Vision is adapted to the natural level of blur present in the retinal image

Neural adaptation to the eye's optics through phase compensation

How does the brain achieve a seemingly veridical and 'in-focus' perception of the world, knowing how severely corrupted visual information is by the eye's optics? Optical blur degrades retinal image quality by reducing the contrast and disrupting the phase of transmitted signals. Neural adaptation can attenuate the impact of blur on image contrast, yet vision rather relies on perceptually-relevant information contained within the phase structure of natural images. Here we show that neural adaptation can compensate for the impact of optical aberrations on phase congruency. We used adaptive optics to fully control optical factors and test the impact of specific optical aberrations on the perceived phase of compound gratings. We assessed blur-induced changes in perceived phase over three distinct exposure spans. Under brief blur exposure, perceived phase shifts matched optical theory predictions. During short-term (~1h) exposure, we found a reduction in blur-induced phase shifts over time, followed by after-effects in the opposite direction-a hallmark of adaptation. Finally, patients with chronic exposure to poor optical quality showed altered phase perception when tested under fully-corrected optical quality, suggesting long-term neural compensatory adjustments to phase spectra. These findings reveal that neural adaptation to optical aberrations compensates for alterations in phase congruency, helping restore perceptual quality over time.

Peripheral Choroidal Response to Localized Defocus Blur: Influence of Native Peripheral Aberrations

Purpose

This study aims to examine the short-term peripheral choroidal thickness (PChT) response to signed defocus blur, both with and without native peripheral aberrations. This examination will provide insights into the role of peripheral aberration in detecting signs of defocus.

Methods

The peripheral retina (temporal 15°) of the right eye was exposed to a localized video stimulus in 11 young adults. An adaptive optics system induced 2D myopic or hyperopic defocus onto the stimulus, with or without correcting native peripheral ocular aberrations (adaptive optics [AO] or NoAO defocus conditions). Choroidal scans were captured using Heidelberg Spectralis OCT at baseline, exposure (10, 20, and 30 minutes), and recovery phases (4, 8, and 15 minutes). Neural network-based automated MATLAB segmentation program measured PChT changes from OCT scans, and statistical analysis evaluated the effects of different optical conditions over time.

Results

During the exposure phase, NoAO myopic and hyperopic defocus conditions exhibited distinct bidirectional PChT alterations, showing average thickening (10.0 ± 5.3 µm) and thinning (-9.1 ± 5.5 µm), respectively. In contrast, induced AO defocus conditions did not demonstrate a significant change from baseline. PChT recovery to baseline occurred for all conditions. The unexposed fovea did not show any significant ChT change, indicating a localized ChT response to retinal blur.

Conclusions

We discovered that the PChT response serves as a marker for detecting peripheral retinal myopic and hyperopic defocus blur, especially in the presence of peripheral aberrations. These findings highlight the significant role of peripheral oriented blur in cueing peripheral defocus sign detection.

Designing for sensory adaptation: what you see depends on what you've been looking at - Recommendations, guidelines and standards should reflect this

Sensory systems continuously recalibrate their responses according to the current stimulus environment. As a result, perception is strongly affected by the current and recent context. These adaptative changes affect both sensitivity (e.g., habituating to noise, seeing better in the dark) and appearance (e.g. how things look, what catches attention) and adjust to many perceptual properties (e.g. from light level to the characteristics of someone's face). They therefore have a profound effect on most perceptual experiences, and on how and how well the senses work in different settings. Characterizing the properties of adaptation, how it manifests, and when it influences perception in modern environments can provide insights into the diversity of human experience. Adaptation could also be leveraged both to optimize perceptual abilities (e.g. in visual inspection tasks like radiology) and to mitigate unwanted consequences (e.g. exposure to potentially unhealthy stimulus environments).

Suprathreshold contrast perception of resolvable high spatial frequencies remain intact in keratoconus

Contrast detection thresholds are elevated with optical quality loss in keratoconus. This study hypothesized that suprathreshold contrast perception is also impaired in keratoconus, with the impairment being predictable from the pattern of loss in threshold-level performance. Contrast detection thresholds were determined across a range of spatial frequencies in 12 cases with mild to severe keratoconus and 12 age-similar controls. These values were used to predict the contrast needed to achieve perceptual matches between reference and test spatial frequency pairs (peak of CSF Vs. 0.3x, 0.5x, 2x or 3x spatial frequency from the peak) for stimuli at 10% and 50% suprathreshold contrast. Contrast thresholds predicted a 1.5 to 6.7-fold increase in the test pattern's contrast to obtain a perceptual match with the reference pattern in keratoconus, relative to controls. Contrary to predictions, the empirical data of contrast matches between test and reference patterns were similar for higher than peak spatial frequencies at both contrast levels. However, as predicted, test patterns required higher contrast than the reference pattern for a perceptual match for lower than peak spatial frequencies. These results were similar to controls and invariant of disease severity, interocular asymmetry and short-term changes in optical quality. Unlike thresholds, suprathreshold contrast perception of resolvable high spatial frequencies appears immune to optical quality losses in keratoconus. These results are discussed in the context of the prevailing models of contrast constancy in healthy humans. Breakdown of contrast constancy at lower than peak spatial frequencies may reflect the properties of the testing paradigm employed here.

Frequency of adapting events affects face aftereffects but not blur aftereffects

The dynamics of visual adaptation remain poorly understood. Recent studies have found that the strength of adaptation aftereffects in the perception of numerosity depends more strongly on the number of adaptation events than on the duration of the adaptation. We investigated whether such effects can be observed for other visual attributes. We measured blur (perceived focus-sharp vs blurred adapt) and face (perceived race- Asian vs. White adapt) aftereffects by varying the number of adaptation events (4 or 16) and the duration of each adaptation event (0.25 s or 1 s). We found evidence for an effect of event number on face but not on blur adaptation, though the effect for faces was significant for only one of the two face adapt conditions (Asian). Our results suggest that different perceptual dimensions may vary in how adaptation effects accrue, potentially because of differences in factors such as the sites (early or late) of the sensitivity changes or nature of the stimulus. These differences may impact how and how rapidly the visual system can adjust to different visual properties.

Case report of the evidence of a spontaneous Reverse Pulfrich effect in monovision after cataract surgery

BACKGROUND

Cataracts affect the optics of the eye in terms of absorption, blur, and scattering. When cataracts are unilateral, they cause differences between the eyes that can produce visual discomfort and harm binocular vision. These interocular differences can also induce differences in the processing speed of the eyes that may cause a spontaneous Pulfrich effect, a visual illusion provoking important depth misperceptions. Interocular differences in light level, like those present in unilateral cataracts, can cause the Classic Pulfrich effect, and interocular differences in blur, like those present in monovision, a common correction for presbyopia, can cause the Reverse Pulfrich effect. The visual system may be able to adapt, or not, to the new optical condition, depending on the degree of the cataract and the magnitude of the monovision correction.

