- •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
cm (one-fourth meter) from the eye without the magnifier (Fig 7-2). Assuming small angles, we therefore divide the focal length of the lens by 4. Thus, a +10 D lens is considered a 2.5× magnifier and is held one-tenth of a meter, its focal length, from the object of interest. Note that rays coming from the object leave the magnifier with zero vergence, so that the user of the magnifier can gaze through it from any distance she prefers.
Figure 7-1 A plus lens used to view an object positioned in the focal plane of the lens. O = object; f = focal length. (Redrawn
from Basic and Clinical Science Course Section 2: Optics, Refraction, and Contact Lenses. San Francisco: American Academy of Ophthalmology; 1986–1987:73. Fig 43.)
Figure 7-2 The reference viewing distance of 25 cm, used in the definition of magnification of simple magnifiers. (Redrawn
from Basic and Clinical Science Course Section 2: Optics, Refraction, and Contact Lenses. San Francisco: American Academy of Ophthalmology; 1986–1987:73. Fig 44.)
Telescopes
A telescope is an optical system designed to increase the angle subtended at the eye by distant objects. It is called afocal because pencils of light entering with zero vergence come out with zero vergence. The first lens, the objective, forms an image of the distant object. The second lens, the eyepiece or ocular, is then used to view the image formed by the objective. With small-angle approximations, a telescope’s angular magnification (or “minification,” if you look through the
telescope turned the other way around) is the longer focal length of the objective divided by the shorter focal length of the ocular, with a minus sign to enable us to figure out whether the final image is upright or inverted:
where
fobj = focal length of objective feye = focal length of eyepiece Peye = power of eyepiece Pobj = power of objective
Galilean Telescope
In a Galilean telescope, the objective is a plus lens, and the eyepiece is a minus lens. Bundles of rays with approximately zero vergence, emanating from various points on a distant object, pass through a low-power plus objective lens. Before the rays are able to arrive to focus at the secondary focal point of the first lens, they meet a higher-power minus lens, the eyepiece, which has been placed so that its primary focal point coincides with the secondary focal point of the first lens. Thus, the rays leave the second lens with no vergence, and the telescope is therefore said to be afocal (Fig 7-3). The image is magnified and upright.
Figure 7-3 Galilean telescope. (Redrawn from Guyton D, West C, Miller J, Wisnicki H. Ophthalmic Optics and Clinical Refraction. London: Prism Press;1999:39.)
The distance separating the eyepiece from the objective, which is the length of the telescope, equals the difference between the focal lengths of the objective and the eyepiece.
Astronomical Telescope
In an astronomical, or Keplerian, telescope, both the objective and the eyepiece are plus lenses. Light without vergence enters a low-power objective lens, just as in the Galilean telescope. Whereas in the Galilean telescope a minus lens is placed in the path before the light reaches its secondary focal point, in the astronomical telescope a stronger, convex lens is placed beyond the secondary focal point of the first convex lens, with its primary focal point coinciding with the secondary focal point of the first lens. The distance separating the eyepiece from the objective is the sum of the focal lengths of the objective and the eyepiece. Once again, we have an afocal system; rays that enter with zero vergence exit with zero vergence. A large low-power objective lens collects relatively large-angle pencils of light from a distant object; in particular, it collects more of the light coming from that object than would enter the viewer’s smaller entrance pupil without the telescope (Fig 7-4).
Figure 7-4 Astronomical telescope. (Redrawn from Guyton D, West C, Miller J, Wisnicki H. Ophthalmic Optics and Clinical Refraction. London: Prism Press; 1999:39.)
The image seen through the astronomical telescope is inverted as well as magnified. If we wish to render the image upright, we must invert it again by passing the light path through at least one more lens or through a set of internally reflecting prisms such as those inside typical binoculars. Because they “fold” the light path, the prisms used in binoculars also enable the binoculars to be more compact and to have the right and left objective lenses spread farther apart than the viewer’s eyes, enhancing the perception of depth. Note that the minus sign in the formula for the telescope’s angular magnification yields, as it should, a positive power for the Galilean telescope’s upright image and a negative power for the astronomical telescope’s inverted image.
Accommodation Through a Telescope
If you look at an object one-third of a meter away, your otherwise emmetropic eye must accommodate 3 diopters. If you look at the same object one-third of a meter away through an afocal telescope, you have to accommodate much more: the accommodation required through the telescope is the usual amount, 3 D, multiplied by the square of the magnification of the telescope. For instance, the accommodation required through a 2× telescope would be 3 × (2)2 = 12 D, which is too difficult for an adult to achieve. Therefore, in order to enable us to see near objects through a telescope, we need to alter the telescope, in the manner we next describe, to form a loupe.
