FEATURE ARTICLE

SPONSORED BY

Wavefront and Adaptive Optics
Mike Gzik, FCLSA

Light can be described in
several ways depending on
how you want to measure it,
and what you want to do with
it. The wavelength of light and
other related properties are
associated with physical optics. Geometric optics deals
with ray tracing, the math of
light, and its behavior with
lenses and mirrors. Lasers and Figure 1: Zernike Polynomials. Thibos, LN; Applegate, RA;
other devices utilizing light in
Schwiegerling, JT; Webb, R; Standards Taskforce Members,
“Standards for Reporting the Optical Aberrations of Eyes,” OSA,
various forms of energy fall
Trends in Optics and Photonics, 2000. Photo courtesy Ray
into quantum optics (phoApplegate.
tons). Quantum optics utilize
both wave and particle aspects to describe aberrations while the more complicated
light.By definition, if the human eye is not expressions are higher order aberrations.
To understand wavefront and adapperfect or emmetropic, then it has a retive optics, we need a short review of the
fractive error or an optical aberration.
properties of light. Ray optics and light
Wavefront technology is a more specific
way of detecting, describing, and measur- particles (corpuscles) was a theory that
Newton, Snell, Descartes, Fermat, and
ing refractive defects. These defects inothers believed in, and was initially supclude, but are not limited to, myopia,
ported by the physicist Planck. This theory
hyperopia, and astigmatism.
began in the early 1600s with Snell’s Law
Defining Light Through History
of Refraction. In this theory, light was
In 1857, Ludwig Von Seidel wrote a paper propagated by rays in the form of corpuscles that some thought vibrated a
describing monochromatic aberrations
substance called ether. In the early 1800s,
concerning lenses and mirrors. These
William Hamilton used work by Snell,
aberrations Seidel called third-order
Descartes, and Fermat to formulate a
optics. They are spherical aberration,
general mathematical theory of ray optics.
coma, astigmatism, curvature of field,
Christian Huygens was the first to
and distortion (pincushion and barrel).
propose
the wave theory in the 1600s.
In 1888, Seidel added chromatic aberration to his list. Astigmatism is now consid- Wave optics seemed to have more supporters in the 1800s with work done by
ered a second order aberration.
Over the next 100 years various meth- Thomas Young, Fresnel, Hooke, and Doppler. The wave theory can be described
ods for measuring and describing optical
using the analogy of waves in water. The
aberrations were used. In the 1990s, a
wave’s length can be determined by meatask force commissioned by the Optical
Society of America recommended the use suring the distance from crest to crest.
of Zernike Polynomials to describe optical Amplitude is the intensity, maximum value
or height of the wave. Frequency is the
aberrations of the eye (Fig. 1). Zernike
Polynomials vary from simple to complex number of wave crests that pass a fixed
point per second.
mathematical expressions. The simple
In the 1800s and early 1900s, the
expressions, which describe defocus and
current theories of light began emerging.
astigmatism, are considered lower order
E Y E W I T N E S S

T H I R D

Q U A R T E R

2 0 0 4

ABOUT THE AUTHOR
Mike Gzik is a New York
State licensed optician/
contact lens practitioner.
He is a Fellow member of
CLSA, JCAHPO COT, NCLE
certified. Mike works for
New York Optometric, a
private optical office in
Syracuse NY, and as a
consultant and technical
trainer for Bausch & Lomb
professional services. He is
an adjunct instructor for
contact lens technology at
SUNY Health Science
Center, Syracuse NY. He was
CLSA member of the year in
2001 and presented the
Theo E. Obrig lecture at the
2002 CLES meeting.

What is wavefront
technology?
Is this new stuff?
How is this measured?
What will influence
the measurements?
How do we interpret
the data?
How does this differ from a
conventional refraction?
What are adaptive optics?
How can we utilize
the data to improve the
quality of a patient’s vision?
What’s in it for me?

