Optics of aberroscopy and super vision.

This paper (1) reviews the fundamental limits to visual performance imposed by optical imaging and photoreceptor sampling to determine the limits to the potential gains offered by ideal corrections; (2) examines the predicted losses in vision induced by chromatic aberration, phase shifts, typical ocular aberrations, and the gains possible by correcting the monochromatic aberrations of the eye; (3) discusses the principles of aberration measurement in the eye; and (4) presents methods for measuring and classifying monochromatic aberrations of the eye.

Power vector analysis of the optical outcome of refractive surgery.

PURPOSE: To demonstrate the power vector method of representing and analyzing spherocylindrical refractive errors. SETTING: School of Optometry, Indiana University, Bloomington, Indiana, USA. METHODS: Manifest and keratometric refractive errors were expressed as power vectors suitable for plotting as points in a 3-dimensional dioptric space. The 3 Cartesian coordinates (x, y, z) of each power vector correspond to the powers of 3 lenses that, in combination, fulfill a refractive prescription: a spherical lens of power M, a Jackson crossed cylinder of power J0 with axes at 90 degrees and 180 degrees, and a Jackson crossed cylinder of power J45 with axes at 45 degrees and 135 degrees. The Pythagorean length of the power vector, B, is a measure of overall blurring strength of a spherocylindrical lens or refractive error. Changes in refractive error due to surgery were computed by the ordinary rules of vector subtraction. RESULTS: Frequency distributions of blur strength (B) clearly demonstrate the effectiveness of refractive surgery in reducing the overall blurring effect of uncorrected refractive error. CONCLUSIONS: Power vector analysis also revealed a reduction in the astigmatic component of these refractive errors. Paired comparisons revealed that the change in manifest astigmatism due to surgery was well correlated with the change in keratometric astigmatism. Power vectors aid the visualization of complex changes in refractive error by tracing a trajectory in a uniform dioptric space. The Cartesian components of a power vector are mutually independent, which simplifies mathematical and statistical analysis of refractive errors. Power vectors also provide a natural link to a more comprehensive optical description of ocular refractive imperfections in terms of wavefront aberration functions and their description by Zernike polynomials.

Use of a Shack-Hartmann aberrometer to assess the optical outcome of corneal transplantation in a keratoconic eye.

We report the optical outcome of corneal transplantation treatment on a keratoconic eye as measured with a Shack-Hartmann aberrometer, and we compare the results with the recovery of visual acuity after surgery. Before surgery, the naked keratoconic eye exhibited extremely large aberrations that could not be measured unless the patient wore a rigid gas-permeable contact lens. With the lens, the computed point-spread function of the eye was large and multimodal, and simulated retinal images confirmed the patient's subjective report of multiple, overlapping images. After full recovery from surgery, aberrations of the corrected eye were much smaller compared with the presurgical eye, which implied a more compact point-spread function and clearer retinal images. These optical changes were mirrored by an improvement in uncorrected visual acuity from 1.3 logarithm of the minimum angle of resolution (logMAR) before surgery to 0 logMAR with spectacle correction after full recovery. We conclude that the Shack-Hartmann aberrometer provides an objective, quantitative assessment of the optical outcome of penetrating keratoplasty that allows the clinician to measure retinal image quality objectively and to accurately simulate the complex visual distortions associated with keratoconus.

On-eye evaluation of optical performance of rigid and soft contact lenses.

A Shack-Hartmann aberrometer was used to assess the optical performances of eyes corrected with rigid or soft contact lenses compared with spectacles. Metrics of optical quality derived from the measured wave aberrations were consistent with the subjective rating of visual clarity by subjects. Optical aberration analysis illustrated the differences in aberration structures of eyes wearing different optical corrections. For our subjects, correction with a rigid gas-permeable lens yielded significantly better optical quality than did the soft contact lens or spectacle lens. This was due to a reduction in the eye's asymmetric (odd-order) aberrations and a reduction in the amount of the eye's positive spherical aberration. These observations can be explained by theoretical calculations of the aberrations of the eye plus lens optical system. We conclude that aberrometry provides a better understanding of the optical effects of contact lenses in situ and could be useful for optimizing future designs of contact lenses.

Optical and visual impact of tear break-up in human eyes.

