Clinical Optics Review

Optics
Board Review
Optics
 Lightbehaves like wave and particle
 Physical optics – wave properties of light
 Geometrical optics – light as rays
 Quantum optics – interaction of light and

matter (wave and particle characteristics)
Physical Optics
Physical Optics
 Wavelength: distance between crests

 Amplitude: height of wave crest / maximum value attained
by electric field
 Frequency: number of wave crests passing a fixed point
per second
Photon Energy
 Wavelength x Frequency (λ x ν) = c
 λ is inversely proportional to v
 Energy per photon (E) = h v

 Wavelength: blue < red
 Frequency: blue > red
 Energy: blue > red
Electromagnetic Spectrum
Interference
 Constructive interference:
 crests of two waves coincide
 Destructive interference:
 crest of one wave coincides with trough of other
wave
 Coherence:
 measure of the ability for two light waves to
interfere
Interference: Applications
 Laser inferometry:
 Evaluates retinal function in pt w/ cataract
 Laser beam split into 2 beams
 Beams overlap on retina, producing interference
fringes, thus you know retina is functioning
 Antireflective coatings
Antireflective Coating
Polarization
 Plane-polarized
(linearly polarized) light:
waves that all have the
electric field in the
same plane
 Polarized sunglasses
 Stereopsis testing
 Haidinger brush
phenomenon
Diffraction
 Bending of light rays when they encounter an
obstruction
 Diffraction limits visual acuity when the pupil
size is less than 2.5mm
Diffraction
 What is the optimal pinhole aperture?
1.2 mm
 Any smaller would greatly increase diffraction
and limit the amount of light into the eye
 Because of diffractive effects, pinhole vision
is rarely better than 20/25
Scattering
 Isolated molecules absorb light and re-radiate
it at same wavelength but different direction
 Causes glare (cataracts, AC flare, corneal
haze)
 Rayleigh Scattering
 Due to scattering of very small particles
 Sky appears blue because of greater scattering of
shorter wavelengths
Lasers
 LightAmplification by Stimulated Emission of
Radiation
 Which of the following features of laser light
enhance its intensity?
 Directionality
 Coherence
 Polarization
 Monochromaticity
Laser-Tissue Interaction
 Name 3 ways lasers damage tissue:
 Photocoagulation (Argon)
 Photodisruption (Nd:YAG)
 Photoablation (Excimer)
Geometrical Optics
Geometrical Optics
 Refractive Index:
n = speed of light in vacuum
speed of light in material
 n is always > 1
 Snell’s law of refraction:
n1 sin θ1 = n2 sin θ2
Refraction
 A fisherman attempts to
spear a fish as shown
at right.
 Should he aim directly

at the fish, in front of
the fish, or behind the
fish as he sees it?
Refraction
 He should aim in front of the
fish.
 When a light ray passes
from a medium with a
higher refractive index to a
medium with a lower
refractive index, it is bent
away from the normal.
 When passing from a lower

refractive index to a higher
refractive index, light is bent
toward the normal.
Total Internal Reflection
Vergence
 A measure of the
spreading (or coming
together) of a bundle of
light rays.
Vergence
 The reciprocal of the distance, in meters,
from the object point or to the image point.
 Units = m-1 = diopters (D)
 Lenses add vergence to light

Vergence
 Plus lenses are
biconvex and add
+ vergence
 Minus lenses are

biconcave and add
- vergence
Thick Lenses
 6 “cardinal points”
 2 principal points / planes (H and H’)
 2 nodal points (n and n’)
 2 focal points (F and F’)
Focal points
 Primary (Anterior) focal point
real object virtual object

Focal points
 Secondary (Posterior) focal point
real image virtual image

Focal Length
 Distance from lens to each of its focal points.
 Focal length in meters:
F = n/D
F = 1/D in air
 Primary focal length of eye

F = 1/60 = 0.017 m = 17mm
 Secondary focal length of eye

F’ = 1.33/60 = 0.0222m = 22mm
Vergence Formula
U + D = V
vergence of Amount of vergence vergence of
light entering added to the light by light leaving the
the lens the lens (power of lens
the lens)
Real or virtual?
light
Upright or Inverted?
Vergence
 An object is located 20 cm to the left of a
-2.00 D lens. Where is the image located?
A) 20 cm to the right of the lens

