Aberrometry for the Common

Joe

Thomas O. Salmon, OD, PhD, FAAO

8/19/11 Revision

Basic teaching objectives

1. What are aberrations?
2. What are aberrometers?
3. How do they work?
4. How do we interpret the data?
5. How can you diagnose abnormal
values?

1. What are aberrations?

Aberrations = refractive errors
Myopia, hyperopia, astigmatism =
LOA
But there are others
Higher-order aberrations (HOA)

Coma
Spherical aberration
Trefoil
Others

Clarification which
aberrations?
Monochromatic
Not chromatic
Not Seidel

Coma
Spherical aberration
Oblique astigmatism
Petzval
Curvature of field

Pupil size, pupil size, pupil

size,

20/200
sized letter

Courtesy of Dr. Donald Miller, Indiana University

Retinal Imaging and Vision at the Frontiers of Adaptive Optics, Physics Today (Jan 2000)

Summary 1
What are aberrations?
A. Refractive errors
Q.

What are higher-order

aberrations?
A. Refractive errors beyond sphere
and cyl.
Q.

2. What are aberrometers?

Instruments that measure

Refractive errors
(super auto-refractors)
Sphere, cylinder + HOAs
(Higher-order aberrations)
corneal topography!

COAS

K topography vs
aberrometry

High-resolution
keratometry

High-resolution
auto-refraction

History of HO
aberrometry
Reagan

1970s and 80s

Strategic defense
Refraction through the
atmosphere
Shack-Hartman wavefront sensor Shack
Astronomy
Adaptive optics (AO)

Ocular HO aberrometry
research

1960 MS Smirnov

1977 Howard Howland

1990 Josef Bille and

Junzhong Liang

J Opt Soc Am A, July 1994

Mid 1990s - other labs

Howland

Bille

Liang

IU Shack-Harmann Wavefront Sensor (catch a wave!)

Clinical HO
aberrometry

Laser refractive
surgery

Large HOAs

Clinical aberrometry

Wavefront-guided
LASIK

COAS

3. How do they work?

Light is projected in.

Reflect off the retina
Light passes through
the eyes optics.
Catch the light.
Analyze it.
Reconstruct the
optical wavefronts
shape

Courtesy of Alcon

Shack-Hartmann
aberrometry
}

Light exiting
the eye

Analyze
each dots
position

Reconstruct
wavefront
shape

What does the wavefront

tell you?

Flat wavefront = perfects optics (no

aberrations)
Elevations = wavefront errors
Wavefront distortions reveal refractive
errors.
-0.5

2
1
0

0.5
-0.5

1.0
0.0

-1 (mm)
pupil
-2

-0.5

-2 -1 0 1 2
pupil (mm)

-1.0 -0.5 0.0 0.5 1.0 1.5

Wavefront error (um)

2.0

Topographic map

Surface plot

Higher-order wavefront
maps
Normal eye

Post LASIK

Besides refractive errors

Optical quality metrics

Modulation transfer function (MTF)
Point spread function (PSF)
Strehl ratio

Visual performance metrics

Simulate the patients vision!

Design the ideal optical correction for

the eye

W-guided RS, CL, spectacles, IOL, etc.

Simulated retinal image

emmetropia

Simulated retinal image for AI

-1.00 -0.50 x 100 HO RMS 0.51 m (6.0mm pupil)

Simulated retinal image

emmetropia

Simulated vision for

TO

-3.00 -2.00 x 170 HO RMS 0.38 m 6.0-mm

pupil

Summary 3
Q. How do
aberrometers work?
A. Measure light that
has passed through
the eye's optics.
Q. Why? (Who cares?)
A. The wavefront
provides a wealth of
info about the eye's
optics and vision.

4. How do we interpret
wavefront data?

Does this eye have good or bad

optics?

How good or bad is the optical

correction?

Are HO aberrations the problem?

Specifically:

1. Which

have?

2. How

aberrations does this eye

bad are they?

Which aberrations are

present?

Wavefront - distorted by all the

aberrations combined

Specifically, which ones are present?

Need Zernike analysis to break it down.

Zernike system = hierarchy of

aberrations

Each aberration causes a particular

shape of wavefront distortion.

Some example wavefronts

sphere

astigmatism

trefoil

-3

Z7

Zernike analysis breaks it

down
=

+
sphere

+
coma

+
astigmatism

trefoil

+ ...

+
spherical
aberration

Z44

Z42

order (n)

Zernike
m
Z(n,m)
Zn ormodes

0
0

1
-1

2
-2

3
-3

-1

H
O
A

4
-4

-2

5
-5

-3

-1

Z1-1

Z11

Combined
Zernike modes

1
Z11
Z2-2

Z20

Z22

2
Z22
Z3-3

Z33

Z31

3
order (n)

Z31

Z3-1

Z33

Magnitud
e
& axis
form

piston
Z0

prism
Z11

sphere
Z20

coma

trefoil
Z31

4
order (n)

astigmati
sm
Z22

spherical
aberration

Z33

quadrafoil
Z40

Z42

Z44

secondary
astigmatism

Zernike analysis tells us

Which aberrations are present.

