Wide-range adaptive optics visual simulator with a tunable lens

Contrast sensitivity is resilient to induced fast periodic defocus oscillations

This study investigates the potential effects of periodic defocus oscillations on contrast sensitivity. Sinusoidal fluctuations at 5, 15, and 25 Hz, with defocus peak-to-valley values ranging from 0.15 to 3 D, were induced by means of a focus-tunable lens after calibrating its dynamic behavior. Monocular contrast sensitivity was measured on five young emmetropic subjects. The experimental data shows that contrast sensitivity loss due to defocus fluctuations is low for a wide range of frequencies and amplitudes. Only for the more severe case studied (25 Hz, ± 1.5 D) contrast threshold showed a clear increase in most subjects. Qualitative comparison of the empirical data with a simulation of modulation loss due to time integration of defocused retinal point spread functions, suggests a short integration time by the eye for defocus blur, around or even below a hundredth of a second.

Head-mounted adaptive optics visual simulator

Adaptive optics visual simulation is a powerful tool for vision testing and evaluation. However, the existing instruments either have fixed tabletop configurations or, being wearable, only offer the correction of defocus. This paper proposes a novel head-mounted adaptive optics visual simulator that can measure and modify complex ocular aberrations in real-time. The prototype is composed of two optical modules, one for the objective assessment of aberrations and the second for wavefront modulation, all of which are integrated into a wearable headset. The device incorporates a microdisplay for stimulus generation, a liquid crystal on silicon (LCoS) spatial light modulator for wavefront manipulation, and a Hartmann-Shack wavefront sensor. Miniature optical components and optical path folding structures, together with in-house 3D printed mounts and housing, were adapted to realize the compact size. The system was calibrated by characterizing and compensating the internal aberrations of the visual relay. The performance of the prototype was analyzed by evaluating the measurement and compensation of low-order and higher-order aberrations induced through trial lenses and phase masks in an artificial eye. The defocus curves for a simulated bifocal diffractive lens were evaluated in real eyes. The results show high accuracy while measuring and compensating for the induced defocus, astigmatism, and higher-order aberrations, whereas the MTF analysis shows post-correction resolution of up to 37.5 cycles/degree (VA 1.25). Moreover, the subjective test results show the defocus curves closely matched to a commercial desktop visual simulator.

Impact of temporal fluctuations in optical defocus on visual acuity: Empirical results and modeling outcomes

Optical defocus in human eyes is seldom steady during naturalistic steady-state viewing. It fluctuates by 0.3 to 0.5 diopters (D) from accommodative microfluctuations and by 1.5 to 2.5 D in dysfunctions such as spasm of near reflex, both with ≤2 Hz low-pass frequency spectra. This study observed losses in monocular visual acuity of cyclopleged adults who encountered varying amplitude (0.25-2.0 D) and temporal frequency (0.25-2.0 Hz) combinations of sinusoidal defoci induced using an electrically tunable lens. Visual acuity, recorded for 300-ms flashes of Sloan optotype presentation using the method of constant stimuli, deteriorated with defocus amplitude at a rate steeper for lower than higher temporal frequencies. A template matching model of acuity, incorporating optical and neural low-pass filters, neural noise, and a cross-correlated decision operator, showed the best match with empirical data when acuity was governed by the minimum defocus available during optotype display. This criterion minimized acuity loss for higher temporal frequencies due to the increased probability of zero-defocus encounters within the presentation duration. Other decision criteria such as defocus averaging across the entire or parts of the presentation duration yielded less satisfactory results. These results imply that vision loss in humans encountering broadband time-varying defocus is dictated by the dominant low frequencies, with higher frequencies largely compensated using the least defocus decision strategy.

Adaptive optics visual simulators: a review of recent optical designs and applications [Invited]

In their pioneering work demonstrating measurement and full correction of the eye's optical aberrations, Liang, Williams and Miller, [JOSA A14, 2884 (1997)10.1364/JOSAA.14.002884] showed improvement in visual performance using adaptive optics (AO). Since then, AO visual simulators have been developed to explore the spatial limits to human vision and as platforms to test non-invasively optical corrections for presbyopia, myopia, or corneal irregularities. These applications have allowed new psychophysics bypassing the optics of the eye, ranging from studying the impact of the interactions of monochromatic and chromatic aberrations on vision to neural adaptation. Other applications address new paradigms of lens designs and corrections of ocular errors. The current paper describes a series of AO visual simulators developed in laboratories around the world, key applications, and current trends and challenges. As the field moves into its second quarter century, new available technologies and a solid reception by the clinical community promise a vigorous and expanding use of AO simulation in years to come.

