Purpose. To compare peripheral lower and higher order aberrations across the horizontal (+/- 40 degrees) and inferior (-20 degrees) visual fields in healthy groups of young and old emmetropes. Methods. We have measured off-axis aberrations in the groups of 30 younger (24 +/- 3 years) and 30 older (58 +/- 5 years) emmetropes. The aberrations of OD were measured using the COAS-HD VR Shack-Hartmann aberrometer in 10 degrees steps to +/- 40 degrees horizontally and -20 degrees inferiorly in the visual field. The aberrations were quantified with Zernike polynomials for a 4 mm pupil diameter. The second-order aberration coefficients were converted to their respective refraction components (M, J(45), and J(180)). Mixed between-within subjects, analysis of variance were used to determine whether there were significant differences in the refraction and aberration components for the between-subjects variable age and the within-subjects variable eccentricity. Results. Peripheral refraction components were similar in both age groups. Among the higher order coefficients, horizontal coma (C(3)(1)) and spherical aberration (C(4)(0)) varied mostly between the groups. Coma increased linearly with eccentricity, at a more rapid rate in the older group than in the younger group. Spherical aberration was more positive in the older group compared with the younger group. Higher order root mean square increased more rapidly with eccentricity in the older group. Conclusions. Like the axial higher order aberrations, the peripheral higher order aberrations of emmetropes increase with age, particularly coma and spherical aberration.
The long-term aim of the work introduced here is to investigate the influence of off-axis aberrations on human vision, especially for subjects with a large central scotoma. The latter use their peripheral vision in spite of its poor off-axis optical quality, and a correction of the off-axis aberrations might be of great assistance. The eccentric fixation angles used by these subjects can be up to 20-30 degrees. In this initial study we have measured oblique astigmatism, the major off-axis aberration, in 20 emmetropic eyes in 10 degrees steps out to 60 degrees nasally and temporally using a 'double pass' setup. The results show very large individual differences and the oblique astigmatism also varies from nasal to temporal side. In an off-axis measurement angle of 30 degrees the astigmatism varied between subjects from 1 to 7-D, with a mean astigmatism of about 4-D on the nasal side and about 1.5-D lower on the temporal side. At 60 degrees temporally, the mean astigmatism was 7-D. At 60 degrees nasally, all subjects had astigmatism larger than 8-D and the mean astigmatism was 11-D. The results indicate that any attempt to correct the off axis astigmatism in an eye with central scotoma cannot be based on central refraction; instead, individual measurements are necessary.
Background. Subjects with absolute central visual field loss use. eccentric fixation and magnifying devices to utilize their residual vision. This preliminary study investigated the importance of an accurate eccentric correction of off-axis refractive errors to optimize the residual visual function for these subjects. Methods. Photorefraction using the PowerRefractor instrument was used to evaluate the ametropia in eccentric fixation angles. Methods were adapted for measuring visual acuity outside the macula using filtered optotypes from high-pass resolution perimetry. Optical corrections were implemented, and the visual function of subjects with central visual field loss was measured with and without eccentric correction. Results. Of the seven cases reported, five experienced an improvement in visual function in their preferred retinal locus with eccentric refraction. Conclusions. The main result was that optical correction for better image quality on the peripheral retina is important for the vision of subjects with central visual field loss, objectively as well as subjectively.
PURPOSE: To compare the subjective visual and objective optical performance of 2 aspherical intraocular lenses (IOLs), the Akreos Adapt Advanced Optics (AO) (Bausch & Lomb, Inc.) and the Tecnis Z9000 (Advanced Medical Optics, Inc.). SETTING: Four university hospitals in Sweden. METHODS: This study comprised 80 patients, 20 each from 4 university hospital centers in Sweden. All patients had bilateral clear corneal phacoemulsification with implantation of an Akreos Adapt AO IOL in 1 eye and Tecnis Z9000 IOL in the other eye according to a randomization protocol. Preoperatively, 90% contrast Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity was measured and the mesopic pupil sizes were determined. Ten to 12 weeks postoperatively, 12.5% and 90% contrast ETDRS visual acuities and photopic and mesopic Functional Acuity Contrast Test chart contrast sensitivities were determined. Wavefront analysis was performed with the Zywave 11 aberrometer (Bausch & Lomb, Inc.), and a questionnaire on the subjective quality of vision was completed by each patient. RESULTS: The Akreos AD IOL and Tecnis Z9000 IOL produced similar high- and low-contrast visual acuities as well as photopic and mesopic contrast sensitivities. The Tecnis Z9000 IOL resulted in lower spherical aberrations of the eye (mean 0.05 +/- 0.13 pm versus 0.35 +/- 0.13 mu m root mean square, 6.0 mm pupil) (P<.001); however, the Akreos AO IOL provided a larger depth of field (mean 1.22 diopter [D] +/- 0.48 [SD] versus 0.86 +/- 0.50 D, 6.0 mm pupil) (P<.001). Patient satisfaction was generally high, although 68.8% of the patients reported some type of visual disturbance postoperatively. Twenty-eight percent of patients reported better subjective visual quality in the Akreos AD eye and 14%, in the Tecnis Z9000 eye (P<.0001). Accordingly, 33% perceived more visual disturbances in the Tecnis Z9000 eye and 11%, in the Akreos AID eye (P<.0001). CONCLUSIONS: Maximum reduction of spherical aberration did not maximize subjective visual quality. The higher perceived quality of vision with the Akreos AD IOL could be because of differences in depth of field, IOL material, or IOL design.