CASE PRESENTATION

Here, we report a unique case of a 45-year-old patient that underwent unilateral cataract surgery resulting in a monovision correction of 2.5 diopters (D): left eye emmetropic after the surgery compensated with a monofocal intraocular lens and right eye myopic with a spherical equivalent of -2.50 D. This patient suffered severe symptoms in binocular vision, which can be explained by a spontaneous Pulfrich effect (a delay measured of 4.82 ms, that could be eliminated with a 0.19 optical density filter). After removing the monovision with clear lens extraction in the second eye, symptoms disappeared. We demonstrate that, at least in this patient, both Classic and Reverse Pulfrich effects coexist after unilateral cataract surgery and that can be readapted by reverting the interocular differences. Besides, we report that the adaptation/readaptation process to the Reverse Pulfrich effect happens in a timeframe of weeks, as opposed to the Classic Pulfrich effect, known to have timeframes of days. Additionally, we used the illusion measured in the laboratory to quantify the relevance of the spontaneous Pulfrich effect in different visual scenarios and tasks, using geometrical models and optic flow algorithms.

CONCLUSIONS

Measuring the different versions of the Pulfrich effect might help to understand the visual discomfort reported by many patients after cataract surgery or with monovision and could guide compensation or intervention strategies.

Case Report: When Two Is Worse Than One-Stereo Imbalance in a Case of Wavefront-guided Scleral Lenses

SIGNIFICANCE

Wavefront-guided scleral lenses (WGSLs) reduce visually debilitating residual higher-order aberrations. Although reduced higher-order aberrations lead to improvement in monocular high-contrast visual acuity (VA), the success of the lenses in everyday life depends on additional factors such as retinal contrast, binocular balance, and stereoacuity.

PURPOSE

This report describes a case where WGSLs provided improved monocular vision compared with scleral lenses (SLs) but reduced binocularity and stereoacuity.

CASE REPORT

A 48-year-old woman with moderate keratoconus right eye (OD) and severe left eye (OS) was fitted with SLs and WGSLs. Visual acuity with best SLs was 20/20 -2 OD and 20/25 -2 OS. Residual higher-order root-mean-square (HORMS) wavefront error (6 mm pupil) was 0.56 μm OD and 1.38 μm OS. Visual acuity with WGSLs was 20/16 -2 OD and 20/25 +2 OS, and residual HORMS was 0.41 μm OD and 0.98 μm OS. Monocularly, WGSLs were reported to provide better VA. However, binocularly, the patient reported an "imbalanced feeling" and preferred the SLs over WGSLs. Binocular VA at distance was 20/25 with SLs and 20/25 -2 with WGSL. To investigate, the Worth Four-Dot test was performed, and the outcomes reported fusion with SLs but suppression OS at distance with WGSLs. Stereoacuity was 160 arc seconds at near and 120 arc seconds at distance with SLs and 400 arc seconds at near and >1200 arc seconds at distance with WGSLs. Dichoptic contrast balancing showed a balance point of 0.48 with SLs and 0.17 with WGSLs, indicating a strong preference toward OD. Simulation of the patient's retinal image revealed a greater difference in image contrast between the two eyes with WGSLs.

CONCLUSIONS

Wavefront-guided scleral lenses reduced HORMS and improved VA compared with SLs. However, in this case, it inadvertently caused binocular imbalance. As WGSLs become more widely available, future work should include methods to optimize binocular balance to maximize overall patient satisfaction.

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.

Evaluating the effect of ocular aberrations on the simulated performance of a new refractive IOL design using adaptive optics

Adaptive optics (AO) visual simulators are excellent platforms for non-invasive simulation visual performance with new intraocular lens (IOL) designs, in combination with a subject own ocular aberrations and brain. We measured the through focus visual acuity in subjects through a new refractive IOL physically inserted in a cuvette and projected onto the eye's pupil, while aberrations were manipulated (corrected, or positive/negative spherical aberration added) using a deformable mirror (DM) in a custom-developed AO simulator. The IOL increased depth-of-focus (DOF) to 1.53 ± 0.21D, while maintaining high Visual Acuity (VA, -0.07 ± 0.05), averaged across subjects and conditions. Modifying the aberrations did not alter IOL performance on average.

Calibrating Vision: Concepts and Questions

The idea that visual coding and perception are shaped by experience and adjust to changes in the environment or the observer is universally recognized as a cornerstone of visual processing, yet the functions and processes mediating these calibrations remain in many ways poorly understood. In this article we review a number of facets and issues surrounding the general notion of calibration, with a focus on plasticity within the encoding and representational stages of visual processing. These include how many types of calibrations there are - and how we decide; how plasticity for encoding is intertwined with other principles of sensory coding; how it is instantiated at the level of the dynamic networks mediating vision; how it varies with development or between individuals; and the factors that may limit the form or degree of the adjustments. Our goal is to give a small glimpse of an enormous and fundamental dimension of vision, and to point to some of the unresolved questions in our understanding of how and why ongoing calibrations are a pervasive and essential element of vision.

Optical Evaluation of Intracorneal Ring Segment Surgery in Keratoconus

Purpose

The purpose of this study was to assess the impact of different intracorneal ring segments (ICRS) combinations on corneal morphology and visual performance on patients with keratoconus.

Methods

A total of 124 eyes from 96 patients who underwent ICRS surgery were analyzed and classified into 7 groups based on ICRS disposition and the diameter of the surgical zone (5- and 6-mm). Pre- and postoperative complete ophthalmological examinations were conducted. Corneal geometry, volume, and symmetry were studied. Zernike polynomials were used to build a virtual ray-tracing model to evaluate optical aberrations and the Visual Strehl (VS).

Results

ICRS induced significant flattening across the cornea, being more pronounced on the anterior (+0.38 mm, P < 0.001) than on the posterior (+0.15 mm, P < 0.001) corneal radius. Asphericity experienced a larger change for a 6-mm surgical zone diameter (from −1.23 ± 1.1 to −1.86 ± 1.2, P < 0.001) than for a 5-mm zone (from −1.99 ± 1.1 to −2.10 ± 1.5, P = 0.536). Mean astigmatism was reduced by 2.05 D (P < 0.001). Combination four was the most effective in reducing astigmatism. Coma decreased by 30% on average and combination one produced an average reduction by 51% (P < 0.05). Patients experienced significant improvement in visual performance, best corrected visual acuity increased from 0.57 ± 0.21 to 0.69 ± 0.21 and VS changed from 0.049 ± 0.02 to 0.065 ± 0.041.

Conclusions

ICRS combinations implanted within 5 mm diameter zone are more effective in flattening the cornea, whereas those implanted on 6 mm diameter are as effective in reducing astigmatism and are a good choice if the asymmetry and the intended flattening are smaller. Combinations with asymmetrical implants are the best option to regularize corneal surface.

Translational Relevance

This study uses methods and metrics of optical research applied to daily clinical practice.

