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Optimal parameters for retinal illumination and imaging

in fundus cameras

E. DeHoog1,* and J. Schwiegerling2,3,1


1
Biomedical Engineering Program, University of Arizona, 1657 East Helen Street, Tucson, Arizona 85721, USA
2
Ophthalmology and Vision Sciences, University of Arizona, 655 North Alvernon Way, Suite 108,
Tucson, Arizona 85711, USA
3
College of Optical Science, University of Arizona, 1630 East University Boulevard, Tucson, Arizona 85721, USA
*Corresponding author: dehooge@u.arizona.edu

Received 27 June 2008; revised 20 August 2008; accepted 29 October 2008;


posted 31 October 2008 (Doc. ID 97963); published 12 December 2008

A fundus camera is a complex optical system for imaging the retina of the eye. Designing a fundus camera
requires the combination of an imaging system and an illumination system to share common optics. This
combination of systems results in the need to find an optimal balance between imaging and illuminating
the retina. We present a series of parameters and methods used to optimize the illumination system of a
fundus camera while maintaining excellent image quality. © 2008 Optical Society of America
OCIS codes: 120.3899, 120.4570.

1. Background being in existence for at least 40 years, the basic de-


The modern fundus camera is an adaptation of a re- sign of the fundus camera has changed little, show-
flex free indirect ophthalmoscope designed in the ing the effectiveness of this particular design.
early 1900s. The principle of reflex free indirect Analysis of a typical fundus camera, shown in
ophthalmoscopy requires that the illumination and Fig. 1, gives insight into the design principles in-
imaging pathways pass through different portions volved in this device. The imaging system is com-
of the optics of the eye to avoid backreflections [1]. posed of three lenses, labeled 20, 24, and 25, and a
Further development of this principle has evolved mirror with a central hole, 21. Lens 20, the objective,
into a complex optical system for retinal imaging forms an intermediate image of the retina, and
called a fundus camera. This particular device pre- lenses 24 and 25 relay the intermediate image to
sents a unique set of design challenges considering the camera, labeled 27 for snapshot imaging. Trans-
the retina of the eye must be illuminated and imaged lation of lens 24 allows the fundus camera to compen-
sate for the defocus present in the patient’s eye. In
simultaneously. The most common solution to this
the imaging path the mirror with the central hole
design challenge is to design two separate systems
simply acts as an aperture placed conjugate to the
sharing common optics. One system is used for illu-
pupil. The size of the central hole limits the size of
mination, and the other system is used for imaging. A
the pupil that the eye can be imaged through, ima-
schematic of such a device from the patent literature
ging pupil diameter, effectively limiting the entrance
is provided in Fig. 1 [2]. This particular design was
pupil diameter of the imaging system. Components
chosen primarily because the basic optical layout is
30–32 are used for continuous observation of the re-
similar to the system provided by Knoll in 1969 and
tina by an infrared imaging camera [2,6].
other patents dated from 2002–2006 [2–5]. Despite
The illumination system is more complex. As
shown in Fig. 1, the illumination and imaging sys-
0003-6935/08/366769-09$15.00/0 tems share the objective and the eye. When a config-
© 2008 Optical Society of America uration like this is used, backreflections from the