Breaks the wavefront down into the

Standard Zernike modes or

Magnitude & axis form

Each Zernike mode = one aberration

But, how bad are the aberrations?

Z analysis also provides a value for

each.

Zernike coefficients

One for each Zernike mode

Units in microns

sign

Must specify pupil size

Absolute Zernike coefficient =

magnitude

+0.25 -0.75 x 111

Conventional Rx:

Zernike coefficients
Mode:
Coefficient
(m):

2nd
-2
Z order
Z0 Z2
2

.56 .27 .64

Rx: +0.19 - 0.67 x 111

Pupil diameter: 5.6 mm
Total RMS: 0.76 m
Higher-order RMS: 0.51
m

3rd order

4th order

Z3-3 Z3-1 Z31 Z33

Z4-4 Z4-2 Z40 Z42 Z44

-.03 .07 -.05 .06

Unit =
m

.03 .04

.11

0 -.08

+ or -

values

RMS wavefront error

The basic data - individual Zernike

coefficients

How bad are combined aberrations?

Total aberrations (LOAs + HOAs)

Just higher-orders (HOA RMS)

Or, just third-order aberrations, etc.

m 2
n

m 2
n

RMS = ( Z ) + ...+ ( Z )

Summary 4. Interpreting the

data

Aberrometers measure wavefronts

Wavefront - distorted by aberrations

Zernike analysis - which aberrations are

present

Zernike coefficients - how bad they are

Data in microns, with signs

RMS - magnitude of grouped aberrations

Pupil size, pupil size, pupil size !

5. Diagnosis - whats normal?

Aberrometry - diagnoses abnormal

optics

Ideal eye = zero aberrations, but

every eye has some aberrations.

So, are those Zernike or RMS

values good or bad?

Need reference norms

OCO Norms

JCRS Dec 2006

2,560 normal eyes
9 sites
Zernike & RMS
norms
Data on www
Google Dr. Salmon

Downloadable info

Full article in PDF

Norms table - PDF & Excel

Signed Zernike coefficients

Absolute values

Combined (polar) Zernike modes

RMS for HOA and orders 3, 4, 5, 6

http://arapaho.nsuok.edu/~salmonto

HOA results
Pupil
diameter

Mean (m)

2x mean

6.0

0.33

0.66

5.0

0.19

0.38

4.0

0.10

0.20

Prominent individual HOAs (6.0-mm

pupil)

Z3-1 (vertical coma) = 0.14

Z40 (spherical aberration) = 0.13

Z3-3 (oblique trefoil) = 0.11

Summary 5
Q. How can you know whats
normal?
A. Compare the data to norms
If more than double the norms
(for that pupil size) suspect
abnormal optics.

Summary the basics

Aberrations = refractive errors

Aberrometers measure wavefronts.

Zernike analysis tells which

aberrations

Zernike coefficients & RMS tell how

bad the aberrations are.

Compare values to norms

Mean HO RMS (6 mm) = 0.33 m

And ...

Dont forget pupil

diameter!

Case example

34 yof, complained of shadows,

diplopia, glare, eye strain,
especially at night

RK OU at age 21

Spec Rx = plano, 20/20- OU

Aberrometry confirmed large

HOAs

HOA wavefront maps (5.0

mm)
OD

OS

mm0

mm0

-1

-1

-2

-2
-2

-1

0
mm

-2.50 -1.25 0.00 1.25 2.50

Wavefront error (um)

RMS=0.89 m

-2

-2.50

-1

0
mm

-1.25 0.00
1.25
2.50
Wavefront error (um)

RMS=0.92 m

Zernike coefficients
0.60
OD

0.50

OS
Normal

0.40

5.0-mm pupil

0.30
0.20
0.10

Abs Zernike coefficient (um)

0.00
Z(3,-3)Z(3,-1)Z(3,1)Z(3,3) Z(4,-4)Z(4,-2)Z(4,0)Z(4,2)Z(4,4) Z(5,-5)Z(5,-3)Z(5,-1)Z(5,1)Z(5,3)Z(5,5)

Zernike mode

HO RMS & pupil size

1
OD

Pupil & RMS data

0.8

OS
Normal

0.6

3.0 mm

5.0 mm
0.4

HO RMS (um)
0.2

5.5

5.0

4.5

4.0

3.5

3.0

Pupil diameter (mm)

2.5

2.0

Aberrometry & refractive

surgery
Replace conventional auto-refractor
Verify pre-op refraction
Guide choice of laser procedure
Data sent to laser for custom
correction
Evaluate quality of the correction

Eye research

Optics of the eye

Optical
corrections

Visual perception
Optics-related
phenomena

0.12

Eye without SCL

Proclear 1 Day
1- Day Acuvue Moist

0.10
0.08
0.06
0.04
0.02
0.00
-0.02

10

20

30

40

Time (seconds)

50

60

Northeastern State University