PURPOSE: To illustrate the utility of wavefront aberrometry in delineating a subtle lenticular abnormality responsible for decreased best-corrected visual acuity in a patient. DESIGN: Case report. METHODS: Clinical data, corneal topography, and wavefront aberrometry with separation of corneal and lenticular components of the higher-order aberrations are analyzed in a patient who presented for refractive surgery evaluation. RESULTS: Clinical evaluation indicated that the cause of visual loss was lenticular, and wavefront aberrometry indicated high negative spherical aberration, leading to the diagnosis of anterior lenticonus. CONCLUSIONS: Wavefront aberrometry has an adjunctive and distinctive role in the preoperative screening process for refractive surgery candidates and in those with subtle unexplained loss of best-corrected visual acuity.
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