Darrin Falk

The BHVI-EyeMapper: Peripheral Refraction and Aberration Profiles

Purpose The aim of this article was to present the optical design of a new instrument (BHVI-EyeMapper, EM), which is dedicated to rapid peripheral wavefront measurements across the visual field for distance and near, and to compare the peripheral refraction and higher-order aberration profiles obtained in myopic eyes with and without accommodation. Methods Central and peripheral refractive errors (M, J180, and J45) and higher-order aberrations (C[3, 1], C[3, 3], and C[4, 0]) were measured in 26 myopic participants (mean [±SD] age, 20.9 [±2.0] years; mean [±SD] spherical equivalent, −3.00 [±0.90] diopters [D]) corrected for distance. Measurements were performed along the horizontal visual field with (−2.00 to −5.00 D) and without (+1.00 D fogging) accommodation. Changes as a function of accommodation were compared using tilt and curvature coefficients of peripheral refraction and aberration profiles. Results As accommodation increased, the relative peripheral refraction profiles of M and J180 became significantly (p < 0.05) more negative and the profile of M became significantly (p < 0.05) more asymmetric. No significant differences were found for the J45 profiles (p > 0.05). The peripheral aberration profiles of C[3, 1], C[3, 3], and C[4, 0] became significantly (p < 0.05) less asymmetric as accommodation increased, but no differences were found in the curvature. Conclusions The current study showed that significant changes in peripheral refraction and higher-order aberration profiles occurred during accommodation in myopic eyes. With its extended measurement capabilities, that is, permitting rapid peripheral refraction and higher-order aberration measurements up to visual field angles of ±50 degrees for distance and near (up to −5.00 D), the EM is a new advanced instrument that may provide additional insights in the ongoing quest to understand and monitor myopia development.

Optical performance of multifocal soft contact lenses via a single-pass method.

Purpose. A physical model eye capable of carrying soft contact lenses (CLs) was used as a platform to evaluate optical performance of several commercial multifocals (MFCLs) with high- and low-add powers and a single-vision control. Methods. Optical performance was evaluated at three pupil sizes, six target vergences, and five CL-correcting positions using a spatially filtered monochromatic (632.8 nm) light source. The various target vergences were achieved by using negative trial lenses. A photosensor in the retinal plane recorded the image point-spread that enabled the computation of visual Strehl ratios. The centration of CLs was monitored by an additional integrated en face camera. Hydration of the correcting lens was maintained using a humidity chamber and repeated instillations of rewetting saline drops. Results. All the MFCLs reduced performance for distance but considerably improved performance along the range of distance to near target vergences, relative to the single-vision CL. Performance was dependent on add power, design, pupil, and centration of the correcting CLs. Proclear (D) design produced good performance for intermediate vision, whereas Proclear (N) design performed well at near vision (p < 0.05). AirOptix design exhibited good performance for distance and intermediate vision. PureVision design showed improved performance across the test vergences, but only for pupils ≥4 mm in diameter. Performance of Acuvue bifocal was comparable with other MFCLs, but only for pupils >4 mm in diameter. Acuvue Oasys bifocal produced performance comparable with single-vision CL for most vergences. Conclusions. Direct measurement of single-pass images at the retinal plane of a physical model eye used in conjunction with various MFCLs is demonstrated. This method may have utility in evaluating the relative effectiveness of commercial and prototype designs.

Peripheral refraction and higher-order aberrations with cycloplegia and fogging lenses using the BHVI-EyeMapper

Purpose To determine if a fogging lens ameliorates accommodative effects driven by the closed-view design of the BHVI-EyeMapper (EM) instrument. We compared cycloplegic refraction and higher-order aberration measurements of the EM with those obtained with a fogging lens. Methods Twenty-six, young, participants (15F, 25 ± 5 years, range: 18–35 years, SE: +0.25 D and −3.50 D) with good ocular health were recruited. Five independent measurements of on- and off-axis refraction and higher-order aberrations were recorded across the horizontal visual field, under two conditions: non-cycloplegic measurements with +1.00 D fogging lens and cycloplegia, always in the same sequence. The contralateral eye was occluded during the measurements. Two drops of 1% Tropicamide delivered within 5 min facilitated cycloplegic measurements. All participants were refracted 30 min after installation of the second drop. Results Mean spherical equivalent measures of the non-cycloplegic condition were significantly more myopic than their cycloplegic counterparts (p < 0.05); approximately by 0.50 D centrally, increasing to 1.00 D towards the periphery. The horizontal astigmatic component, J180, demonstrated small but statistically significant differences between the test conditions. Differences were predominant for eccentricities greater than 30°, in both nasal and temporal meridians. The oblique astigmatic component, J45, was not significantly different between the test conditions. The primary spherical aberration coefficient C(4, 0) was significantly less positive for the non-cycloplegic state than its cycloplegic counterpart. This result held true across the entire horizontal visual field. The horizontal coma and trefoil coefficients C(3, 1) and C(3, 3) were not significantly different between the two conditions. Conclusions The use of +1.00 D fogging lens without cycloplegia did not provide complete relaxation of accommodation. The discrepancies between cycloplegic and non-cycloplegic EM measurements were found to be more pronounced for peripheral field angles than central measures, for both M and J180 components.

