Objective measurement of wave aberrations of the human eye with the use of a Hartmann-Shack wave-front sensor

Recent advances in measurement of monochromatic aberrations of human eyes

The field of aberrations of the human eye is moving rapidly, being driven by the desire to monitor and optimise vision following refractive surgery. It is important for ophthalmologists and optometrists to have an understanding of the magnitude of various aberrations and how these are likely to be affected by refractive surgery and other corrections. In this paper, I consider methods used to measure aberrations, the magnitude of aberrations in general populations and how these are affected by various factors (for example, age, refractive error, accommodation and refractive surgery) and how aberrations and their correction affect spatial visual performance.

Robust wavefront segment registration based on a parallel approach

This paper presents a robust registration algorithm for wavefront reconstruction from multiple partial measurements. Wavefronts exceeding the dynamic range or size of the Shack-Hartmann sensor can be measured as a set of segments. The wavefront is reconstructed by parallel registration of these wavefront segments, enabling compensation for sensor misalignment as well as for phase differences. For registration, a global mismatch metric is minimized by rigid body transformations and propagation of the wavefront segments. Apart from the description of the algorithm, a simulation-based evaluation and comparison to the iterative closest point (ICP) algorithm is performed. It is shown that in the case of a noisy data set, the parallel approach enables reconstruction errors that are a factor of 10 smaller than the result obtained with the ICP algorithm.

Complex wavefront sensing based on alternative structured phase modulation

Spatial light modulators (SLMs), which generate varying phase modulation, are widely used in coherent diffraction imaging. Random patterns are uploaded on the SLM to modulate the measured wavefront. However, a random pattern is highly complex and requires a reliable SLM. In addition, the uncorrelated terms generated from the random modulations need to be sufficiently captured using an imaging sensor with a high signal-to-noise ratio (SNR) to avoid stagnation during iterations. We propose an alternative structured phase modulation (ASPM) method. The modulations are composed of orthogonally placed phase bars that introduce uncorrelated modulations. The ASPM modulation can act as the phase grating; in addition, the modulated intensities are concentrated, which can be captured with a high SNR. The complexity of the ASPM patterns is significantly reduced, which is helpful for utilizing the SLM to generate reliable phase modulation.

Correcting Higher Order Aberrations Using Image Processing

Higher Order Aberrations (HOAs) are complex refractive errors in the human eye that cannot be corrected by regular lens systems. Researchers have developed numerous approaches to analyze the effect of these refractive errors; the most popular among these approaches use Zernike polynomial approximation to describe the shape of the wavefront of light exiting the pupil after it has been altered by the refractive errors. We use this wavefront shape to create a linear imaging system that simulates how the eye perceives source images at the retina. With phase information from this system, we create a second linear imaging system to modify source images so that they would be perceived by the retina without distortion. By modifying source images, the visual process cascades two optical systems before the light reaches the retina, a technique that counteracts the effect of the refractive errors. While our method effectively compensates for distortions induced by HOAs, it also introduces blurring and loss of contrast; a problem that we address with Total Variation Regularization. With this technique, we optimize source images so that they are perceived at the retina as close as possible to the original source image. To measure the effectiveness of our methods, we compute the Euclidean error between the source images and the images perceived at the retina. When comparing our results with existing corrective methods that use deconvolution and total variation regularization, we achieve an average of 50% reduction in error with lower computational costs.

Adaptive optics: principles and applications in ophthalmology

This is a comprehensive review of the principles and applications of adaptive optics (AO) in ophthalmology. It has been combined with flood illumination ophthalmoscopy, scanning laser ophthalmoscopy, as well as optical coherence tomography to image photoreceptors, retinal pigment epithelium (RPE), retinal ganglion cells, lamina cribrosa and the retinal vasculature. In this review, we highlight the clinical studies that have utilised AO to understand disease mechanisms. However, there are some limitations to using AO in a clinical setting including the cost of running an AO imaging service, the time needed to scan patients, the lack of normative databases and the very small size of area imaged. However, it is undoubtedly an exceptional research tool that enables visualisation of the retina at a cellular level.

Laser beam focusing through a moderately scattering medium using a bimorph mirror

The rarely considered case when the optical radiation passes through the weakly scattering medium, e.g. mid-density atmospheric fog with the number of scattering events up to 10 was investigated in this paper. We demonstrated an improvement of focusing of a laser beam (λ=0.65 µm) passed through the 5 mm-thick layer of scattering suspension of 1 µm polystyrene microbeads diluted in a distilled water. For the first time the low-order aberration corrector - wide aperture bimorph deformable mirror with 48 electrodes configured in 6 rings was used to optimize a far-field focal spot. We compared efficiencies of the algorithm that optimized the positions of the focal spots on Shack-Hartmann type sensor and the algorithm that optimized the peak brightness and the diameter of the far-field focal spot registered with a CCD. We experimentally demonstrated the increase of the peak brightness of the far-field focal spot by up to 60% due to the use of the bimorph deformable mirror for beam focusing through the scattering medium with concentration values of scatterers ranged from 10⁵ to 10⁶ mm^-3.

Accuracy of WASCA Aberrometer Refraction Compared to Manifest Refraction and Cycloplegic Refraction in Hyperopia Measurement

Purpose

To explore the agreement between the wavefront supported custom ablation (WASCA) aberrometer and manifest refraction (MR) and cycloplegic refraction (CR) in hyperopia testing.

Methods

Ninety eyes of 90 hyperopic patients (spherical equivalent ≥ +0.5 D) were evaluated; MR, CR, and WASCA refraction (WR) were performed consecutively. Analysis pupil size was 6.0 mm in WASCA measurement using the Seidel method. The conventional notation was transferred into vector components for analysis, i.e., spherical equivalent (M) and two cross-cylinders at axis 0° (J₀) and axis 45° (J₄₅). Bland-Altman plots were used to test the agreement between the two measurements.

