ELEMENTARY OPHTHALMIC OPTICS
CONTENTS OBJECTIVES QUICK-START GUIDE: OPTICS, REFRACTION, AND RETINOSCOPY PART 1: OPTICS HIGHLIGHTS GLOSSARY INTRODUCTION THE CAMERA OBSCURA: PINHOLE IMAGING CONVEX LENSES COMBINING LENSES IMAGING NEARBY OBJECTS: VERGENCE AND THE VERGENCE EQUATION CONCAVE LENSES SUMMARY THUS FAR IMAGES IN DENSER MEDIA A VERY MUCH SIMPLIFIED MODEL EYE ASTIGMATISM PART 2: REFRACTION OVERVIEW OF CLINICAL REFRACTION STEP 1 PERFORM THE PRELIMINARIES STEP 2 OCCLUDE 1 EYE STEP 3 OBTAIN INITIAL ESTIMATE OF THE REFRACTIVE ERROR STEP 4 REFINE CYLINDER AXIS AND POWER STEP 5 REFINE SPHERE POWER STEP 6 OCCLUDE THE RIGHT EYE, REFRACT THE LEFT EYE STEP 7 ACCOMMODATIVE CONTROL AND BINOCULAR BALANCE STEP 8 REFRACT FOR NEAR VISION FINAL REMARKS PART 3: RETINOSCOPY THE ROLE OF RETINOSCOPY TYPES OF RETINOSCOPES FUNDAMENTAL CONCEPTS PRELIMINARIES FOR RETINOSCOPY BASIC RETINOSCOPE OPERATION PUTTING IT ALL TOGETHER SUBJECTIVE RETINOSCOPY FINDINGS 1 GEOMETRIC OPTICS REFRACTIVE INDEX FLAT REFRACTING SURFACES: SNELL’S LAW PRISMS PRISM POWER FRESNEL PRISMS REFLECTION CRITICAL ANGLE AND TOTAL INTERNAL REFLECTION REFRACTION BY A SINGLE CURVED SURFACE TWO-SIDED LENSES PRINCIPAL PLANES AND RAY TRACING DEPTH OF FOCUS AND DEPTH OF FIELD GENERAL REFRACTING SYSTEMS CHARACTERISTICS OF OBJECTS AND IMAGES: REAL AND VIRTUAL TRANSVERSE MAGNIFICATION AXIAL (LONGITUDINAL) MAGNIFICATION CONJUGATE POINTS NODAL POINTS THE REDUCED, OR EQUIVALENT, OPTICAL SYSTEM ABERRATIONS POINT SPREAD FUNCTION WAVEFRONT THEORY CHROMATIC ABERRATION THE CONOID OF STURM THE SPHERICAL EQUIVALENT THE POWER CROSS POWER-VERSUS-MERIDIAN GRAPH JACKSON CROSS CYLINDER MIRRORS TELESCOPES APPENDIX 1-1 DERIVATION OF THE VERGENCE EQUATION AND THE LENSMAKER’S EQUATION FROM SNELL’S LAW APPENDIX 1-2 FERMAT’S PRINCIPLE APPENDIX 1-3 DERIVATION OF THE VERGENCE EQUATION FOR MIRRORS APPENDIX 1-4 DYNAMIC RAY TRACING 2 PHYSICAL OPTICS WHAT IS LIGHT? VISIBLE LIGHT WAVE OR PARTICLE? QUANTUM ELECTRODYNAMICS: UNIFYING THEORY OF LIGHT REFRACTION AND REFLECTION SCATTERING PHENOMENA OF LIGHT POLARIZATION INTERFERENCE AND COHERENCE DIFFRACTION MEASURES OF LIGHT RADIOMETRY PHOTOMETRY CONVERSION BETWEEN RADIOMETRIC AND PHOTOMETRIC OUTPUTS LIGHT SOURCES: LASERS FUNDAMENTALS THERAPEUTIC LASER–TISSUE INTERACTIONS LIGHT HAZARDS APPENDIX 2-1 RECONCILIATION OF GEOMETRIC OPTICS AND PHYSICAL OPTICS CHAPTER EXERCISES QUESTIONS ANSWERS 3 OPTICS OF THE HUMAN EYE 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 EYE GROWTH AND REFRACTIVE ERRORS DEVELOPMENTAL MYOPIA PREVENTION OF MYOPIA PROGRESSION DEVELOPMENTAL HYPEROPIA APPENDIX 3-1 EXPLANATION OF THE ETDRS VISUAL ACUITY CHART 4 CLINICAL REFRACTION MINUS CYLINDER AND PLUS CYLINDER