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Effect of pupil size on uncorrected visual acuity in astigmatic eyes
  1. Kazutaka Kamiya1,
  2. Hidenaga Kobashi1,
  3. Kimiya Shimizu1,
  4. Takushi Kawamorita2,
  5. Hiroshi Uozato2
  1. 1Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa, Japan
  2. 2Department of Orthoptics and Visual Science, School of Allied Health Sciences, University of Kitasato, Kanagawa, Japan
  1. Correspondence to Kazutaka Kamiya, Department of Ophthalmology, University of Kitasato School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan; kamiyak-tky{at}


Aim To determine the effects of pupil size on uncorrected visual acuity (UCVA) in astigmatic eyes.

Methods The authors examined 20 normal eyes of 20 healthy volunteers (age 26.7±4.9 years (mean±SD); 8 men, 12 women). After fully correcting cycloplegic refraction, the authors created with-the-rule and against-the-rule astigmatism of 1, 2, and 3 dioptres (D) in each eye, and then assessed UCVA using artificial pupils (1 to 5 mm) in these astigmatic eyes. Measurements were performed three times, and the mean value was used for statistical analysis.

Results In eyes with with-the-rule astigmatism of 1, 2 and 3 D, logMAR UCVA was 0.04±0.08, 0.09±0.09 and 0.16±0.16 for 1 mm pupils, −0.01±0.09, 0.12±0.15 and 0.33±0.24 for 2 mm pupils, 0.02±0.09, 0.20±0.19 and 0.46±0.30 for 3 mm pupils, 0.02±0.08, 0.24±0.20 and 0.48±0.21 for 4 mm pupils, and 0.08±0.10, 0.33±0.18 and 0.53±0.22 for 5 mm pupils, respectively. The variance of the data was statistically significant (p=0.03 for 1 D, p<0.001 for 2 D, p<0.001 for 3 D, analysis of variance). Similar results were obtained in eyes with against-the-rule astigmatism.

Conclusions Both the amount of astigmatism and the pupil size can affect UCVA in astigmatic eyes. It is suggested that not only the amount of astigmatism but also the pupil size should be taken into consideration for acquiring better visual performance in astigmatic eyes.

  • Astigmatism
  • pupil size
  • visual acuity
  • optics and refraction
  • treatment surgery

Statistics from


  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Local Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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