Purpose. The purpose of this study was twofold: to verify a fast, clinically applicable method for determining off-axis refraction and to assess the impact of objectively obtained off-axis refractive correction on peripheral low-contrast visual acuity. Methods. We measured peripheral low-contrast resolution acuity with Gabor patches both with and without off-axis correction at 20 degrees in the nasal visual field of 10 emmetropic subjects; the correction was obtained using a commercial open-field Hartmann-Shack wavefront sensor, the COAS-HD VR aberrometer. Off-axis refractive errors were calculated for a 5-mm circular pupil inscribed within the elliptical wavefront by COAS using the instruments' inbuilt "Seidel sphere" method. Results. Most of the subjects had simple myopic astigmatism, at 20 degrees in the nasal visual field ranging from -1.00 to -2.00 DC, with axis orientations generally near 90 degrees. The mean uncorrected and corrected low-contrast resolution acuities for all subjects were 0.92 and 0.86 logMAR, respectively (an improvement of 0.06 logMAR). For subjects with a scalar power refractive error of 1.00 diopters or more, the average improvement was 0.1 logMAR. The observed changes in low-contrast resolution acuity were strongly correlated with off-axis astigmatism (Pearson r = 0.95; p < 0.0001), the J(180) cross-cylinder component (Pearson r = 0.82; p = 0.0034), and power scalar (Pearson r = -0.75; p = 0.0126). Conclusions. The results suggest that there are definite benefits in correcting even moderate amounts of off-axis refractive errors; in this study, as little as -1.50 DC of off-axis astigmatism gave improvements of up to a line in visual acuity. It may be even more pertinent for people who rely on optimal peripheral visual function, specifically those with central visual field loss; the use of open-field aberrometers could be clinically useful in rapidly determining off-axis refractive errors specifically for this patient group who are generally more challenging to refract.
In a clinical setting, emphasis is given to foveal visual function, and tests generally only utilize static stimuli. In this study, we measured static (SVA) and dynamic visual acuity (DVA) in the central and peripheral visual field on healthy, young emmetropic subjects using stationary and drifting Gabor patches. There were no differences between SVA and DVA in the peripheral visual field; however, SVA was superior to DVA in the fovea for both velocities tested. In addition, there was a clear naso-temporal asymmetry for both SVA and DVA for isoeccentric locations in the visual field beyond 10 degrees eccentricity. The lack of difference in visual acuity between static and dynamic stimuli found in this study may reflect the use of drift-motion as opposed to displacement motion used in previous studies.
Introduction: The aim of the present studies was to investigate the effect on spherical aberration of different non custom-made contact lenses, both with and without aberration control. Methods: A wavefront analyser (Zywave™, Bausch & Lomb) was used to measure the aberrations in each subject's right eye uncorrected and with the different contact lenses. The first study evaluated residual spherical aberration with a standard lens (Focus Dailies Disposable, Ciba Vision) and with an aberration controlled contact lens (ACCL) (Definition AC, Optical Connection Inc.). The second study evaluated the residual spherical aberrations with a monthly disposable silicone hydrogel lens with aberration reduction (PureVision, Bausch & Lomb). Results: Uncorrected spherical aberration was positive for all pupil sizes in both studies. In the first study, residual spherical aberration was close to zero with the standard lens for all pupil sizes whereas the ACCL over-corrected spherical aberration. The results of the second study showed that the monthly disposable lens also over-corrected the aberration making it negative. The changes in aberration were statistically significant (p < 0.05) with all lenses. Conclusion: Since the amount of aberration varies individually we suggest that aberrations should be measured with lenses on the eye if the aim is to change spherical aberration in a certain direction.