PURPOSE: The purpose of this study was to examine the optical and visual impact of tear break-up. METHODS: Optical quality of the eye was assessed during periods of nonblinking by quantifying vessel contrast in the fundus image and by monitoring the psychophysical contrast sensitivity and the spatial distribution of tear thickness changes by retroillumination. All measures were obtained from three eyes either with or without a soft contact lens. RESULTS: A noticeable decrease in retinal vessel contrast and contrast sensitivity were observed soon after a blink. Both of these measures of optical quality of the eye showed a similar pattern of image degradation both with and without a soft contact lens. Although trial-to-trial variability was considerable, sample means show that image contrast in the low spatial frequency range can drop to between 20% and 40% of initial values after 60 seconds of nonblinking. Retroillumination of the tear film showed local intensity fluctuations that progressively spread across the pupil with increasing time after the blink. CONCLUSIONS: Optical aberrations created by tear break-up contribute to the decline in image quality observed objectively and psychophysically. The decline in image quality that accompanies tear break-up may be a direct cause of the blurry vision complaints commonly encountered in dry-eye patients.

Longitudinal evaluation of optical aberrations following laser in situ keratomileusis surgery.

Objective measurements of the optical aberrations of an eye were taken with a Shack-Hartmann aberrometer immediately before, immediately after, and at regular intervals over a two month recovery period following LASIK refractive surgery. Results indicate that the surgery induced large amounts of positive spherical aberration which regressed slightly during recovery. Computed point-spread functions for various pupil diameters indicate that retinal image quality was the same before and after surgery for small and medium sized pupils (<4 mm diameter) but was significantly degraded for large pupils (>4 mm).

Reference axis selection: subcommittee report of the OSA Working Group to establish standards for measurement and reporting of optical aberrations of the eye.

It is the committee's recommendation that the ophthalmic community use the line of sight as the reference axis for the purposes of calculating and measuring the ocular optical aberrations.

Clinical applications of the Shack-Hartmann aberrometer.

The efficacy of the Shack-Hartmann technique for measuring the optical aberrations of the eye was evaluated for four classes of clinical conditions associated with optically abnormal eyes. These categories (with specific examples) are: anomalies of the tear film (dry eye), corneal disease (keratoconus), corneal refractive surgery [laser-assisted in situ keratomileusis (LASIK)], and lenticular cataract. We show that in each of these cases, it is possible to obtain at least a partial topographic map of the refractive aberrations of the patient's eyes, but severe losses of data integrity can occur. We further show that the Shack-Hartmann aberrometer provides additional information about the eye's imperfections on a very fine spatial scale (< 0.4 mm) which scatter light and further degrade the quality of the retinal image. Taken together, spatial maps of the variation of optical aberrations and scatter across the eye's entrance pupil represents an improved description of the optical imperfections of the abnormal eye.

Relationship between acuity for gratings and for tumbling-E letters in peripheral vision.

Earlier studies have reported that grating resolution is sampling-limited in peripheral vision but that letter acuity is generally poorer than grating acuity. These results suggest that peripheral resolution of objects with rich Fourier spectra may be limited by some factor other than neural sampling. To examine this suggestion we formulated and tested the hypothesis that letter acuity in the periphery is sampling-limited, just as it is for extended and truncated gratings. We tested this hypothesis with improved methodology to avoid the confounding factors of target similarity, alphabet size, individual variation, peripheral refractive error, and stimulus size. Acuity was measured for an orientation-discrimination task (horizontal versus vertical) for a three-bar resolution target and for a block-E letter in which all strokes have the same length. We confirmed previous reports in the literature that acuity for these targets is worse than for extended sinusoidal gratings. To account for these results quantitatively, we used difference-spectrum analysis to identify those frequency components of the targets that might form a basis for performing the visual discrimination task. We find that discrimination performance for the three-bar targets and the block-E letters can be accounted for by a sampling-limited model, provided that the limited number of cycles that are present in the characteristic frequency of the stimulus is taken into account. Quantitative differences in acuity for discriminating other letter pairs (e.g., right versus left letters E or characters with short central strokes) could not be attributed to undersampling of either the characteristic frequency or the frequency of maximum energy in the difference spectrum. These results suggest additional tests of the sampling theory of visual resolution, which are the subject of a companion paper.

Sampling limits and critical bandwidth for letter discrimination in peripheral vision.

We develop and test two functional hypotheses based on the sampling theory of visual resolution that might account for letter acuity in peripheral vision. First, a letter smaller than the acuity limit provides insufficient veridical energy for performing the task, and, second, the available veridical energy is masked by increased amounts of visible but aliased energy. These two hypotheses make opposite predictions about the effect of low-pass filtering on letter acuity, which we tested experimentally by using filtered letters from the tumbling-E alphabet. Our results reject the masking hypothesis in favor of the energy insufficiency hypothesis. Additional experiments in which high-pass-filtered letters were used permitted the isolation of a critical band of spatial frequencies, which is necessary and sufficient for achieving maximum visual acuity. This critical band varied with the particular pair of letters to be discriminated but was in the range 0.9-2.2 cycles per letter.

Comparison of the eye's wave-front aberration measured psychophysically and with the Shack-Hartmann wave-front sensor.