20 December 2008 / Vol. 47, No. 36 / APPLIED OPTICS 6769


common optics can be a considerable problem to re- gate to the front surface of the objective. Light that
solving the image. Despite using excellent antireflec- would be backreflected from the front surface of the
tive (AR) coatings, backreflections from the common objective is absorbed by the black dot [2,6,5].
optics can be significantly greater than the light re- The design objectives of the illumination system of
flected by the retina [7–9]. In order to overcome back- the fundus camera are to eliminate backreflections
reflections, creative schemes must be implemented from the cornea and maximize the irradiance on the
in the design of an illumination system [1]. retina and the detector or camera while maintaining
In this particular camera there are two sources, 10 complete illumination across the portion of the retina
and 13. These sources serve different purposes, a being imaged. Completing a successful design re-
flash source, 13, for snapshot retinal imaging and an quires understanding the trade-offs that come with
incandescent source, 10, for continuous observation. the three criteria listed. The goal of our paper is to
Despite having different purposes, each illumination explore trade-offs involved in design of the illumina-
path uses the same principles. The sources are con- tion system of a fundus camera. These trade-offs in-
jugate to an annular aperture, 16. Lens 17a and 17b clude: resolution, detector irradiance, efficiency, and
relay the image of the annulus to a mirror with a hole uniformity. Existing literature only gives schematics
in the center, 21. This central hole in the mirror is that do not include enough information to recreate a
conjugate to the plane of the pupil of the eye. This working system. This leaves the engineer to deter-
central hole controls the size of the unilluminated mine which parameters are optimal for the task of
portion of the pupil of eye. The entire system of optics retinal imaging and illumination and how changing
relays the source to the pupil of the eye [2,6,5]. these parameters affects the performance of the sys-
As previously mentioned, eliminating backreflec- tem. Our study is presented to better understand a
tions is of key importance in the design of a fundus few of the parameter involved in fundus camera
camera. Backreflections from the cornea are elimi- design.
nated with careful placement of the annular aper-
2. Methods
ture, the holed mirror and iris, 22 in the system.
The holed mirror is critical in the coupling of the ima- A model of a simplified fundus camera was con-
ging and illumination paths and managing system structed using the sequential and nonsequential cap-
backreflections. This component allows the outer abilities of ZEMAX. The simplified system, Table 1,
edges of the pupil to be illuminated, hence illuminat- consists of the optics common to the illumination and
ing the retina, and leaving the center of pupil unillu- imaging system, the eye, E, an objective, 21, and a
minated for the purpose of imaging the retina while holed mirror, 21; see Fig. 2. In this configuration
minimizing corneal backreflections. The annular the holed mirror is conjugate to the physical pupil
aperture blocks stray light from the illumination sys- of the eye model. Considering the source is conjugate
tem that could pass through the hole in the center of to the holed mirror, the mirror, 21, itself was modeled
the mirror and cause difficulty in resolving the im- as an annulus of point emitters. In the center of the
annulus a detector was placed to measure the light
age. The iris blocks any remaining cornea backreflec-
reflected by the retina and/or cornea. To minimize
tions located at the edges of the image. Eliminating
aberrations, an aspheric objective, 21, is used. For
backreflections from the objective is accomplished by
the purpose of this study, backreflections from the ob-
use of a black dot, 19. The black dot is placed conju-
jective were not considered. Our previous models of
an entire fundus camera have shown that the black
dot and annular aperture in the preceding illumina-
tion optics eliminate backreflections from the objec-
tive [10]. These results are consistent with the claims
made by patent literature [2,5]. The sequential and
nonsequential eye models are based on the Escudero
and Navarro eye model [11]. Depending on the pur-
pose of the simulation being preformed, the retina of
the eye was modeled either as an absorbing media or
a scattering media with Lambertian properties con-
sistent with the literature [7,8]. The pupil was set to
a maximum diameter of 7:5 mm to simulate the eye
being dilated [9]. Using this configuration, a series

Fig. 1. Design schematic of a fundus camera from a patent filed in Table 1. Simplified Camera Prescription
2003 [2]. The imaging path is shown with solid rays. The illumina-
tion path is shown with dashed rays. The annular illumination Radius Thickness
pattern is created at the iris of the eye by the center of the illumi- (mm) Conic (mm) Glass
nation path using an annulus, 16, and a mirror with a central hole,
Working distance 0 0 25
21, located at the conjugate planes of the iris. A plate with a black
Objective 29.1 −2:2 10 n-sk16
dot, 19, is placed conjugate to the objective, 20, to remove backre-
Source distance −29:1 −2:2 124.5
flections from the objective.

6770 APPLIED OPTICS / Vol. 47, No. 36 / 20 December 2008


to the retina and back to the individual pixels of the
imaging detector. Next, efficiency is defined as

Φd
η¼  100%: ð3Þ
Φs

Efficiency, η, measures how efficiently light emitted


by the source is transferred to the detector. Finally,
uniformity, U, is used to measure the how power dis-
Fig. 2. Simplified retinal illumination system consisting of a tribution on the retina deviated from a uniform dis-
model eye, an objective, and a holed mirror. The holed mirror, tribution. Uniformity is defined as 1 minus the
21, reflects the image of source object. percent difference between the power at 85% of the
radius of the illuminated area, Φ85% , to the power at
of simulations were conducted to determine the the center of the illuminated area, Φcenter . Mathema-
optimal configuration for retinal illumination and tically, U can be expressed:
imaging.
A series of parameters must be defined to under- jΦcenter − Φ85% j
U ¼1− : ð4Þ
stand the optimization process. The first parameter Φmax
is the illumination ratio, IR, defined as
Before characterizing the illumination parameters,
RL it is necessary to determine the effect of imaging pu-
IR ¼ ; ð1Þ pil size on retinal image quality. This is determined
Ri
by measuring the rms wavefront error as a function
where RL is the inner radius of the illumination an- of pupil size. From the data a Strehl ratio can be com-
nulus and Ri is the radius of the imaging pupil; see puted as a metric for image quality [12].
Fig. 3. This parameter is useful for quantifying the To determine the optimal configuration for retinal
difference between RL and Ri necessary to eliminate imaging and illumination a series of simulations are
corneal backreflections. Note that Ri is fixed by the conducted. First, it is important to measure the illu-
size of the hole in the mirror and/or the iris behind mination ratio for a given configuration. This is a cri-
the mirror. The second parameter is the normalized tical step, considering it is necessary to find the
detector irradiance, NDI, defined as proper illumination ratio that removes cornea back-
reflections from the detector. Any corneal backreflec-
tions, which can be as much as 2% of the incident
Φd power, are significantly greater than the power re-
NDI ¼ ; ð2Þ
Φs A d flected from the retina (based on Fresnel reflection,
calculation between refractive indices cornea and air
where Φd is the power on the detector, Ad is the area [7,8]). To isolate backreflections from the cornea, the
of the detector, and Φs is the power emitted by the retina is set as a perfect absorbing material. Then
source. The irradiance ratio gives a measure of how the illumination ratio is determined by setting the
effectively light from the source is being transferred size of the detector (size of the hole in the mirror, 21,
in a full system), corresponding to the conjugate ima-
ging pupil diameter, Ri , and varying size of the inner
radius of the source annulus (size of the inner radius
of the annular illumination pattern on the mirror),
corresponding to the conjugate inner radius of the il-
lumination annulus, RL , until the power on the de-
tector is zero. The effects of the working f -number,
WF#, of the objective lens and divergence angle of the
source on the illumination are then characterized.
An important aspect to illuminating the retina for
imaging is to provide a relatively uniform distribu-
tion. If this is not accomplished, retinal images are
likely to have dark regions where information cannot
be gathered. When designing the illumination optics
that relay the source to the holed mirror, it is impor-
tant to consider the numerical aperture, NA, of the
Fig. 3. Illumination annulus and imaging pupil located at the pu-
beam incident to the holed mirror. In our case the in-
pil of the eye. Ri designates the radius of the imaging pupil. RL cident NA is modeled as the source angle at each
designates the inside radius of the annular illumination pattern point.
at the pupil. The white annulus between RL and Ri is space needed After determining the illumination ratio necessary
between parameters to prevent corneal backreflections. to null corneal backreflections, the retina surface

