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An introduction to refractive errors of the eye.
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Emmetropia and its aberrations.
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[STATE OF VISION AND REFRACTION IN URBAN AND RURAL SCHOOLCHILDREN].
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A theory for interpreting book reinoscope observations.
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An algorithm for computing astigmatic refractive errors from ocular parameters.
Calculation of total refractive astigmatism by analyzing refractive parameters of the individual components can be very tedious, especially when the principal meridians among all the components are not orthogonal. A straightforward programming algorithm for accomplishing these calculations is presented. The algorithm is applicable to any programmable device which performs trigonometric functions.
Physiological strategies for emmetropia.
PURPOSE: To identify relationships among age-independent ocular biometric variables which contribute to ocular refraction in adult human eyes, and to identify differences in those relationships between emmetropes and ametropes. METHODS: Manifest refraction (DRS methodology), corneal refractive power (keratometry), and axial anterior segment (anterior cornea to posterior lens), vitreous cavity (posterior lens to anterior sclera) and total globe (anterior cornea to anterior sclera) length (A-scan ultrasonography) were determined in 185 unaccommodated right eyes of adult humans aged 18 to 70 years. There were 136 emmetropes with absolute refractive error < or = 2.0 diopter, and 49 ametropes (47 myopes, 2 hyperopes) with absolute refractive error of 2.25-11.0 diopters. RESULTS: Refraction decreased significantly with increasing globe and vitreous cavity length in emmetropes and ametropes. Anterior segment length was also significantly negatively correlated with refraction in emmetropes, but not in ametropes. Corneal refractive power was not correlated with refraction in either group, but decreased significantly with increasing globe length in both, more strongly in emmetropes. Globe and vitreous cavity length were significantly positively correlated in both groups, more strongly in ametropes. Anterior segment length increased significantly with increasing globe length in emmetropes but not in ametropes. Anterior segment length decreased significantly with increasing vitreous cavity length in ametropes but not in emmetropes. CONCLUSION: These findings indicate an "inflatable anterior segment" as well as the classic "inflatable globe" mechanism of emmetropization. This newly described anterior segment mechanism involving increased separation between the cornea and the lens with increasing globe size appears to be absent in adult human myopia.
Relation of refractive error to optometric tests.
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Relation of refractive error to optometric tests.
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A model to explain the difference between changes in refraction and central ocular surface power after laser in situ keratomileusis.
PURPOSE: After refractive surgery, changes in central ocular surface power are usually less than actual changes in refraction. The aim of this paper was to examine the theoretical changes in the radius of the epithelial-stromal interface and corneal stromal refractive index which could take place to account for some of the empirical findings. METHODS: The parameters of an aspheric human eye model featuring gradient index optics was modified using data from a clinical study evaluating effects of laser in situ keratomileusis (LASIK) for correction of moderate to high myopia. Computations were performed to determine: 1) theoretical postoperative radius of the epithelial-stromal interface and hence distribution of epithelial thickness, and 2) refractive index of the stroma when the epithelium was of fixed uniform thickness. RESULTS: Within the central 2-mm diameter refractive zone of the cornea after LASIK for myopia, either of two factors could account for the difference between changes in central ocular surface power and the actual change in ocular refraction: 1) a steepening of the epithelial-stromal interface resulting from a 400% centrifugal increase in epithelial thickness, or 2) a reduction in stromal refractive index from an average of 1.376 to 1.364. CONCLUSION: The difference between the observed changes in refraction and central ocular surface power could be explained by reduction in stromal refractive index and this could be secondary to a 6.5% increase in water content of the stroma during the postoperative period. The epithelial-stromal interface after LASIK is unlikely to steepen by the extent predicted by our model. This surface is not the source of the difference between the change in refraction and change in central ocular surface power.
Calculating the surgically induced refractive change following ocular surgery.
Calculating the surgically induced refractive change following ocular surgery is important for evaluating the results of keratore-fractive procedures, smaller incisions and various wound closures for cataract surgery, and the effect of suturing techniques and suture removal following corneal transplant surgery. We present a ten-step method of calculating the spherical- and cylindrical-induced refractive change in a manner suitable for a programmable calculator or personal computer. Several applications are given including (1) adding the overrefraction to the spectacle correction, (2) determining the surgically induced refractive change from the preoperative and postoperative refractions, (3) determining the surgically induced refractive change from the K-readings, (4) rotating axes, (5) determining the power at meridians oblique to the principal meridians of a spherocylinder, (6) determining the coupling ratio, and (7) averaging axes. Standard methods for calculating and reporting aggregate results are also given.
A physiological study of refractive errors.
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A physiological study of refractive errors.
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Distribution of ocular biometric parameters and refraction in a population-based study of Australian children.
