- •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
From trigonometry, we can estimate the angle at which light rays from the trabecular meshwork strike the air–tear-film interface. The situation is illustrated in Figure 1-19 using average anatomical dimensions. We ignore the effect of the back surface of the cornea because this surface has relatively little power and we are performing only a rough calculation. From basic trigonometry,
Interestingly, this rough calculation shows that θc is exceeded by only a few degrees. When the cornea is ectatic (as in some cases of keratoconus), the angle of incidence is less than θc and the angle structures are visible without a gonioscopy lens.
Figure 1-19 Average anatomical dimensions of the anterior segment. (Illustration developed b y Kevin M. Miller, MD,
and rendered b y C. H. Wooley.)
Dispersion
With the exception of a vacuum, which always has a refractive index of 1.000, refractive indices are not fixed values. They vary as a function of wavelength. In general, refractive indices are higher for short wavelengths and lower for long wavelengths. As a result, blue light travels more slowly than red light in most media, and Snell’s law predicts a greater angle of refraction for blue light than for
red light (Fig 1-20).
Figure 1-20 Chromatic dispersion. (Illustration developed b y Kevin M. Miller, MD, and rendered b y C.H. Wooley.)
The Abbe number, also known as the V-number, is a measure of a material’s dispersion. Named for the German physicist Ernst Abbe (1840–1905), the Abbe number V is defined as
where nD, nF, and nC are the refractive indices of the Fraunhofer D, F, and C spectral lines (589.2 nm, 486.1 nm, and 656.3 nm, respectively). Low-dispersion materials, which demonstrate low chromatic aberration, have high values of V. High-dispersion materials have low values of V. Abbe numbers for common optical media typically range from 20 to 70.
Reflection and Refraction at Curved Surfaces
For the sake of simplicity, the laws of reflection and refraction were illustrated at flat optical interfaces. However, most optical elements have curved surfaces. To apply the law of reflection or refraction to curved surfaces, the position of the surface normal must be determined because the angles of incidence, reflection, and refraction are defined with respect to the surface normal. Once the position of the surface normal is known, the laws of refraction and reflection define the relationship between the angle of incidence and the angles of refraction and reflection, respectively.
Although there is a mathematical procedure for determining the position of the surface normal in any situation, the details of it are beyond the scope of this text. For selected geometric shapes, however, the position of the surface normal is easy to determine. In particular, the surface normal to a spherical surface always intersects the center of the sphere. For example, Figure 1-21 shows a ray incident on a spherical surface. The incident ray is 2 cm above, and parallel to, the optical axis. The surface normal is found with the extension of a line connecting the center of the sphere to the point where the incident ray strikes the surface. The angle of incidence and the sine of the angle of incidence are determined by simple trigonometry.
Figure 1-21 A ray 2 cm above and parallel to the optical axis is incident on a spherical surface. The surface normal is found by connecting the point where the ray strikes the surface to the center of the sphere (point C). The angle of incidence is found using similar triangles and trigonometry (arctan 2/7 = 16.6°). (Illustration developed b y Edmond H. Thall, MD,
and Kevin M. Miller, MD, and rendered b y C. H. Wooley.)
The Fermat Principle
The mathematician Pierre de Fermat posited that light travels from one point to another along the path requiring the least time. Both Snell’s law of refraction and the law of reflection can be mathematically derived from the Fermat principle. This principle is summarized below and further detailed in Appendix 1.2 at the end of this chapter.
Suppose that the law of refraction were unknown, and consider light traveling from a point source in air, across an optical interface, to some point in glass (Fig 1-22). Unaware of Snell’s law, we might consider various hypothetical paths that light might follow as it moves from point A to point B. Path 3 is a straight line from A to B and is the shortest total distance between the points. However, a large part of path 3 is inside glass, where light travels more slowly. Path 3 is not the fastest route. Path 1 is the longest route from A to B but has the shortest distance in glass. Nevertheless, the extreme length of the overall route makes this a fairly slow path. Path 2 is the best compromise between distance in glass and total path length, and this is the path light will actually follow.
Figure 1-22 Light traveling from points A to B follows only path 2 because it requires the least time. Light does not travel
along either path 1 or path 3. (Illustration developed b y Edmond H. Thall, MD, and Kevin M. Miller, MD, and rendered b y C. H. Wooley.)
Using mathematics beyond the scope of this text, it can be shown that the optimal path is the one predicted by Snell’s law. Thus, Snell’s law is a consequence of the Fermat principle.
Figure 1-23 shows light from an object point traveling along 2 different paths to the image point. According to the Fermat principle, the time required to travel from object to image point (or, alternatively, the optical path length, OPL) must be exactly identical for each path or the paths will not intersect at the image point.
