- •Contents
- •General Introduction
- •Objectives
- •1 Geometric Optics
- •Rays, Refraction, and Reflection
- •Introduction
- •Point Sources, Pencils, and Beams of Light
- •Object Characteristics
- •Image Characteristics
- •Magnification
- •Image Location
- •Depth of Focus
- •Image Quality
- •Light Propagation
- •Optical Media and Refractive Index
- •Law of Rectilinear Propagation
- •Optical Interfaces
- •Law of Reflection (Specular Reflection)
- •Law of Refraction (Specular Transmission)
- •Normal Incidence
- •Total Internal Reflection
- •Dispersion
- •Reflection and Refraction at Curved Surfaces
- •The Fermat Principle
- •Pinhole Imaging
- •Locating the Image: The Lensmaker’s Equation
- •Ophthalmic Lenses
- •Vergence
- •Reduced Vergence
- •Thin-Lens Approximation
- •Lens Combinations
- •Virtual Images and Objects
- •Focal Points and Planes
- •Paraxial Ray Tracing Through Convex Spherical Lenses
- •Paraxial Ray Tracing Through Concave Spherical Lenses
- •Objects and Images at Infinity
- •Principal Planes and Points
- •Section Exercises
- •Focal Lengths
- •Gaussian Reduction
- •Knapp’s Law, the Badal Principle, and the Lensmeter
- •Afocal Systems
- •Section Exercises
- •Questions
- •Power of a Lens in a Medium
- •Spherical Interface and Thick Lenses
- •Thick Lens
- •Back Vertex Power Is Not True Power
- •Aberrations of Ophthalmic Lenses
- •Third-Order Seidel Aberrations
- •Chromatic Aberrations
- •Avoiding Aberrations
- •Mirrors
- •Reflection From a Plane Mirror
- •Spherically Curved Mirrors
- •Reversal of the Image Space
- •The Central Ray for Mirrors
- •Vergence Calculations for Mirrors
- •Spherocylindrical Lenses
- •Combination of Spherocylindrical Lenses
- •The Conoid of Sturm
- •The Jackson Cross Cylinder
- •Prisms
- •Prism Diopter
- •Prismatic Effect of Lenses and the Prentice Rule
- •Prism Aberrations
- •Fresnel Prisms
- •Chapter Exercises
- •Questions
- •Appendix 1.1
- •Quick Review of Angles, Trigonometry, and the Pythagorean Theorem
- •Appendix 1.2
- •Light Properties and First-Order Optics
- •2 Optics of the Human Eye
- •The Human Eye as an Optical System
- •Schematic Eyes
- •Important Axes of the Eye
- •Pupil Size and Its Effect on Visual Resolution
- •Visual Acuity
- •Contrast Sensitivity and the Contrast Sensitivity Function
- •Refractive States of the Eyes
- •Binocular States of the Eyes
- •Accommodation and Presbyopia
- •Epidemiology of Refractive Errors
- •Developmental Myopia
- •Developmental Hyperopia
- •Prevention of Refractive Errors
- •Chapter Exercises
- •Questions
- •3 Clinical Refraction
- •Objective Refraction Technique: Retinoscopy
- •Positioning and Alignment
- •Fixation and Fogging
- •The Retinal Reflex
- •The Correcting Lens
- •Finding Neutrality
- •Retinoscopy of Regular Astigmatism
- •Aberrations of the Retinoscopic Reflex
- •Subjective Refraction Techniques
- •Astigmatic Dial Technique
- •Stenopeic Slit Technique
- •Cross-Cylinder Technique
- •Refining the Sphere
- •Binocular Balance
- •Cycloplegic and Noncycloplegic Refraction
- •Overrefraction
- •Spectacle Correction of Ametropias
- •Spherical Correcting Lenses and the Far Point Concept
- •The Importance of Vertex Distance
- •Cylindrical Correcting Lenses and the Far Point Concept
- •Prescribing for Children
- •Myopia
- •Hyperopia
- •Anisometropia
- •Clinical Accommodative Problems
- •Presbyopia
- •Accommodative Insufficiency
- •Accommodative Excess
- •Accommodative Convergence/Accommodation Ratio
- •Effect of Spectacle and Contact Lens Correction on Accommodation and Convergence
- •Prescribing Multifocal Lenses
- •Determining the Add Power of a Bifocal Lens
- •Types of Bifocal Lenses
- •Trifocal Lenses
- •Progressive Addition Lenses
- •The Prentice Rule and Bifocal Lens Design
- •Occupation and Bifocal Segment
- •Prescribing Special Lenses
- •Aphakic Lenses
- •Absorptive Lenses
- •Special Lens Materials
- •Therapeutic Use of Prisms
- •Chapter Exercises
- •Questions
- •Appendix 3.1
- •Common Guidelines for Prescribing Cylinders for Spectacle Correction
- •4 Contact Lenses
- •Introduction
- •Contact Lens Glossary
- •Clinically Important Features of Contact Lens Optics
- •Field of Vision
- •Image Size
- •Accommodation
- •Convergence Demands
- •Tear Lens
- •Correcting Astigmatism
- •Correcting Presbyopia
- •Contact Lens Materials and Manufacturing
- •Materials
- •Manufacturing