Trade-Off Asymmetric Profile for Extended-Depth-of-Focus Ocular Lens

We explore the possibility of extending the depth of focus of an imaging lens with an asymmetric quartic phase-mask, while keeping the aberration within a relatively low level. This can be intended, for instance, for ophthalmic applications, where no further digital processing can take place, relying instead on the patient’s neural adaptation to their own aberrations. We propose a computational optimization method to derive the design-strength factor of the asymmetric profile. The numerical and experimental results are shown. The optical experiment was conducted by means of a modulo-2π phase-only spatial light modulator. The proposed combination of the asymmetric mask and the lens can be implemented in a single refractive element. An exemplary case of an extended-depth-of focus intraocular lens based on the proposed element is described and demonstrated with a numerical experiment.

Matching convolved images to optically blurred images on the retina

Convolved images are often used to simulate the effect of ocular aberrations on image quality, where the retinal image is simulated by convolving the stimulus with the point spread function derived from the subject's aberrations. However, some studies have shown that convolved images are perceived far more degraded than the same image blurred with optical defocus. We hypothesized that the positive interactions between the monochromatic and chromatic aberrations in the eye are lost in the convolution process. To test this hypothesis, we evaluated optical and visual quality with natural optics and with convolved images (on-bench, computer simulations, and visual acuity [VA] in subjects) using a polychromatic adaptive optics system with monochromatic (555 nm) and polychromatic light (WL) illumination. The subject's aberrations were measured using a Hartmann Shack system and were used to convolve the visual stimuli, using Fourier optics. The convolved images were seen through corrected optics. VA with convolved stimuli was lower than VA through natural aberrations, particularly in WL (by 26% in WL). Our results suggest that the systematic decrease in visual performance with visual acuity and retinal image quality by simulation with convolved stimuli appears to be primarily associated with a lack of favorable interaction between chromatic and monochromatic aberrations in the eye.

Changes of tuning but not dynamics of contrast adaptation with age

Normal aging results in pronounced optical and neural changes in the visual system. Processes of adaptation are thought to help compensate for many of these changes in order to maintain perceptual constancy, but it is uncertain how stable adaptation itself remains with aging. We compared the dynamics of adaptation in young (aged 19-24 years) and older (aged 66-74) adults. Contrast thresholds for Gabor patterns were tracked during and after 300 s adaptation to vertical and horizontal Gabor patches. The time course of contrast adaptation and asymptotic adaptation magnitude were similar between older and young adults when normalized for their respective baseline thresholds. Older adults showed stronger transfer of adaptation to the orthogonal orientation and there was an asymmetry between the transfer of adaptation between the horizontal and vertical orientations for both groups. These results suggest age-related changes in orientation tuning while the processes of cortical contrast adaptation remain largely intact with aging.

Color perception and compensation in color deficiencies assessed with hue scaling

Anomalous trichromats have three classes of cone receptors but with smaller separation in the spectral sensitivities of their longer-wave (L or M) cones compared to normal trichromats. As a result, the differences in the responses of the longer-wave cones are smaller, resulting in a weaker input to opponent mechanisms that compare the LvsM responses. Despite this, previous studies have found that their color percepts are more similar to normal trichromats than the smaller LvsM differences predict, suggesting that post-receptoral processes might amplify their responses to compensate for the weaker opponent inputs. We evaluated the degree and form of compensation using a hue-scaling task, in which the appearance of different hues is described by the perceived proportions of red-green or blue-yellow primary colors. The scaling functions were modeled to estimate the relative salience of the red-green to blue-yellow components. The red-green amplitudes of the 10 anomalous observers were 1.5 times weaker than for a group of 26 normal controls. However, their relative sensitivity at threshold for detecting LvsM chromatic contrast was on average 6 times higher, consistent with a 4-fold gain in the suprathreshold hue-scaling responses. Within-observer variability in the settings was similar for the two groups, suggesting that the suprathreshold gain did not similarly amplify the noise, at least for the dimension of hue. While the compensation was pronounced it was nevertheless partial, and anomalous observers differed systematically from the controls in the shapes of the hue-scaling functions and the corresponding loci of their color categories. Factor analyses further revealed different patterns of individual differences between the groups. We discuss the implications of these results for understanding both the processes of compensation for a color deficiency and the limits of these processes.

Functional reallocation of sensory processing resources caused by long-term neural adaptation to altered optics

The eye’s optics are a major determinant of visual perception. Elucidating how long-term exposure to optical defects affects visual processing is key to understanding the capacity for, and limits of, sensory plasticity. Here, we show evidence of functional reallocation of sensory processing resources following long-term exposure to poor optical quality. Using adaptive optics to bypass all optical defects, we assessed visual processing in neurotypically-developed adults with healthy eyes and with keratoconus – a corneal disease causing severe optical aberrations. Under fully-corrected optical conditions, keratoconus patients showed altered contrast sensitivity, with impaired sensitivity for fine spatial details and better-than-typical sensitivity for coarse spatial details. Both gains and losses in sensitivity were more pronounced in patients experiencing poorer optical quality in their daily life and mediated by changes in signal enhancement mechanisms. These findings show that adult neural processing adapts to better match the changes in sensory inputs caused by long-term exposure to altered optics.

Vision is protected against blue defocus

Due to chromatic aberration, blue images are defocused when the eye is focused to the middle of the visible spectrum, yet we normally are not aware of chromatic blur. The eye suffers from monochromatic aberrations which degrade the optical quality of all images projected on the retina. The combination of monochromatic and chromatic aberrations is not additive and these aberrations may interact to improve image quality. Using Adaptive Optics, we investigated the optical and visual effects of correcting monochromatic aberrations when viewing polychromatic grayscale, green, and blue images. Correcting the eye’s monochromatic aberrations improved optical quality of the focused green images and degraded the optical quality of defocused blue images, particularly in eyes with higher amounts of monochromatic aberrations. Perceptual judgments of image quality tracked the optical findings, but the perceptual impact of the monochromatic aberrations correction was smaller than the optical predictions. The visual system appears to be adapted to the blur produced by the native monochromatic aberrations, and possibly to defocus in blue.

Asymmetries in visual acuity around the visual field

Human vision is heterogeneous around the visual field. At a fixed eccentricity, performance is better along the horizontal than the vertical meridian and along the lower than the upper vertical meridian. These asymmetric patterns, termed performance fields, have been found in numerous visual tasks, including those mediated by contrast sensitivity and spatial resolution. However, it is unknown whether spatial resolution asymmetries are confined to the cardinal meridians or whether and how far they extend into the upper and lower hemifields. Here, we measured visual acuity at isoeccentric peripheral locations (10 deg eccentricity), every 15° of polar angle. On each trial, observers judged the orientation (± 45°) of one of four equidistant, suprathreshold grating stimuli varying in spatial frequency (SF). On each block, we measured performance as a function of stimulus SF at 4 of 24 isoeccentric locations. We estimated the 75%-correct SF threshold, SF cutoff point (i.e., chance-level), and slope of the psychometric function for each location. We found higher SF estimates (i.e., better acuity) for the horizontal than the vertical meridian and for the lower than the upper vertical meridian. These asymmetries were most pronounced at the cardinal meridians and decreased gradually as the angular distance from the vertical meridian increased. This gradual change in acuity with polar angle reflected a shift of the psychometric function without changes in slope. The same pattern was found under binocular and monocular viewing conditions. These findings advance our understanding of visual processing around the visual field and help constrain models of visual perception.

