Nick Fogt

Three interferometric methods for measuring the thickness of layers of the tear film.

The thickness of different layers of the tear film has been measured by three types of interference method, namely, wavelength-dependent fringes (WDFs), thickness-dependent fringes (TDFs), and angle-dependent fringes (ADFs). This review begins with a discussion of characteristics which are common to all these methods--high-, intermediate-, and low-index layers, phase, optical path difference, and contrast. For each of the three methods, we present a figure showing constructive and destructive interference, derive equations for calculating tear layer thickness, describe a typical optical system, and show representative results. The particular advantages and limitations of each method are discussed. Given the clinical importance of the tear film in dry eye syndrome and contact lens wear, it is unfortunate that there are considerable discrepancies among the results of interferometric and other methods for measuring tear film thickness; further development of these noninvasive, interferometric methods should help to provide a clearer picture of the thickness of different layers of the tear film, in normal and dry eyes, and in contact lens wear.

The syndrome of 'pure akinesia' and its relationship to progressive supranuclear palsy

Five patients developed a stereotyped syndrome of progressive akinesia of gait, speech, and handwriting without rigidity, tremor, or dementia. The symptoms did not improve with levodopa. These clinical findings conform to a syndrome described repeatedly in Japan since 1974 as “pure akinesia.” Evidence has indicated that pure akinesia often represents a pre-ocular motor, and in some cases an ocular motor-sparing, form of progressive supranuclear palsy (PSP). Although we found disorders of eyelid movements, none of the patients demonstrated a gaze palsy on clinical examination. Four patients underwent eye movement recordings. The two patients with the longest disease duration had slow or small vertical saccades. These findings support the notion that patients with pure akinesia may develop a vertical gaze palsy, similar to that in PSP, late in their course. Our patients show that pure akinesia occurs in North America as well as in Japan. Recognition of the syndrome of pure akinesia may suggest the diagnosis of PSP before the development of abnormalities of ocular movement.

Interferometric measurement of tear film thickness by use of spectral oscillations

A method of measuring the tear film thickness is described in which interference causes oscillations in the reflectance spectrum from the tears. Strong oscillations were usually observed when a contact lens was worn. Measurement of modulation and phase of these oscillations confirmed that they were associated with the tear layer in front of the contact lens. Calculated thickness of this layer averaged 2.7 microns. In one out of five subjects, weak oscillations were sometimes observed without a contact lens. These oscillations probably arose from the aqueous layer of the tears with a thickness of approximately 3 microns. The relative merits of three interference methods of measuring the tear film are discussed.

The effect of experience on the detection of small eye movements.

Purpose The purpose of this study was to determine whether experience improves detection of small eye movements similar to those seen in the cover test during ideal conditions. Methods Three groups of examiners with varying amounts of experience in eye movement detection tasks were studied. Eight examiners were 1st-year optometry students, six were 4th-year optometry students, and six were practicing optometrists. To determine thresholds for eye movement detection, examiners indicated the horizontal direction in which the eyes of one of the experimenters moved. The direction and extent of each eye movement was randomly selected. The extent of the eye movement was one of eight logarithmic steps from a maximum that was determined through an initial session where the approximate sensitivity of the examiners was found (generally ± 1.75 prism diopters). Results Detection thresholds were determined by fitting the data with a cumulative Gaussian function. The mean horizontal eye movement eye movement necessary to obtain 99% correct judgments was 2.65 prism diopters for the 1st-year students, 2.47 prism diopters for the 4th-year students, and 2.40 prism diopters for the practicing optometrists. Conclusions The results indicate that during ideal conditions, little or no training is required for efficient detection of small eye movements.

The treatment of superior oblique myokymia utilizing the Harada-Ito procedure.

A woman with superior oblique myokymia (SOM) was cured of her condition by performing a Harada-Ito procedure. This procedure involves transposing the anterior portion of the superior oblique tendon, which is responsible for cyclorotation, nasally to create an effective weakening of the anterior portion of the tendon instead of temporal displacement utilized for superior oblique paresis. We measured the patients eye movements before and after surgery, using the magnetic search coil technique, and confirmed that (1) the SOM was abolished and (2) vertical eye movements, including saccades, were unaffected.

