Optical Devices in Ophthalmology and Optometry: Technology, Design Principles, and Clinical Applications

625 Pages·2014·37.63 MB·English

by  Michael Kaschke, Karl-Heinz Donnerhacke, and Michael Stefan Rill

MichaelKaschke,
Karl-HeinzDonnerhacke,
andMichaelStefanRill
OpticalDevicesin
OphthalmologyandOptometry
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MichaelKaschke,Karl-HeinzDonnerhacke,
andMichaelStefanRill
Optical Devices in
Ophthalmology and Optometry
Technology, DesignPrinciples,and Clinical Applications
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ToSylviawithouthersupportnothingwouldhavebeenpossible.
MichaelKaschke
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VII
Contents
Preface XV
PartOne 1
1 StructureandFunction 3
1.1 AnatomyoftheHumanEye 4
1.2 Retina:TheOpticalSensor 10
1.2.1 RetinalStructure 10
1.2.2 FunctionalAreas 12
1.3 RecommendedReading 14
References 14
2 OpticsoftheHumanEye 15
2.1 OpticalImaging 15
2.1.1 EntranceandExitPupils 17
2.1.2 CardinalPoints 19
2.1.3 EyeAxes 20
2.1.4 Accommodation 21
2.1.5 Resolution 23
2.1.6 Adaption 26
2.1.7 Stiles–CrawfordEffect 28
2.1.8 DepthofField 29
2.1.9 BinocularVision 30
2.1.10 SpectralProperties 32
2.2 SchematicEyeModels 33
2.2.1 ParaxialModel:TheGullstrandEye 34
2.2.2 FiniteWide-AngleModels 38
2.2.3 ApplicationsofEyeModels 44
2.3 ColorVision 45
2.4 RecommendedReading 47
References 47
VIII Contents
3 VisualDisordersandMajorEyeDiseases 49
3.1 RefractiveErrors 49
3.1.1 Axial-SymmetricAmetropia:MyopiaandHyperopia 51
3.1.2 Astigmatism 51
3.1.3 NotationsofSpherocylindricRefractioninAstigmaticEyes 53
3.1.4 Anisometropia 54
3.1.5 DistributionofRefractiveErrors 54
3.1.6 RefractiveErrorsCausedbyDiseases 55
3.2 Cataract 56
3.3 Glaucoma 57
3.4 Age-RelatedMacularDegeneration 60
3.4.1 ARM 60
3.4.2 DryAMD 60
3.4.3 WetAMD 61
3.5 DiabeticRetinopathy 64
3.6 RetinalVeinOcclusions 65
3.7 InfectiveEyeDiseases 66
3.7.1 Trachoma 66
3.7.2 Onchocerciasis 67
3.8 MajorCausesforVisualImpairment 67
3.9 MajorCausesofBlindness 68
3.10 Socio-EconomicImpactofEyeDiseases 70
3.11 RecommendedReading 72
ProblemstoChapters1–3 72
References 76
PartTwo 79
4 IntroductiontoOphthalmicDiagnosisandImaging 81
4.1 DeterminationoftheEye’sRefractiveStatus 82
4.2 Visualization,Imaging,andStructuralAnalysis 82
4.3 DeterminationoftheEye’sFunctionalStatus 85
4.3.1 GlobalFunctionalStatus 85
4.3.2 LocalFunctionalStatus 86
4.4 LightHazardProtection 86
References 87
5 DeterminationoftheRefractiveStatusoftheEye 89
5.1 Retinoscopy 91
5.1.1 IlluminationBeamPath 92
5.1.2 ObservationBeamPath 93
5.1.3 MeasurementProcedure 96
5.1.4 AccuracyinRetinoscopy 98
5.1.5 Applications 99
Contents IX
5.2 AutomatedObjectiveRefractometers(Autorefractors) 100
5.2.1 CommonCharacteristicsofAutorefractors 100
5.2.2 MeasuringMethods 102
5.2.3 MeasurementAccuracyandLimitationsofAutomatic
Refractometers 120
5.3 Aberrometers 121
5.3.1 FundamentalsofAberrometry 121
5.3.2 GeneralMeasurementPrinciplesforAberrometers 126
5.3.3 GeneralRemarksonAberrometry 127
5.3.4 Hartmann–ShackWavefrontAberrometer(OutgoingLight
Aberrometer) 127
5.3.5 IngoingLightAberrometers 131
5.3.6 CommercialAberrometers 133
5.4 WavefrontReconstructionandWavefrontAnalysis 133
5.4.1 FromWavefronttoRefraction(WavefrontAnalysis) 135
5.4.2 ApplicationsofWavefrontAnalysis 140
5.5 Excursus:RefractiveCorrectionwithEyeGlassesandContact
Lenses 141
5.6 RecommendedReading 143
5.7 Problems 143
References 144
6 OpticalVisualization,Imaging,andStructuralAnalysis 147
6.1 MedicalMagnifyingSystems 147
6.1.1 OpticsofaSingleLoupe 148
6.1.2 MedicalLoupes 149
6.2 SurgicalMicroscopes 151