PURPOSE: To study the distribution of spherical equivalent refraction and ocular biometric parameters in a young Australian population. METHODS: Noncontact methods were used to examine ocular dimensions and cycloplegic autorefraction in a stratified random cluster sample of year 1 Sydney school students (n = 1765), mean age 6.7 years (range, 5.5-8.4 years). Repeated measures of axial length, anterior chamber depth, and greatest and least corneal radius of curvature (CR1, CR2, respectively) were taken in each eye. Refraction was measured as the spherical equivalent. RESULTS: Mean spherical equivalent refraction in right eyes was +1.26 +/- 0.03 D (SEM; range, -4.88 to +8.58). The distribution was peaked (kurtosis 14.4) and slightly skewed to the right (skewness, 1.7). Prevalence of myopia, defined as spherical equivalent refraction < or = -0.5 D, was 1.43% (95% CI, 0.94-2.18) in the overall population. Axial length, anterior chamber depth, and corneal radii of curvature were normally distributed. The mean axial length in right eyes was 22.61 +/- 0.02 mm (SEM; range, 19.64-25.35). The mean anterior chamber depth was 3.34 +/- 0.01 mm (SEM; range, 2.14-4.06). Mean CR1 was 7.85 +/- 0.01 mm (SEM) and mean CR2 was 7.71 +/- 0.01 mm (SEM). The distribution of axial length/mean corneal radius ratio was peaked (leptokurtic) with a mean of 2.906. Mean axial length was longer, anterior chambers were deeper, and corneas were flatter in the boys. CONCLUSIONS: A peaked (leptokurtic) distribution of spherical equivalent refraction was present in this predominantly hyperopic 6-year-old population. The results also showed that ocular biometric measures were normally distributed, with statistically significant gender differences found in measurements.
Ocular biometry and refraction in Mongolian adults.
OBJECTIVE: To describe the variation in ocular biometry and its association with refraction in adult Mongolians. METHODS: The study included 1800 subjects, aged 40 years or more, who were selected in two Mongolian provinces-Hövsgöl and Omnögobi-to participate in this population survey. Axial length (AL) and its components, as well as noncycloplegic autorefraction and corneal power (CP), were measured. RESULTS: Of those selected, 1617 subjects (90.0%) were examined. Mean +/- SD of AL was 23.13 +/- 1.15 mm. There was a very small but significant increase in mean AL with age (0.05 mm per decade, P = 0.03). Autorefraction was performed on 620 of 675 subjects of those examined in Omnögobi. The age and gender standardized prevalences of myopia (< -0.5 D), emmetropia, hyperopia (> +0.5 D), astigmatism (< -0.5 D of cylinder) and anisometropia (>1.0 D difference between eyes) were 17.2%, 49.9%, 32.9%, 40.9%, and 10.7%, respectively. Prevalence of myopia showed no clear trend with increasing age, whereas hyperopia, astigmatism, and anisometropia all increased monotonically. Multiple regression models revealed that AL (P < 0.001) and VCD (P < 0.001) were the strongest determinants of refractive error. CONCLUSIONS: In this cross-sectional study of adult Mongolians, a much lower prevalence of myopia was found than in other East Asian populations studied to date. The mean AL differed little between age groups, in marked contrast to data on Chinese people.
A PHILOSOPHY OF REFRACTION FOR AVIATION PERSONNEL.
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Power vector analysis of the optical outcome of refractive surgery.
PURPOSE: To demonstrate the power vector method of representing and analyzing spherocylindrical refractive errors. SETTING: School of Optometry, Indiana University, Bloomington, Indiana, USA. METHODS: Manifest and keratometric refractive errors were expressed as power vectors suitable for plotting as points in a 3-dimensional dioptric space. The 3 Cartesian coordinates (x, y, z) of each power vector correspond to the powers of 3 lenses that, in combination, fulfill a refractive prescription: a spherical lens of power M, a Jackson crossed cylinder of power J0 with axes at 90 degrees and 180 degrees, and a Jackson crossed cylinder of power J45 with axes at 45 degrees and 135 degrees. The Pythagorean length of the power vector, B, is a measure of overall blurring strength of a spherocylindrical lens or refractive error. Changes in refractive error due to surgery were computed by the ordinary rules of vector subtraction. RESULTS: Frequency distributions of blur strength (B) clearly demonstrate the effectiveness of refractive surgery in reducing the overall blurring effect of uncorrected refractive error. CONCLUSIONS: Power vector analysis also revealed a reduction in the astigmatic component of these refractive errors. Paired comparisons revealed that the change in manifest astigmatism due to surgery was well correlated with the change in keratometric astigmatism. Power vectors aid the visualization of complex changes in refractive error by tracing a trajectory in a uniform dioptric space. The Cartesian components of a power vector are mutually independent, which simplifies mathematical and statistical analysis of refractive errors. Power vectors also provide a natural link to a more comprehensive optical description of ocular refractive imperfections in terms of wavefront aberration functions and their description by Zernike polynomials.
ANISOMETROPIA AND THE FUNDUS CAMERA.
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