B) 50 cm to the right of the lens
C) 33 cm to the left of the lens
D) 14 cm to the left of the lens
Vergence
 D) 14 cm to the left of the lens
100/-7 = -14cm
The intermediate image formed by the concave lens is
A) Real , inverted
B) Virtual, upright
C) Real, upright
D) Virtual, inverted
 B) virtual, upright
Schematic Eye
Reduced Schematic Eye
F n F’
17 mm
power = +60 D
5.5 mm
17 mm 22.5 mm
Mirrors
 Angleof incidence
= angle of reflection
 Convex mirrors add minus vergence

 Concave mirrors add plus vergence
 Plane mirrors add zero vergence
 Image space is reversed: image rays are on same
side as object rays
Mirrors
 Central ray passes through center of curvature (C)
not through center of mirror.
real, inverted
virtual, upright
Mirrors
 U+D=V
 F=r/2
(r=radius of curvature)
 Reflecting power
D=1/F=2/r
 What is the reflecting power of

cornea?
 2/.008 = 250D (-250D)
Magnification
 Transverse Magnification
= Image height / Object height
= Image distance / Object distance
= Object vergence / Image vergence
 Mag =U/V
trans
 For lens combinations the total magnification

is the product of the individual magnifications.
Where is the intermediate
image?
+6 -4
50 cm 12.5 cm
+6 -4
-2 +4
50 cm 12.5 cm 12.5 cm
•Is the object virtual or real? Inverted or erect?

•What is the magnification?
M = U/V = -2/+4 = -0.5
Where is the final image?
+6 -4
-2 +4 +8 +4
50 cm 12.5 cm 12.5 cm 12.5 cm
Mag = U/V = -2/+4 * +8/+4 = -1

Simple Magnifiers
 The (angular) magnification of a simple plus lens is
defined as the ratio of the size of the image produced by
the lens to the size of the object viewed at 25 cm
 Magsimplemagnifier =D/4
 Examples:
 + 8D lens is called a 2x magnifier
 +20D lens is a 5x magnifier

Direct ophthalmoscope
 What is the angular magnification of a retinal image
using direct ophthalmoscopy in an emmetrope?
 Mag = 60D / 4 = 15x
 (the pts retina appears 15x larger than if it were cut

out of the eye and held at 25 cm)
Telescopes
 Receives parallel rays from a distant object
and projects parallel rays out.
(i.e. an afocal system)
 2 lenses : objective + eyepiece
 Transverse magnification is same for every

object regardless of location.
 Mag = Deyepiece / Dobjective

telescope
Keplerian Telescope
 Objective: low-power plus lens

 Eyepiece: high-power plus lens
 Separation: sum of focal lengths
 Image: inverted, all light from objective is collected
 Astronomical telescope
Gallilean Telescope
 Objective: low-power plus lens

 Eyepiece: high-power minus lens
 Separation: difference between focal lengths
 Image: upright, some light collected from objective is lost
 Surgical loupes
Prisms: True or False?
 The power in prism diopters is the number of
centimeters that light is displaced perpendicularly for
every centimeter that the light travels.
 False, it’s for every 100 cm

Prisms: True or False?
 Glass prisms are

calibrated while held in
the angle of minimum
deviation.
 False, it’s Prentice position

Prisms
 Real images created by prisms are deviated toward
the prism base.
Prentice’s Rule
 Except at its optical center, a spherical lens
has prism at every point on it’s surface.
Δ =hxD
Δ = prism diopters
h = distance from optical center in cm
D = diopter power of the lens
Prentice’s Rule
 If a patient with no
ocular misalignment
reads 1 cm below the
optical centers of his
single vision glasses,
with the different lens
powers as shown, what
prismatic effect is
induced?
Prentice’s Rule
 The powers of the
lenses acting in the
vertical meridians are
used
 Total prismatic effect in

