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Understanding
Optical Aberrations
Wavefront
technology allows us to better understand the complex optical aberrations
that degrade visual function in the human eye. This technology has
ushered in a new era of refractive surgery by not only attaining
supernormal visual acuities but by improving other aspects of visual
function as well.
There
are many different aberrations in the normal eye, but one that has
significant deleterious effects on vision is called spherical aberration.
Reduced scotopic (low light) contrast sensitivity and the presence
of halos are two manifestations of decreased visual function that
directly relate to this higher-order aberration.
Spherical
aberration
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The
natural human cornea is steeper in the center and flatter
towards the periphery. This configuration, known as a prolate
surface, provides the ideal refractive configuration for stigmatic
optics: parallel rays focusing at one point on the retina
(Figure 1). What would happen if the cornea did not have a
prolate shape but was a perfect sphere with the same steepness
at the visual axis and towards the periphery? The optics of
this system would no longer be stigmatic.
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Figure
1
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An
ideal cornea is steeper in the center and flatter towards
the periphery. This prolate configuration allows light rays
entering along the visual axis & in the corneal periphery
to focus at a single point on the retina
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Figure
2
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While
paraxial rays still come to a point focus on the retina, light
rays entering the peripheral cornea would be bent too much
and would focus in front of the fovea (central point on the
retina). These light rays degrade contrast sensitivity and
visual acuity when the pupil is enlarged, such as in low-light
conditions.
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Positive
spherical aberration: Peripheral rays are bent too much, focus
in front of the fovea & degrade image quality
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If
we continue to flatten the central cornea, we move into an
oblate configuration; the cornea is flat in the center and
steep towards the periphery (Figure 3). This configuration
also suffers from positive spherical aberration. When we perform
conventional LASIK or PRK myopic refractive surgery, we are
inducing positive spherical aberration by flattening the central
optical zone while leaving the peripheral cornea un-touched.
We are converting the cornea from the more optically efficient
prolate configuration to a less efficient oblate surface.
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Figure
3
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An
'Oblate' cornea is flat centrally & steep towards the
far periphery. Peripheral rays are bent too much, focus in
front of the fovea & degrade image quality
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When the
positive spherical aberration is particularly pronounced, the patient
may experience a myopic shift as the best focus of the image shifts
anteriorly.
As
mentioned earlier, the ideal cornea (Figure 1) has a prolate configuration,
namely steep in the center and flat towards the periphery.
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However,
If we take this to an extreme and continue to steepen the
central cornea and flatten the periphery, we will produce
optics that contain significant negative spherical aberration
(Figure 4).
In this extreme prolate configuration, peripheral rays are
not bent enough and focus at a virtual point behind the fovea,
again degrading contrast sensitivity and visual function.
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Figure
4
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Negative
spherical aberration: In this extreme prolate cornea, peripheral
rays are not bent enough and focus at a virtual point behind
the fovea, degrading image quality.
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Let's
examine two major areas of visual function degraded by spherical
aberration: glare/halos and decreased contrast sensitivity. Spherical
Aberration causes glare and halos. In looking at Figure 3, one can
imagine that the peripheral rays from a point light source might
degrade image quality in the form of a myopic shift, manifest most
commonly during scotopic conditions.
Figure
5
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To
understand contrast sensitivity, let's examine Figure 5, which
shows a contrast sensitivity grading. The spatial frequency
of alternating light and dark stripes increases from left
to right. The contrast decreases from bottom to top. The grading
appears to have a hump in the middle at the spatial frequencies
for which the human eye is most sensitive.
The red curve in Figure 5, demonstrating this sensitivity,
represents the contrast sensitivity function (CSF) for the
youthful human eye. Spherical aberration shifts this CSF curve
downward, to the blue curve, for example, degrading contrast
sensitivity at all spatial frequencies. Another measure of
visual function, the modulation transfer function (MTF), relates
spatial frequency and contrast acuity. Spherical aberration
also negatively affects the MTF.
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CSF:
Spatial frequency is shown increasing to the right while image
contrast decreases along the vertical axis. There is a range
of frequencies in the middle that are easier to appreciate
at low contrast than those on either end. The red line highlights
this and represents the contrast sensitivity function of the
youthful human eye. The presence of spherical aberration shifts
this curve downward to the blue curve, denying the eye from
detecting subtle contrast changes and image detail.
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The
complementary nature of the cornea and lens breaks down with age.
As we move past age 40, the lens shape changes such that it begins
to contribute positive spherical aberration, which adds to that
of the cornea, reducing contrast sensitivity and visual acuity in
dark conditions.
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