Interesting article - Adaptive Optics

Discussion in 'Optometry Archives' started by The Central Scrutinizer, Feb 9, 2006.

  1. Never heard of this before, but it sounds fascinating...
    PixelOptics is currently just one of several companies trying to
    develop "supervision" for everyone -- including the Department of

    PixelOptics just won a $3.5M USD grant from the Department of Defense
    for research to perfect "supervision" technology. The company claims
    that it can double the quality of a client's eyesight by using
    extremely sensitive lasers capable of detecting the slightest anomalies
    on the surface of the eye - then compensating for those defects using
    a powered optoelectronic lens. PixelOptics uses electronically
    controlled pixels that are embedded inside of traditional eyeglass lens
    to bend and manipulate light as it enters the lens.. After the
    software makes some adjustments, the pixel will then be programmed to
    fix any problems that a person may have.

    Since PixelOptics hardware is dynamic, the company also envisions
    future systems to adapt to light levels and ambient conditions to
    further improve vision. Adaptive optics are hardly a new concept;
    researchers and the military have been using adaptive optics on
    telescopes and spy satellites to compensate for irregularities in the
    atmosphere. Using such small scale adaptive optics for human eyes, on
    the other hand, is certainly a new concept that we will see a lot more
    of in the future.
    The Central Scrutinizer, Feb 9, 2006
    1. Advertisements

  2. Scott MacRae, MD at the University of Rochester Medical Center did a
    lot of research in adaptive optics as a part of development of
    wavefront-guided excimer laser ablations for refractive surgery. They
    were able to measure and adjust lower order aberrations (sphere and
    cylinder) as well as higher order aberrations with patients.

    Interestingly, it was found that when all aberrations were removed and
    the patient had "pure optics", the patients subjectively complained of
    poor vision quality. Induce some aberrations, and the vision quality
    improved. Apparently human vision is designed to accept and enhance
    some higher order aberrations.

    Glenn Hagele
    Executive Director

    "Consider and Choose With Confidence"

    Email to glenn dot hagele at usaeyes dot org

    I am not a doctor.
    Glenn -, Feb 9, 2006
    1. Advertisements

  3. The Central Scrutinizer

    Neil Brooks Guest

    I find things like this fascinating, if maddening ;-)

    In my case--congenital/infantile esotropia--three subsequent
    strabismus surgeries have failed to achieve stable orthotropia or
    reasonable stereopsis. The (my) theory is: fusion is a heavily
    neurologic process. Though the mechanical alignment may be perfect,
    the fusion center may be underdeveloped, providing little 'detent' to
    encourage long-term stability in alignment.

    Further, the mind has adapted somewhat to seeing a certain way,
    providing an apparent tendency to restore alignment to what it finds
    most comfortable.

    Another example from my story: accommodative spasm. Despite the fact
    that I now wear full plus contact lenses--the Rx derived from
    Atropinised wavefront aberrometry--and appropriate near-vision add
    over-Rx, my eyes still have a dramatic tendency toward pseudomyopia,
    even without apparent provocation.

    While some of this can be ascribed to ciliary hypertonicity and/or
    'instrument myopia,' it's also possible that a portion is due to a
    neurologic predisposition--something that refractive surgery, extra
    plus, clear lens exchange, etc. likely won't change.

    If only I had worn a minus lens ... you know ... at the threshold ....
    maybe I wouldn't have developed this stair-case hyperopia.

    Neil Brooks, Feb 9, 2006

  4. Picture the use of such technology to correct post surgical eyes with
    suture-induced High-order aberrations like trefoil. Almost guaranteed
    such patients would prefer to get rid of the aberrations.
    Scott Seidman, Feb 9, 2006
  5. If only I had worn a minus lens ... you know ... at the threshold .... maybe I wouldn't have developed this stair-case hyperopia.