Purpose. When performing perimetry, refracting subjects with central visual field loss, and in emmetropization studies, it is important to accurately measure peripheral refractive errors. Traditional methods for foveal refraction often give uncertain results in eccentric angles as a result of the large aberrations and the reduced retinal function. The aim of this study is therefore to compare and evaluate four methods for eccentric refraction. Methods. Four eccentric methods were tested on 50 healthy subjects: one novel subjective procedure, optimizing the detection contrast sensitivity with different trial lenses, and three objective ones: photorefraction with a PowerRefractor, wavefront measurements with a Hartmann-Shack sensor, and retinoscopy. The peripheral refractive error in the horizontal nasal visual field of the right eye was measured in 20 degrees and 30 degrees. Results. In general, the eccentric refraction methods compared reasonably well. However, the following differences were noted. Retinoscopy showed a significant difference from the other methods in the axis of astigmatism. In 300 eccentric angle, it was not possible to measure 15 of the subjects with the PowerRefractor and the instrument also tended to underestimate high myopia (<-6 D). The Hartmann-Shack sensor showed a myopic shift of approximately 0.5 D in both eccentricities. The subjective method had a relatively larger spread. Conclusions. This study indicates that it is possible to assess the eccentric refraction with all methods. However, the Hartmann-Shack technique was found to be the most useful method. The agreement between the objective methods and the subjective eccentric refraction shows that detection contrast sensitivity in the periphery is affected by relatively small amounts of defocus.
We present a population study of peripheral wavefront aberrations in large off-axis angles in terms of Zernike coefficients. A laboratory Hartmann-Shack sensor was used to assess the aberrations in 0 degrees, 20 degrees, and 30 degrees in the nasal visual field of 43 normal eyes. The elliptical pupil meant that the quantification could be done in different ways. The three approaches used were (1) over a circular aperture encircling the pupil, (2) over a stretched version of the elliptical pupil, and (3) over a circular aperture within the pupil (MATLAB conversion code given). Astigmatism (c(2)(2)) increased quadratically and coma (c(3)(1)) linearly with the horizontal viewing angle, whereas spherical aberration (c(4)(0)) decreased slightly toward the periphery. There was no correlation between defocus and angle, although some trends were found when the subjects were divided into groups depending on refractive error. When comparing results of different studies it has to be kept in mind that the coefficients differ depending on how the elliptical pupil is taken into consideration.
Purpose. This study investigates the benefits of eccentric refractive correction to resolution and detection thresholds in different contrasts for seven subjects with central visual field loss (CFL) and for four healthy control subjects with normal vision.
Methods. Refractive correction in eccentric viewing angles, i.e., the preferred retinal location for the CFL subjects and 20 degrees off-axis for the control subjects, was assessed by photorefraction with the PowerRefractor instrument and by wavefront analysis using the Hartmann-Shack principle. The visual function with both eccentric and central corrections was evaluated using number identification and grating detection.
Results. For the CFL subjects, the resolution and detection thresholds varied between individuals because of different preferred retinal locations and cause of visual field loss. However, all seven CFL subjects showed improved visual function for resolution and detection tasks with eccentric correction compared with central correction. No improvements in high-contrast resolution were found for the control subjects.
Conclusions. These results imply that optical eccentric correction can improve the resolution acuity for subjects with CFL in situations where healthy eyes do not show any improvements.
Retinal sampling poses a fundamental limit to resolution acuity in the periphery. However, reduced image quality from optical aberrations may also influence peripheral resolution. In this study, we investigate the impact of different degrees of optical correction on acuity in the periphery. We used an adaptive optics system to measure and modify the off-axis aberrations of the right eye of six normal subjects at 20 degrees eccentricity. The system consists of a Hartmann-Shack sensor, a deformable mirror, and a channel for visual testing. Four different optical corrections were tested, ranging from foveal sphero-cylindrical correction to full correction of eccentric low- and high-order monochromatic aberrations. High-contrast visual acuity was measured in green light using a forced choice procedure with Landolt C's, viewed via the deformable mirror through a 4.8-mm artificial pupil. The Zernike terms mainly induced by eccentricity were defocus and with- and against-the-rule astigmatism and each correction condition was successfully implemented. On average, resolution decimal visual acuity improved from 0.057 to 0.061 as the total root-mean-square wavefront error changed from 1.01 mu m to 0.05 mu m. However, this small tendency of improvement in visual acuity with correction was not significant. The results suggest that for our experimental conditions and subjects, the resolution acuity in the periphery cannot be improved with optical correction.
A mirror symmetry in the aberrations between the left and right eyes has previously been found foveally, but while a similar symmetry for the peripheral visual field is likely, it has not been investigated. Nevertheless, the peripheral optical quality is often evaluated in only one eye, because it is more time efficient than analyzing the whole visual field of both eyes. This study investigates the correctness of such an approach by measuring the peripheral wavefront aberrations in both eyes of 22 subjects out to +/- 40 degrees horizontally. The largest aberrations (defocus, astigmatism, and coma) were found to be significantly correlated between the left and right eyes when comparing the same temporal or nasal angle. The slope of the regression line was close to +/- 1 (within 0.05) for these aberrations, with a negative slope for the horizontally odd aberrations, i.e. the left and right eyes are mirror symmetric. These findings justify that the average result, sampled in one of the two eyes of many subjects, can be generalized to the other eye as well.
