As Dr. Goggin indicates, we used internal astigmatism to designate the vectorial difference between refractive and corneal astigmatism. We referenced the description of this astigmatic difference by Alpins in 1997, which was called ocular residual astigmatism (ORA).1 However, we used internal astigmatism instead of ORA. One reason for this was the recommendation of a reviewer of the paper who did not agree with the use of the acronym ORA because of potential confusion with the commercial name of the device used for characterizing corneal biomechan-ical properties, the Ocular Response Analyzer.
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