31

the wavefront will have irregularities since the light rays exit the eye at different times. as well as other optical 32 refractive errors that were at that time left unnamed.00D lens. A camera captures the emerging reflected light rays as they pass through an array of small lenslets. invented and improved optical lenses that were used in telescopes and microscopes. Figure 3: Hartmann-Shack Wavefront Sensor. If the emerging light is from an optically perfect eye. This was known as Scheiner’s principle. Maxwell calculated that electromagnetic waves traveled at the speed of light. Along with a series of computations. or a wavefront. these principles are used in some aberrometers. Hartmann-Shack aberrometers project an infrared laser light point image on the retina. For example. Einstein. or corrected refractive error. History of Wavefront Technologies In the 1600s. Today. With a Tscherning aberrometer. The distortion is compared to a perfect grid image and the values are expressed in polynomial expansion form. a grid is projected onto the retina and cameras record the image distortion. Liang & Williams 1997 JOSA. Newton. 3). this image is compared to an image of an ideal wavefront and the deviations are computed. and others. work done by Fraunhofer on absorption lines for elements led to James Maxwell’s equations of electromagnetic fields. a British astronomer. An eye with an uncorrected refractive error saw two spots of light. An eye with no refractive error. They not only discovered the properties of spherical lenses in these instruments. using a grid superimposed on a +4. pupil. Cassegrain. If the eye has aberrations. was the first to use cylindrical lenses to correct astigmatism in the early 1800s. crystalline lens. 1). Discovering the problem helped to lead to solutions. The principle is still used today in some autorefractors. Hartman used the principles of Scheiner’s disk and by increasing the number of apertures in the disk presented numerous points of reference. and vitreous on its way to the retina. An instrument using this principle is only able to detect an error that would require a sphere or sphero-cylinder lens correction. 4 and 5). to be measured. The instrument subtracts this wavefront from a “perfect” wavefront and the difference becomes a map of the eye’s optical aberrations (Fig. Shack and Platt improved on this system by replacing the apertures with small lenses. was able to determine subjective deviations of a point source of light (he used a star). but also distortions caused by the optics of these lenses. this modification would allow for a mathematical interpretation of data that yielded an aberration map. all of the individual rays will exit the eye simultaneously and the wavefront will be straight or perfectly curved (Fig. They discovered chromatic and spherical aberration. Technology in optics leapt forward during the late 1600s and early 1700s. Bohr. 2 and 3). Leeuenhoek. In 1818.FEATURE ARTICLE Figure 2: Hartmann-Shack Wavefront Sensor. This double pinhole disk was used to measure refracting errors. Work. and the deviations from a perfect wavefront were measured and mathematically converted to a wavefront map (Fig. This lens array projected a specific pattern or wave of light points on the retina. a laser light projects an image onto the retina. The instrument then assumes the reflected image originates from a point source on the retina. His findings were published in 1894. Galileo. led to Luneburg’s final mathematical identification of optics with electromagnetism in 1944. E Y E W I T N E S S T H I R D Q U A R T E R 2 0 0 4 . Smirnov used Scheiner’s disk but with a fixed light source for the reference pinhole and a movable light for the second pinhole. A more sensitive method of determining complicated refractive errors was made by Smirnov in 1961. Wavefront and the Eye’s Refraction In wavefront technology. theory. Lippershey. In an aberrated eye. George Airy. Hertz demonstrated that electromagnetic waves were reflected and refracted like light. and analysis by Planck. a Jesuit astronomer and philosopher described an optical device currently known as Scheiner’s disk in his book Optical Foundations of the Eye. and an aberration map is produced using Zernike polynomials (Fig. saw a single spot of light viewed at distance. the Cassegrain reflecting telescope was able to correct spherical aberration. and others. The image must pass through the cornea. The next phase of development came when Tscherning.