Zernike polynomials and their associated coefficients are commonly used to quantify the wavefront aberrations of the eye. When the aberrations of different eyes, pupil sizes, or corrections are compared or averaged, it is important that the Zernike coefficients have been calculated for the correct size, position, orientation, and shape of the pupil. We present the first complete theory to transform Zernike coefficients analytically with regard to concentric scaling, translation of pupil center, and rotation. The transformations are described both for circular and elliptical pupils. The algorithm has been implemented in MATLAB, for which the code is given in an appendix.
Purpose. When the wavefront aberrations of the eye are measured with a Hartmann-Shack (HS) sensor, the resulting spot pattern must be unwrapped, that is, for each lenslet the corresponding spot must be identified. This puts a limitation on the measurable amount of aberrations. To extend the range of an HS sensor, a powerful unwrapping algorithm has been developed. Methods. The unwrapping algorithm starts by connecting the central HS spots to the central lenslets. It then fits a B-spline function through a least squares estimate to the deviations of the central HS spots. This function is then extrapolated to find the expected locations of HS spots for the unconnected lenslets. The extrapolation is performed gradually in an iterative manner; the closest unconnected lenslets are extrapolated and connected, and then the B-spline function is least squares fitted to all connected HS spots and extrapolated again. Results. Wavefront aberrations from eyes with high aberrations can be successfully unwrapped with the developed algorithm. The dynamic range of a typical HS sensor increases 3.5 to 13 times compared with a simple unwrapping algorithm. Conclusions. The implemented algorithm is an efficient unwrapping tool and allows the use of lenslets with a low numerical aperture and thus gives a relatively higher accuracy of measurements of the ocular aberrations.
In a previous study we have shown that correction of peripheral refractive errors can improve the remaining vision in the preferred retinal location (PRL) of subjects with large central visual field loss (CFL). Measuring peripheral refractive errors with traditional methods is often difficult due to the low visual acuity and large aberrations. Therefore a Hartmann-Shack (HS) sensor has been designed to measure peripheral wavefront aberrations in CFL subjects. Method: The HS sensor incorporates an eyetracker and analyzing software designed to handle large wavefront aberrations. To ensure that the measurement axis is aligned with the subject's PRL, a special fixation target has been developed. It consists of concentric rings surrounding the aperture of the HS together with a central fixation mark along the measurement axis. Results: Some initial measurements on subjects with CFL have been performed successfully. As a first step in improving the peripheral optics of the eye, the wavefront data have been used to calculate the subject's optimal eccentric refraction. Conclusion: Measuring the wavefront aberrations is a fast and easy way to assess the details of the optics in subjects with CFL. The wavefront data can then be used to better understand the problems of eccentric correction.
In a previous study we have shown that correction of peripheral refractive errors can improve the remaining vision of subjects with large central visual field loss. Measuring peripheral refractive errors with traditional methods is often difficult due to low visual acuity and large aberrations. Therefore a Hartmann-Shack sensor has been designed to measure peripheral wave front aberrations in subjects using eccentric viewing. The sensor incorporates an eye tracker and analyzing software designed to handle large wave front aberrations and elliptic pupils. To ensure that the measurement axis is aligned with the direction of the subject's preferred retinal location, a special fixation target has been developed. It consists of concentric rings surrounding the aperture of the sensor together with a central fixation mark along the measurement axis. Some initial measurements on subjects using eccentric viewing have been performed successfully. As a first step in improving the peripheral optics of the eye, the wave front has been used to calculate the eccentric refraction. This refraction has been compared to the refraction found with the Power-Refractor instrument. Measuring the off-axis wave front is a fast way to assess the optical errors in the subject's eccentric viewing angle and to better understand the problems of eccentric correction.
Purpose: Many myopia control interventions are designed to induce myopic relative peripheral refraction. However, myopes tend to show asymmetries in their sensitivity to defocus, seeing better with hypermetropic rather than myopic defocus. This study aims to determine the influence of chromatic aberrations (CA) and higher-order monochromatic aberrations (HOA) in the peripheral asymmetry to defocus. Methods: Peripheral (20° nasal visual field) low-contrast (10%) resolution acuity of nine subjects (four myopes, four emmetropes, one hypermetrope) was evaluated under induced myopic and hypermetropic defocus between ±5 D, under four conditions: (a) Peripheral Best Sphere and Cylinder (BSC) correction in white light; (b) Peripheral BSC correction + CA elimination (green light); (c) Peripheral BSC correction + HOA correction in white light; and (d) Peripheral BSC correction + CA elimination + HOA correction. No cycloplegia was used, and all measurements were repeated three times. Results: The slopes of the peripheral acuity as a function of positive and negative defocus differed, especially when the natural HOA and CA were present. This asymmetry was quantified as the average of the absolute sum of positive and negative defocus slopes for all subjects (AVS). The AVS was 0.081 and 0.063 logMAR/D for white and green light respectively, when the ocular HOA were present. With adaptive optics correction for HOA, the asymmetry reduced to 0.021 logMAR/D for white and 0.031 logMAR/D for green light, mainly because the sensitivity to hypermetropic defocus increased when HOA were corrected. Conclusion: The asymmetry was only slightly affected by the elimination of the CA of the eye, whereas adaptive optics correction for HOA reduced the asymmetry. The HOA mainly affected the sensitivity to hypermetropic defocus.
