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.
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