    Hey Neil - *WHAP!* ;)
    The Central Scrutinizer, Feb 9, 2006
  6. The Central Scrutinizer

    acemanvx Guest

    posted a reply but it didnt show up so heres it again. high order
    aberrations prevent the eye from seeing its best. I get 20/30 with
    conventional glasses. Looking forward to 20/15 or even 20/10!
    acemanvx, Feb 9, 2006
  7. The Central Scrutinizer

    acemanvx Guest

    By the way, I have more to say!

    a recent article about how adaptive optics may be materalizing! Imagine
    glasses that correct your higher order aberrations too! I have the
    feeling alot more people will be wearing glasses, even those seeing
    20/20 when they find out what 20/10 is like! Suddenly those 20/40 very
    low myopes that dont bother with glasses because it doesnt make much of
    a difference will suddenly embrace glasses because now that their high
    order aberrations get corrected in addition to their refractive error,
    they will really see clear!

    I have the feeling millions who got laser or other refractive surgury
    will be disapointed to be back in glasses in order to enjoy good, crisp
    vision. All forms of refractive surgury, especially laser induces more
    aberrations so they arent seeing as good as they should. I can see RS
    being alot less popular because it cant give you vision as clear as
    conventional glasses, much less wavefront glasses! If someone was given
    the choice of getting 20/20 with lasik or 20/10 with wavefront glasses,
    almost all will choose wavefront glasses! Lasik would be a complete
    waste for me since ill still need glasses to see clearly and may in
    fact also need reading glasses.
    acemanvx, Feb 9, 2006
  8. The Central Scrutinizer

    acemanvx Guest

    One more comment: I read that true wavefront glasses needs to be
    dynamic because your eyes are constantly moving and shifting focus so
    youll need glasses with tiny sensors that follow your every eye
    movement. Stationary wavefront only works if you keep your eyes
    perfectly still and centered so they align with the aberrations. We
    need something that follows the movement of your eyes to keep the
    aberrations aligned at all times. This poses many technological
    challenges and may be some 15 to 20 years away from reaching the
    market. There already is (stationary) wavefront glasses out but my
    friends say 9 out of 10 people see no difference or they actually see a
    little worse! The 1 in 10 who do see a difference have a large number
    of aberrations, usually from a bad lasik experience. One guy had lots
    of glare and his wavefront glasses reduced the glare.
    acemanvx, Feb 9, 2006
  9. The Central Scrutinizer

    acemanvx Guest

    hyperopia is an eye that failed to fully complete emmetropization.
    Almost everyone starts out hyperopic in their infancy and early
    childhood. I went thru emmetropization too far and ended up myopic.

    As for adaptive optics, its the ticket for anyone with a number of high
    order aberrations like me. Conventional glasses cant compenstate for
    this so I fall a little shy of 20/20 at 20/30. I really wonder what
    20/15, or even 20/10 vision looks like! This will also be great for
    those post-lasik patients who had their aberrations increased and dont
    see well, especially at night.
    acemanvx, Feb 9, 2006
  10. The Central Scrutinizer

    acemanvx Guest

    I pinhole to a full 20/25 and I can almost see the 20/20 line but its
    too small because of my minus glasses which minify. Because alot of my
    aberrations are located on the center, the pinhole cant help me 100%.
    With tomorrows glasses I may be like 20/15 WITH minification(which
    would make me a little better than 20/15 in fact) I also got
    topographies and have already been commented by several about my
    aberrations and astigmastim. The fact pinhole makes a difference is a
    good indicator my limit is optical. Wavefront glasses work better than
    pinhole. By the way about a third of people cant correct to 20/20, not
    even with contacts.
    acemanvx, Feb 9, 2006
  11. The Central Scrutinizer

    otisbrown Guest

    Dear Central,

    In fact, there is a "school of thought" (i.e., second opinion) that
    when a child's refractive state is +3 or so (and he is young
    and "adaptive) the "plus" should be kept off his face, until
    his eyes "adapt" down to a normal zero to +2 diopters.

    On a optical control-system the effect of putting a +3 on
    a child at +3 diopters, is that his refractive state
    will not only stay at +3 but will "move positive" -- as
    was the case for Neil Brooks.