Optical power mapping using paraxial laser scanning

A new instrument has been developed and built to measure the spatially resolved optical power of intra-ocular and contact lenses. Currently available instruments are based on either Hartmann Shack or Moiré Fringe techniques, which both have inherent limitations in terms of measurement range, sensitivity and achievable lateral resolution. Our new method uses a narrow laser beam which is scanned paraxially across the surface of the lens. The angle of the deflected beam is determined by capturing the lateral laser spot position at two different axial locations by means of a beam-splitter and two position sensitive, optical detectors. From the matrix of deflection angles, the spherical and cylindrical power components as well as higher order aberrations can be extracted and displayed as spatially resolved power maps. While measurement speed is compromised due to the scanning operation, the achievable lateral resolution can be as high as 20μm and the power accuracy in the order of milli-diopters. Soft contact lenses and foldable IOLs can be placed in wet cells to maintain hydration and form stability. Sample measurements of contact and intra ocular lenses are presented.

Validation of a quasi real-time global aberrometer: the EyeMapper

Interest in measuring peripheral refraction rapidly and accurately has been stimulated by increasing evidence that the eyes peripheral refractive state can influence axial growth. In response to this, a new clinical instrument, the EyeMapper, was developed which performs quasi real-time global (central and peripheral) refraction measurements of the human eye. The EyeMapper is an aberrometer comprising a unique deflection system to permit an extremely rapid visual field scan. Refraction measurements are taken from -50° to +50° in 10° steps within 0.45 seconds. Multiple pupil imaging paths through the deflection system provide improved lateral and axial pupil alignment, and by rotating the instrument around its main optical axis, global power maps of the eye can be generated. Using a model eye with a pivoting and translating reflective surface to simulate the peripheral and central retina, the EyeMapper was cross-validated against a conventional aberrometer (COAS-HD, Wavefront Sciences, USA) and an autorefractor (Shin-Nippon NVision K5001, Japan). In addition, the right eyes of ten participants were measured across the horizontal visual field and in one eye, refraction measurements were performed globally. Overall, the EyeMapper showed good agreement and improved repeatability when compared to the other two instruments.

Working sketch of an anatomically and optically equivalent physical model eye

Our aim was to fabricate a bench-top physical model eye that closely replicates anatomical and optical properties of the average human eye, and to calibrate and standardize this model to suit normal viewing conditions and subsequently utilize it to understand the optical performance of corrective lens designs; especially multifocal soft contact lenses. Using available normative data on ocular biometrics and Zemax ray-tracing software as a tool, we modeled 25, 45 and 55 year-old average adult human eyes with discrete accommodation levels and pupil sizes. Specifications for the components were established following manufacturing tolerance analyses. The cornea was lathed from an optical material with refractive index of 1.376 @ 589 nm and the crystalline lenses were made of Boston RGP polymers with refractive indices of 1.423 (45 & 55yr) and 1.429 (25yr) @ 589 nm. These two materials served to model the equivalent crystalline lens of the different age-groups. A camera, the acting retina, was hosted on the motor-base having translatory and rotary functions to facilitate the simulation of different states of ametropia and peripheral refraction respectively. We report on the implementation of the first prototype and present some simulations of the optical performance of certain contact lenses with specific levels of ametropia, to demonstrate the potential use of such a physical model eye. On completion of development, calibration and standardization, optical quality assessment and performance predictions of different ophthalmic lenses can be studied in great detail. Optical performance with corrective lenses may be reliably simulated and predicted by customized combined computational and physical models giving insight into the merits and pitfalls of their designs