Introduction: The aim of the present study was to evaluate changes in spherical aberration and their effect on visual quality (visual acuity and contrast sensitivity) in both distance and near with different non-custom-made contact lenses. Methods: A wavefront analyser was used to measure the aberrations in each subject's eyes uncorrected and with the contact lenses: a standard lens and two aspherical contact lenses. High-contrast visual acuity at distance was measured with Test-Chart 2000(100% contrast) and at near with Sloan ETDRS Near Point chart (100% contrast). Low-contrast visual acuity at distance was measured with Test-Chart 2000 (10% contrast) and contrast measurements at near with Mars letter contrast sensitivity chart. Results: Mean spherical aberration was positive for all pupil sizes in the uncorrected eye, residual spherical aberration was close to zero with the standard lens for all pupil sizes, whereas the two aspheric contact lenses over-corrected spherical aberration. The changes in aberration were statistically significant (p < 0.05) with all lenses. No significant difference could be detected between trial frame correction, spherical and aspherical soft contact lens designs with respect to visual quality. This was the case for both distance and near. Conclusion: The results are in line with previous studies and indicate that non-custom-made spherical aberration control contact lenses have little effect on visual quality as defined in this study.
The aim of the present project was to investigate accommodative behavior in young adults and adolescents fitted with an aspheric multifocal (center distance) contact lens with focus on evaluating whether these lenses can be an alternative treatment for subjects in which a reduced level of blur and thereby accommodation in near vision is aimed at. Twenty normal subjects aged between 21 and 35 years participated in the study. Aberrometry was perfomed using a Zywave (TM) aberrometer, first on the uncorrected eyes of all subjects, and again while the subjects wore a multifocal contact lens with a +1.00 add. A Shin-Nippon N Vision-K 5001 Autoref-Keratometer was used to measure accommodative response with two different refractive corrections: (1) habitual spectacle correction only, and (2) habitual correction and a aspheric multifocal (center distance) contact lens. Four hours of adaptation to the lens was allowed. The lag when wearing only the habitual spectacles was compared with the lag while wearing both the habitual spectacles and the aspheric multifocal contact lens. The mean lag of accommodation for the subject group was 0.85 D (+/-0.57 SD) and 0.75 D (+/-0.52 SD) without and with the multifocal lens, respectively. Statistical analyses showed no difference in lag (t = 0.8479, p = 0.407) with and without the lens. In conclusion, young normal subjects do not relax accommodation when fitted with aspheric multifocal center distance lenses when the addition is +1.00. It is therefore unlikely that subjects with accommodative ability, in whom the treatment purpose is to reduce blur and thereby accommodation, can be effectively treated with such lenses.
The difference in peripheral retinal image quality between myopic and emmetropic eyes plays a major role in the design of the optical myopia interventions. Knowing this difference under accommodation can help to understand the limitations of the currently available optical solutions for myopia control. A newly developed dual-angle open-field sensor was used to assess the simultaneous foveal and peripheral (20 degrees nasal visual field) wavefront aberrations for five target vergences from -0.31 D to -4.0 D in six myopic and five emmetropic participants. With accommodation, the myopic eyes showed myopic shifts, and the emmetropic eyes showed no change in RPR. Furthermore, RPR calculated from simultaneous measurements showed lower infra-subject variability compared to the RPR calculated from peripheral measurements and target vergence. Other aberrations, as well as modulation transfer functions for natural pupils, were similar between the groups and the accommodation levels, foveally and peripherally. Results from viewing the same nearby target with and without spectacles by myopic participants suggest that the accommodative response is not the leading factor controlling the amplitude of accommodation microfluctuations.