The influence of vergence adaptation on open-loop vergence dynamics

The objectives of this experiment were to measure the effect of sustained convergence on the open-loop vergence peak velocity and open-loop vergence amplitude, and to assess the correlation between changes in the phoria and changes in open-loop vergence peak velocity induced by sustained convergence. Subjects sustained convergence on a target that required 12 degrees of convergence for 5 minutes. Convergence and divergence movements of 4 degrees from the 12 degrees convergent position were measured before and after sustained convergence. Following sustained convergence, the open-loop vergence peak velocity and vergence amplitude both increased for convergence (regression slope=3.68, r=0.47). Vergence velocity and vergence amplitude both decreased for divergence (regression slope=1.76, r=0.36). After sustained convergence, a convergent shift in the phoria was noted in most cases. This shift correlated with changes in open-loop peak vergence velocity more for convergence (regression slope=1.1, r=0.33) than for divergence (regression slope=0.71, r=0.22). The results might be due to shifts in disparity detection brought about by the period of sustained convergence.

Comparison of the monocular occlusion and a direct method for objective measurement of fixation disparity

Purpose. Previous studies have measured objective fixation disparity using a monocular occlusion method, by which the monocular components of misalignment are revealed by measuring the shift in the position of the fixating eye after occlusion of the other eye. Methods. We assessed the use of the monocular occlusion method by comparing it to direct measurements of binocular vergence. Results. The direct method required precise calibration, but was found to be reliable. Several problems were discovered with the monocular occlusion method: (1) when using a central fusion stimulus, fixation was difficult to control accurately enough to measure the small monocular shifts in eye position expected at lower vergence demands; (2) with a peripheral fusion target, objective fixation disparity could not be measured directly; and (3) upon occlusion, a variable saccade occurred in the fixating eye. Conclusion. Objective measurement of fixation disparity with the direct method is quicker and more reliable than with the monocular occlusion method.

The Effect of Refractive Lenses on Perceived Direction

The accuracy of directional localization with refractive lenses was determined by open-loop pointing for four myopic habitual contact lens wearers. The target was a single point of light at random locations (dark), or was embedded in a horizontal array of lights (light). In the dark, the regression slope of indicated vs actual target position was significantly less for spectacles than for contact lenses, as predicted from the prismatic effects of the spectacles. In the light, slopes for spectacles and contacts were not significantly different. These results suggest that spectacle wearers do not utilize eye position information in making direction judgments in the light.

Saccadic latencies for achromatic and chromatic targets.

The purpose of this experiment was to compare saccadic latencies for supra-threshold achromatic and chromatic targets of equivalent contrast. Two experiments were performed. In the first experiment, subjects made saccades to horizontal and vertical chromatic (red, green, and blue) targets. The luminance of these targets was matched to the luminance of the white background. In the second experiment, subjects made saccades to horizontal and vertical achromatic targets whose luminance contrast was matched to the chromatic contrast of the targets in the first experiment using the CIE L*a*b* color space. In the first experiment, the saccadic latencies did not vary significantly (p = 0.074) for the different target colors. However, in the second experiment the mean latency for achromatic targets (268.6 ms +/- 53.1) varied significantly from the pooled latency for color targets (318.4 ms +/- 75.1).

The effect of saccades and brief fusional stimuli on phoria adaptation.

Purpose. The purpose of this experiment was to determine whether brief fusional stimuli and saccades similar to those seen in the alternate cover test affect phoria disadaptation. Methods. Three cover test conditions were performed randomly. Before each test condition, subjects fused for 2 min at an angle convergent to the subjective phoria. In one test condition, subjects viewed monocularly. In another condition, subjects alternately fixated with each eye (no binocular time). In a third condition, subjects alternately fixated with each eye, and there was a 100-ms period of binocular viewing between alternations. The ocular vergence angle was monitored using scleral search coils. Results. Vergence angle was plotted against time for each condition. The area under this plot was determined using a computer program. The area reflected the rate at which ocular vergence returned to the original phoria position. The mean area for the monocular condition was 300.9, the mean area for alternate fixation with no binocular time was 300.3, and the mean area for alternate fixation with binocular time was 205.2. Conclusions Saccadic alternations do not affect phoria adaptation. However, short periods in which binocular disparate images are viewed significantly increase the rate at which phoria adaptation declines for some subjects.