Results

The mean Ms obtained with MR and CR were 3.23 ± 1.74 D and 4.04 ± 2.04 D, respectively (P < 0.001), and the correlation was high (r = 0.90, P < 0.001). The WR was highly correlated with MR and CR in terms of M (r = 0.89, 0.87), but not significantly correlated in J₀ and J₄₅. The total dioptric power vector error was 0.18 ± 1.00 D between WR and MR and −0.64 ± 1.03 D between WR and CR. The limits of agreement of all vector components were beyond ± 1.0 D. With hyperopia level increase, WR tended to overestimate MR (P = 0.04), whereas WR always underestimated CR.

Conclusions

WASCA could act as a reference of subjective refraction in hyperopia measurement, the exchangeability is not fully applicable.

Translational Relevance

WASCA can provide an alternative for objective refraction in hyperopia measurement.

Average gradient of Zernike polynomials over polygons

Wavefront estimation from slope sensor data is often achieved by fitting measured slopes with Zernike polynomial derivatives averaged over the sampling subapertures. Here we discuss how the calculation of these average derivatives can be reduced to one-dimensional integrals of the Zernike polynomials, rather than their derivatives, along the perimeter of each subaperture. We then use this result to derive closed-form expressions for the average Zernike polynomial derivatives over polygonal areas, only requiring evaluation of polynomials at the polygon vertices. Finally, these expressions are applied to simulated Shack-Hartmann wavefront sensors with 7 and 23 fully illuminated lenslets across a circular pupil, with their accuracy and calculation time compared against commonly used integration methods.

Wavefront reconstruction of a Shack-Hartmann sensor with insufficient lenslets based on an extreme learning machine

In a standard Shack-Hartmann wavefront sensor, the number of effective lenslets is the vital parameter that limits the wavefront restoration accuracy. This paper proposes a wavefront reconstruction algorithm for a Shack-Hartmann wavefront sensor with an insufficient microlens based on an extreme learning machine. The neural network model is used to fit the nonlinear corresponding relationship between the centroid displacement and the Zernike model coefficients under a sparse microlens. Experiments with a 6×6 lenslet array show that the root mean square (RMS) relative error of the proposed method is only 4.36% of the initial value, which is 80.72% lower than the standard modal algorithm.

Shack-Hartmann versus reverse Hartmann wavefront sensors: experimental results

With respect to the classical Shack-Hartmann (SH) wavefront sensor (WFS), the recently proposed reverse Hartmann (RH) sensor inverts the locations of the filtering and observation planes and forms a direct image of the pupil on a detector array. The slopes of the wavefront error (WFE) are then reconstructed by using a double Fourier transform algorithm. It turns out that the same algorithm can also be applied to the raw data acquired by SH sensors. This Letter presents the first, to the best of our knowledge, experimental results obtained with a simplified RH WFS and their comparison to those provided by a reference SH sensor, in both classical and double Fourier transform modes. They demonstrate that similar WFE measurement accuracy is achievable when using the three techniques, at least within the limit of our test bench that is estimated around $\lambda/10$λ/10 RMS.

Dependence of fluorodeoxyglucose (FDG) uptake on cell cycle and dry mass: a single-cell study using a multi-modal radiography platform

High glucose uptake by cancer compared to normal tissues has long been utilized in fluorodeoxyglucose-based positron emission tomography (FDG-PET) as a contrast mechanism. The FDG uptake rate has been further related to the proliferative potential of cancer, specifically the proliferation index (PI) - the proportion of cells in S, G2 or M phases. The underlying hypothesis was that the cells preparing for cell division would consume more energy and metabolites as building blocks for biosynthesis. Despite the wide clinical use, mixed reports exist in the literature on the relationship between FDG uptake and PI. This may be due to the large variation in cancer types or methods adopted for the measurements. Of note, the existing methods can only measure the average properties of a tumor mass or cell population with highly-heterogeneous constituents. In this study, we have built a multi-modal live-cell radiography system and measured the [18F]FDG uptake by single HeLa cells together with their dry mass and cell cycle phase. The results show that HeLa cells take up twice more [18F]FDG in S, G2 or M phases than in G1 phase, which confirms the association between FDG uptake and PI at a single-cell level. Importantly, we show that [18F]FDG uptake and cell dry mass have a positive correlation in HeLa cells, which suggests that high [18F]FDG uptake in S, G2 or M phases can be largely attributed to increased dry mass, rather than the activities preparing for cell division. This interpretation is consistent with recent observations that the energy required for the preparation of cell division is much smaller than that for maintaining house-keeping proteins.

Validation of a Clinical Aberrometer Using Pyramidal Wavefront Sensing

SIGNIFICANCE

Measurement of ocular aberrations is a critical component of many optical corrections.

PURPOSE

This study examines the accuracy and repeatability of a newly available high-resolution pyramidal wavefront sensor-based aberrometer (Osiris by Costruzione Strumenti Oftalmici, Firenze, Italy).

METHODS

An engineered model eye and a dilated presbyopic eye were used to assess accuracy and repeatability of aberration measurements after systematic introduction of lower- and higher-order aberrations with calibrated trial lenses (sphere +10.00 to -10.00 D, and astigmatic -4.00 and -2.00 D with axis 180, 90, and 45°) and phase plates (-0.57 to 0.60 μm of Seidel spherical aberration defined over a 6-mm pupil diameter). Osiris aberration measurements were compared with those acquired on a previously calibrated COAS-HD aberrometer for foveal and peripheral optics both with and without multizone dual-focus contact lenses. The impact of simulated axial and lateral misalignment was evaluated.

RESULTS

Root-mean-square errors for paraxial sphere (corneal plane), cylinder, and axis were, respectively, 0.07, 0.11 D, and 1.8° for the engineered model and 0.15, 0.26 D, and 2.7° for the presbyopic eye. Repeatability estimates (i.e., standard deviation of 10 repeat measures) for the model and presbyopic eyes were 0.026 and 0.039 D for spherical error. Root-mean-square errors of 0.01 and 0.02 μm, respectively, were observed for primary spherical aberration and horizontal coma (model eye). Foveal and peripheral measures of higher- and lower-order aberrations measured with the Osiris closely matched parallel data collected with the COAS-HD aberrometer both with and without dual-focus zonal bifocal contact lenses. Operator errors of focus and alignment introduced changes of 0.018 and 0.02 D/mm in sphere estimates.