Contact lenses, the reverse Pulfrich effect, and anti-Pulfrich monovision corrections

Interocular differences in image blur can cause processing speed differences that lead to dramatic misperceptions of the distance and three-dimensional direction of moving objects. This recently discovered illusion-the reverse Pulfrich effect-is caused by optical conditions induced by monovision, a common correction for presbyopia. Fortunately, anti-Pulfrich monovision corrections, which darken the blurring lens, can eliminate the illusion for many viewing conditions. However, the reverse Pulfrich effect and the efficacy of anti-Pulfrich corrections have been demonstrated only with trial lenses. This situation should be addressed, for clinical and scientific reasons. First, it is important to replicate these effects with contact lenses, the most common method for delivering monovision. Second, trial lenses of different powers, unlike contacts, can cause large magnification differences between the eyes. To confidently attribute the reverse Pulfrich effect to interocular optical blur differences, and to ensure that previously reported effect sizes are reliable, one must control for magnification. Here, in a within-observer study with five separate experiments, we demonstrate that (1) contact lenses and trial lenses induce indistinguishable reverse Pulfrich effects, (2) anti-Pulfrich corrections are equally effective when induced by contact and trial lenses, and (3) magnification differences do not cause or impact the Pulfrich effect.

Testing the effect of ocular aberrations in the perceived transverse chromatic aberration

We have measured the ocular transverse chromatic aberration (TCA) in 11 subjects using 2D-two-color Vernier alignment, for two pupil diameters, in a polychromatic adaptive optics (AO) system. TCA measurements were performed for two pupil diameters: for a small pupil (2-mm), referred to as 'optical TCA' (oTCA), and for a large pupil (6-mm), referred to 'perceived TCA' (pTCA). Also, the TCA was measured through both natural aberrations (HOAs) and AO-corrected aberrations. Computer simulations of pTCA incorporated longitudinal chromatic aberration (LCA), the patient's HOAs measured with Hartmann-Shack, and the Stiles-Crawford effect (SCE), measured objectively by laser ray tracing. The oTCA and the simulated pTCA (no aberrations) were shifted nasally 1.20 arcmin and 1.40 arcmin respectively. The experimental pTCA (-0.27 arcmin horizontally and -0.62 vertically) was well predicted (81%) by simulations when both the individual HOAs and SCE were considered. Both HOAs and SCE interact with oTCA, reducing it in magnitude and changing its orientation. The results indicate that estimations of polychromatic image quality should incorporate patient's specific data of HOAs, LCA, TCA & SCE.

Testing impacts of global blur profiles using a multiscale vision simulator

Although it is possible to specify the impact of blur at a specific retinal location, a lack of understanding exists regarding how the inhomogeneous blur distribution across the retina (i.e., global blur) affects the quality of an optical correction at a specific retinal location. To elucidate this issue, a multiscale visual simulator combining the projection of a controllable high-resolution stimulus and an ocular monitoring system was constructed to simultaneously simulate foveal and extrafoveal blurs. To define the range and capability of a wide-angle stimulation, an optimal working pupil was evaluated by optical ray-tracing via a Monte Carlo simulation, including optical variations corresponding to fixational eye movements. To investigate the impacts of global blur on the perception of discrete regions of the visual field, the bothersome blur threshold from five subjects was measured through this novel system using a collection of zonal blurs (annuli image projected sequentially at discrete retinal regions), and these impacts were compared with those using a spatially-varying blur (continuum of simultaneously projected zonal blurs of varying strengths, simulating retinal blur variations). Our results show that the zonal blur threshold does not entirely predict the global blur threshold, having a tendency to overestimate blur the threshold. It was concluded that, in addition to the amount of defocus present at a defined retinal location, the perception of individual defocused retinal regions can be affected by global blur. Given that blur tolerance can affect the perception of optically induced blurs, the findings provide useful implications for designing new optical correction.

Prior Experience Alters the Appearance of Blurry Object Borders

Object memories activated by borders serve as priors for figure assignment: figures are more likely to be perceived on the side of a border where a well-known object is sketched. Do object memories also affect the appearance of object borders? Memories represent past experience with objects; memories of well-known objects include many with sharp borders because they are often fixated. We investigated whether object memories affect appearance by testing whether blurry borders appear sharper when they are contours of well-known objects versus matched novel objects. Participants viewed blurry versions of one familiar and one novel stimulus simultaneously for 180 ms; then made comparative (Exp. 1) or equality judgments regarding perceived blur (Exps. 2–4). For equivalent levels of blur, the borders of well-known objects appeared sharper than those of novel objects. These results extend evidence for the influence of past experience to object appearance, consistent with dynamic interactive models of perception.

The Verriest Lecture: Adventures in blue and yellow

Conventional models of color vision assume that blue and yellow (along with red and green) are the fundamental building blocks of color appearance, yet how these hues are represented in the brain and whether and why they might be special are questions that remain shrouded in mystery. Many studies have explored the visual encoding of color categories, from the statistics of the environment to neural processing to perceptual experience. Blue and yellow are tied to salient features of the natural color world, and these features have likely shaped several important aspects of color vision. However, it remains less certain that these dimensions are encoded as primary or "unique" in the visual representation of color. There are also striking differences between blue and yellow percepts that may reflect high-level inferences about the world, specifically about the colors of light and surfaces. Moreover, while the stimuli labeled as blue or yellow or other basic categories show a remarkable degree of constancy within the observer, they all vary independently of one another across observers. This pattern of variation again suggests that blue and yellow and red and green are not a primary or unitary dimension of color appearance, and instead suggests a representation in which different hues reflect qualitatively different categories rather than quantitative differences within an underlying low-dimensional "color space."

VioBio lab adaptive optics: technology and applications by women vision scientists

PURPOSE

Adaptive Optics allows measurement and manipulation of the optical aberrations of the eye. We review two Adaptive Optics set-ups implemented at the Visual Optics and Biophotonics Laboratory, and present examples of their use in better understanding of the role of optical aberrations on visual perception, in normal and treated eyes.