Purpose: Multifocal soft contact lenses have been used to decrease the progression of myopia, presumably by inducing relative peripheral myopia at the same time as the central image is focused on the fovea. The aim of this study was to investigate how the peripheral optical effect of commercially available multifocal soft contact lenses can be evaluated from objective wavefront measurements. Methods: Two multifocal lenses with high and low add and one monofocal design were measured over the ±40° horizontal field, using a scanning Hartmann-Shack wavefront sensor on four subjects. The effect on the refractive shift, the peripheral image quality, and the depth of field of the lenses was evaluated using the area under the modulation transfer function as the image quality metric. Results: The multifocal lenses with a centre distance design and 2 dioptres of add induced about 0.50 dioptre of relative peripheral myopia at 30° in the nasal visual field. For larger off-axis angles the border of the optical zone of the lenses severely degraded image quality. Moreover, these multifocal lenses also significantly reduced the image quality and increased the depth of field for angles as small as 10°-15° Conclusions: The proposed methodology showed that the tested multifocal soft contact lenses gave a very small peripheral myopic shift in these four subjects and that they would need a larger optical zone and a more controlled depth of field to explain a possible treatment effect on myopia progression.
Understanding peripheral optical errors and their impact on vision is important for various applications, e.g. research on myopia development and optical correction of patients with central visual field loss. In this study, we investigated whether correction of higher order aberrations with adaptive optics (AO) improve resolution beyond what is achieved with best peripheral refractive correction. A laboratory AO system was constructed for correcting peripheral aberrations. The peripheral low contrast grating resolution acuity in the 20 nasal visual field of the right eye was evaluated for 12 subjects using three types of correction: refractive correction of sphere and cylinder, static closed loop AO correction and continuous closed loop AO correction. Running AO in continuous closed loop improved acuity compared to refractive correction for most subjects (maximum benefit 0.15logMAR). The visual improvement from aberration correction was highly correlated with the subject's initial amount of higher order aberrations (p=0.001, R 2=0.72). There was, however, no acuity improvement from static AO correction. In conclusion, correction of peripheral higher order aberrations can improve low contrast resolution, provided refractive errors are corrected and the system runs in continuous closed loop.
PURPOSE. Peripheral optical corrections are often thought to give few visual benefits beyond improved detection acuity. However, patients with central visual field loss seem to benefit from peripheral correction, and animal studies suggest a role for peripheral vision in the development of myopia. This study was conducted to bridge this gap by systematically studying the sensitivity to optical defocus in a wide range of peripheral visual tasks. METHODS. The spatial frequency threshold for detection and resolution in high and low contrast with stationary and drifting gratings were measured off-axis (20 nasal visual field) in five subjects with a peripheral optical correction that was varied systematically +/- 4 D. RESULTS. All visual tasks, except high-contrast resolution, were sensitive to optical defocus, particularly low-contrast resolution with an increase of up to 0.227 logMAR/D. The two myopic subjects exhibited a very low sensitivity to defocus by negative lenses for low-contrast tasks, whereas all subjects were equally affected by myopic defocus. Contrary to expectations, drifting gratings made little difference overall. CONCLUSIONS. Optical defocus as low as 1 D has a large impact on most peripheral visual tasks, with high-contrast resolution being the exception. Since the everyday visual scenery consists of objects at different contrast levels, it is understandable that persons with central visual field loss are helped by correction of peripheral refractive errors. The asymmetry in sensitivity to peripheral optical defocus in low-contrast tasks that was experienced by the myopic subjects in this study merits further investigation.
PURPOSE. Animal studies suggest that the periphery of the eye plays a major role in emmetropization. It is also known that human myopes tend to have relative peripheral hyperopia compared to the foveal refraction. This study investigated peripheral sensitivity to defocus in human subjects, specifically whether myopes are less sensitive to negative than to positive defocus. METHODS. Sensitivity to defocus (logMAR/D) in the 20 degrees nasal visual field was determined in 16 emmetropes (6 males and 10 females, mean spherical equivalent -0.03 +/- 0.13 D, age 30 +/- 6 10 years) and 16 myopes (3 males and 13 females, mean spherical equivalent -3.25 +/- 2 D, age 25 +/- 6 years) using the slope of through-focus low-contrast resolution (10%) acuity measurements. Peripheral wavefront measurements at the same angle were obtained from 13 of the myopes and 9 of the emmetropes, from which the objective depth of field was calculated by assessing the area under the modulation transfer function (MTF) with added defocus. The difference in depth of field between negative and positive defocus was taken as the asymmetry in depth of field. RESULTS. Myopes were significantly less sensitive to negative than to positive defocus (median difference in sensitivity 0.06 logMAR/D, P = 0.023). This was not the case for emmetropes (median difference -0.01 logMAR/D, P = 0.382). The difference in sensitivity between positive and negative defocus was significantly larger for myopes compared to emmetropes (P = 0.031). The correlation between this difference in sensitivity and objective asymmetry in depth of field due to aberrations was significant for the whole group (R-2 = 0.18, P 0.02) and stronger for myopes (R-2 = 0.8, P < 0.01). CONCLUSIONS. We have shown that myopes, in general, are less sensitive to negative than to positive defocus, which can be linked to their aberrations. This finding is consistent with a previously proposed model of eye growth that is driven by the difference between tangential and radial peripheral blur.
