Chapter 1 The retinal image in the human eye

Using a video-based eye tracker to analyse the binocular near-reflex dynamics response

PURPOSE

This study presents a novel video-based eye-tracking system for analysing the dynamics of the binocular near-reflex response. The system enables the simultaneous measurement of convergence, divergence and pupillary size during accommodation and disaccommodation to aid the comprehensive understanding of the three-component near-reflex.

METHODS

A high-speed (90 Hz) video-based eye tracker was used to capture changes in eye gaze and pupil radius in 15 participants in response to altering stimulus conditions. An offline analysis involved separating the gaze vector components and pupil radius, which were fitted to a hyperbolic tangent function to characterise the dynamics of the near-reflex process.

RESULTS

Significant differences in the temporal parameters of the pupil radius were observed between the near-to-far and far-to-near vision changes, with faster miosis compared with mydriasis. Additionally, differences in response times were found between gaze angle components, with longer convergence times compared to changes in the vertical direction (saccades). The steady-state values of the gaze components and pupil radius were in line with theoretical expectations and previous reports.

CONCLUSIONS

The proposed system provides a non-invasive, portable and cost-effective method for evaluating near-reflex dynamics under natural viewing conditions using a video-based eye tracker. The sampling rate ensures the accurate assessment of vergence eye movements and pupillary dynamics. By simultaneously measuring eye convergence, divergence and pupil size, the system offers a more comprehensive assessment of the near-reflex response. This makes it a valuable tool for clinical diagnosis, research studies and investigating the effects of near work on the visual system.

Effect of peripheral refractive errors on driving performance

The effect of peripheral refractive errors on driving while performing secondary tasks at 40° of eccentricity was studied in thirty-one young drivers. They drove a driving simulator under 7 different induced peripheral refractive errors (baseline (0D), spherical lenses of +/- 2D, +/- 4D and cylindrical lenses of +2D and +4D). Peripheral visual acuity and contrast sensitivity were also evaluated at 40°. Driving performance was significantly impaired by the addition of myopic defocus (4D) and astigmatism (4D). Worse driving significantly correlated with worse contrast sensitivity for the route in general, but also with worse visual acuity when participants interacted with the secondary task. Induced peripheral refractive errors may negatively impact driving when performing secondary tasks.

The effects of toxicological agents on the optics and mitochondria of the lens and the mitochondria of the corneal epithelium

This review describes how the morphology and distribution of the mitochondria of the epithelium and the superficial fibre layers of the lens were studied using confocal scanning laser microscopy. This research was correlated with an effort to use the optical properties of the intact lens in culture as a proxy for the cornea in measuring ocular toxicity. In turn, this work led to the confocal study of the in vitro and then the in vivo cornea and their possible use in using confocal microscopy to evaluate the effect of various treatments on the integrity of the surface of the eye. Finally, confocal examination of the mitochondria of the lens has provided an avenue to the study of mitochondrial dynamics.

The effect of monocular and binocular viewing on the accommodation response to real targets in emmetropia and myopia

PURPOSE

Decreased blur-sensitivity found in myopia has been linked with reduced accommodation responses and myopigenesis. Although the mechanism for myopia progression remains unclear, it is commonly known that myopic patients rarely report near visual symptoms and are generally very sensitive to small changes in their distance prescription. This experiment investigated the effect of monocular and binocular viewing on static and dynamic accommodation in emmetropes and myopes for real targets to monitor whether inaccuracies in the myopic accommodation response are maintained when a full set of visual cues, including size and disparity, is available.

METHODS

Monocular and binocular steady-state accommodation responses were measured with a Canon R1 autorefractor for target vergences ranging from 0-5 D in emmetropes (EMM), late-onset myopes (LOM), and early-onset myopes (EOM). Dynamic closed-loop accommodation responses for a stationary target at 0.25 m and step stimuli of two different magnitudes were recorded for both monocular and binocular viewing.