    There is no "magic pill" here -- just an honest difference
    of opinion.

    But, "Central" many a truth is said in jest.


    otisbrown, Feb 10, 2006
  12. The Central Scrutinizer

    p.clarkii Guest

    By the way, I have more to say!

    we all wait with baited breath to hear what aceman has to say.
    p.clarkii, Feb 10, 2006
  13. The Central Scrutinizer

    otisbrown Guest

    Dear "Central",

    Subject: Adaptive optics -- Adaptive Eye to A lens.

    Re: The second opinion on the plus lens.

    Looks like you were correct about Neil Brooks. An over-prescribed
    plus can certainly make a monkey-primate eye "more positive".
    It is possible that the same "adaptiveness" also occurs
    for the human-primate eye.

    Dr. Allen supports the second-opinion which is to "go slow" about
    putting a young child in a full-strength plus lens.

    You suggestion about stair-case hyperopia is correct.




    How to Eliminate Hyperopia

    (A HIGH positive refractive state of the fundamental eye.)

    by Merrill Allen, OD, PhD, FAAO, FCOVD


    Indiana University.

    Summary: The young eye should be given time to move towards zero
    diopters refractive state (emmetropiia). A strong plus
    lens will interfere with the "normalization" process
    (i.e,, interfere with "emmetropization".) This statement
    is the "second-opinion" by a highly qualified experts.

    Re: When I'm in the mall, I see thick glasses on small children
    and I have to control myself. I know that wearing those
    glasses blocks emmetropization. (i.e., blocks the
    process of normal vision growth. Subsequently, a
    proven characteristic of the primate eye. OSB) If Mom
    would put the glasses on the child only in the
    afternoon, the child would grow out of his/her hyperopia
    and require several spectacle power reductions. If the
    child's correction is less than the refractive error,
    he/she will grow out of the need for those glasses and
    soon weaker lenses will be needed. Dr. M. Allen


    Humans are adaptable. The refractive error distribution in
    the population of newborns is almost a normal curve. By the first
    grade the distribution has become leptokurtic with the great
    majority of the population falling within -0.5 and +2.00 diopters
    of error. The babies have grown out of their refractive errors!

    Graduate Students at Indiana University did a study of babies
    at 2 weeks of age who performed as well on focusing tests as
    college students. The one baby who did not was about 5 D
    hyperopic. After 6 weeks or so it was clearly withdrawn and
    abnormal in personality. The baby could not respond to the test.
    Application of +4 D glasses changed the baby's personality
    overnight! Regarding the overcoming of hyperopia by optometric
    intervention, the baby above was not followed, but if the baby
    continued to wear those glasses, now as an adult, he/she will
    still be +4 hyperopic.

    I worked with an 18 month old esotropic girl whose eyes were
    so crossed I thought she had convergence fixus. However when I
    held her at arms length and turned my body through 360 degrees her
    vestibulars took over and her eyes straightened and she showed
    nystagmus. At each of the three visits I increased the plus to
    take home. Her eyes straightened with +11D. Then at the age of
    three years while moving to another city she lost her glasses and
    went without them for 3 months. The new eye examination showed
    her Rx to be +4. She had lost 7 diopters in three months!

    I did not realize the significance and was not smart enough
    to say to Mom: "Let's leave the glasses off for another 3
    months," or "Let's wear plano glasses with binasal occluders for 3
    months." The last checkup of this patient was at age 18 years when
    she was wearing +4D contact lenses! We cured her of esotropia and
    reduced 7 diopters of hyperopia! She has of course continued to
    be straight eyed.

    Wild monkeys have low hyperopia or emmetropia and no myopia.
    Caged monkeys have less hyperopia and much more myopia. Because
    the evidence for emmetropization is so strong, I suggest a couple
    of approaches on how to emmetropize young hyperopes.