Evaluation of a liquid membrane-based tunable lens and a solid-state LIDAR camera feedback system for presbyopia

Presbyopia is an age-related loss of accommodation ability of the eye which affects individuals in their late 40s or early 50s. Presbyopia reduces the ability of a person to focus on closer objects at will. In this study, we assessed electronically tunable lenses for their aberration properties as well as for their use as correction lenses. The tunable lenses were evaluated in healthy subjects with cycloplegia by measuring visual acuity and contrast sensitivity for their use in presbyopia correction. Furthermore, we have developed and demonstrated the feasibility of a feedback mechanism for the operation of tunable lenses using a portable solid-state LIDAR camera with a processing time of 40 ± 5 ms.

Applications of augmented reality in ophthalmology [Invited]

Throughout the last decade, augmented reality (AR) head-mounted displays (HMDs) have gradually become a substantial part of modern life, with increasing applications ranging from gaming and driver assistance to medical training. Owing to the tremendous progress in miniaturized displays, cameras, and sensors, HMDs are now used for the diagnosis, treatment, and follow-up of several eye diseases. In this review, we discuss the current state-of-the-art as well as potential uses of AR in ophthalmology. This review includes the following topics: (i) underlying optical technologies, displays and trackers, holography, and adaptive optics; (ii) accommodation, 3D vision, and related problems such as presbyopia, amblyopia, strabismus, and refractive errors; (iii) AR technologies in lens and corneal disorders, in particular cataract and keratoconus; (iv) AR technologies in retinal disorders including age-related macular degeneration (AMD), glaucoma, color blindness, and vision simulators developed for other types of low-vision patients.

Adaptation to the eye's chromatic aberration measured with an adaptive optics visual simulator

Some aspects of vision after correcting the longitudinal chromatic aberration (LCA) of the eye are not yet completely understood. For instance, correcting the LCA notably alters the through focus visual acuity (VA) curve, but it does not improve the best VA obtained for the natural case. In this work, vision with corrected LCA is further investigated by using an adaptive optics visual simulator (AOVS). VA was measured continuously during 20 minutes in 5 subjects under both natural and corrected LCA conditions to explore possible adaptation effects. Low contrast VA as a function of time exhibited a consistent and significant boost of 0.19 in decimal scale after an average time of 10.9 minutes of continuous testing. For high contrast, only one subject showed a similar increase in VA. These results suggest that some LCA neural adaptation may exist, particularly for low contrast. This adaptation impacts the performance of vision under corrected LCA, and possibly prevents measurement for immediate visual benefit. The results have practical implications for the design and visual testing of optical aids, especially those correcting, or altering, the LCA.

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.

Impact of longitudinal chromatic aberration on through-focus visual acuity

An enhanced adaptive optics visual simulator (AOVS) was used to study the impact of chromatic aberration on vision. In particular, through-focus visual acuity (VA) was measured in four subjects under three longitudinal chromatic aberration (LCA) conditions: natural LCA, compensated LCA and doubled LCA. Ray-tracing simulations using a chromatic eye model were also performed for a better understanding of experimental results. Simulations predicted the optical quality of the retinal images and VA by applying a semi-empirical formula. Experimental and ray tracing results showed a significant agreement in the natural LCA case (R² = 0.92). Modifying the LCA caused an impairment in the predictability of the results, with decreasing correlations between experiment and simulations (compensated LCA, R² = 0.84; doubled LCA, R² = 0.59). VA under modified LCA was systematically overestimated by the model around the best focus position. The results provided useful information on how LCA manipulation affects the depth of focus. Decreased capability of the model to predict VA in modified LCA conditions suggests that neural adaptation may play a role.

Simultaneous aberration and aperture control using a single spatial light modulator

A method to simultaneously control aberrations and the aperture of an optical system using a single phase-only spatial light modulator was investigated. The experiment was performed using a liquid-crystal-on-silicon spatial light modulator (LCoS-SLM) within an adaptive optics system used for visual testing, although the method has broader applications in adaptive optics field. The performance of the technique was characterized through the estimation of the system's modulation transfer functions (MTFs) by using a random chart method. MTFs obtained from the phase modulation-based approach were compared with those from using a real aperture (diaphragm). The areas under the MTFs for the two conditions were similar up to 98%, confirming that the low-pass filter effect associated to the size of the entrance pupil was similar for the phase-modulated pupil and the physical pupil. As an example of application, both aberrations and pupil were controlled by a single phase-only modulator to study the through-focus visual performance in real subjects. Limitations and possible enhancements of the presented method were also discussed. The presented technique reduces complexity and cost of adaptive optics systems. It opens the door to new experiments by allowing dynamic modulation of aberrations and apertures of any shape.