RESULTS

All refractive groups showed similar accommodation stimulus response curves consistent with previously published data. Viewing a stationary near target monocularly, LOMs demonstrated slightly larger accommodation microfluctuations compared with EMMs and EOMs; however, this difference was absent under binocular viewing conditions. Dynamic accommodation step responses revealed significantly (p < 0.05) longer response times for the myopic subject groups for a number of step stimuli. No significant difference in either reaction time or the number of correct responses for a given number of step-vergence changes was found between the myopic groups and EMMs.

CONCLUSION

When viewing real targets with size and disparity cues available, no significant differences in the accuracy of static and dynamic accommodation responses were found among EMM, EOM, and LOM. The results suggest that corrected myopes do not experience dioptric blur levels that are substantially different from emmetropes when they view free space targets.

Variability of wavefront aberration measurements in small pupil sizes using a clinical Shack-Hartmann aberrometer

BACKGROUND

Recently, instruments for the measurement of wavefront aberration in the living human eye have been widely available for clinical applications. Despite the extensive background experience on wavefront sensing for research purposes, the information derived from such instrumentation in a clinical setting should not be considered a priori precise. We report on the variability of such an instrument at two different pupil sizes.

METHODS

A clinical aberrometer (COAS Wavefront Scienses, Ltd) based on the Shack-Hartmann principle was employed in this study. Fifty consecutive measurements were performed on each right eye of four subjects. We compared the variance of individual Zernike expansion coefficients as determined by the aberrometer with the variance of coefficients calculated using a mathematical method for scaling the expansion coefficients to reconstruct wavefront aberration for a reduced-size pupil.

RESULTS

Wavefront aberration exhibits a marked variance of the order of 0.45 microns near the edge of the pupil whereas the central part appears to be measured more consistently. Dispersion of Zernike expansion coefficients was lower when calculated by the scaling method for a pupil diameter of 3 mm as compared to the one introduced when only the central 3 mm of the Shack - Hartmann image was evaluated. Signal-to-noise ratio was lower for higher order aberrations than for low order coefficients corresponding to the sphero-cylindrical error. For each subject a number of Zernike expansion coefficients was below noise level and should not be considered trustworthy.

CONCLUSION

Wavefront aberration data used in clinical care should not be extracted from a single measurement, which represents only a static snapshot of a dynamically changing aberration pattern. This observation must be taken into account in order to prevent ambiguous conclusions in clinical practice and especially in refractive surgery.

The prospects for super-acuity: limits to visual performance after correction of monochromatic ocular aberration

It has recently been suggested that correction of the monochromatic aberration of the eye could lead to substantial improvements in visual acuity and contrast sensitivity function. After consideration of the best-corrected visual acuity of normal eyes, the optical and neural limits to visual performance are reviewed. It is concluded that, even if current problems with the accuracy of the suggested techniques of aberration correction, through corneal excimer laser ablation or customised contact lenses, can be overcome, changes in monochromatic ocular aberration over time, the continuing presence of chromatic aberration, errors of focus associated with lags and leads in accommodation, and other factors, are likely to result in only minor improvements in the high-contrast acuity performance of most normal eyes being produced by attempted aberration control. Significant gains in contrast sensitivity might, however, be achievable, particularly under mesopic and scotopic conditions when the pupil is large, provided that correct focus can be maintained. In the immediate future, reduction of the high levels of aberration that are currently found in eyes that have undergone refractive surgery and in some abnormal eyes should bring useful benefits.

Effect of beta-adrenoceptor antagonists on autonomic control of ciliary smooth muscle

PURPOSE

Pharmacological intervention with peripheral sympathetic transmission at ciliary smooth muscle neuro-receptor junctions has been used against a background of controlled parasympathetic activity to investigate the characteristics of autonomic control of ocular accommodation.

