PONE-D-22-10607Correlation between higher-order aberration and photophobia after cataract surgeryPLOS ONE

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Reviewer #2: Yes

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Reviewer #2: Yes

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Reviewer #2: Yes

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Reviewer #1: Review of PONE-D-22-10607

In this well-written paper the authors describe a relationship between photophobia and higher order lens aberrations measured before and after cataract surgery. They show an anticipated reduction in glare following surgery, and a correlation between glare and higher order lens aberrations.

The authors need to say a little more about how they measured photophobia. “We scored photophobia from 0 (patient does not experience photophobia at all) to 10 (patient experiences severe photophobia to open eyes) … We asked patients to score the degree of photophobia on a sunny day…” There appears to have been little control over the viewing conditions, indeed patients appear to be scoring the photophobia from memory. Please specify exactly how photophobia was measured i.e. the wording of the questions used and the setting in which they were asked.

The authors acknowledge that large individual differences in self-reported glare occur despite identical “visual inputs”. Some individuals are more susceptible to uncomfortable sensations than others, and this is often related to headache susceptibility. Do the authors have information concerning headaches? Because the susceptibility to uncomfortable sensation varies with individual, the authors are correct to analyse the worst eye, but they refer to “35 of 41 eyes” as if the eyes are independent of the individual, which they are not.

The distinction between glare and photophobia needs to be elaborated a little. In particular it would be useful to know whether patients experienced pain. Photophobia often implies discomfort or pain, whereas glare usually implies impaired vision. The distinction is often made in terms of “discomfort glare” and “disability glare”. Were the patients reporting pain (photophobia) or simply glare? I suspect when the scores were low they were reporting disability glare, and when high both disability and discomfort glare. The authors have divided scores into zero and above zero. Is this an appropriate division? Were the high scores associated with headaches?

There are a few minor infelicities of English usage as follows:

“impinged spatial properties and wavelength distribution on retinal images.”

“decreased in postoperatively”

“alternation in photophobia” instead of alteration in photophobia

Reviewer #2: The manuscript describes a technically reliable scientific study with data supporting the conclusion. The study was carried out strictly with proper control, replication and sample size. This study draws appropriate conclusions based on the data provided.

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Reviewer #1: No

Reviewer #2: No

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Attachments

Attachment

Submitted filename: Review for PONE-D-22-10607-wy.docx

Correlation between higher-order aberration and photophobia after cataract surgery

PONE-D-22-10607R1

Dear Dr. Horiguchi,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Manuel Spitschan

Academic Editor

PLOS ONE

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