Using a statistical description of keratoconus (KC) topography, schematic eye models of various KC conditions are constructed to study their optical influence on visual performance. The cone shape, protruding height and extent, and distance from the visual zone are independently investigated with the three-dimensional optical eye-modeling and ray-tracing techniques. The subsequent spherical equivalent (SE), cylinder, together with residual high-order ocular aberrations, are examined and related to each separated variable. The results show that myopic nature of SE is greatly dominated by the location of the cone. The cylinder is determined by the cone shape when the cone is inside the visual zone. It is dominated by the cone location when the cone is away from visual axis. The least myopic meridian always falls on the cone direction, and the high-order aberrations strongly relate to the cone dimension. This study investigates KC cone effect on optical quality and provides comprehension of clinical observations.
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