The Shack-Hartmann wave-front sensor offers many theoretical advantages over other methods for measuring aberrations of the eye; therefore it is essential that its accuracy be thoroughly tested. We assessed the accuracy of a Shack-Hartmann sensor by directly comparing its measured wave-front aberration function with that obtained by the Smirnov psychophysical method for the same eyes. Wave-front profiles measured by the two methods agreed closely in terms of shape and magnitude with rms differences of approximately lambda/2 and approximately lambda/6 (5.6-mm pupil) for two eyes. Primary spherical aberration was dominant in these profiles, and, in one subject, secondary coma was opposite in sign to primary coma, thereby canceling its effect. Discovery of an unusual, subtle wave-front anomaly in one individual further demonstrated the accuracy and sensitivity of the Shack-Hartmann wave-front sensor for measuring the optical quality of the human eye.

Acuity perimetry and the sampling theory of visual resolution.

Visual resolution is limited by neural sampling of the retinal image everywhere in the visual field except the fovea, where optical limitations usually dominate. Consequently, measurements of resolution acuity may be interpreted as estimates of the spatial density of the mosaic of photoreceptors (in parafoveal retina) or ganglion cells (in peripheral retina) of the living human eye. Recent experiments in the basic visual sciences have paved the way for clinical applications of this approach to the problem of detecting the loss of photoreceptors and ganglion cells during aging and in a variety of retinal diseases.

Entoptic image quality of the retinal vasculature.

Spatial details of entoptically visible retinal vessels were investigated using transcleral and Maxwellian-view stimulators. Nine normal subjects provided detailed drawings of the entoptic images which were digitized and superimposed onto digitized fundus photographs and fluorescein angiograms from the same eyes. Subjects also used a tracing method to locate visible entoptic features. The trans-scleral method provided images similar in detail to standard fundus photography (lacking capillary detail, but capturing larger arteries, veins, arterioles and venules) in the macula and around the disk. The Maxwellian-view method illuminated the fovea (7.7 degree field) and provided foveola capillary detail (capillaries traversing the foveola, the capillary arcade forming the FAZ) as well as the larger foveal vessels supplying the foveola, and often contained more foveal detail that available with fluorescein angiography.

Interaction between sub- and supra-Nyquist spatial frequencies in peripheral vision.

In peripheral vision, high-frequency gratings beyond the Nyquist limit are visible as aliased patterns but, as shown previously, their visibility can be masked by superimposed sub-Nyquist gratings. Is the converse also true? Can supra-Nyquist gratings affect the detectability of sub-Nyquist gratings? In this study, we investigated the masking effect of high contrast, supra-Nyquist components of a compound grating on the contrast detection of sub-Nyquist components by employing a temporal three-alternative, forced-choice (3AFC) masking paradigm. We found that high-frequency, aliased gratings with contrast just 2 or 3 times above threshold can have a powerful masking effect on low-frequency, resolved gratings in peripheral vision. This result was surprising because prior results from sub-Nyquist masking studies in the fovea and the periphery have indicated that masking occurs only when the mask contrast is at least 5 times greater than threshold. Strong masking by supra-Nyquist gratings that are only just visible may be accounted for by an irregular sampling model in which the alias of the mask is distributed over a band of frequencies in the sub-Nyquist range. Furthermore, if undersampling is the explanation for the results of this study, then masking must occur after spatial sampling.

Effects of refractive error on detection acuity and resolution acuity in peripheral vision.

PURPOSE: To evaluate the effect of refractive error on detection acuity and resolution acuity in peripheral vision. METHODS: Detection acuity, defined as the highest spatial frequency for which luminance gratings can be discriminated from a uniform field, and resolution acuity, defined as the highest spatial frequency for which spatial patterns are perceived veridically, was determined for vertical and horizontal gratings located at 20 degrees, 30 degrees, and 40 degrees of eccentricity. Resolution was also measured for tumbling-E discrimination at these locations. Refractive state of the eye for test targets was manipulated by introducing an ophthalmic trial lens into the line of sight for the stimulus while holding accommodative state fixed. RESULTS: Detection acuity in the periphery varied significantly with the amount of optical defocus, whereas acuity for grating resolution or letter discrimination was unaffected by defocus over a large range (up to 6 D). These results are consistent with the working hypothesis that detection acuity in the periphery is limited by contrast insufficiency under normal viewing conditions, but resolution is limited by ambiguity because of neural undersampling. CONCLUSIONS: The large depth of focus for resolution acuity measured for peripheral vision indicates that spatial resolution is likely to remain sampling-limited even when peripheral refractive errors are not fully corrected, thus relaxing the methodologic requirements for obtaining noninvasive estimates of neural sampling density of the living eye in a clinical setting.