RECENT FINDINGS

Two systems (AOI and AOII) are described that measure ocular aberrations with a Hartmann-Shack wavefront sensor, which operates in closed-loop with an electromagnetic deformable mirror, and visual stimuli are projected in a visual display for psychophysical measurements. AOI operates in infrared radiation (IR) light. AOII is provided with a supercontiniuum laser source (IR and visible wavelengths), additional elements for simulation (spatial light modulator, temporal multiplexing with optotunable lenses, phase plates, cuvette for intraocular lenses-IOLs), and a double-pass retinal camera. We review several studies undertaken with these AO systems, including the evaluation of the visual benefits of AO correction, vision with simulated multifocal IOLs (MIOLs), optical aberrations in pseudophakic eyes, chromatic aberrations and their visual impact, and neural adaptation to ocular aberrations.

SUMMARY

Monochromatic and chromatic aberrations have been measured in normal and treated eyes. AO systems have allowed understanding the visual benefit of correcting aberrations in normal eyes and the adaptation of the visual system to the eye's native aberrations. Ocular corrections such as intraocular and contact lenses modify the wave aberrations. AO systems allow simulating vision with these corrections before they are implanted/fitted in the eye, or even before they are manufactured, revealing great potential for industry and the clinical practice. This review paper is part of a special issue of Ophthalmic & Physiological Optics on women in visual optics, and is co-authored by all women scientists of the research team.

Blur adaptation: clinical and refractive considerations

The human visual system is amenable to a number of adaptive processes; one such process, or collection of processes, is the adaptation to blur. Blur adaptation can be observed as an improvement in vision under degraded conditions, and these changes occur relatively rapidly following exposure to blur. The potential important future directions of this research area and the clinical implications of blur adaptation are discussed.

Vision with different presbyopia corrections simulated with a portable binocular visual simulator

Presbyopes can choose today among different corrections to provide them with functional vision at far and near, and the outcomes and patient satisfaction depend on the selection. In this study, we present a binocular and portable vision simulator, based on temporal multiplexing of two synchronized tunable lenses allowing see-through and programmable visual simulations of presbyopic corrections. Seventeen binocular corrections were tested: 3 Monofocal (Far, Intermediate, Near), 4 Simultaneous Vision (bifocal, trifocal), 2 Monovision (far and near in either eye) and 8 Modified Monovision corrections (Simultaneous vision in one eye, Monofocal in the other eye). Perceived visual quality was assessed through the simulated corrections in 8 cyclopleged subjects who viewed a composite realistic visual scene with high contrast letters and a landscape at far (4 m) and a high contrast text at intermediate (66 cm) and near (33 cm) distances. Perceptual scores were obtained on a scale of 0 to 5 (low to high perceived quality). Perceptual preference was assessed by judging 36 random image pairs (6 repetitions) viewed through 9 binocular presbyopic corrections using two-interval forced choice procedures. The average score, across far and near distances, was the highest for Monovision (4.4±0.3), followed by Modified Monovision (3.4±0.1), Simultaneous Vision (3.0±0.1) and Monofocal corrections (2.9±0.2). However, the mean difference between far and near was lower for Simultaneous Vision and Monovision (0.4±0.1 PS) than Modified Monovision (1.8±0.7) or monofocal corrections (3.3±1.5). A strong significant correlation was found between the perceptual scores and the percentages of energy in focus, for each correction and distance (R = 0.64, p<0.0001). Multivariate ANOVA revealed significant influence of observation distances (p<10-9) and patients (p = 0.01) on Perceptual Score. In conclusion, we have developed a binocular portable vision simulator that can simulate rapidly and non-invasively different combinations of presbyopic corrections. This tool has applications in systematic clinical evaluation of presbyopia corrections.

Factors Influencing Pseudo-Accommodation-The Difference between Subjectively Reported Range of Clear Focus and Objectively Measured Accommodation Range

The key determinants of the range of clear focus in pre-presbyopes and their relative contributions to the difference between subjective range of focus and objective accommodation assessments have not been previously quantified. Fifty participants (aged 33.0 ± 6.4 years) underwent simultaneous monocular subjective (visual acuity measured with an electronic test-chart) and objective (dynamic accommodation measured with an Aston open-field aberrometer) defocus curve testing for lenses between +2.00 to −10.00 DS in +0.50 DS steps in a randomized order. Pupil diameter and ocular aberrations (converted to visual metrics normalized for pupil size) at each level of blur were measured. The difference between objective range over which the power of the crystalline lens changes and the subjective range of clear focus was quantified and the results modelled using pupil size, refractive error, tolerance to blur, and ocular aberrations. The subjective range of clear focus was principally accounted for by age (46.4%) and pupil size (19.3%). The objectively assessed accommodative range was also principally accounted for by age (27.6%) and pupil size (15.4%). Over one-quarter (26.0%) of the difference between objective accommodation and subjective range of clear focus was accounted for by age (14.0%) and spherical aberration at maximum accommodation (12.0%). There was no significant change in the objective accommodative response (F = 1.426, p = 0.229) or pupil size (F = 0.799, p = 0.554) of participants for levels of defocus above their amplitude of accommodation. Pre-presbyopes benefit from an increased subjective range of clear vision beyond their objective accommodation due in part to neural factors, resulting in a measured depth-of-focus of, on average, 1.0 D.

Effect of Crystalline Lens Aberrations on Adaptive Optics Simulation of Intraocular Lenses

PURPOSE

To evaluate the impact of the lens aberrations on the adaptive optics visual simulation of pseudophakic intraocular lens (IOL) profiles.

METHODS

In 20 right phakic eyes, lens higher order aberrations (HOAs) were calculated as the whole eye minus the corneal aberrations. Visual simulation using low and high contrast corrected distance visual acuity (CDVA) testing was carried out with the VAO instrument (Voptica, SL, Murcia, Spain), considering three optical conditions of the lens: removing HOA (no lens-HOA), removing spherical aberration (no lens-SA), and with lens HOA (natural condition). In addition, a through-focus visual simulation of a trifocal diffractive IOL profile with high contrast CDVA was also measured in two conditions: no lens-HOA and natural condition. Three different pupil sizes (3, 4.5, and 6 mm) were tested for all conditions.

RESULTS

There were no significant intersubject differences between the three optical conditions and in the IOL simulation for all pupil sizes (P > .05). For 4.5- and 6-mm pupils, mean VA values of the no-lens SA and no lens-HOA conditions were similar and slightly worse than those of the natural condition. Individual differences between the no lens-HOA condition and the other two optical conditions, estimated as 95% limits of agreement, were acceptable for 3-mm pupil but worse as pupil diameter increased.

CONCLUSIONS

The effect of lens aberrations on visual simulation is imperceptible for a small pupil diameter of 3 mm. Although the increment of pupil size increases the probability of patients with significant visual impact of lens HOAs, the mean intersubject VA differences are negligible. [J Refract Surg. 2019;35(2):126-131.].