TERMINOLOGY EXAMINATION ROOM LENGTH OBJECTIVE REFRACTION TECHNIQUE: RETINOSCOPY FIXATION AND FOGGING ABERRATIONS OF THE RETINOSCOPIC REFLEX PSEUDONEUTRALIZATION CYCLOPLEGIC RETINOSCOPY SUBJECTIVE REFRACTION TECHNIQUES STENOPEIC SLIT TECHNIQUE CROSS-CYLINDER TECHNIQUE REFINING THE SPHERE BINOCULAR BALANCE CYCLOPLEGIC AND NONCYCLOPLEGIC REFRACTION OVERREFRACTION 5 EYEGLASSES 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 PANTOSCOPIC TILT 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 PRENTICE’S RULE AND BIFOCAL LENS DESIGN OCCUPATION AND BIFOCAL SEGMENT PRESCRIBING SPECIAL LENSES APHAKIC LENSES ABSORPTIVE LENSES SPECIAL LENS MATERIALS THERAPEUTIC USE OF PRISMS MANAGEMENT OF ANISOMETROPIA TROUBLESHOOTING FOR DISSATISFIED SPECTACLE WEARERS PHARMACOLOGIC TREATMENT OF PRESBYOPIA 6 CONTACT LENSES CONTACT LENS OPTICS ANISOMETROPIA AND IMAGE SIZE ACCOMMODATION CORRECTING ASTIGMATISM CONTACT LENS MATERIALS PATIENT HISTORY AND EXAMINATION CONTACT LENS SELECTION CONTACT LENS FITTING SOFT CONTACT LENSES CORNEAL RIGID GAS-PERMEABLE CONTACT LENSES TORIC SOFT CONTACT LENSES CONTACT LENSES FOR PRESBYOPIA KERATOCONUS AND THE ABNORMAL CORNEA SCLERAL RIGID GAS-PERMEABLE CONTACT LENSES CONTACT LENS OVERREFRACTION THERAPEUTIC USE OF CONTACT LENSES ORTHOKERATOLOGY AND CORNEAL RESHAPING CUSTOM CONTACT LENSES CONTACT LENS CARE AND SOLUTIONS CONTACT LENS–RELATED PROBLEMS AND COMPLICATIONS INFECTIONS HYPOXIC/METABOLIC PROBLEMS TOXICITY MECHANICAL PROBLEMS INFLAMMATION DRY EYE OVER-THE-COUNTER CONTACT LENSES FEDERAL LAW AND CONTACT LENSES 7 INTRAOCULAR LENSES OPTICAL CONSIDERATIONS FOR INTRAOCULAR LENSES INTRAOCULAR LENS POWER CALCULATION INTRAOCULAR LENS POWER CALCULATION AFTER CORNEAL REFRACTIVE SURGERY INSTRUMENT ERROR FORMULA ERROR POWER CALCULATION METHODS FOR EYES AFTER A KERATOREFRACTIVE PROCEDURE SPECIAL CONSIDERATION: POSTOPERATIVE REFRACTIVE SURPRISE IN PATIENTS WHO HAVE UNDERGONE MYOPIC KERATOREFRACTIVE CORRECTION 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 MODULATION TRANSFER FUNCTION INTRAOCULAR LENS STANDARDS 8 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 APPENDIX 8-1 DERIVATION OF THE MUNNERLYN FORMULA 9 OPTICAL INSTRUMENTS REFRACTION AND TOPOGRAPHY LENSMETER AUTOREFRACTORS KERATOMETER CORNEAL TOPOGRAPHY WAVEFRONT ABERROMETERS ANTERIOR- AND POSTERIOR-SEGMENT IMAGING SLIT-LAMP BIOMICROSCOPE EXAMINATION TECHNIQUES APPLANATION TONOMETRY SURGICAL MICROSCOPE SPECULAR MICROSCOPY AUXILIARY LENSES FOR SLIT-LAMP EXAMINATION OF THE RETINA OPHTHALMOSCOPY FUNDUS CAMERA SCANNING LASER OPHTHALMOSCOPE OPTICAL COHERENCE TOMOGRAPHY ADAPTIVE OPTICS 10 VISION REHABILITATION LOW VISION EVALUATION: HISTORY PATIENTS’ GOALS OCULAR HISTORY