In 1971, Rempt et al. reported peripheral refraction patterns (skiagrams) along the horizontal visual field in 442 people. Later in the same year, Hoogerheide et al. used skiagrams in combination with medical records to relate skiagrams in emmetropes and hyperopes to progression of myopia in young adults. The two articles have spurred interest in peripheral refraction in the past decade. We challenge the understanding that their articles provide evidence that the peripheral refraction pattern along the horizontal visual field is predictive of whether or not a person develops myopia. First, although it has been generally assumed that the skiagrams were measured before the changes in refraction were monitored, Hoogerheide et al. did not state that this was the case. Second, if the skiagrams were obtained at an initial examination and given the likely rates of recruitment and successful completion of training, the study must have taken place during a period of 10 to 15 years; it is much more likely that Hoogerheide et al. measured the skiagrams in a shorter period. Third, despite there being many more emmetropes and hyperopes in the Rempt et al. article than there are in the Hoogerheide et al. article, the number of people in two types of "at risk" skiagrams is greater in the latter; this is consistent with the central refraction status being reported from an earlier time by Hoogerheide et al. than by Rempt et al. In summary, we believe that the skiagrams reported by Hoogerheide et al. were taken at a later examination, after myopia did or did not occur, and that the refraction data from the initial examination were retrieved from the medical archives. Thus, this work does not provide evidence that peripheral refraction pattern is indicative of the likely development of myopia.
Measuring the contrast sensitivity function (CSF) in the periphery of the eye is complicated. The lengthy measurement time precludes all but the most determined subjects. The aim of this study was to implement and evaluate a faster routine based on the quick CSF method (qCSF) but adapted to work in the periphery. Additionally, normative data is presented on neurally limited peripheral CSFs. A peripheral qCSF measurement using 100 trials can be performed in 3 min. The precision and accuracy were tested for three subjects under different conditions (number of trials, peripheral angles, and optical corrections). The precision for estimates of contrast sensitivity at individual spatial frequencies was 0.07 log units when three qCSF measurements of 100 trials each were averaged. Accuracy was estimated by comparing the qCSF results with a more traditional measure of CSF. Average accuracy was 0.08 log units with no systematic error. In the second part of the study, we collected three CSFs of 100 trials for six persons in the 20 degrees nasal, temporal, inferior, and superior visual fields. The measurements were performed in an adaptive optics system running in a continuous closed loop. The Tukey HSD test showed significant differences (p < 0.05) between all fields except between the nasal and the temporal fields. Contrast sensitivity was higher in the horizontal fields, and the inferior field was better than the superior. This modified qCSF method decreases the measurement time significantly and allows otherwise unfeasible studies of the peripheral CSF.
The nocturnal helmet gecko, Tarentola chazaliae, discriminates colors in dim moonlight when humans are color blind. The sensitivity of the helmet gecko eye has been calculated to be 350 times higher than human cone vision at the color vision threshold. The optics and the large cones of the gecko are important reasons why they can use color vision at low light intensities. Using photorefractometry and an adapted laboratory Hartmann-Shack wavefront sensor of high resolution, we also show that the optical system of the helmet gecko has distinct concentric zones of different refractive powers, a so-called multifocal optical system. The intraspecific variation is large but in most of the individuals studied the zones differed by 15 diopters. This is of the same magnitude as needed to focus light of the wavelength range to which gecko photoreceptors are most sensitive. We compare the optical system of the helmet gecko to that of the diurnal day gecko, Phelsuma madagascariensis grandis. The optical system of the day gecko shows no signs of distinct concentric zones and is thereby monofocal.
Optimal temporal modulation of the stimulus can improve foveal contrast sensitivity. This study evaluates the characteristics of the peripheral spatiotemporal contrast sensitivity function in normal-sighted subjects. The purpose is to identify a temporal modulation that can potentially improve the remaining peripheral visual function in subjects with central visual field loss. High contrast resolution cut-off for grating stimuli with four temporal frequencies (0, 5, 10 and 15 Hz drift) was first evaluated in the 10° nasal visual field. Resolution contrast sensitivity for all temporal frequencies was then measured at four spatial frequencies between 0.5 cycles per degree (cpd) and the measured stationary cut-off. All measurements were performed with eccentric optical correction. Similar to foveal vision, peripheral contrast sensitivity is highest for a combination of low spatial frequency and 5–10 Hz drift. At higher spatial frequencies, there was a decrease in contrast sensitivity with 15 Hz drift. Despite this decrease, the resolution cut-off did not vary largely between the different temporal frequencies tested. Additional measurements of contrast sensitivity at 0.5 cpd and resolution cut-off for stationary (0 Hz) and 7.5 Hz stimuli performed at 10, 15, 20 and 25° in the nasal visual field also showed the same characteristics across eccentricities.
