Aberropia leads to decrease in image quality due to higher order aberrations (HOA). Correction of these HOA poses a great challenge to clinicians. A case report is presented here where a 30 year old male visited with complaints of cloudy vision, diplopia in reduced illumination along with inferior vertical elongation of light during night time in the right eye since 6 years. The unaided visual acuity was found to be 0.0 Log MAR units and near acuity was N6. The patient did not accept any correction in subjective refraction. The aberrometry findings revealed vertical trefoil and vertical coma of −0.33 μm and 0.53 μm in the right eye and −0.07 μm and 0.12 μm in the left eye. Orbscan revealed a difference of 30 μm and 25 μm between the anterior and posterior float for the right and left eye respectively. Due to the significant increase in irregular astigmatism, vertical coma and vertical trefoil in the right eye, rigid gas permeable lenses and Rose K lenses were tried, but the symptoms did not reduce. This was due to the increase in posterior corneal astigmatism as the posterior float was more than 25 μm in the right eye which led to a diagnosis of early keratoconus. As the decrease in pupil size reduces HOA, a pin hole (2.5 mm pupil) soft contact lens was tried which reduced the symptoms. Hence a novel method is proposed to eliminate HOA which corrects aberropia by using pin hole soft contact lenses.