and the Customized Contact Lens corrective changes to the actuators (usually piezoelectric)* are made. in 1989. astronomers had a clear aberration-free view of the universe for the first time. Planar wavefront Aberrated wavefront Ray tracing aberrometry projects multiple rays of laser light onto the retina.” Reflected light from one lenslet crosses over into a region designated for a different spot. The Tscherning and Hartman–Shack. Dynamic skiascopy uses a moving slit projected in to the eye A (retinoscopy). This is due to a condition known as “crossover.SPONSORED BY Planar wavefront Spherical wavefront Line through exit pupil Reference sphere Figure 4: The perfect eye. The first fully operational telescope with active optics was put into use in La Silla. the size and weight of the primary and secondary Deformable reflective surfaces also lent themselves to surface fluctuations Mirror Computer caused by gravity and structural instability. The calculation for the refractive error is based on the relative motion of the slit image. E Y E W I T N E S S T H I R D Q U A R T E R 2 0 0 4 Adaptive optics is the term used to describe an optical system created to correct higher order aberrations detected by a wavefront sensor. The incoming wavefront is constantly sampled by charged-coupled devices (CCD’s). Additionally. All of these systems have advantages and disadvantages. In this form of adaptive optics. Changes in the Earth’s atmosphere (temperature and density) constantly change the index of refraction of the air through which the light must travel. A wavefront aberration map is then produced. Chile. both frequently used aberrometers. Light from distant objects enFigure 6: Rochester Adaptive Optics System. the samples are taken and thousands of adjustments are rapidly made each second. may not accurately measure a cornea with significant amounts of irregularity. Aberrated Wavefront Adaptive Optics for the Human Eye Figure 7: Customized contact lenses. Temperature Reference sphere fluctuations create small changes in the surface of the glass lenses Figure 5: The aberrated eye. Rochester Adaptive Optics Active optics combines actuators in the mirrors with comSystem puter calculations to deform the primary and secondary mirrors to correct for the surface aberrations. and mirror systems due to natural expansion and contraction. ters the atmosphere and this wavefront (from real optical infinity) is distorted. cannot overcome inherent problems. For the human eye this optical system may be an 33 . despite precision optics and computer-enhanced photography. SLD Adaptive optics also uses small actuators in the reflective Gratings or Display Snellen Letters surfaces of the primary and secondary mirrors to correct for in White Light atmospheric induced aberrations. Terrestrial telescopes. The resulting exit location is compared to the known entry point position and the aberrations are calculated using polynomial expressions. This combination of active and adaptive optics has increased the astronomical properties of terrestrial telescopes to rival that of the Hubble’s atmosphere-free optics. These misdirected images confuse the instrument and inaccurate readings may occur. A Line through exit pupil Adaptive Optics With the launch of the Hubble space telescope. This is to compensate for Wavefront the changes caused by temperature fluctuations affecting the Sensor mirrors and structural changes due to the size of the mirrors. * Electricity or polarity induced in certain crystals by mechanical stress. calculations are made.