Visual simulators replicate vision with multifocal lenses

Adaptive optics (AO) visual simulators based on deformable mirrors, spatial light modulators or optotunable lenses are increasingly used to simulate vision through different multifocal lens designs. However, the correspondence of this simulation with that obtained through real intraocular lenses (IOLs) tested on the same eyes has not been, to our knowledge, demonstrated. We compare through-focus (TF) optical and visual quality produced by real multifocal IOLs (M-IOLs) -bifocal refractive and trifocal diffractive- projected on the subiect's eye with those same designs simulated with a spatial light modulator (SLM) or an optotunable lens working in temporal multiplexing mode (SimVis technology). Measurements were performed on 7 cyclopleged subjects using a custom-made multichannel 3-active-optical-elements polychromatic AO Visual Simulator in monochromatic light. The same system was used to demonstrate performance of the real IOLs, SLM and SimVis technology simulations on bench using double-pass imaging on an artificial eye. Results show a general good correspondence between the TF performance with the real and simulated M-IOLs, both optically (on bench) and visually (measured visual acuity in patients). We demonstrate that visual simulations in an AO environment capture to a large extent the individual optical and visual performance obtained with real M-IOLs, both in absolute values and in the shape of through-focus curves.

Visual adaptation and the amplitude spectra of radiological images

We examined how visual sensitivity and perception are affected by adaptation to the characteristic amplitude spectra of X-ray mammography images. Because of the transmissive nature of X-ray photons, these images have relatively more low-frequency variability than natural images, a difference that is captured by a steeper slope of the amplitude spectrum (~ − 1.5) compared to the ~ 1/f (slope of − 1) spectra common to natural scenes. Radiologists inspecting these images are therefore exposed to a different balance of spectral components, and we measured how this exposure might alter spatial vision. Observers (who were not radiologists) were adapted to images of normal mammograms or the same images sharpened by filtering the amplitude spectra to shallower slopes. Prior adaptation to the original mammograms significantly biased judgments of image focus relative to the sharpened images, demonstrating that the images are sufficient to induce substantial after-effects. The adaptation also induced strong losses in threshold contrast sensitivity that were selective for lower spatial frequencies, though these losses were very similar to the threshold changes induced by the sharpened images. Visual search for targets (Gaussian blobs) added to the images was also not differentially affected by adaptation to the original or sharper images. These results complement our previous studies examining how observers adapt to the textural properties or phase spectra of mammograms. Like the phase spectrum, adaptation to the amplitude spectrum of mammograms alters spatial sensitivity and visual judgments about the images. However, unlike the phase spectrum, adaptation to the amplitude spectra did not confer a selective performance advantage relative to more natural spectra.

Individual differences in visual science: What can be learned and what is good experimental practice?

We all pass out our lives in private perceptual worlds. The differences in our sensory and perceptual experiences often go unnoticed until there emerges a variation (such as 'The Dress') that is large enough to generate different descriptions in the coarse coinage of our shared language. In this essay, we illustrate how individual differences contribute to a richer understanding of visual perception, but we also indicate some potential pitfalls that face the investigator who ventures into the field.

Role of parafovea in blur perception

The blur experienced by our visual system is not uniform across the visual field. Additionally, lens designs with variable power profile such as contact lenses used in presbyopia correction and to control myopia progression create variable blur from the fovea to the periphery. The perceptual changes associated with varying blur profile across the visual field are unclear. We therefore measured the perceived neutral focus with images of different angular subtense (from 4° to 20°) and found that the amount of blur, for which focus is perceived as neutral, increases when the stimulus was extended to cover the parafovea. We also studied the changes in central perceived neutral focus after adaptation to images with similar magnitude of optical blur across the image or varying blur from center to the periphery. Altering the blur in the periphery had little or no effect on the shift of perceived neutral focus following adaptation to normal/blurred central images. These perceptual outcomes should be considered while designing bifocal optical solutions for myopia or presbyopia.

Vision science and adaptive optics, the state of the field

Adaptive optics is a relatively new field, yet it is spreading rapidly and allows new questions to be asked about how the visual system is organized. The editors of this feature issue have posed a series of question to scientists involved in using adaptive optics in vision science. The questions are focused on three main areas. In the first we investigate the use of adaptive optics for psychophysical measurements of visual system function and for improving the optics of the eye. In the second, we look at the applications and impact of adaptive optics on retinal imaging and its promise for basic and applied research. In the third, we explore how adaptive optics is being used to improve our understanding of the neurophysiology of the visual system.

Visual Adaptation

Sensory systems continuously mold themselves to the widely varying contexts in which they must operate. Studies of these adaptations have played a long and central role in vision science. In part this is because the specific adaptations remain a powerful tool for dissecting vision, by exposing the mechanisms that are adapting. That is, "if it adapts, it's there." Many insights about vision have come from using adaptation in this way, as a method. A second important trend has been the realization that the processes of adaptation are themselves essential to how vision works, and thus are likely to operate at all levels. That is, "if it's there, it adapts." This has focused interest on the mechanisms of adaptation as the target rather than the probe. Together both approaches have led to an emerging insight of adaptation as a fundamental and ubiquitous coding strategy impacting all aspects of how we see.

Effects of optical blur reduction on equivalent intrinsic blur

PURPOSE

To determine the effect of optical blur reduction on equivalent intrinsic blur, an estimate of the blur within the visual system, by comparing optical and equivalent intrinsic blur before and after adaptive optics (AO) correction of wavefront error.

METHODS

Twelve visually normal subjects (mean [±SD] age, 31 [±12] years) participated in this study. Equivalent intrinsic blur (σint) was derived using a previously described model. Optical blur (σopt) caused by high-order aberrations was quantified by Shack-Hartmann aberrometry and minimized using AO correction of wavefront error.

RESULTS

σopt and σint were significantly reduced and visual acuity was significantly improved after AO correction (p ≤ 0.004). Reductions in σopt and σint were linearly dependent on the values before AO correction (r ≥ 0.94, p ≤ 0.002). The reduction in σint was greater than the reduction in σopt, although it was marginally significant (p = 0.05). σint after AO correlated significantly with σint before AO (r = 0.92, p < 0.001), and the two parameters were related linearly with a slope of 0.46.

CONCLUSIONS

Reduction in equivalent intrinsic blur was greater than the reduction in optical blur after AO correction of wavefront error. This finding implies that visual acuity in subjects with high equivalent intrinsic blur can be improved beyond that expected from the reduction in optical blur alone.

A cyclopean neural mechanism compensating for optical differences between the eyes

The two eyes of an individual routinely differ in their optical and neural properties, yet percepts through either eye remain more similar than predicted by these differences. Little is known as to how the brain resolves this conflicting information. Differences in visual inputs from the two eyes have been studied extensively in the context of binocular vision and rivalry [1], but it remains unknown how the visual system calibrates and corrects for normal variability in image quality between the eyes, and whether this correction is applied to each eye separately or after their signals have converged. To test this, we used adaptive optics to control and manipulate the blur projected on each retina, and then compared judgments of image focus through either eye and how these judgments were biased by adapting to different levels of blur. Despite significant interocular differences in the magnitude of optical blur, the blur level that appeared best focused was the same through both eyes, and corresponded to the ocular blur of the less aberrated eye. Moreover, for both eyes, blur aftereffects depended on whether the adapting blur was stronger or weaker than the native blur of the better eye, with no aftereffect when the blur equaled the aberrations of the better eye. Our results indicate that the neural calibration for the perception of image focus reflects a single 'cyclopean' site that is set monocularly by the eye with better optical quality. Consequently, what people regard as 'best-focused' matches the blur encountered through the eye with better optics, even when judging the world through the eye with poorer optics.

