- •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
Figure 1-16 The fisherman must throw the spear in front of the virtual fish to hit the actual fish. (Illustration
developed b y Kevin M. Miller, MD, rendered b y Jonathan Clark, and modified b y Neal H. Ateb ara, MD.)
From your knowledge of Snell’s law, you know that the fish is not where it appears to be. If you throw the spear at the fish, you will certainly miss it. What you have to do is throw the spear in front of the virtual fish, the one you see, to hit the real fish.
Normal Incidence
Normal incidence occurs when a light ray is perpendicular to the optical interface. In other words, the surface normal coincides with the ray. If the interface is a refracting surface, the ray is undeviated. Light changes speed as it crosses the interface but does not change direction. If the surface reflects specularly, rays and pencils of light will be reflected back along a 90° angle to the surface.
Total Internal Reflection
Total internal reflection (TIR) occurs when light travels from a high-index medium to a low-index medium and the angle of incidence exceeds a certain critical angle. Under these circumstances, the
incident ray does not pass through the interface; all light is reflected back into the high-index medium. The law of reflection governs the direction of the reflected ray.
Figure 1-17A shows a light ray traveling from a high-index medium (spectacle crown glass) into a low-index medium (air). In this situation, the transmitted ray bends away from the surface normal, and thus the angle of transmission exceeds the angle of incidence. As the angle of incidence increases, the angle of transmission increases to a greater degree. Eventually, the angle of transmission equals 90°. At this point, the ray grazes along the optical interface and is no longer transmitted (Fig 1-17B).
Figure 1-17 A, When light travels from a high-index medium to a low-index medium, it bends away from the surface normal. B, At the critical angle, θc, the refracted light travels in the optical interface. C, Beyond the critical angle, all light is reflected by the interface. In A and B, light is also reflected by the interface (not shown). (Illustration developed b y Kevin M. Miller,
MD, and rendered b y C. H. Wooley.)
The critical angle is the angle of incidence that produces a transmitted ray 90° to the surface normal. The critical angle, θc, is calculated from Snell’s law:
ni sin θc = nt sin 90°
The sine of 90° is 1; thus, ni sin θc = nt
Rearranging gives
So, the angle of transmission is 90° when the angle of incidence is
In the current example, ni = 1.000 and nt = 1.523, so the critical angle is 41.0°.
What happens when the angle of incidence exceeds the critical angle? As Figure 1-17C shows, the angle of transmission increases as the angle of incidence increases, but the angle of transmission cannot exceed 90°. Consequently, refraction cannot occur. Indeed, Snell’s law has no valid mathematical solution (in real numbers) when the critical angle is exceeded. Instead, the incident ray is 100% reflected.
TIR is a rather curious phenomenon. Consider light traveling from spectacle crown glass to air. If the angle of incidence is 10°, the light transmits easily as it crosses the interface. However, if the angle of refraction is 45°, the interface becomes an impenetrable barrier! The interface is transparent to some rays and opaque to others. Physicists have devoted considerable attention to this phenomenon.
TIR has great practical value. In the early 1600s, it was difficult to make a good mirror. The best surfaces could specularly reflect only about 80% of incident light, and the rest was diffusely reflected, which made these surfaces nearly useless as imaging devices. However, TIR is just that— total. When TIR occurs, 100% of the light is reflected. In the past, often the only way to make a practical mirror was to use internally reflecting prisms. Today, TIR is still used in prisms within binoculars, slit lamps, and operating microscopes, for example. Clinically, TIR is a nuisance when clinicians are trying to examine the anterior chamber angle. (See Clinical Example 1-5.)
Clinical Example 1-5
Total internal reflection (TIR) makes it impossible to view the eye’s anterior chamber angle without the use of a contact lens. Light from the angle undergoes TIR at the air–cornea interface (technically, the air–tear-film interface) (Fig 1-18A). Light from the angle never escapes the eye. Using a contact lens to eliminate the air at the surface of the cornea (Fig 1- 18B) overcomes the problem. Light travels from the cornea (or coupling gel) to the higher- index contact lens. TIR never occurs when light travels from a medium of lower index to one of higher index, so light enters the contact lens and is reflected from the mirror. TIR does not occur at the front surface of the contact lens because the angle of incidence is less than the critical angle.
Figure 1-18 A, Light from the anterior chamber angle undergoes total internal reflection (TIR) at the air–tear- film interface. B, A contact lens prevents TIR and allows visualization of the angle structures. (Illustration
developed b y Kevin M. Miller, MD, and rendered b y C.H. Wooley.)
Assuming the refractive index of the tear film on the front surface of the cornea is 1.333, the critical angle for the air–tear-film interface is