6.2.1 RequirementsforSurgicalMicroscopes 152
6.2.2 FunctionalPrinciple 154
6.2.3 ModularStructureofSurgicalMicroscopes 160
6.2.4 Prospects 176
6.3 ReflectionMethodsforTopographicMeasurements 177
6.3.1 Keratometer 178
6.3.2 PlacidoRingCornealTopographer 187
6.4 SlitLamp 200
6.4.1 FunctionalPrinciple 201
6.4.2 ModularStructure 202
6.4.3 TypesofIlluminationforVariousApplications 205
6.4.4 AccessoriesforOtherExaminationsandMeasurements 208
6.4.5 Prospects 212
6.5 Scanning-SlitProjectionDevices 212
6.5.1 LateralScanning-SlitProjectionTechniques 213
6.5.2 ScheimpflugImagingofRotating-SlitProjections 217
6.5.3 ClinicalRelevanceandApplications 223
6.6 Ophthalmoscope 225
X Contents
6.6.1 FunctionalPrinciple 226
6.6.2 DirectOphthalmoscope 227
6.6.3 IndirectOphthalmoscope 230
6.7 FundusCamera 236
6.7.1 RequirementsforaFundusCamera 237
6.7.2 FunctionalPrinciple 238
6.7.3 FieldofViewandMagnification 241
6.7.4 Wide-FieldImaging 241
6.7.5 ColorandMonochromeImaging 241
6.7.6 FluorescenceAngiography 242
6.7.7 FundusAutofluorescence 244
6.7.8 StereoscopicImagingandAnalysis 246
6.7.9 EquipmentSolutions 248
6.7.10 Prospects 248
6.8 Scanning-LaserDevices 249
6.8.1 ConfocalScanning-LaserOphthalmoscope 250
6.8.2 ConfocalScanning-LaserTomograph 259
6.8.3 Scanning-LaserPolarimeter 261
6.9 RecommendedReading 267
6.10 Problems 267
References 273
7 OpticalCoherenceMethodsforThree-DimensionalVisualizationand
StructuralAnalysis 277
7.1 IntroductiontoOpticalCoherenceTomography 278
7.2 DevelopmentofOCTandLCIasanExampleofModernMedical
TechnologyInnovation 280
7.2.1 AcademicResearch–ConceptionofOCT(until1993) 281
7.2.2 FirstGenerationofCommercialOCTs(1993–2002) 281
7.2.3 SecondGenerationofOCTs–ZEISSStratusOCT(2002–2006) 283
7.2.4 ThirdGenerationofOCTs–Frequency-DomainOCT
(2007–current) 283
7.3 PrinciplesofLow-CoherenceInterferometryandOpticalCoherence
Tomography 285
7.3.1 MichelsonInterferometrywithCoherentLight 285
7.3.2 MichelsonInterferometrywithLow-CoherenceLight 286
7.3.3 Time-DomainOCT 289
7.3.4 Frequency-DomainOCT 291
7.3.5 Swept-SourceOCT 295
7.3.6 OverviewandComparisonofOCTSystems 297
7.4 ElementsofOCTTheory 300
7.4.1 TheoryofTime-DomainOCT–AxialResolution 301
7.4.2 TheoryofFrequency-DomainOCT 304
7.4.3 EffectofGroupVelocityDispersioninOCTSystems 309
7.4.4 SensitivityandSignal-To-NoiseRatioinTD-OCTandFD-OCT 311
Contents XI
7.5 DeviceDesignofOCTs 313
7.5.1 LightSources 313
7.5.2 CommercialSystems 315
7.6 OphthalmicApplicationsofOCT 316
7.6.1 PosteriorSegmentoftheEye 317
7.6.2 AnteriorPartoftheEye 320
7.7 OpticalBiometrybyLow-CoherenceInterferometry 324
7.7.1 Dual-BeamLow-CoherenceInterferometry 327
7.7.2 ApplicationsofOpticalBiometry 329
7.8 Prospects 334
7.9 RecommendedReading 338
7.10 Problems 338
References 341
8 FunctionalDiagnostics 345
8.1 VisualFieldExamination 346
8.1.1 PhysiologicalAspectsandFunctionalPrinciples 346
8.1.2 BasicPerimeterDesign 351
8.1.3 AlternativePerimetricConcepts 357
8.1.4 Prospects 362
8.2 MetabolicMapping 363
8.2.1 MicrocirculationMapping 363
8.2.2 FluorophoreMapping 366
8.2.3 Prospects 367
8.3 RecommendedReading 367
8.4 Problems 368
References 368
PartThree 371
9 Laser–TissueInteraction 373
9.1 Absorption 374
9.2 ElasticScattering 375
9.2.1 RayleighScattering 376
9.2.2 MieScattering 376
9.3 OpticalPropertiesofBiologicalTissue 376
9.4 InteractionofIrradiatedBiologicalTissue 378
9.4.1 PhotochemicalResponse 379
9.4.2 PhotothermalResponse 380
9.4.3 Photoablation 383
9.4.4 Plasma-InducedAblationandPhotodisruption 384
9.5 PropagationofFemtosecondPulsesinTransparentMedia 391
9.5.1 Self-Focusing 392
9.5.2 Self-PhaseModulation 392