METHODS

A continuously recording infra-red optometer was used to measure accommodation on a group of five visually normal emmetropic subjects under open- and closed-loop conditions. A double-blind protocol between saline, timolol and betaxolol was used to differentiate between the localised action on ciliary smooth muscle and effects induced by changes in stimulus conditions. Data were collected before and 45 min following the instillation of saline, timolol or betaxolol. Open-loop post-task decay was investigated following 3 min sustained near fixation of a stimulus placed 3 D above the subject's pre-task tonic accommodation level. Closed-loop dynamic responses were recorded for each treatment condition while subjects viewed sinusoidally (0.05-0.6 Hz) or stepwise vergence-modulated targets over a 2 D range (2-4 D).

RESULTS

Open-loop data demonstrate a rapid post-task regression to pre-task tonic accommodation levels for saline and betaxolol control conditions. A slow positive post-task shift was induced by timolol indicating that sympathetic inhibition contributes to accommodative adaptation during sustained near vision. Closed-loop accommodation responses to temporally modulated sinusoidal stimuli showed characteristic features for both saline and betaxolol control conditions. Timolol induced a reduced gain for low- and mid-temporal frequencies (< 0.3 Hz) but did not affect the response at higher temporal frequencies. Response times to stepwise stimuli increased following the instillation of timolol for the near-to-far fixation condition compared with the controls and was related to the period of sustained prior fixation.

CONCLUSIONS

Modulation of accommodation under open- and closed-loop conditions by a non-selective beta-blocker is consistent with the temporal and inhibitory features of sympathetic innervation to ciliary smooth muscle. Although parasympathetic innervation predominates there is evidence to support a role for sympathetic innervation in the control of ocular accommodation.

Constriction of the visual field of children after early visual deprivation

PURPOSE

We measured the extent of the monocular visual fields of children deprived of normal visual experience and examined the influence of the timing and duration of deprivation, of whether deprivation was monocular or binocular, of having patched the fellow eye, and of optical factors.

METHODS

The Goldmann perimeter and a 6.4' stimulus of either 31.8 cd/m2 (target 12e) or of 318 cd/m2 (target 14e) were used to test 44 children treated for a dense and central cataract in one (n = 25) or both (n = 31) eyes that developed before 6 years of age. Then, the influence of optical factors was assessed in two adults treated for a late-onset, unilateral cataract and in two children treated for unilateral congenital cataract.

RESULTS

Compared with age norms or the normal fellow eye, all children treated for cataract showed a restricted field, especially temporally, even when deprivation began as late as 6 years of age and lasted less than 6 months. The restrictions were larger than those shown by the adults who developed cataracts. The restrictions were larger after longer deprivation and monocular deprivation than after binocular deprivation. However, children who regularly patched the fellow nondeprived eye and, therefore, experienced less interocular competition, exhibited smaller restrictions temporally. Neither visual acuity nor optical factors could account for all of the restrictions in the deprived children.

CONCLUSIONS

The development of the visual field is vulnerable to the effects of deprivation, especially to unilateral deprivation and to long deprivation. The losses likely reflect alterations in the visual pathways subserving peripheral vision.

Analytic approximation of the off-axis modulation transfer function of the eye

Published experimental measurements of the ocular modulation transfer function (MTF) in the peripheral field are approximated by the expression T(f) = exp[-(f/fc)n], where T(f), f, fc, and n are modulation transfer, spatial frequency, spatial frequency constant and MTF index, respectively. It is shown that n (which describes the shape of the MTF) remains relatively constant at about 0.9 for field angles out to 40 deg but fc (which defines the spatial frequency scaling) declines steeply over this range, depending upon the pupil diameter and conditions of focus. The oblique astigmatism of the eye plays a major role in the off-axis changes in fc at field angles > or = 20 deg. The approximation may be useful in allowing the form of the degraded optical stimulus in studies of the peripheral retinal function to be evaluated.