spectacles or a comaphakic in her left eye with an IOL. In OS 7. OS 41. She has dry eyes OU.. This may have been due to working to use the wealth of the additional optical surface. look at the lower right display. +4. conventional or CASE HISTORY custom soft contact lenses. unable to obtain a wavefront reading Researchers are currently for that eye.75 -1. There is also a slight custom soft contact lenses.86 mm (43. difficult at first and an easier way to whose “toric-like” design is visualize the data supplied by the used to minimize rotation that ZYWAVE II is to look the point spread would otherwise displace the function. corneal graft and a PTK bination of these. and government agencies.0 mm.D. improvement in the Snellen visual Bausch & Lomb has developed a acuity OU and subjectively she reports process that transmits the inforeverything is more sharp and distinct. 8. 9.00 D).87 @ 20 / 43. 2-axis CNC lathe. a ing on the right eye with the contact researcher at Bausch & Lomb. with the addition of the contact tions and projects the corrected lens on the patient’s left eye. an OD 7. The more is not yet available. This adaptive optic tact lenses in place (Fig. Wavefront aberrometry was performed on both eyes with by a wavefront sensor.8 mm OZ. 7. The end result Interpreting a wavefront map is is a customized soft contact lens Figure 9: Post-contact lens fitting. Institute of Optics. function” (PSF). the higher order the aberration. Ian Cox. contact lenses are the current Figure 10: With gas permeable lenses in place.FEATURE ARTICLE adaptive optic array. Ph. 8). this array. We did obtain a wavefront readcal application. creating information gathered by crossover with the instrument and or wavefront technology to correct pupil size at the time of the measurethe human eye in a more practiment. Utilizing the (phototherapeutic keratectomy).00 D). 7). lens in place. Unfortusystem corrects the eye’s aberranately. 7. adaptive This case is a 58-year-old female contact lens patient with map dot optic guides. On readouts (Fig. Center Contact Lens Parameters: for Visual Science. cost and availability of wavefront 34 E Y E W I T N E S S T H I R D Q U A R T E R 2 0 0 4 . The patient reports an the feasibility of correcting improvement in vision when wearing higher order aberrations with the contact lenses. 10). She is intraocular lenses. then sent to a computer that controls a Wavefront aberrometry was performed on both eyes without condeformable mirror.25 @ 175 / 44. however. 9 and demonstrates a change in the the University of Rochester on aberration map. the eye focuses on a display of 11⁄ 2 D prism. 10. OS +1. This is displayed in Figure has been involved in studies with Figure 8: Pre-contact lens fitting. 20/30-2 Snellen letters in white light and the Prism was added to the lens design because of excessive superior retinal image is analyzed for aberrations decentration. This Customized contact lenses visualization is called a “point spread are technically feasible.25 @ 110 2+distortion At the University of Rochester. 10. are currently conducting research in this K’s OD 43. mation gathered by a wavefront The wavefront analysis supports this for sensor to a computer controlled the right eye. astronomer’s technology of wavefront Rx: OD +3. industry. A PSF is what a patient practical application on a larger may see through their aberration if scale for the general population looking at a point of light.37 @ 85 2+ distortion new and exciting field.25 -2.00 x 52 20/ 40+2 BCVA academia.86 mm (43. 6). 20/30-1 and adaptive optics was constructed.50 D. corrected optics (Fig. Plano. custom corneal dystrophy and an incipient cataract in her right eye.8 mm OZ. custom ablation.0 mm. array utilizing a wavefront aberrometer 11⁄ 2 D prism. Some of the streamers or deviations from a point of feasibility challenges of custom light.50 x 155 20/30-2 BCVA analysis and adaptive optics. we were image back to the eye (Fig. The information is and without lenses in place using a B&L ZYWAVE II aberrometer**.