Correction and manipulation of peripheral refractive errors are indispensable for people with central vision loss and in optical interventions for myopia control. This study investigates further enhancements of peripheral vision by compensating for monochromatic higher-order aberrations (with an adaptive optics system) and chromatic aberrations (with a narrowband green filter, 550 nm) in the 20 degrees nasal visual field. Both high-contrast detection cutoff and contrast sensitivity improved with optical correction. This improvement was most evident for gratings oriented perpendicular to the meridian due to asymmetric optical errors. When the natural monochromatic higher-order aberrations are large, resolution of 10% contrast oblique gratings can also be improved with correction of these errors. Though peripheral vision is mainly limited by refractive errors and neural factors, higher-order aberration correction beyond conventional refractive errors can still improve peripheral vision under certain circumstances.
A prolonged exposure to foveal defocus is well known to affect the visual functions in the fovea. However, the effects of peripheral blur adaptation on foveal vision, or vice versa, are still unclear. In this study, we therefore examined the changes in contrast sensitivity function from baseline, following blur adaptation to small as well as laterally extended stimuli in four subjects. The small field stimulus (7.5° visual field) was a 30. min video of forest scenery projected on a screen and the large field stimulus consisted of 7-tiles of the 7.5° stimulus stacked horizontally. Both stimuli were used for adaptation with optical blur (+2.00. D trial lens) as well as for clear control conditions. After small field blur adaptation foveal contrast sensitivity improved in the mid spatial frequency region. However, these changes neither spread to the periphery nor occurred for the large field blur adaptation. To conclude, visual performance after adaptation is dependent on the lateral extent of the adaptation stimulus.
The aim of this study was to evaluate the accommodation response under both mono-and polychromatic light while varying the amount of spherical aberration. It is thought that chromatic and spherical aberrations are directional cues for the accommodative system and could affect response time, velocity or lag. Spherical aberration is often eliminated in modern contact lenses in order to enhance image quality in the unaccommodated eye. This study was divided into two parts. The first part was done to evaluate the amount of spherical and other Zernike aberrations in the unaccommodated eye when uncorrected and with two types of correction (trial lens and spherical-aberration controlled contact lens) and the second part evaluated the dynamic accommodation responses obtained when wearing each of the corrections under polychromatic and monochromatic conditions. Measurements of accommodation showed no significant differences in time, velocity and lag of accommodation after decreasing the spherical aberration with a contact lens, neither in monochromatic nor polychromatic light. It is unlikely that small to normal changes of spherical aberration in white light or monochromatic mid-spectral light affect directional cues for the accommodative system, not in white light or mid-spectral monochromatic light, since the accommodative response did not show any change.
Transverse chromatic aberration (TCA) is one of the largest optical errors affecting the peripheral image quality in the human eye. However, the effect of chromatic aberrations on our peripheral vision is largely unknown. This study investigates the effect of prism-induced horizontal TCA on vision, in the central as well as in the 20 degrees nasal visual field, for four subjects. Additionally, the magnitude of induced TCA (in minutes of arc) was measured subjectively in the fovea with a Vernier alignment method. During all measurements, the monochromatic optical errors of the eye were compensated for by adaptive optics. The average reduction in foveal grating resolution was about 0.032 +/- 0.005 logMAR/arcmin of TCA (mean +/- std). For peripheral grating detection, the reduction was 0.057 +/- 0.012 logMAR/arcmin. This means that the prismatic effect of highly dispersive spectacles may reduce the ability to detect objects in the peripheral visual field.
The purpose of this study was to measure the transverse chromatic aberration (TCA) across the visual field of the human eye objectively. TCA wasmeasured at horizontal and vertical field angles out to ±15° from foveal fixation in the right eye of four subjects. Interleaved retinal images were taken at wavelengths 543 nm and 842 nm in an adaptive optics scanning laser ophthalmoscope (AOSLO). To obtain true measures of the human eye's TCA, the contributions of the AOSLO system's TCA were measured using an on-axis aligned model eye and subtracted from the ocular data. The increase in TCA was found to be linear with eccentricity, with an average slope of 0.21 arcmin/degree of visual field angle (corresponding to 0.41 arcmin/degree for 430 nm to 770 nm). The absolute magnitude of ocular TCA varied between subjects, but was similar to the resolution acuity at 10° in the nasal visual field, encompassing three to four cones. Therefore, TCA can be visually significant. Furthermore, for high-resolution imaging applications, whether visualizing or stimulating cellular features in the retina, it is important to consider the lateral displacements between wavelengths and the variation in blur over the visual field.