    Only prescribe as much plus as needed to keep the eyes
    straight. (In the case of our baby that couldn't focus and had
    personality problems, the plus probably wouldn't be needed for
    more than a week or two as the child figured out how to use his

    At most the Rx should only be about half of the retinoscopic
    Rx and then reduced in power as the eyes change. With esotropia,
    more plus power may be needed at first to establish normal
    binocular vision, after which treatment of hyperopia may proceed.
    Alternatively for esotropia, the no Rx, binasal approach, see
    below, is highly recommended. Use no lens power but provide
    binasal occluders such as frosty Scotch tape applied with the
    outer edges placed at the distance apart of the centers of the
    pupils, minus 4mm.

    A growing child will require frequent occluder adjustments as
    his/her pupillary distance increases. The binasals will
    straighten crossed or exotropic eyes as well as cause
    emmetropization. Within 6 months the occluders can be removed.
    Strabismus and refractive error should be cured in that time! if
    you or the parents forget, the child will grow out of the binasals
    [they will cover less and less of the visual field] and will be

    We know that older people grow into myopia, so I would not
    put an upper age on when a person can grow out of hyperopia. The
    important condition is that they be able to intensively pursue
    visual tasks requiring accommodation. If they are not visually
    involved, and if we eliminate the need to emmetropize, they will
    not emmetropize!

    When I'm in the mall, I see thick glasses on small children
    and I have to control myself. I know that wearing those glasses
    blocks emmetropization. If Mom would put the glasses on the child
    only in the afternoon, the child would grow out of his/her
    hyperopia and require several spectacle power reductions. If the
    child's correction is less than the refractive error, he/she will
    grow out of the need for those glasses and soon weaker lenses will
    be needed.
    otisbrown, Feb 10, 2006
  14. The Central Scrutinizer

    Neil Brooks Guest

    What is ... the threshold, Alex?
    Neil Brooks, Feb 10, 2006
  15. The Central Scrutinizer

    Quick Guest

    Wow, I was scanning (read the first 3 or 4 words
    every 10 or 20 lines) and this came accross as
    Quick, Feb 10, 2006
  16. The Central Scrutinizer

    otisbrown Guest

    Dear Quck,

    That was Dr. Allen's statement. You should read
    the complete paper to understand what
    the man was saying -- rather than skimming
    and not having a clue.

    The majority opinion is indeed to put a full-strength
    plus lens on a child (like Neil). Dr. Allen was
    suggesting a "go slow" process because the
    eye is indeed "adaptive", and a full strength
    "plus" will result in the eye moving in
    a positive direction.

    Allen simply "objected" to that majority-opinion.


    otisbrown, Feb 10, 2006
  17. The Central Scrutinizer

    Quick Guest

    How could one tell from your post?
    Quick, Feb 10, 2006
  18. The Central Scrutinizer

    axxx Guest


    I have small belief in words if they are said RS surgeon :(
    Glenn ,What symptoms rather "poor vision quality" ???
    These researches are in an initial stage. Why you present it as " the
    obvious fact "???

    Ace 20/20>20/15>20/10
    It is similar: in a computer the graphic editor do " sharpen filter "
    at processing a photo.

    You can try good RGP lens.
    Why you cannot come to dr. Leukoma???
    I am assured that DR will give you greater discount in the price as you
    are " the expert of sight " :)
    You dont have time and money for travel to dr. Leukoma???
    Problem-money:( ???
    axxx, Feb 10, 2006
  19. The Central Scrutinizer

    axxx Guest

    I wish to correct.
    I have small belief in words if they are said RS surgeon :(
    And especially in unsubstantiated interpretation Glenn H :)
    axxx, Feb 10, 2006
  20. Glenn, can you post the reference? Not to argue about the finding about
    how the eye/brain deals with high-order aberration (which I have no problem
    with), but I'd like to know whether the aberrations were removed optically
    at the bench, or with photorefractive surgery. I think some people might
    be getting the wrong impression.
    Scott Seidman, Feb 10, 2006
    1. Advertisements

Ask a Question

Want to reply to this thread or ask your own question?

You'll need to choose a username for the site, which only take a couple of moments (here). After that, you can post your question and our members will help you out.