- •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 8-10 The effect of the size of a light source on spatial coherence. The interferometer fringe pattern produced by a second point source (point B) of light is shifted relative to the first point source (point A). Superimposing both patterns results in a new pattern with decreased fringe contrast. A small light source has high spatial coherence and produces high-contrast fringes. If a light source is too large (ie, consists of numerous point sources), no fringes will be seen.
(Illustration b y Edmond H. Thall, MD.)
Electromagnetic Waves
The corpuscular theory of light was abandoned after Young provided strong evidence that light is a wave phenomenon. The next question is, What type of wave? James Clerk Maxwell developed equations describing the behavior of electric and magnetic fields. Maxwell discovered that oscillating electric fields (ie, those that rhythmically reverse polarity) are inextricably linked to oscillating magnetic fields and that such electromagnetic (EM) fields can radiate as waves. In 1862, Maxwell calculated the speed of EM waves and found that they moved at the speed of light, and he thus concluded that light is an EM wave. Several phenomena can be explained by the EM wave theory.
Polarization
The electric field of an EM wave oscillates perpendicularly to its magnetic field, and both oscillate perpendicularly to their direction of propagation (Fig 8-11). Because the electric and magnetic fields oscillate in lockstep, for simplicity only the electric field is shown in most illustrations. The EM
plane of polarization is defined by the orientation of the electric-field oscillation (eg, vertical in Fig 8-11) and direction of propagation. In general, the plane of polarization of an EM wave may have any orientation (ie, horizontal, vertical, or oblique).
Figure 8-11 Light is polarized. The plane of polarization is specified with reference to the direction of propagation and the direction of the oscillating electric (E) or magnetic (H) field, which always oscillate perpendicularly to each other. In this view, the electric field is polarized vertically and the magnetic field horizontally, but they could be interchanged, or polarization could be in any oblique meridian. (Illustration b y Jonathan Clark.)
Note that there is no such thing as “unpolarized” light. Typically, the plane of polarization changes rapidly (about every 10–13 to 10–14 second) and randomly, resulting in light that is randomly polarized. Linearly polarized light, however, has a single unchanging plane of polarization. In circularly polarized light, the plane of polarization rotates, and the (maximum) electric-field vector traces a corkscrew pattern as the wave propagates. Viewed head-on, the field vector traces a circle. In elliptically polarized light, which represents a more general case of circular polarization, the plane of polarization rotates as the wave propagates, but the (maximum) electric-field vector traces an ellipse instead of a circle.
Refractive Index and Dispersion
EM waves travel fastest in a vacuum and slower in any transparent material medium. All EM frequencies travel at the same speed in vacuum, but in any transparent medium, each frequency travels at a different speed—a phenomenon called dispersion. The refractive index (n) is the ratio of the speed of light in a vacuum divided by its speed in a given material. Dispersion is measured using the refractive index at 3 different wavelengths. This measurement, the Abbe number (V), is defined as
where nd, nF, and nC represent wavelengths (in a vacuum) of 587.6 nm, 486.1 nm, and 656.3 nm, respectively. Larger Abbe numbers indicate lower dispersion.
Reflection, Transmission, and Absorption
Consider light striking the interface between 2 materials such as air and glass (Fig 8-12). Some light is reflected according to the law of reflection and some transmitted (refracted) according to Snell’s law.
Figure 8-12 At the interface of 2 transparent media, some incident light is reflected and some is refracted (transmitted). The amount of reflected light increases as the angle of incidence increases, and the amount of light refracted decreases commensurately. When, as in this case, the reflected and refracted rays form a right angle, all the reflected light is linearly polarized parallel to the interface (ie, perpendicular to the plane of incidence). (Illustration b y Edmond H. Thall, MD.)
The question is, How much light is reflected and how much transmitted? Applying electromagnetic wave theory, Fresnel demonstrated that the greater the difference in the refractive
indices or the greater the angle of incidence, the greater the degree of reflection and, consequently, the less light transmitted. For an air–glass interface, typically about 4% of light is reflected at low angles of incidence. Tears have a lower refractive index than glass, so an air–tear-film interface reflects even less light—about 2%.
Light reflected at the front and back surfaces of the cornea and the crystalline lens produces the 4 Purkinje images. The reader should be able to rank the Purkinje images from brightest to dimmest in both phakic and pseudophakic eyes.
Fresnel also showed that reflected light tends to be linearly polarized parallel to the interface. Reflected light is completely polarized if the angle of incidence equals the Brewster angle:
where nt and ni are the refractive indices of the transmitted and incident media, respectively. At the Brewster angle, all the reflected light is linearly polarized, but not all the linearly polarized light is reflected. Consequently, the transmitted light is a mixture of linearly and randomly polarized light.
When light moves from a higher to lower refractive index medium, it will be completely reflected
(total internal reflection [TIR]) if the angle of incidence exceeds the critical angle:
Note that the critical angle always exceeds the Brewster angle. TIR is what prevents visualization of the angle during slit lamp examination. In rare cases, the cornea might be so distorted that the angle is visible without gonioscopy, but usually some method must be employed to prevent TIR and make the angle visible.
Absorption is usually expressed as an optical density (OD). An OD of 1 represents a transmittance of 10%; an OD of 2, a transmittance of 1% (0.01); and an OD of 3, a transmittance of 0.1% (0.001). In general, the expression for optical density is
where T is the transmittance. (See Chapter 3 for a discussion of absorptive lenses.)
The Electromagnetic Spectrum
All EM radiation is fundamentally the same phenomenon, but its manifestations strongly depend on frequency. The frequency of EM radiation has no specific upper or lower limit. The spectrum is divided into regions in which the radiation is produced and detected by similar techniques; thus, various EM regions partially overlap (Fig 8-13).
