We present a new adaptive optics visual simulator (AOVS), allowing to both measure and manipulate the optical aberrations of the eye of any patient, including those with large refractive errors. The instrument incorporates a Hartmann-Shack wavefront sensor (HS), a liquid crystal on silicon spatial light modulator (LCOS-SLM), and a variable lens. A motorized diaphragm with a variable diameter ranging from 0.5 to 8.2 mm was incorporated at the exit pupil plane of the instrument, permitting visual testing for any pupil size. Presenting of visual stimuli was done using a high definition digital light processing projector (DLP), which provided provided bright, realistic visual conditions, enabling photopic vision. The AO visual simulator has been successfully proved in real subjects, including those exhibiting moderate and high levels of myopia. The AOVS was successfully tested in different subjects, including those exhibiting moderate and high levels of myopia. Aberrations were measured with the HS after pre-compensation of defocus with the variable lens, and LCOS-SLM corrected for the rest of aberrations. This visual simulator could be used in most patients, irrespectively of their refraction or the amount of aberrations.
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