Measurement and customization of optical corrections are done only for distance correction and not in an accommodated eye. Education and Development at B&L for their assistance. Changes in the wavefront aberrations over time. Decentered adaptive optics can induce different aberrations than those which they were originally intended to correct..D. Higher Order Aberrations: Zernike expansion modes in the third order and higher are collectively called higher order aberrations. There are also challenges to wavefront customized ablation. may induce different aberrations later. As in customized contact lenses.D. Chromatic aberration is currently unable to be measured with a wavefront sensor or corrected with customized ablations. Starbursts at night are caused by spherical aberration and comet tails from lighted objects are caused by coma. the retina may not have the capability to process improved images projected onto it. and potentially eliminate. vertically.”—Dictionary of Eye Terminology Lower Order Aberrations: The second radial order in the Zernike expansion. Another application of adaptive optics is in refractive surgery. Spherical aberration is seen in many post-LASIK and PRK patients. Spherical Aberration: When peripheral light rays focus in front of more central rays. and viewing outside the best focus range may be adversely affected. Definitions Aberration: “A deviation from the normal. the higher order aberrations are not only easier to detect they are more necessary to correct.D. CCD’s are composed of a grid of photon-absorbing material and electronics that collect and measure the electrons released by the material when light hits it. Wavefront assessment can help the surgeon minimize. These include. Biomechanical effects of laser ablation on corneal tissue with regard to wound healing and shape changes may render preoperative calculations inaccurate. Clinically seen in decentered corneal graft patients. making dilation necessary. this induced aberration. The depth of field may again be affected because the aberrations are corrected for the best focus. Astigmatism: The refractive cylindrical aspect of the aberration. and. it is seen in post-LASIK and PRK patients and is the cause of night myopia. References available upon request. Research Optometrist at B&L. Increasing knowledge of wavefront technology will ultimately enable contact lens professionals to understand and improve fitting techniques in all lens materials. Secondary Spherical Aberration: A more complex higher order spherical aberration. They are also used in spectroscopy. or expected course” (American Heritage Dictionary). In the December 2001 editorial of the American Journal of Ophthalmology. and computer guided lathes. Coma: When rays at one edge of the system are focused before the center and the center is focused before the opposite edge. Refractive hyperopia is negative defocus. ** My thanks to Michelle Lagana. Secondary Coma: A more complex higher order coma. proper. Point Spread Function (PSF): PSF is the distribution of light in the image plane for a point object. Tilt: Can be thought of as prism. or a combination of both but does not change the focus of the wavefront. CCD (charged—coupled device): A solid-state electronic device used to gather light. Piston doesn’t affect the optical properties of the wavefront. Director of Professional Relations. and other irregular astigmatism patients report degradation in vision at night. Pier. Piston: A constant used in fitting Zernike polynomials to the wavefront. Ian Cox. O. O. Defocus: The spherical aspect of the aberration. Trefoil: Often called triangular astigmatism. as well as stable and non-rotating lens designs. graft. Other peculiar visual complaints can be addressed more accurately and specifically than simply using the term irregular astigmatism. Michael D.SPONSORED BY aberrometers. the higher order aberrations are more difficult to measure.. In larger pupil sizes. centration is critical in correcting aberrations. In a pupil 3 mm or smaller.” Some early studies have indicated that customized ablations may decrease the amount of higher order spherical aberration seen post-surgically. which includes defocus and astigmatism.D. due to the aging of an individual with a static correction. The optical effect of a point source of light similar in appearance to a comet’s tail. curvature. O. O. Refractive myopia is positive defocus. Regarding the potential to creating “super vision” with adaptive optics. Researcher at B&L. E Y E W I T N E S S T H I R D Q U A R T E R 2 0 0 4 35 . shifting the wavefront position horizontally. Research Optometrist at B&L.. density) of an optical device (lens or prism). similar to astigmatism but contains three axes instead of two.. and trefoil. spherical aberration. but are not limited to.D. Clinically. Paul China. Optical Aberration: “Blurred or distorted image quality that results from inherent physical properties (shape. MacRae and Williams cite nine limitations of higher order correction or measurement. Ph. Those of us in the contact lens field know that gas permeable contact lenses usually correct the irregular cornea more efficiently than spectacles or soft contact lenses. An analogy would be a high definition TV signal broadcast to a low definition TV. coma. Wavefront technology can help explain some patient complaints in a more scientific way.. Many laser companies are combining wavefront technology and topographical instrumentation to help program refractive lasers for “custom ablation. This is why keratoconus.