Longitudinal chromatic aberration of the human eye in the visible and near infrared from wavefront sensing, double-pass and psychophysics

Longitudinal Chromatic Aberration (LCA) influences the optical quality of the eye. However, the reported LCA varies across studies, likely associated to differences in the measurement techniques. We present LCA measured in subjects using wavefront sensing, double-pass retinal images, and psychophysical methods with a custom-developed polychromatic Adaptive Optics system in a wide spectral range (450-950 nm), with control of subjects' natural aberrations. LCA measured psychophysically was significantly higher than that from reflectometric techniques (1.51 D vs 1.00 D in the 488-700 nm range). Ours results indicate that the presence of natural aberrations is not the cause for the discrepancies across techniques.

Single neural code for blur in subjects with different interocular optical blur orientation

The ability of the visual system to compensate for differences in blur orientation between eyes is not well understood. We measured the orientation of the internal blur code in both eyes of the same subject monocularly by presenting pairs of images blurred with real ocular point spread functions (PSFs) of similar blur magnitude but varying in orientations. Subjects assigned a level of confidence to their selection of the best perceived image in each pair. Using a classification-images-inspired paradigm and applying a reverse correlation technique, a classification map was obtained from the weighted averages of the PSFs, representing the internal blur code. Positive and negative neural PSFs were obtained from the classification map, representing the neural blur for best and worse perceived blur, respectively. The neural PSF was found to be highly correlated in both eyes, even for eyes with different ocular PSF orientations (rPos = 0.95; rNeg = 0.99; p < 0.001). We found that in subjects with similar and with different ocular PSF orientations between eyes, the orientation of the positive neural PSF was closer to the orientation of the ocular PSF of the eye with the better optical quality (average difference was ∼10°), while the orientation of the positive and negative neural PSFs tended to be orthogonal. These results suggest a single internal code for blur with orientation driven by the orientation of the optical blur of the eye with better optical quality.

Factors accounting for the 4-year change in acuity in patients between 50 and 80 years

PURPOSE

It is well known that acuity slowly decreases in the later decades of life. We wish to determine the extent by which 4-year longitudinal acuity changes can be accounted for by changes in optical quality, or combination of optical quality metrics and of age between 50 and 80 years.

METHODS

High-contrast logMAR acuity, 35 image quality metrics, 4 intraocular scatter metrics, and 4 Lens Opacification Classification System III metrics and entry age were measured on one eye of each of the 148 subjects. Acuity change between baseline and the last visit was regressed against change in each metric for all eyes and a faster changing subset of 50 eyes with a gain or loss of four or more letters.

RESULTS

Average change across 148 subjects was a 1.6 ± 4 letter loss (t148 = 4.31, p < 0.001) and loss for the faster changing subset was 3.4 ± 6.1 letters (t50 = 2.73, p = 0.008). The multiple-regression model for faster changing eyes included change in point spread function entropy, posterior subcapsular cataract, and trefoil and baseline age (sequential r adjusted values of 0.19, 0.27, 0.32, and 0.34, respectively; p = 1.48 × 10 for the full four-factor model). The same variables entered the multiple-regression model for the full 148 data set where most of the acuity measurements were within test-retest error and accounted for less of the variance (r adjusted = 0.15, p = 2.37 × 10).

CONCLUSIONS

Despite being near noise levels for the measurement of acuity, change in optical quality metrics was the most important factor in eyes that lost or gained four or more letters of acuity. These findings should be generalizable given that our 4-year acuity change is essentially identical to other studies and indicate that these optical quality markers can be used to help identify those on a faster track to an acuity change.

Short-term neural adaptation to simultaneous bifocal images

Simultaneous vision is an increasingly used solution for the correction of presbyopia (the age-related loss of ability to focus near images). Simultaneous Vision corrections, normally delivered in the form of contact or intraocular lenses, project on the patient's retina a focused image for near vision superimposed with a degraded image for far vision, or a focused image for far vision superimposed with the defocused image of the near scene. It is expected that patients with these corrections are able to adapt to the complex Simultaneous Vision retinal images, although the mechanisms or the extent to which this happens is not known. We studied the neural adaptation to simultaneous vision by studying changes in the Natural Perceived Focus and in the Perceptual Score of image quality in subjects after exposure to Simultaneous Vision. We show that Natural Perceived Focus shifts after a brief period of adaptation to a Simultaneous Vision blur, similar to adaptation to Pure Defocus. This shift strongly correlates with the magnitude and proportion of defocus in the adapting image. The magnitude of defocus affects perceived quality of Simultaneous Vision images, with 0.5 D defocus scored lowest and beyond 1.5 D scored “sharp”. Adaptation to Simultaneous Vision shifts the Perceptual Score of these images towards higher rankings. Larger improvements occurred when testing simultaneous images with the same magnitude of defocus as the adapting images, indicating that wearing a particular bifocal correction improves the perception of images provided by that correction.

Blur Detection is Unaffected by Cognitive Load

Blur detection is affected by retinal eccentricity, but is it also affected by attentional resources? Research showing effects of selective attention on acuity and contrast sensitivity suggests that allocating attention should increase blur detection. However, research showing that blur affects selection of saccade targets suggests that blur detection may be pre-attentive. To investigate this question, we carried out experiments in which viewers detected blur in real-world scenes under varying levels of cognitive load manipulated by the N-back task. We used adaptive threshold estimation to measure blur detection thresholds at 0°, 3°, 6°, and 9° eccentricity. Participants carried out blur detection as a single task, a single task with to-be-ignored letters, or an N-back task with four levels of cognitive load (0, 1, 2, or 3-back). In Experiment 1, blur was presented gaze-contingently for occasional single eye fixations while participants viewed scenes in preparation for an easy picture recognition memory task, and the N-back stimuli were presented auditorily. The results for three participants showed a large effect of retinal eccentricity on blur thresholds, significant effects of N-back level on N-back performance, scene recognition memory, and gaze dispersion, but no effect of N-back level on blur thresholds. In Experiment 2, we replicated Experiment 1 but presented the images tachistoscopically for 200 ms (half with, half without blur), to determine whether gaze-contingent blur presentation in Experiment 1 had produced attentional capture by blur onset during a fixation, thus eliminating any effect of cognitive load on blur detection. The results with three new participants replicated those of Experiment 1, indicating that the use of gaze-contingent blur presentation could not explain the lack of effect of cognitive load on blur detection. Thus, apparently blur detection in real-world scene images is unaffected by attentional resources, as manipulated by the cognitive load produced by the N-back task.