CONCLUSIONS

The newly available clinical pyramidal aberrometer provided accurate and repeatable measures of lower- and higher-order aberrations, even in the challenging but clinically important cases of peripheral retina and multifocal optics.

Effects of the LASIK flap thickness on corneal biomechanical behavior: a finite element analysis

Background

It is well known that the biomechanical properties change after LASIK refractive surgery. One reason is the impact of flap creation on the residual stroma. The results have revealed that the change is closely related with the flap thickness in several studies. However, the quantitative relationships between the distributions of displacement and stress on the corneal surface and flap thickness have not been studied. The aim of the study was to quantify evaluate the biomechanical change caused by the LASIK flap.

Methods

By building a finite element model of the cornea, the displacement, the stress and the strain on the corneal surface were analyzed.

Results

The results showed that the corneal flap could obviously cause the deformation of the anterior corneal surface. For example, the displacement of the corneal vertex achieved 15 μm more than that without corneal flap, when the thickness of corneal flap was 120 μm thick. This displacement was enough to cause the change of aberrations in the human eyes. In the central part of the cornea, the stress on the anterior corneal surface increased with flap thickness. But the change in the stress on the posterior corneal surface was significantly less than that on the anterior surface. In addition, the stress in the central part of the anterior corneal surface increased significantly as the intra-ocular pressure (IOP) increase. Furthermore the increase of IOP had a clearly less effect on stress distribution at the edge of the cornea. Distributions of strain on the corneal surface were similar to those of stress.

Conclusions

The changes in the biomechanical properties of cornea after refractive surgery should not be ignored.

Intraoperative aberrometry versus preoperative biometry for intraocular lens power selection in axial myopia

PURPOSE

To compare the accuracy of intraoperative wavefront aberrometry (ORA) and the Hill-radial basis function (RBF) formula with other formulas based on preoperative biometry in predicting residual refractive error after cataract surgery in eyes with axial myopia.

SETTING

Private practice, Harrisburg, Pennsylvania, USA.

DESIGN

Retrospective consecutive case series.

METHODS

Eyes with an axial length (AL) greater than 25.0 mm had cataract extraction with intraocular lens implantation. For each eye, the 1-center Wang-Koch AL-optimized Holladay 1 formula was used to select an IOL targeting emmetropia. Residual refractive error was predicted preoperatively using the SRK/T, Holladay 1 and 2, Barrett Universal II, and Hill-RBF formulas and intraoperatively using wavefront aberrometry. The postoperative refraction was compared with the preoperative and intraoperative predictions.

RESULTS

The study comprised 37 patients (51 eyes). The mean numerical errors ± standard error associated with using the SRK/T, Holladay 1, AL-optimized Holladay 1, Holladay 2, Barrett Universal II, and Hill-RBF formulas and intraoperative wavefront aberrometry were 0.20 ± 0.06 diopters (D), 0.33 ± 0.06 D, -0.02 ± 0.06 D, 0.24 ± 0.06 D, 0.19 ± 0.06 D, 0.22 ± 0.06 D, and 0.056 ± 0.06 D, respectively (P < .001). The proportion of patients within ±0.5 D of the predicted error was 74.5%, 62.8%, 82.4%, 79.1%, 73.9%, 76.7%, and 80.4%, respectively (P = .090). Hyperopic outcomes occurred in 70.6%, 76.5%, 49.0%, 74.4%, 76.1%, 74.4%, and 45.1% of the eyes, respectively (P = .007).

CONCLUSIONS

Intraoperative wavefront aberrometry was better than all formulas based on preoperative biometry and as effective as the AL-optimized Holladay 1 formula in predicting residual refractive error and reducing hyperopic outcomes. The Hill-RBF formula's performance was similar to that of the fourth-generation formulas.

Cellular imaging of inherited retinal diseases using adaptive optics

Adaptive optics (AO) is an insightful tool that has been increasingly applied to existing imaging systems for viewing the retina at a cellular level. By correcting for individual optical aberrations, AO offers an improvement in transverse resolution from 10-15 μm to ~2 μm, enabling assessment of individual retinal cell types. One of the settings in which its utility has been recognised is that of the inherited retinal diseases (IRDs), the genetic and clinical heterogeneity of which warrants better cellular characterisation. In this review, we provide a summary of the basic principles of AO, its integration into multiple retinal imaging modalities and its clinical applications, focusing primarily on IRDs. Furthermore, we present a comprehensive summary of AO-based cellular findings in IRDs according to their associated disease-causing genes.

Accounting for focal shift in the Shack-Hartmann wavefront sensor

The Shack-Hartmann wavefront sensor samples a beam of light using an array of lenslets, each of which creates an image onto a pixelated sensor. These images translate from their nominal position by a distance proportional to the average wavefront slope over the corresponding lenslet. This principle fails in partially and/or non-uniformly illuminated lenslets when the lenslet array is focused to maximize peak intensity, leading to image centroid bias. Here, we show that this bias is due to the low Fresnel number of the lenslets, which shifts the diffraction focus away from the geometrical focus. We then demonstrate how the geometrical focus can be empirically found by minimizing the bias in partially illuminated lenslets.

Optical properties of electrically controlled arc-electrode liquid-crystal microlens array for wavefront measurement and adjustment

An electrically controlled arc-electrode liquid-crystal microlens array (AE-LCMLA), with tuning and swing focus, is proposed, which can be utilized to replace the traditional mechanically controlled microlenses and also cooperate with photosensitive arrays to solve the problems of measuring and further adjusting a strong distortion wavefront. The top patterned electrode of a single LC microlens is composed of three arc-electrodes distributed symmetrically around a central microhole for constructing the key controlling structures of the LC cavity in the AE-LCMLA. All the arc-electrodes are individually controlled, and then the focal spot of each microlens can be moved freely in a three-dimensional fashion including along the optical axial direction and over the focal plane by simply adjusting the driving signal voltage applied over each arc-electrode, independently. The featured performances of the AE-LCMLA in a wavelength range of ∼501-561  nm are the driving signal voltage being relatively low (less than ∼11  V_rms), the focal length tuning range being from ∼2.54  mm to ∼3.50  mm, the maximum focus swing distance being ∼52.92  μm, and the focus swing ratio K being ∼20‰.