Detection of blue under chromatic adaptation: the effects of stimulus size and eccentricity

We measured thresholds for the perception of blue under chromatic adaptation to white, green, yellow or red at the eccentricities of 0-70 deg in the temporal visual field of four subjects. We used a series of stimulus sizes at each eccentricity, without a prior assumption of any peripheral size-scaling factor. The CIE 1976 UCS (u',v') chromaticity coordinates corresponding to blue perception were subtracted from the chromaticity coordinates of the adaptation field in order to obtain the threshold differences (du',dv') in chromaticity coordinates. Spatial scaling factors for the perception of blue were obtained by non-linear regression (E2 + 5 deg) refers to the eccentricity at which stimulus diameter had to be doubled in order to maintain performance found at the eccentricity of 2.5 deg. E2 for the perception of blue tint varied from 1.2 to 36 deg depending on the state of chromatic adaptation and subject. For the perception of blue tint in yellow three subjects and for the perception of blue tint in red one subject had no spatial scaling factor that would make performance independent of eccentricity. Thus, spatial scaling does not always work.

Accommodative microfluctuations and pupil diameter

The nominally steady-state accommodation response exhibits temporal variations which can be characterized by two dominant regions of activity; a low frequency component (LFC < 0.6 Hz) and a high frequency component (1.0 < or = HFC < or = 2.1 Hz). There is no consensus as to the relative contribution made by each of the frequency components of the microfluctuations to the control of steady-state accommodation. We investigate the effect of variations in artificial pupil diameter (0.5, 1, 2, 3, 4 and 5 mm pupils) on the microfluctuations of accommodation, while three young emmetropic subjects view, monocularly, a photopic high contrast Maltese cross target placed at a dioptric distance equal to their open-loop accommodation level. Average power spectra were calculated for five accommodation signals, each of 10 sec duration, collected for each viewing condition at a sampling rate of 102.4 Hz using a continuously recording infrared objective optometer. For artificial pupil diameters < or = 2 mm the power of the LFC was found to increase as a function of reducing pupil diameter, while for artificial pupil diameters > 2 mm the LFC was found to be relatively constant. No systematic change in the HFC with varying artificial pupil diameter was observed. Changes in the root-mean-square (r.m.s.) value of the fluctuations with varying pupil diameter were significant (one-way ANOVA, F = 8.507, P = 0.0001, d.f. = 89) and showed a similar form to the changes in the LFC.(ABSTRACT TRUNCATED AT 250 WORDS)

Chromatic aberration and ocular focus: Fincham revisited

Longitudinal chromatic aberration of the eye (LCA) produces "color fringes" at edges that specify focus. Fincham [(1951) British Journal of Ophthalmology, 35, 381-393] concluded that these chromatic effects were important for accommodation, but most investigators disagree. We monitored accommodation in 25 subjects while they viewed a sinusoidally moving target (1.5-2.5 D at 0.2 Hz) in a Badal optometer. The target was monochromatic (590 nm with 10 nm bandwidth), or white (3000 K) with LCA normal, neutralized or reversed. Sensitivity to the effects of LCA is profound and widespread. Gain decreases substantially and phase-lag increases when LCA is eliminated, and reversing the aberration severely disrupts accommodation. The ordered arrangement of spectral foci produced by LCA seems to be a fundamental aspect of the stimulus for "reflex" accommodation.

The wide-angle pattern electroretinogram. Relation between pattern electroretinogram amplitude and stimulus area using large stimuli

Pattern electroretinograms (PERGs) were recorded from two normal human subjects in response to various spatial frequencies and stimulus areas. The maximum stimulus area was 75 degrees x 86 degrees which was achieved by using a standard TV monitor and a reduced viewing distance. The amplitude of the PERG increased with area in an approximately logarithmic fashion over the range investigated. The explanation relates to non-linearities of the stimulus, the retinal image and neural processing. The wide-angle PERG may be useful in the assessment of retinal diseases affecting the mid-peripheral inner retina, such as diabetic retinopathy.