Refraction b. Chromatic c. Planck c. Myopic shift c. Series 58 Please Record Answers Below by filling in appropriate circle 11. Aberration control d. Amplitude d. Spherical aberration d. Astigmatism b. A B C D 5. call (800) 296-9776. Wind direction b. and the behavior with lenses and mirrors. A B C D 17. Defocus c. Coma b. Quantum optics can be described through all of the following aspects of light except: a. Defocus c. Aberrometers b. Spheric c. Spherical aberrations can be seen clinically in which of the following patients? a. A B C D 18. A prototype custom soft contact lens made to correct for higher order aberrations resembles the design of which type of soft contact lens? a. A B C D 15. Retroactive optics c. Date _____________ 1. Field defects ❑ NCLE ❑ JCAHPO This course has been designated Level III. A B C D 14. Particle d. Einstein d. Deformable mirrors c. Adaptive optics d. Which of the following is a lower order aberration? a. Wavefront technology c. A B C D 11. the math of light. Aphakic 13. Physical optics b. VA 20170. Aberrations 10. Coma b. Scheiner’s disk 12. Hooken Ladder c. and measuring optical defects is called: a. Coma c. Luneburg 7. George Airy b. Spherical 9. A B C D 15. Reflecting optics b. A B C D 14. Spherical aberration d. Distortion b. A B C D 17. A B C D 13. A double pinhole disk first used in the 1600s to detect aberrations of the eye is known as a: a. What is the optical surface in a telescope that corrects for aberration? a. Shapes of aberrations d.FEATURE ARTICLE SPONSORED BY Successfully Complete These Questions to the Article on Pages 31–35 to Receive NCLE/JCAHPO Credit. CCD d. A B C D 9. Adaptive optics Please select CEC credit: b. Scheiner’s Disk b. In wavefront aberrometry. Who mathematically identified optics with electromagnetism? a. The aberration that occurs when peripheral light rays focus in front of more central rays is called: b. Spherical d. In the wave theory. Aspheric projector shape b. A B C D 8. Index of refraction c. submit your completed quiz. A B C D 16. Ozone layer 4. along with an $18 processing fee to: CLSA. Myopia and hyperopia fall in which category of aberrations? a. Fresnel Prism 4. Coma 3. A more specific way of detecting. James Maxwell a. light is measured in all except: a. A B C D 36 E Y E W I T N E S S T H I R D Q U A R T E R 2 0 0 4 . A B C D 12. Wave c. Adaptive optic system d. Leonardo DiCaprio c. the wavefront exiting the eye is measured against the: a. Wavefront instruments 2. Aberration 8. Macular degeneration d. Aberration optics 2. Map dot dystrophy 6. Toric d. Photon 7. Aberrometer c. 16. Fax (703) 437-0727. Post PRK and LASIK c. it is easier to detect: a. Hartmann–Shack is a name for a type of: a. Quantum optics d. Chromatic aberration 3. Name _______________________________________________________________ Address ______________________________________________________________ City/State/Zip _________________________________________________________ Phone (with area code) _________________________________________________ Credit Card: ❑ American Express ❑ Discover ❑ MasterCard ❑ Visa Card Number _________________________________________________________ Signature ______________________________________ Exp. Quantum optics 10. Defocus 5. Frequency 1. Doppler Ganger d. Refractive error of the eye b. is usually described as: a. Chromatic aberration b. Active optic system RECEIVE CEC—The technical article on pages 31–35 has been submitted for approval for one continuing education credit unit with the National Contact Lens Examiners (NCLE) and the Joint Commission on Allied Health Personnel in Ophthalmology (JCAHPO). Multifocal b. Simulated perfect wavefront d. Mathematical expressions c. Linguistic terms for aberrations b. A B C D 20. The first use of a cylindrical lens to correct astigmatism was by: a. 441 Carlisle Drive. describing. Bohr b. Zernike Polynomials are? a. A B C D 19. With a pupil that is larger than 5 mm. Hans Lippershey d. To obtain your CEC. What is the term used to describe an optical system used to correct the aberrations detected by a wavefront measuring device? a. Geometric optics c. A B C D 19. Keratoconus b. Fees are waived for current CLSA members. Higher order aberrations d. A B C D 6. Herndon. Ion force fields d. A B C D 20. the aberration is called: a. Ray tracing. Astigmatism d. Wavelength c. If you’re not a member of CLSA. If a patient reports an image that looks like a comet’s tail. Aspheric optics 18. Adaptive optics for telescopes are designed to correct for aberrations caused by fluctuations in the atmosphere’s: a. Corneal topography c.