"For Mass Eye and Ear Special Issue" Adaptive Optics in the Evaluation of Diabetic Retinopathy

Retinal imaging is a fundamental tool for clinical and research efforts in the evaluation and management of diabetic retinopathy. Adaptive optics (AO) is an imaging technique that enables correction of over 90% of the optical aberrations of an individual eye induced primarily by the tear film, cornea and lens. The two major tasks of any AO system are to measure the optical imperfections of the eye and to then compensate for these aberrations to generate a corrected wavefront of reflected light from the eye. AO scanning laser ophthalmoscopy (AOSLO) provides a theoretical lateral resolution limit of 1.4 μm, allowing the study of microscopic features of the retinal vascular and neural tissue. AOSLO studies have revealed irregularities of the photoreceptor mosaic, vascular loss, and details of vascular lesions in diabetic eyes that may provide new insight into development, regression, and response to therapy of diabetic eye disease.

Simulation of visual acuity by personalizable neuro-physiological model of the human eye

We present a model of the whole visual train to estimate an individual's visual acuity based on their eye's physical properties. Our simulation takes into account the optics of the eye, neural transmission and noise, as well as the recognition process. Personalized input data are represented by the ocular wavefront aberration and pupil diameter, both either coming from in vivo measurements of a subject or being produced by optical design software using a schematic eye. This flexibility opens the door to a broad range of potential applications, such as objective visual acuity measurements and intraocular lens design. Our algorithm contains only two adjustable neural parameters: additive noise σ, and discrimination range δρ, with their values being experimentally calibrated by fitting the results of simulations to the outcome of real acuity tests performed on healthy young subjects with normal vision (visual acuity: 0…-0.3 logMAR range). It was established that by using fixed values of σ = 0.10 and δρ = 0.0025 for each person examined, the residual of the acuity simulations averaged over the calibration group reached its minimum at 0.045 logMAR.

Irregular Astigmatism and Higher-Order Aberrations in Eyes With Dry Eye Disease

Visual disturbances were included in the definition of dry eye disease in the 2007 Dry Eye Workshop report. As a result, quality of vision (QoV) in dry eye patients has received increased attention. Corneal topography and wavefront sensors have been used to objectively and quantitatively evaluate optical quality, with data showing increases in irregular astigmatism and higher-order aberrations (HOAs) in dry eye patients. Furthermore, ocular optical characteristics are influenced by the tear film, which constantly fluctuates over time. Therefore, dynamic quantitative assessments of optical quality with continuous measurements are essential to understanding QoV in dry eye patients. This review summarizes what is known and what advances have been made in evaluating and understanding QoV in dry eye patients. In particular, corneal topographic and wavefront analyses, conducted both overseas and in Japan, are described.

WISH: wavefront imaging sensor with high resolution

Wavefront sensing is the simultaneous measurement of the amplitude and phase of an incoming optical field. Traditional wavefront sensors such as Shack-Hartmann wavefront sensor (SHWFS) suffer from a fundamental tradeoff between spatial resolution and phase estimation and consequently can only achieve a resolution of a few thousand pixels. To break this tradeoff, we present a novel computational-imaging-based technique, namely, the Wavefront Imaging Sensor with High resolution (WISH). We replace the microlens array in SHWFS with a spatial light modulator (SLM) and use a computational phase-retrieval algorithm to recover the incident wavefront. This wavefront sensor can measure highly varying optical fields at more than 10-megapixel resolution with the fine phase estimation. To the best of our knowledge, this resolution is an order of magnitude higher than the current noninterferometric wavefront sensors. To demonstrate the capability of WISH, we present three applications, which cover a wide range of spatial scales. First, we produce the diffraction-limited reconstruction for long-distance imaging by combining WISH with a large-aperture, low-quality Fresnel lens. Second, we show the recovery of high-resolution images of objects that are obscured by scattering. Third, we show that WISH can be used as a microscope without an objective lens. Our study suggests that the designing principle of WISH, which combines optical modulators and computational algorithms to sense high-resolution optical fields, enables improved capabilities in many existing applications while revealing entirely new, hitherto unexplored application areas.

Wide-range adaptive optics visual simulator with a tunable lens

An adaptive optics visual simulator (AOVS) with an extended dioptric range was developed, allowing measuring and correcting aberrations in a majority of highly ametropic eyes. In the instrument, a tunable lens is used for defocus correction, while a liquid-crystal-on-silicon spatial light modulator is used for compensating or inducing any other aberration. The instrument incorporates a digital projector, which uses a micromirror array to display the stimuli. A motorized diaphragm enables operation for any physiological pupil size. A full description of the instrument and its calibration are provided, together with the results obtained in seven highly myopic subjects with refraction of -7.2±1.8  D (mean±SD). Refraction obtained with the instrument was compared to the standard refraction prescribed by trial lenses. When using the refraction obtained by the AOVS, the visual acuity (VA) exhibited an average increase of 0.21 (decimal scale). The visual impact of correcting high-order aberrations is presented in three subjects, whose VAs slightly improved with the correction. High myopes are able to benefit from the improved refraction assessment. The new instrument creates a possibility for a wide number of new experiments, especially for eyes exhibiting large refractive errors, where previous AO instruments failed to operate.