the reading position =
4Δ of vertical prism
 Will induce a left
hypertropia
Fresnel Prisms
 Fresnel prisms are equivalent to side-by-side
strips of long, narrow, thin prisms.
fresnel prism
Fresnel Prisms
 Used to avoid the weight of conventional
prisms.
 Plastic Fresnel prisms are available as Press-
On prisms from 0.5Δ to 40Δ.
 Visual acuity suffers by one or two lines with
higher power prisms because of glare and
chromatic aberration.
Bifocal Segments
 ImageJump – prismatic power at top of bifocal
segment
 Executive has no image jump
 Image Displacement – total prism in reading
position
 What type of add minimizes image
displacement with:
 Plus lenses?
 Round top
 Minus lenses?
 Flat top
Question
 A patient with congenital nystagmus has a
null point measured to be 10° to the left of
fixation. The appropriate prism prescription
to rectify the induced head turn is
a. 10∆ BI OS, 10∆ BO OD
b. 10∆ BI OD, 10∆ BO OS
c. 20∆ BI OS, 20∆ BI OD
d. 20∆ BI OD, 20∆ BO OS
e. 20∆ BI OS, 20∆ BO OD
(Regular) Astigmatism
 Curvature of an astigmatic lens has minimum
and maximum values, located in meridians
90° apart.
 An astigmatic surface cannot bring light rays
to a point (stigma) of focus.
 Instead two focal lines are formed.
 Geometric figure is formed called Conoid of

Sturm.
Astigmatism
 Each focal line is formed by the power of the lens
acting 90° away from the focal line.
Conoid of Sturm
 Spherical equivalent = sphere + ½ cylinder

Type of Astigmatism
Location Sphere Sphere + Cyl
Compound Vitreous - -
Myope
Simple One vitreous 0/- -/0
Myope One retina
Mixed Straddle Retina +/- -/+
Simple Hyperope One retina +/0 0/+

Behind retina
Compound Behind retina + +
Hyperope
Maddox Rod
Jackson-Cross
 Which of the following is a Jackson-Cross
cylinder?
 A) +0.50-0.25 x 90
 B) -1.00+0.50 x 180
 C)+2.00-4.00 x 90
 D)-4.00 +2.00 x 90
Accomodation
 Theaccomodative amplitude of a 60 yr. old
healthy person is approximately:
1.50 D
 Accomodativeamplitude:
age 40 = 6.0 44 = 4.5 48 = 3.0
>age 48 decreases by 0.50 every 4 yrs
<age 40 increases by 1.0 every 4 yrs
Kestenbaum’s Rule
A 72 yr. old patient with bilateral macular
degeneration has a distance acuity of 20/100. The
add required for this patient to read newspaper print
is:
A) +1.00
B) +3.00
C) +4.00
D) +5.00
E) +10.00
Contact Lenses
 ObtainRefraction & K's
 Choose base curve steeper than low K
 Usu +0.50 D steeper to form tear lens
 Prevents apical touch
 Convert refraction to Minus cylinder form
 Disregard the cylinder
 Convert to zero vertex distance
 Subtract +0.50 spherical tear lens from the
sphere value to obtain the final RGP sphere
Accounting for the tear lens in
RGPs
 Steeper add minus SAM

 Flatter add plus FAP
 Power of the “tear lens” is 0.25 D for every 0.05 mm
radius of curvature difference between contact lens
and cornea
 Therefractive error of an eye is -3.00 D, the
K measurement is 7.80 mm and the base
curve chosen for the rigid contact lens is 7.95
mm. What is the anticipated power of the
contact lens?
 Power of tear lens: 7.95-7.80 = 0.15 mm = 0.75 D

 CL power: -3.00 D + 0.75 D = -2.25 D (FAP)

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Optics

 Geometrical optics – light as rays

 Quantum optics – interaction of light and

 Wavelength: distance between crests

 Energy per photon (E) = h v

 Snell’s law of refraction:

 Should he aim directly

 When passing from a lower

 Lenses add vergence to light

 Minus lenses are

real object virtual object

real image virtual image

 Primary focal length of eye

 Secondary focal length of eye

A) 20 cm to the right of the lens

 Convex mirrors add minus vergence

 What is the reflecting power of

 For lens combinations the total magnification

•Is the object virtual or real? Inverted or erect?

50 cm 12.5 cm 12.5 cm 12.5 cm

Mag = U/V = -2/+4 * +8/+4 = -1

 +20D lens is a 5x magnifier

 Mag = 60D / 4 = 15x

 (the pts retina appears 15x larger than if it were cut

 Transverse magnification is same for every

 Mag = Deyepiece / Dobjective

 Objective: low-power plus lens

 Objective: low-power plus lens

 False, it’s for every 100 cm

 Glass prisms are

 False, it’s Prentice position

 Total prismatic effect in

 Geometric figure is formed called Conoid of

 Spherical equivalent = sphere + ½ cylinder

Simple Hyperope One retina +/0 0/+

 Steeper add minus SAM

 Power of tear lens: 7.95-7.80 = 0.15 mm = 0.75 D

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