- •Patient Examination and Contact Lens Selection
- •Patient Examination
- •Contact Lens Selection
- •Contact Lens Fitting
- •Soft Contact Lenses
- •Rigid Gas-Permeable Contact Lenses
- •Toric Soft Contact Lenses
- •Contact Lenses for Presbyopia
- •Keratoconus and the Abnormal Cornea
- •Contact Lens Overrefraction
- •Gas-Permeable Scleral Contact Lenses
- •Therapeutic Lens Usage
- •Orthokeratology and Corneal Reshaping
- •Custom Contact Lenses and Wavefront Technology
- •Contact Lens Care and Solutions
- •Contact Lens–Related Problems and Complications
- •Infections
- •Hypoxic/Metabolic Problems
- •Toxicity
- •Mechanical Problems
- •Inflammation
- •Chapter Exercises
- •Questions
- •Appendix 4.1
- •Transmission of Human Immunodeficiency Virus in Contact Lens Care
- •Appendix 4.2
- •Federal Law and Contact Lenses
- •5 Intraocular Lenses
- •Intraocular Lens Designs
- •Classification
- •Background
- •Optical Considerations for Intraocular Lenses
- •Intraocular Lens Power Calculation
- •Piggyback and Supplemental Intraocular Lenses
- •Intraocular Lens Power Calculation After Corneal Refractive Surgery
- •Instrument Error
- •Index of Refraction Error
- •Formula Error
- •Power Calculation Methods for the Post–Keratorefractive Procedure Eye
- •Intraocular Lens Power in Corneal Transplant Eyes
- •Silicone Oil Eyes
- •Pediatric Eyes
- •Image Magnification
- •Lens-Related Vision Disturbances
- •Nonspherical Optics
- •Multifocal Intraocular Lenses
- •Types of Multifocal Intraocular Lenses
- •Clinical Results of Multifocal Intraocular Lenses
- •Accommodating Intraocular Lenses
- •Intraocular Lens Standards
- •Chapter Exercises
- •Questions
- •Appendix 5.1
- •History of Intraocular Lens Design
- •6 Optical Considerations in Keratorefractive Surgery
- •Corneal Shape
- •Angle Kappa
- •Pupil Size
- •Irregular Astigmatism
- •Application of Wavefront Analysis in Irregular Astigmatism
- •Causes of Irregular Astigmatism
- •Conclusion
- •Chapter Exercises
- •Questions
- •7 Optical Instruments and Low Vision Aids
- •Magnification
- •Telescopes
- •Galilean Telescope
- •Astronomical Telescope
- •Accommodation Through a Telescope
- •Surgical Loupe
- •General Principles of Optical Engineering
- •Terminology
- •Measurements of Performance of Optical Systems
- •Optical Instruments and Techniques Used in Ophthalmic Practice
- •Direct Ophthalmoscope
- •Indirect Ophthalmoscope
- •Fundus Camera
- •Slit-Lamp Biomicroscope
- •Gonioscopy
- •Surgical Microscope
- •Geneva Lens Clock
- •Lensmeter
- •Knapp’s Rule
- •Optical Pachymeter
- •Applanation Tonometry
- •Specular Microscopy
- •Keratometer
- •Topography
- •Ultrasonography of the Eye and Orbit
- •Macular Function Tests
- •Scanning Laser Ophthalmoscopes
- •Scheimpflug Camera
- •Autorefractors
- •Optical Coherence Tomography
- •Optical Aids
- •Magnifiers
- •Telescopes
- •Prisms
- •High-Add Spectacles
- •Nonoptical Aids
- •Electronic Devices
- •Lighting, Glare Control, and Contrast Enhancement
- •Nonvisual Assistance
- •Eccentric Viewing or Fixation Training
- •Instruction and Training
- •Chapter Exercises
- •Questions
- •Appendix 7.1
- •Approach to the Patient With Low Vision
- •8 Physical Optics
- •The Corpuscular Theory of Light
- •Diffraction
- •The Speed of Light
- •The Superposition of Waves
- •Coherence
- •Electromagnetic Waves
- •Polarization
- •Refractive Index and Dispersion
- •Reflection, Transmission, and Absorption
- •The Electromagnetic Spectrum
- •Frequency and Color
- •Energy in an Electromagnetic Wave
- •Quantum Theory
- •Light Sources
- •Thermal Sources
- •Luminescent Sources
- •Fluorescence
- •Phosphorescence
- •Lasers
- •Light–Tissue Interactions
- •Photocoagulation
- •Photoablation
- •Photodisruption
- •Photoactivation
- •Light Scattering
- •Rayleigh Scattering
- •Mie Scattering
- •The Tyndall Effect
- •Radiometry and Photometry
- •Light Hazards
- •Clinical Applications
- •Polarization
- •Interference
- •Diffraction
- •Imaging and the Point Spread Function
- •Image Quality—Modulation Transfer Function
- •Chapter Exercises
- •Questions
- •Appendix 8.1
- •Radiometric and Photometric Units
- •Basic Texts
- •Related Academy Materials
- •Requesting Continuing Medical Education Credit
Basic Texts
Clinical Optics
Albert DM, Miller JW, Azar DT, Blodi BA, eds. Albert & Jakobiec’s Principles and Practice of Ophthalmology. 4 vols. 3rd ed. Philadelphia: Elsevier/Saunders; 2008.