Large dynamic range autorefraction with a low-cost diffuser wavefront sensor

Wavefront sensing with a thin diffuser has emerged as a potential low-cost alternative to a lenslet array for aberrometry. Here we show that displacement of caustic patterns can be tracked for estimating wavefront gradient in a diffuser wavefront sensor (DWFS), enabling large dynamic-range wavefront measurements with sufficient accuracy for eyeglass prescription measurements. We compare the dynamic range, repeatability, precision, and number of resolvable prescriptions of a DWFS to a Shack-Hartmann wavefront sensor (SHWFS) for autorefraction measurement. We induce spherical and cylindrical errors in a model eye and use a multi-level Demon's non-rigid registration algorithm to estimate caustic displacements relative to an emmetropic model eye. When compared to spherical error measurements with the SHWFS using a laser diode with a laser speckle reducer, the DWFS demonstrates a ∼5-fold improvement in dynamic range (-4.0 to +4.5 D vs. -22.0 to +19.5 D) with less than half the reduction in resolution (0.072 vs. 0.116 D), enabling a ∼3-fold increase in the number of resolvable prescriptions (118 vs. 358). In addition to being lower-cost, the unique, non-periodic nature of the caustic pattern formed by a diffuser enables a larger dynamic range of aberration measurements compared to a lenslet array.

Probing Computation in the Primate Visual System at Single-Cone Resolution

Daylight vision begins when light activates cone photoreceptors in the retina, creating spatial patterns of neural activity. These cone signals are then combined and processed in downstream neural circuits, ultimately producing visual perception. Recent technical advances have made it possible to deliver visual stimuli to the retina that probe this processing by the visual system at its elementary resolution of individual cones. Physiological recordings from nonhuman primate retinas reveal the spatial organization of cone signals in retinal ganglion cells, including how signals from cones of different types are combined to support both spatial and color vision. Psychophysical experiments with human subjects characterize the visual sensations evoked by stimulating a single cone, including the perception of color. Future combined physiological and psychophysical experiments focusing on probing the elementary visual inputs are likely to clarify how neural processing generates our perception of the visual world.

Measuring Ocular Aberrations Sequentially Using a Digital Micromirror Device

The Hartmann–Shack wavefront sensor is widely used to measure aberrations in both astronomy and ophthalmology. Yet, the dynamic range of the sensor is limited by cross-talk between adjacent lenslets. In this study, we explore ocular aberration measurements with a recently-proposed variant of the sensor that makes use of a digital micromirror device for sequential aperture scanning of the pupil, thereby avoiding the use of a lenslet array. We report on results with the sensor using two different detectors, a lateral position sensor and a charge-coupled device (CCD) scientific camera, and explore the pros and cons of both. Wavefront measurements of a highly aberrated artificial eye and of five real eyes, including a highly myopic subject, are demonstrated, and the role of pupil sampling density, CCD pixel binning, and scanning speed are explored. We find that the lateral position sensor is mostly suited for high-power applications, whereas the CCD camera with pixel binning performs consistently well both with the artificial eye and for real-eye measurements, and can outperform a commonly-used wavefront sensor with highly aberrated wavefronts.

Adaptive optics imaging of the human retina

Adaptive Optics (AO) retinal imaging has provided revolutionary tools to scientists and clinicians for studying retinal structure and function in the living eye. From animal models to clinical patients, AO imaging is changing the way scientists are approaching the study of the retina. By providing cellular and subcellular details without the need for histology, it is now possible to perform large scale studies as well as to understand how an individual retina changes over time. Because AO retinal imaging is non-invasive and when performed with near-IR wavelengths both safe and easily tolerated by patients, it holds promise for being incorporated into clinical trials providing cell specific approaches to monitoring diseases and therapeutic interventions. AO is being used to enhance the ability of OCT, fluorescence imaging, and reflectance imaging. By incorporating imaging that is sensitive to differences in the scattering properties of retinal tissue, it is especially sensitive to disease, which can drastically impact retinal tissue properties. This review examines human AO retinal imaging with a concentration on the use of the Adaptive Optics Scanning Laser Ophthalmoscope (AOSLO). It first covers the background and the overall approaches to human AO retinal imaging, and the technology involved, and then concentrates on using AO retinal imaging to study the structure and function of the retina.

Clinical evaluation of the repeatability of ocular aberrometry obtained with a new pyramid wavefront sensor

PURPOSE

To evaluate the intrasubject repeatability of the ocular aberrometry obtained with a new ocular pyramidal aberrometer technology in a sample of normal eyes.

METHODS

A total of 53 healthy eyes of 53 subjects with ages ranging from 18 to 45 years were included in this study. In all cases, three consecutive acquisitions were obtained. Intrasubject repeatability of the measurements with a pyramidal aberrometer was calculated. Intrasubject repeatability for 4.0- and 6.0-mm pupils was evaluated within the subject standard deviation (S_w) and intraclass correlation coefficient.

RESULTS

Low values of the S_w and intraclass correlation coefficient outcomes close to 1 were observed for the sphere and cylinder at 3.0-mm pupil size. Most low S_w and intraclass correlation coefficient values close to 1 were observed for total, low-order aberrations and higher-order aberrations root mean square and for each Zernike coefficient analysis (intraclass correlation coefficient ⩾0.798) at 4.0-mm pupil size, with more limited outcomes for the aberrometric coefficient of Z(4, 4) with an intraclass correlation coefficient of 0.683. For a 6.0 mm pupil diameter, low S_w and intraclass correlation coefficient values close to 1 were observed for all aberrometric parameters or Zernike coefficients analyzed (intraclass correlation coefficient ⩾0.850).

CONCLUSION

The new pyramidal aberrometer Osiris provides repeatable and consistent measurements of ocular aberrometry measurements in normal eyes.

Polynomial decomposition method for ocular wavefront analysis

Zernike circle polynomials are in widespread use for wavefront analysis because of their orthogonality over a circular pupil and their representation of balanced classical aberrations. However, some of the higher-order modes contain linear and quadratic terms. A new aberration series is proposed to better separate the low- versus higher-order aberration components. Because its higher-order modes are devoid of linear and quadratic terms, our new basis can be used to better fit the low- and higher-order components of the wavefront. This new basis may quantify the aberrations more accurately and provide clinicians with coefficient magnitudes which better underline the impact of clinically significant aberration modes.