The effect of 0.5% thymoxamine on the pattern-onset electroretinogram

Thymoxamine constricts the pupil without significant effect on accommodation and was used in this study because of the extreme sensitivity of the pattern electroretinogram (PERG) to defocus at high spatial frequencies. Pilocarpine, used in previous studies, can cause an unpredictable spasm of accommodation. A reduction in pupil size has two effects on the PERG due to illuminance and optical degradation. Illuminance differences can be compensated by neutral density filters. This allows the effects of optical degradation on the PERG to be examined under conditions of constant adaptation. Our studies on a group of 10 subjects have shown the PERG to be proportional to contrast. As contrast degradation is reduced with a smaller pupil, a larger PERG amplitude is predicted. However the tuning of neural elements under constant adaptation should not alter. Pattern onset ERGs were recorded from a further 10 subjects in response to checkerboards of various spatial frequencies under two conditions, a) with pupils moised by thymoxamine hydrochloride 0.5% and b) with natural pupils. Adaptation level was equated by a 0.4 neutral density filter before the natural pupils. The group-averaged PERGs were analyzed into retinal illuminance and pattern-specific responses. A paired t-test showed the pattern-onset ERG amplitudes to be significantly different in the two conditions, but the computed pattern-specific responses were virtually identical. These results therefore support the theory and method used for the extraction of the pattern-specific response.

Calculation of the influence of lateral chromatic aberration on image quality across the visual field

The magnitude of lateral chromatic aberration and its effect on image contrast were computed for a modified, reduced-eye model of the human eye, using geometrical optics. The results indicate that lateral chromatic aberration is a major factor affecting image quality for obliquely incident rays of polychromatic light. Modulation transfer functions for white sinusoidal gratings decline monotonically with spatial frequency, with eccentricity of the stimulus in the peripheral visual field, with grating orientation relative to the visual meridian, and with decentering of the pupil. Image contrast is largely independent of the color temperature of white light over the range 2800 to 12,000 K, but it improves significantly for the polychromatic green light of the P-31 oscilloscope phosphor. Selective filtering by macular pigment increases image contrast by an amount that grows with spatial frequency to about a factor of 1.5 at the foveal resolution limit. Reduced contrast caused by lateral chromatic aberration accounts for most of the threefold loss of acuity that occurs for foveal viewing through a decentered pupil. The aberration probably has negligible effect on peripheral acuity but may act to limit aliasing of peripheral patterns.

The effects of image degradation on retinal illuminance and pattern responses to checkerboard stimuli

The contrast of a retinal image is less than that of the external stimulus owing to a process of optical degradation. Theoretical studies have shows that this affects the pattern and illuminance detectors of the retina differently and provides a new insight into the nature of contrast stimulation and the mechanisms responsible for the pattern electroretinogram. Consensus data on the optical transfer function of the eye are applied to the Fourier transform of the pattern stimulus and the retinal illuminance distribution is determined. The checkerboard image is shown to undergo substantial degradation for those check sizes used in experimental and clinical observations. Current concepts of contrast and modes of stimulation are examined and methods are described for quantifying the effects on stimulation of illuminance and pattern detectors. The findings are applied to experimental data on spatial tuning functions of electroretinograms elicited by checkerboard pattern stimulation. It is concluded that the signal predominantly originates from local illuminance, but that this can account for only part of the response with small check sizes. The remainder must be a highly selective response to spatial frequency. If the predicted degradation is accepted, a similar conclusion must be reached for many previously reported tuning functions of the pattern electroretinogram as well as to the present experiment on eight normal eyes.

Modulation dependence of the accommodation response to sinusoidal gratings

The steady-state, monocular, accommodation response to sinusoidal grating targets (spatial frequencies 0.67, 2.0, 6.0 and 18 c/deg) at effective distances between 0.2 and 1.0 m was measured with a laser optometer, as a function of the grating modulation. In general, only a rather weak dependence of the response on modulation was observed. The results are discussed in terms of the theoretical modulation of the retinal image as a function of defocus. It is argued that the accommodative system usually works to produce a contrast in the grating image which is well above the detection threshold. Considerable inter-subject differences in response were observed, suggesting that a variety of strategies may be employed by different subjects when engaged upon the same voluntary accommodation task.