Campbell CJ. Physiological Optics. Hagerstown, MD: Harper & Row; 1974.
Corboy JM. The Retinoscopy Book: An Introductory Manual for Eye Care Professionals. 5th ed. Thorofare, NJ: Slack; 2003.
Duke-Elder S, Abrams D. Ophthalmic Optics and Refraction. St Louis: Mosby; 1970. System of Ophthalmology; vol 5.
Michaels DD. Visual Optics and Refraction: A Clinical Approach. 3rd ed. St Louis: Mosby; 1985. Milder B, Rubin ML. The Fine Art of Prescribing Glasses Without Making a Spectacle of Yourself.
3rd ed. Gainesville, FL: Triad; 2004.
Rubin ML. Optics for Clinicians. Gainesville, FL: Triad; 1993.
Stein HA, Slatt BJ, Stein RM, Freeman MI. Fitting Guide for Rigid and Soft Contact Lenses: A Practical Approach. 4th ed. St Louis: Mosby; 2002.
Tasman W, Jaeger EA, eds. Duane’s Ophthalmology on DVD-ROM. Philadelphia: Lippincott Williams & Wilkins; 2012.
Yanoff M, Duker JS. Ophthalmology: Expert Consult Premium Edition. 3rd ed. St Louis: Mosby; 2009.
Related Academy Materials
The Academy is dedicated to providing a wealth of high-quality clinical education resources for ophthalmologists.
Print Publications and Electronic Products
For a complete listing of Academy products related to topics covered in this BCSC Section, visit our online store at http://store.aao.org/clinical-education/topic/comprehensive-ophthalmology.html. Or call Customer Service at 866.561.8558 (toll free, US only) or +1 415.561.8540, Monday through Friday, between 8:00 AM and 5:00 PM (PST).
Online Resources
Visit the Ophthalmic News and Education (ONE®) Network at http://www.aao.org/clinical-education to find relevant videos, online courses, journal articles, practice guidelines, self-assessment quizzes, images and more. The ONE Network is a free Academy-member benefit.
Access free, trusted articles and content with the Academy’s collaborative online encyclopedia, EyeWiki, at http://eyewiki.org/Main_Page.
Requesting Continuing Medical Education Credit
The American Academy of Ophthalmology is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The American Academy of Ophthalmology designates this enduring material for a maximum of 15 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The American Medical Association requires that all learners participating in activities involving enduring materials complete a formal assessment before claiming continuing medical education (CME) credit. To assess your achievement in this activity and ensure that a specified level of knowledge has been reached, a posttest for this Section of the Basic and Clinical Science Course is provided online. A minimum score of 80% must be obtained to pass the test and claim CME credit.
To take the posttest and request CME credit online:
1.Go to www.aao.org/cme and log in.
2.Click on “Claim CME Credit and View My CME Transcript” and then “Report AAO Credits.”
3.Select the appropriate Academy activity. You will be directed to the posttest.
4.Once you have passed the test with a score of 80% or higher, you will be directed to your transcript. If you are not an Academy member, you will be able to print out a certificate of participation once you have passed the test.
CME expiration date: June 1, 2016. AMA PRA Category 1 Credits™ may be claimed only once between June 1, 2013, and the expiration date.
For assistance, contact the Academy’s Customer Service department at 866-561-8558 (U.S. only) or 415-561-8540 between 8:00 AM and 5:00 PM (PST), Monday through Friday, or send an e-mail to customer_service@aao.org.
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