High resolution full field wavefront measurement of a misaligned miniature lens

Compared with the industry standard MTF consequential testing result, the full field transmitted wavefront testing is more analytical for field aberration analysis. A novel wavefront measuring device specialized for the miniature lens testing application is developed to measure the full field aberration in a high resolution of 35x36 radial-azimuthal fields. The device adapts the high dynamic range Shack-Hartman wavefront sensor to minimize the alignment uncertainty induced from collimator under high field angle. The plane symmetrical aberration due to elements misalignment is identified and quantified throughout the measured field. The field constant coma and field linear astigmatism contributes most aberration errors to the edge of the field as expected. Through the field dependent aberration analysis. This device proves that the miniature lens image quality near the edge of the field is practically limited by the misalignment of the optical elements.

Fresnel diffraction analysis of Ronchi and reverse Hartmann tests

This paper presents a Fresnel diffraction analysis of classical Ronchi and reverse Hartmann tests. Simplified analytical expressions of the intensity patterns observed by the camera are established, allowing quantitative measurements of the wavefront slopes of the tested optical system. The wavefronts are then reconstructed from their slopes using a double Fourier transform algorithm. The optimization of the operational parameters of the system is discussed in view of different quality criteria, including relative pupil shear and contrast factors in both monochromatic and polychromatic light. Practical examples of applications are studied with the help of numerical simulations, demonstrating that measurement accuracies better than λ/100 RMS are achievable on properly dimensioned systems. Finally, the technique is also applicable to wavefront sensing in adaptive optics systems.

Hartmann-Shack wavefront sensing without a lenslet array using a digital micromirror device

The common Hartmann-Shack wavefront sensor makes use of a lenslet array to sample in-parallel optical wavefronts. Here, we introduce a Hartmann-Shack wavefront sensor that employs a digital micromirror device in combination with a single lens for serial sampling by scanning. Sensing is analyzed numerically and validated experimentally using a deformable mirror operated in closed-loop adaptive optics with a conventional Hartmann-Shack wavefront sensor, as well as with a set of ophthalmic trial lenses, to generate controllable amounts of monochromatic aberrations. The new sensor is free of crosstalk and can potentially operate at kilohertz speed. It offers a reconfigurable aperture that can exclude unwanted parts of the wavefront.

Effects of tear film dynamics on quality of vision

The precorneal tear film is maintained by blinking and exhibits different phases in the tear cycle. The tear film serves as the most anterior surface of the eye and plays an important role as a first refractive component of the eye. Alterations in tear film dynamics may cause both vision-related and ocular surface-related symptoms. Although the optical quality associated with the tear film dynamics previously received little attention, objective measurements of optical quality using wavefront sensors have enabled us to quantify optical aberrations induced by the tear film. This has provided an objective method for assessing reduced optical quality in dry eye; thus, visual disturbances were included in the definition of dry eye disease in the 2007 Dry Eye Workshop report. In addition, sequential measurements of wavefront aberrations have provided us with valuable insights into the dynamic optical changes associated with tear film dynamics. This review will focus on the current knowledge of the mechanisms of wavefront variations that are caused by different aspects of tear film dynamics: specifically, quality, quantity and properties of the tear film, demonstrating the respective effects of dry eye, epiphora and instillation of eye drops on the quality of vision.

Effect of optical aberrations on intraocular pressure measurements using a microscale optical implant in ex vivo rabbit eyes

Elevated intraocular pressure (IOP) is the only modifiable major risk factor of glaucoma. Recently, accurate and continuous IOP monitoring has been demonstrated in vivo using an implantable sensor based on optical resonance with remote optical readout to improve patient outcomes. Here, we investigate the relationship between optical aberrations of ex vivo rabbit eyes and the performance of the IOP sensor using a custom-built setup integrated with a Shack-Hartmann sensor. The sensor readouts became less accurate as the aberrations increased in magnitude, but they remained within the clinically acceptable range. For root-mean-square wavefront errors of 0.10 to 0.94  μm, the accuracy and the signal-to-noise ratio were 0.58  ±  0.32  mm Hg and 15.57  ±  4.85  dB, respectively.

A Comparison of Higher Order Aberrations in Eyes Implanted with AcrySof IQ SN60WF and AcrySof SN60AT Intraocular Lenses

PURPOSE

To evaluate the efficacy of AcrySof SN60WF aspheric intraocular lens (IOL) in decreasing spherical aberration and total higher order aberrations (HOAs) after cataract surgery compared to the spherical SN60AT lens.

METHODS

Wavefront analysis was conducted on 28 eyes of 28 patients that underwent un-complicated phacoemulsification with implantation of either SN60WF (15 eyes) or SN60AT lenses (13 eyes). Eyes with a history of uveitis, retinal diseases, and previous surgery were excluded.

RESULTS

SN60WF eyes had less mean absolute spherical aberration than SN60AT eyes both at 4 mm (0.04+/-0.03 vs 0.11+/-0.03 RMS, p<0.0001) and 6 mm pupils (0.09+/-0.04 vs 0.43+/-0.12 RMS, p<0.0001). Mean total HOAs was lower in the SN60WF group at 6 mm pupils (0.44+/-0.14 vs 0.56+/-0.13 RMS, p=0.0274), while no difference was seen at 4 mm pupils (0.20+/-0.10 vs 0.25+/-0.08 RMS, p=0.160). There were no clinically significant differences between the SN60WF and SN60AT IOLs both at 4 and 6 mm pupils in terms of coma (0.16+/-0.07 vs 0.18+/-0.09 RMS, p=0.514 and 0.25+/-0.12 vs 0.23+/-0.12 RMS, p=0.664) and trefoil (0.14+/-0.09 vs 0.10+/-0.05 RMS, p=0.167 and 0.28+/-0.12 vs 0.23+/-0.07 RMS, p=0.199). There were no differences be-tween groups in mean age, axial length, postoperative spherical equivalent, IOL power, or corneal curvature.