Astigmatism impact on visual performance: meridional and adaptational effects

PURPOSE

Astigmatic subjects are adapted to their astigmatism and perceptually recalibrate upon its correction. However, the extent to which prior adaptation to astigmatism affects visual performance, whether this effect is axis dependent, and the time scale of potential changes in visual performance after astigmatism correction are not known. Moreover, the effect of possible positive interactions of aberrations (astigmatism and coma) might be altered after recalibration to correction of astigmatism.

METHODS

Visual acuity (VA) was measured in 25 subjects (astigmats and non-astigmats, corrected and uncorrected) under induction of astigmatism and combinations of astigmatism and coma while controlling subject aberrations. Astigmatism (1.00 diopter) was induced at three different orientations, the natural axis, the perpendicular orientation, and 45 degrees for astigmats and at 0, 90, and 45 degrees for non-astigmats. Experiments were also performed, adding coma (0.41 μm at a relative angle of 45 degrees) to the same mentioned astigmatism. Fourteen different conditions were measured using an 8-Alternative Forced Choice procedure with Tumbling E letters and a QUEST algorithm. Longitudinal measurements were performed up to 6 months. Uncorrected astigmats were provided with proper astigmatic correction after the first session.

RESULTS

In non-astigmats, inducing astigmatism at 90 degrees, produced a statistically lower reduction in VA than at 0 or 45 degrees, whereas in astigmats, the lower decrease in VA occurred for astigmatism induced at the natural axis. Six months of astigmatic correction did not reduce the insensitivity to astigmatic induction along the natural axis. Differences after orientation of astigmatism were also found when adding coma to astigmatism.

CONCLUSIONS

The impact of astigmatism on VA is greatly dependent on the orientation of the induced astigmatism, even in non-astigmats. Previous experience to astigmatism plays a significant role on VA, with a strong bias toward the natural axis. In contrast to perceived isotropy, the correction of astigmatism does not shift the bias in VA from the natural axis of astigmatism.

Change in visual acuity is well correlated with change in image-quality metrics for both normal and keratoconic wavefront errors

We determined the degree to which change in visual acuity (VA) correlates with change in optical quality using image-quality (IQ) metrics for both normal and keratoconic wavefront errors (WFEs). VA was recorded for five normal subjects reading simulated, logMAR acuity charts generated from the scaled WFEs of 15 normal and seven keratoconic eyes. We examined the correlations over a large range of acuity loss (up to 11 lines) and a smaller, more clinically relevant range (up to four lines). Nine IQ metrics were well correlated for both ranges. Over the smaller range of primary interest, eight were also accurate and precise in estimating the variations in logMAR acuity in both normal and keratoconic WFEs. The accuracy for these eight best metrics in estimating the mean change in logMAR acuity ranged between ±0.0065 to ±0.017 logMAR (all less than one letter), and the precision ranged between ±0.10 to ±0.14 logMAR (all less than seven letters).

Multiple zone multifocal phase designs

New multifocal phase designs aiming at expanding depth of focus in the presbyopic eye are presented. The designs consist of multiple radial or angular zones of different powers or of combined low- and high-order aberrations. Multifocal performance was evaluated in terms of the dioptric range for which the optical quality is above an appropriate threshold, as well as in terms of the area under the through-focus optical quality curves. For varying optical power designs optimal through-focus performance was found for a maximum of three to four zones. Furthermore adding more zones decreased the optical performance of the solution. Angular zone designs provided better multifocal performance (1.95 times on average) than radial zone designs with identical number of zones and the same power range. The optimal design (angular design with three zones) surpassed by 33% the multifocal performance of a bifocal angular zone design and by 32% a standard multifocal phase plate with induced spherical aberration only. By using combinations of low- and high-order aberrations the through-focus range can be extended further by another 0.5 D beyond that of the best design of varying optical power. These designs can be implemented in adaptive optics systems for testing their visual performance in subjects and converted into multifocal contact lenses, intraocular lenses, or presbyopic corneal laser ablation profiles.

Using pattern classification to measure adaptation to the orientation of high order aberrations

Background

The image formed by the eye's optics is blurred by the ocular aberrations, specific to each eye. Recent studies demonstrated that the eye is adapted to the level of blur produced by the high order aberrations (HOA). We examined whether visual coding is also adapted to the orientation of the natural HOA of the eye.

Methods and Findings

Judgments of perceived blur were measured in 5 subjects in a psychophysical procedure inspired by the “Classification Images” technique. Subjects were presented 500 pairs of images, artificially blurred with HOA from 100 real eyes (i.e. different orientations), with total blur level adjusted to match the subject's natural blur. Subjects selected the image that appeared best focused in each random pair, in a 6-choice ranked response. Images were presented through Adaptive Optics correction of the subject's aberrations. The images selected as best focused were identified as positive, the other as negative responses. The highest classified positive responses correlated more with the subject's Point Spread Function, PSF, (r = 0.47 on average) than the negative (r = 0.34) and the difference was significant for all subjects (p<0.02). Using the orientation of the best fitting ellipse of angularly averaged integrated PSF intensities (weighted by the subject's responses) we found that in 4 subjects the positive PSF response was close to the subject's natural PSF orientation (within 21 degrees on average) whereas the negative PSF response was almost perpendicularly oriented to the natural PSF (at 76 degrees on average).

Conclusions

The Classification-Images inspired method is very powerful in identifying the internally coded blur of subjects. The consistent bias of the Positive PSFs towards the natural PSF in most subjects indicates that the internal code of blur appears rather specific to each subject's high order aberrations and reveals that the calibration mechanisms for normalizing blur also operate using orientation cues.

Persistent biases in subjective image focus following cataract surgery

We explored the perception of image focus in patients with cataracts, and how this perception changed following cataract removal and implantation of an intraocular lens. Thirty-three patients with immature senile cataract and with normal retinal function were tested before surgery and 2 days after surgery, with 18 of the patients retested again at 2 months following surgery. The subjective focus of natural images was quantified in each session by varying the slope of the image amplitude spectra. At each time, short-term adaptation to the spectral slope was also determined by repeating the measurements after exposure to images with blurred or sharpened spectra. Despite pronounced acuity deficits, before surgery images appeared "best-focused" when they were only slightly blurred, consistent with a strong compensation for the acuity losses. Post-operatively, the image slopes that were judged "in focus" before surgery appeared too sharp. This bias remained strong at 2 months, and was independent of the rapid blur aftereffects induced by viewing filtered images. The focus settings tended to renormalize more rapidly in patients with higher post-operative acuity, while acuity differences were unrelated to the magnitude of the short-term blur aftereffects. Our results suggest that subjective judgments of image focus are largely compensated as cataracts develop, but potentially through a very long-term form of adaptation that results in persistent biases after the cataract is removed.