OPHTHALMOLOGY

ERROR OF REFRACTION
Objectives
Error Of Refraction (EOR)
Test Visual Acuity
Diagnosis/ Types of EOR
Treatment

Important Terms to REMEMBER:

SIGHT:
- Vision / visual perception
- Power of seeing
LIGHT:
- ElectroMagnetic Radiation (EMR) FOCUS / FOCAL POINT
- Travels in waves (like water - Refraction or bending of different light
waves) rays converging on a point.
- visible wave spectrum (380 – 700 nm)

IMAGE
7 types of waves in the EMR
- artifacts that depicts visual perception
1. GAMMA RAYS
2. X-RAYS - visual products of sight perception of an
3. UV object
4. VISIBLE SPECTRUM
REFRACTIVE ERROR / Error of Refraction (EOR)
5. INFRARED
6. MICROWAVES - eye disorder caused by irregularity in the
7. RADIO/ TV WAVES shape of eye
- causes poor image focusing
 resulting to blurred & impaired
vision
Test for Visual Acuity (VA)
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Types of Error of Refraction / Ammetropia:
Due to:
PERFECT VISION: 20/20
POOR VISION: 20/200
Diagnosis/ Types of EOR
Emmetropia
Signs/ Symptoms of Error of Refraction
1. MYOPIA (near-sighted)
2. HYPEROPIA (far-sighted)
3. ASTIGMATISM
4. PRESBYOPIA
MYOPIA
1. Refractive: refractive power of the anterior
segment is too GREAT for
the length of the eye
2. Axial: eye is too long in axial length.
Divided into 3 types:
 Physiologic myopia
 Pathologic or degenerative myopia
 Lenticular myopia
PHYSIOLOGIC MYOPIA:
 Most common type because of
inadequate correlation of the refractive
power of the anterior segment with the
length of the eye
 Onset is 5-10 years old or begin as late
as 25.
 Gradually increases until eye is full
grown about 18 years of age.
 Seldom exceeds 6 diopters
PATHOLOGIC OR DEGENERATIVE
MYOPIA:
 Is an abnormality in which the
axial length of the eye is excessive
because of the overgrowth of the
posterior 2/3rd of the eye
 Starts as physiologic but then
continues to enlarge.
NORMAL RETINA
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Lenticular Myopia
Types:
 Increase in the refractive power of the lens.
1. Simple astigmatism: when the focus one
 Seen in DM, nuclear sclerosis cataract and
meridian is on the retina:
drugs such as
► Simple myopic: the other is anterior to
1. Hydralazine retina
2. Chlorthalidone ► Simple hyperopia: the other behind the
3. Phenothiazines retina
2. Compound Myopic astigmatism: both
HYPEROPIA
meridians are in front of retina
Due to:
3. Compound Hyperopic astigmatism: when
1. Refractive: refractive power of the anterior
both focus are behind retina
segment
4. Mixed Astigmatism: when one focal line
is inadequate for the length of the globe
is in front of the retina and the other is
2. Axial: if the globe is too short
behind the retina.
3.Ageing: Presbyopia

Pathologic Hyperopia:
1. Microphthalmia
2. Fovea centralis displaced anteriorly by
orbital tumors, subretinal fluid and
intraocular tumors.
3. Lens dislocation to the vitreous; aphakia.

ASTIGMATISM
 Is an optical condition in which the
refracting power of the eye is not the same PRESBYOPIA
in all meridians.
 Thus if the refracting power of the eye is
58 D in the vertical and 60 D in the
horizontal, 2 diopters of astigmatism are
present.
 Rays of light do not focus at a point in the 60 d
meridian and the 58 D meridian.
The distance separating these focal lines is
the Interval of Sturm.
 Astigmatism usually occur because the cornea
has 2 different radii of curvature at
right angles to each other.
 Astigmatism is REGULAR when the
meridians of minimal and maximal refraction
are at right angles (90 degrees) to each other.
 IRREGULAR when the meridians are not at DIOPTER
right angles to each other.  Unit of measurement of refractive power.
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 Is equal to the reciprocal of the focal length of
a lens in meter
 A lens with a 5 diopter power will have a focal
length of 0.2 meters
 D= 1/ f (meters)
 5D=1/0.2 meters

TREATMENT

PRISM:
= is a piece of optical quality glass or
plastic with a triangular face.
= are combined (apex to apex, and base to
base) in optics to create lenses.
=Characteristics of prisms:
Light is bent toward the base of the
prism. The power (light bending
ability) of a prism is measured in
prism diopters. CYLINDRICAL LENS
=A one prism diopter will deviate light 1cm at
a distance of one meter.

Application of different lenses to treat

Error of refraction
LENSES Treatment of error of refraction
SPHERICAL LENSES 1. Lenses or corrective spectacles
 All light rays have some degree of vergence. 2. Contact lens
That is, they are either moving closer to one 3. Invasive procedures
another (convergence), or they are moving a. IOL implantation
away from one another (divergence), or they b. Lasik
are parallel (zero vergence).
 Vergence is measured in diopters.

CONVERGING LENSES

DIVERGING LENSES