CONCLUSIONS

An aspheric posterior optic IOL design with thinner center effectively reduces the positive ocular spherical aberration observed in the pseudophakic and elderly eyes, especially at larger pupillary diameters (6 mm), with no notable increase in coma. However, reduction in total ocular HOAs was only significant at 6 mm pupils.

Numerical analysis of wavefront aberration correction using multielectrode electrowetting-based devices

We present numerical simulations of multielectrode electrowetting devices used in a novel optical design to correct wavefront aberration. Our optical system consists of two multielectrode devices, preceded by a single fixed lens. The multielectrode elements function as adaptive optical devices that can be used to correct aberrations inherent in many imaging setups, biological samples, and the atmosphere. We are able to accurately simulate the liquid-liquid interface shape using computational fluid dynamics. Ray tracing analysis of these surfaces shows clear evidence of aberration correction. To demonstrate the strength of our design, we studied three different input aberrations mixtures that include astigmatism, coma, trefoil, and additional higher order aberration terms, with amplitudes as large as one wave at 633 nm.

Improvement in error propagation in the Shack-Hartmann-type zonal wavefront sensors

Estimation of the wavefront from measured slope values is an essential step in a Shack-Hartmann-type wavefront sensor. Using an appropriate estimation algorithm, these measured slopes are converted into wavefront phase values. Hence, accuracy in wavefront estimation lies in proper interpretation of these measured slope values using the chosen estimation algorithm. There are two important sources of errors associated with the wavefront estimation process, namely, the slope measurement error and the algorithm discretization error. The former type is due to the noise in the slope measurements or to the detector centroiding error, and the latter is a consequence of solving equations of a basic estimation algorithm adopted onto a discrete geometry. These errors deserve particular attention, because they decide the preference of a specific estimation algorithm for wavefront estimation. In this paper, we investigate these two important sources of errors associated with the wavefront estimation algorithms of Shack-Hartmann-type wavefront sensors. We consider the widely used Southwell algorithm and the recently proposed Pathak-Boruah algorithm [J. Opt.16, 055403 (2014)JOOPDB0150-536X10.1088/2040-8978/16/5/055403] and perform a comparative study between the two. We find that the latter algorithm is inherently superior to the Southwell algorithm in terms of the error propagation performance. We also conduct experiments that further establish the correctness of the comparative study between the said two estimation algorithms.

Using Spherical-Harmonics Expansions for Optics Surface Reconstruction from Gradients

In this paper, we propose a new algorithm to reconstruct optics surfaces (aka wavefronts) from gradients, defined on a circular domain, by means of the Spherical Harmonics. The experimental results indicate that this algorithm renders the same accuracy, compared to the reconstruction based on classical Zernike polynomials, using a smaller number of polynomial terms, which potentially speeds up the wavefront reconstruction. Additionally, we provide an open-source C++ library, released under the terms of the GNU General Public License version 2 (GPLv2), wherein several polynomial sets are coded. Therefore, this library constitutes a robust software alternative for wavefront reconstruction in a high energy laser field, optical surface reconstruction, and, more generally, in surface reconstruction from gradients. The library is a candidate for being integrated in control systems for optical devices, or similarly to be used in ad hoc simulations. Moreover, it has been developed with flexibility in mind, and, as such, the implementation includes the following features: (i) a mock-up generator of various incident wavefronts, intended to simulate the wavefronts commonly encountered in the field of high-energy lasers production; (ii) runtime selection of the library in charge of performing the algebraic computations; (iii) a profiling mechanism to measure and compare the performance of different steps of the algorithms and/or third-party linear algebra libraries. Finally, the library can be easily extended to include additional dependencies, such as porting the algebraic operations to specific architectures, in order to exploit hardware acceleration features.

Adaptive optics scanning laser ophthalmoscopy in fundus imaging, a review and update

Adaptive optics scanning laser ophthalmoscopy (AO-SLO) has been a promising technique in funds imaging with growing popularity. This review firstly gives a brief history of adaptive optics (AO) and AO-SLO. Then it compares AO-SLO with conventional imaging methods (fundus fluorescein angiography, fundus autofluorescence, indocyanine green angiography and optical coherence tomography) and other AO techniques (adaptive optics flood-illumination ophthalmoscopy and adaptive optics optical coherence tomography). Furthermore, an update of current research situation in AO-SLO is made based on different fundus structures as photoreceptors (cones and rods), fundus vessels, retinal pigment epithelium layer, retinal nerve fiber layer, ganglion cell layer and lamina cribrosa. Finally, this review indicates possible research directions of AO-SLO in future.

Development of novel adjustable focus head mount display for concurrent image-guided treatment applications

PURPOSE

A conventional see-through head mount display contains many optical lenses, which can be problematic in image-guided treatment applications due to its size, weight, structure, and focus limitation. Therefore, we have designed a new type of see-through head mount display with a reduced number of optical lenses and an adequate optical resolution that can be utilized for image-guided treatment applications.

MATERIALS AND METHODS

A new type of adjustable focus head mount display with expanded virtual images and an external treatment space that can be provided to the eyes of a user by enlarging the images of a small display is designed and investigated in this study. This type of head mount display can be used in image-guided treatment applications because of the dual paths of imaging and treatment from the optical systems. Therefore, this system with an adjustable focus function can aid doctors in obtaining images for the treatment of the eyes of patients because every patient has a unique pupil size.

RESULTS

The results of the adjustable focus see-through head mount display showed distortion values of +0.36% in the +1 diopter location and -0.55% in the -4 diopter location, and there are less significant modulation transfer function differences within the ±5 diopter locations.

CONCLUSIONS

Low optical distortions within ±0.5 diopters can help doctors image the eye conditions of patients through fewer image processing techniques. Therefore, the designed adjustable focus head mount display can provide low optical aberrations and high optical modulation transfer function resolutions for image-guided treatment applications.

