Article
  3. Non-orthogonal spectacle correction for irregular astigmatism.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Adela HulpusSt Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
Ritchie HenrySt Pauls Eye Unit, Royal Liverpool University Hospital, Liverpool, UK.
Lynn WhiteDepartment of Research and Development, LWVision, Leicestershire, UK.
Bernardo T LopesOphthalmology Eye Clinic, Alder Hey Children's NHS Foundation Trust, Liverpool, UK.
Vito RomanoDepartment of Medical and Surgical Specialties, Radiological Sciences, and Public Health, Ophthalmology Clinic, University of Brescia, Brescia, Italy.
Ahmed AbassDepartment of Materials, Design and Manufacturing Engineering, School of Engineering, University of Liverpool, Liverpool, UK.ORCID 0000-0002-8622-4632

Funding

Fight for Sight and the UK Keratoconus Self-Help and Support Association 24KE20
6 · The paper itself

Abstract

purposeTo investigate the potential improvement in visual acuity and subjective perception of image quality in patients with keratoconus using non-orthogonal correction (NOC) cylinder trial lenses where the steep and flat power meridians are set at angles less or greater than 90°.

methodsA set of NOC plano/cylindrical trial lenses, where the axes between the power meridians were set at a range of non-orthogonal angles, were used to refract 18 participants with keratoconus in whom 23 eyes were used for testing. Corneal elevation data were processed by bespoke MATLAB code from Pentacam Scheimpflug tomographer scans. Each participant first underwent subjective refraction using standard orthogonal cylinder trial lenses, and the monocular best-corrected visual acuity (BCVA, logMAR) was recorded for each eye. They then underwent a second subjective refraction using NOC cylinder trial lenses created for the study and completed a questionnaire to elicit their subjective appraisal of letter clarity and ghosting.

resultsFourteen (61%) eyes demonstrated an increase in objective BCVA with the NOC versus the orthogonal correction; seven (30%) eyes showed no change and in two (9%) eyes, the BCVA was slightly worse. Further, 87% and 79% experienced an increase in letter clarity and a reduction in ghosting, respectively, independent of changes in BCVA. The majority of non-orthogonal angles were in the range of 80°-85°, and it was possible to refine the cylinder and axis of the NOC further compared with the orthogonal correction. All but one of the participants said they would be interested in trying non-orthogonal spectacles if the opportunity arose.

conclusionsCorrecting irregular astigmatism in keratoconic individuals with non-orthogonal spectacle correction may provide benefit in terms of increased visual acuity, improvements in letter clarity and a reduction of ghosting effects. This type of correction has the potential to improve the overall quality of life for patients with keratoconus.

Indexed as

AstigmatismCorneal TopographyEyeglassesKeratoconusRefraction, OcularVisual AcuityAdultFemaleHumansMaleYoung Adultastigmatismcorneanon‐orthogonal astigmatismoptical power

Identifiers

PMID39396112
PMCPMC11629853

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.