GENERAL HISTORY CHARLES BONNET SYNDROME LOW VISION EVALUATION: ASSESSMENT OF VISUAL FUNCTION REFRACTION CONTRAST SENSITIVITY CENTRAL VISUAL FIELD PERIPHERAL VISUAL FIELD ASSESSMENT OF OTHER VISUAL FUNCTIONS PERFORMANCE OF VISUAL TASKS INTERVENTIONS TECHNOLOGY AND ELECTRONIC DEVICES OPTICAL DEVICES NONOPTICAL AIDS AND ALTERNATIVE STRATEGIES SIGHT SUBSTITUTION TRAINING VISION REHABILITATION FOR FIELD LOSS DISCUSSION WITH PATIENTS OTHER SERVICES PEDIATRIC VISION REHABILITATION RESOURCES MATERIALS FOR PATIENTS MATERIALS FOR OPHTHALMOLOGISTS OBJECTIVES UPON COMPLETION OF BCSC SECTION 3, CLINICAL OPTICS AND VISION REHABILITATION, THE READER SHOULD BE ABLE TO EXPLAIN THE PRINCIPLES OF LIGHT PROPAGATION AND IMAGE FORMATION STATE SOME OF THE FUNDAMENTAL EQUATIONS THAT DESCRIBE OR MEA SURE SUCH PROPERTIES AS REFRACTION, REFLECTION, MAGNIFICATION, AND VERGENCE EXPLAIN HOW THE PRINCIPLES NOTED ABOVE CAN BE APPLIED DIAGNOS TICALLY AND THERAPEUTICALLY DESCRIBE THE CLINICAL APPLICATION OF SNELL’S LAW AND THE LENSMAKER’S EQUATION DESCRIBE THE RELATIONSHIP BETWEEN PHYSICAL OPTICS AND GEOMETRIC OPTICS DESCRIBE THE CLINICAL AND TECHNICAL RELEVANCE OF SUCH OPTICAL PHENOMENA AS INTERFERENCE, COHERENCE, POLARIZATION, DIFFRACTION, AND SCATTERING EXPLAIN THE BASIC PROPERTIES OF LASER LIGHT AND HOW THEY AFFECT LASER–TISSUE INTERACTION IDENTIFY OPTICAL MODELS OF THE HUMAN EYE AND DESCRIBE HOW TO APPLY THEM DESCRIBE VARIOUS ASPECTS OF VISUAL PERFORMANCE, INCLUDING VISUAL ACUITY, BRIGHTNESS SENSITIVITY, COLOR PERCEPTION, AND CONTRAST SENSITIVITY LIST THE STEPS FOR PERFORMING STREAK RETINOSCOPY IDENTIFY THE STEPS FOR PERFORMING A MANIFEST REFRACTION USING A PHOROPTER OR TRIAL LENSES DESCRIBE THE USE OF THE JACKSON CROSS CYLINDER DESCRIBE THE INDICATIONS FOR PRESCRIBING BIFOCAL AND PROGRESSIVE LENSES AS WELL AS COMMON DIFFICULTIES ENCOUNTERED IN THEIR USE IDENTIFY THE MATERIALS AND FITTING PARAMETERS OF BOTH SOFT AND RIGID CONTACT LENSES DESCRIBE THE BASIC METHODS OF CALCULATING INTRAOCULAR LENS (IOL) POWERS AND THE ADVANTAGES AND DISADVANTAGES OF THE DIFFERENT METHODS EXPLAIN THE CONCEPTUAL BASIS OF MULTIFOCAL IOLS AND HOW THE CORRECTION OF PRESBYOPIA DIFFERS BETWEEN IOLS AND SPECTACLES EXPLAIN THE OPTICAL PRINCIPLES UNDERLYING VARIOUS MODALITIES OF REFRACTIVE CORRECTION: SPECTACLES, CONTACT LENSES, IOLS, AND REFRACTIVE SURGERY DESCRIBE THE OPERATING PRINCIPLES OF VARIOUS OPTICAL INSTRUMENTS IN ORDER TO USE THEM EFFECTIVELY DESCRIBE THE VISUAL NEEDS OF PATIENTS WITH LOW VISION AND HOW TO ADDRESS THESE NEEDS THROUGH USE OF OPTICAL AND NONOPTICAL DEVICES AND/OR APPROPRIATE REFERRALS STATE HOW SOCIAL DETERMINANTS OF HEALTH CAN AFFECT THE LOW-VISION PATIENT POPULATION