Stereoscopic depth constancy

Depth constancy is the ability to perceive a fixed depth interval in the world as constant despite changes in viewing distance and the spatial scale of depth variation. It is well known that the spatial frequency of depth variation has a large effect on threshold. In the first experiment, we determined that the visual system compensates for this differential sensitivity when the change in disparity is suprathreshold, thereby attaining constancy similar to contrast constancy in the luminance domain. In a second experiment, we examined the ability to perceive constant depth when the spatial frequency and viewing distance both changed. To attain constancy in this situation, the visual system has to estimate distance. We investigated this ability when vergence, accommodation and vertical disparity are all presented accurately and therefore provided veridical information about viewing distance. We found that constancy is nearly complete across changes in viewing distance. Depth constancy is most complete when the scale of the depth relief is constant in the world rather than when it is constant in angular units at the retina. These results bear on the efficacy of algorithms for creating stereo content.

This article is part of the themed issue ‘Vision in our three-dimensional world’.

Aberrometry Repeatability and Agreement with Autorefraction

SIGNIFICANCE

Commercially available aberrometers are essential to clinical studies evaluating refractive error and image quality. The Discovery System (Innovative Visual Systems, Elmhurst, IL) is a promising clinical instrument that allows investigators to export aberration data for research and analysis purposes. An assessment of the Discovery System's performance is essential to the interpretation of the data obtained.

PURPOSE

The aims of this study were to determine the between-visit repeatability of refractive error and higher-order aberration measurements with the Discovery System and to examine between-instrument agreement of refractive error measurements with the Discovery System and Grand Seiko WAM-5500 open-field autorefractor (Grand Seiko Co., Hiroshima, Japan).

METHODS

Cycloplegic refractive error values from the Discovery System (over a 3-mm pupil) and the Grand Seiko autorefractor were converted to power vectors (M, J0, and J45), and averaged. Zernike coefficients were also calculated by the Discovery System over a 6-mm pupil through the sixth radial order. Between-visit repeatability and agreement were evaluated using Bland-Altman difference-versus-mean plots. A t-test compared each mean difference (bias) to zero, and the 95% limits of agreement were calculated.

RESULTS

Twenty-five young adults with a mean (±SD) cycloplegic spherical-equivalent refractive error of -2.91 ± 1.85 diopters (D) (range, -6.96 to +0.74 D) were enrolled. There were no significant between-visit differences with the Discovery System for M, J0, J45, third- through sixth-order root mean square (RMS), higher-order RMS, or spherical aberration (all P > .30), and the repeatability for defocus and higher-order RMS were ±0.31 D and ±0.095 μm, respectively, for a 6-mm pupil. At a 3-mm pupil, the Discovery System, on average, measured slightly more positive values than the Grand Seiko for M (0.28 D), J0 (0.11 D), and J45 (0.12 D; all P < .005).

CONCLUSIONS

The Discovery System was very repeatable and would be an appropriate instrument to measure cycloplegic refractive error and higher-order aberration changes in adults. Small differences in refractive error were found between the Discovery System and Grand Seiko.

Review of adaptive optics OCT (AO-OCT): principles and applications for retinal imaging [Invited]

In vivo imaging of the human retina with a resolution that allows visualization of cellular structures has proven to be essential to broaden our knowledge about the physiology of this precious and very complex neural tissue that enables the first steps in vision. Many pathologic changes originate from functional and structural alterations on a cellular scale, long before any degradation in vision can be noted. Therefore, it is important to investigate these tissues with a sufficient level of detail in order to better understand associated disease development or the effects of therapeutic intervention. Optical retinal imaging modalities rely on the optical elements of the eye itself (mainly the cornea and lens) to produce retinal images and are therefore affected by the specific arrangement of these elements and possible imperfections in curvature. Thus, aberrations are introduced to the imaging light and image quality is degraded. To compensate for these aberrations, adaptive optics (AO), a technology initially developed in astronomy, has been utilized. However, the axial sectioning provided by retinal AO-based fundus cameras and scanning laser ophthalmoscope instruments is limited to tens of micrometers because of the rather small available numerical aperture of the eye. To overcome this limitation and thus achieve much higher axial sectioning in the order of 2-5µm, AO has been combined with optical coherence tomography (OCT) into AO-OCT. This enabled for the first time in vivo volumetric retinal imaging with high isotropic resolution. This article summarizes the technical aspects of AO-OCT and provides an overview on its various implementations and some of its clinical applications. In addition, latest developments in the field, such as computational AO-OCT and wavefront sensor less AO-OCT, are covered.

Mechanisms of Visual Disturbance in Dry Eye

Dry eye has been believed to be a chronic, symptomatic ocular surface disease that affects vision in a limited manner, because it is difficult to detect visual or optical changes using standard visual acuity testing. In practice, common visual complaints associated with dry eye include fluctuating vision with blinking, blurred vision, glare, and eye fatigue. This review discusses our past and current understanding of visual disturbances in dry eye and the various tools available for assessing visual function or optical quality. Tear film instability and ocular surface damage are key factors in the core mechanism underlying dry eye. The mechanisms of these vision-related subjective symptoms of dry eye based on visual function, particularly wavefront aberrations or light scattering, and the core mechanism of dry eye are described. Tear film instability is associated with decreased stability of postblink higher-order aberrations, leading to "fluctuating vision with blinking" and with increased ocular forward light scattering, leading to "glare." Ocular surface damage in the overlying optical zone (in the central corneal regions), is associated with increased higher-order aberrations and increased corneal backward light scattering that can lead to "blurred vision". "Eye fatigue" occurs when patients with dry eye struggle to see things under such visual symptoms.

Two-photon Shack-Hartmann wavefront sensor

We introduce a simple wavefront sensing scheme for aberration measurement of pulsed laser beams in near-infrared wavelengths (<2200  nm), where detectors are not always available or are very expensive. The method is based on two-photon absorption in a silicon detector array for longer wavelengths detection. We demonstrate the simplicity of such implementations with a commercially available Shack-Hartmann wavefront sensor and discuss the detection sensitivity of this method.