20 December 2008 / Vol. 47, No. 36 / APPLIED OPTICS 6771


property is changed to a scattering material with where is σ rms wavefront error [12]. According to the
characteristics from the literature [7,8]. A series of eye models, a Strehl ratio of greater than 80% is
simulations are conducted to determine the amount maintained for an imaging pupil diameter smaller
of power transferred from the source to the detector. than 2 mm (Escudero and Navarro) and 3:5 mm (Liou
In these simulations, the WF# of the system and cor- and Brennan), Fig. 5; the Strehl ratio deteriorates ra-
responding illumination ratio are varied and the pidly for larger pupil sizes [12]. Similar results have
source angle remains constant. From these data been shown in previous experiments in which the
the efficiency and normalized detector irradiance are MTF of the eye is measured for different pupil sizes
determined. [15,16]. It should be noted the Liou and Brennan
To determine the effects of the working distance on model has notably different levels of spherical aber-
retina illumination, the pupil of the eye is moved ration than most other eye models and underesti-
from the focus of the objective by varying the working mates the dispersion of the ocular media, and these
distance between the eye and the objective, shown in differences potentially affect the outcomes of this
Fig. 4. WF#, source angle, and source distance re- analysis [17–19]. Consequently, the optimal pupil
mains fixed. The illumination ratio, efficiency, unifor- size may be different than what is suggested by this
mity, and normalized detector irradiance are then model. A more recent decentered anatomically accu-
determined for each defocused position. rate eye model shows that a Strehl ratio of 80% or
As a final experiment, the eye model is changed to greater is maintained for pupil sizes smaller than
decentered eye model proposed by Liou and Brennan 1:5 mm and drops more rapidly for larger pupil sizes
[13]. The decentered eye model is tilted to align the than other eye models used [20]. This exercise de-
visual axis along the optical axis of the system. Pre- monstrates that it is ideal to image the retina at a
viously performed experiments are repeated and smaller imaging pupil diameter to reduce the effects
compared to data from the decentered eye model. of ocular aberrations on the image quality of the
system.
3. Results B. Source Angle
When beginning the design of the illumination sys-
A. Imaging Pupil Diameter tem of a fundus camera, the characteristics of the
Ideally, a fundus camera should provide maximum source and optics relaying the source to the holed
irradiance on the retina and excellent image quality. mirror must be considered. The relay optics, respon-
From a purely radiometric standpoint, as the size of sible for imaging the source onto the mirror, must be
the imaging pupil increases, the amount of light that designed to meet a minimum image space numerical
can be collected by the objective increases, and the aperture (NA). By meeting this minimum NA, the
amount of light entering the eye decreases. Based light incident the mirror will be distributed over the
solely on these considerations, the geometry of the entire retinal field of view, FOV, of the imaging sys-
situation states the power reflected from the retina tem. Failure to meet the minimum NA will result in
is maximized when the area of the illuminating an- an annular illumination pattern on the retina that is
nulus and the area of the imaging pupil are the same. unacceptable; see Fig. 6(b). A calculation based on
For a 7:5-mm pupil this results in an approximately the illumination ratio can be used to determine the
5:2-mm imaging diameter, while the outer annulus is minimum angle, α, for complete illumination of the
used for illumination [14]. This simple analysis, retina; see Fig. 7. If a cross section of the eye is con-
however, does not take into account the effects of pu- sidered, then the objective lens focuses light from the
pil size on imaging quality. The Strehl ratio for var- source to a point on the pupil. The angular subtense
ious pupil diameters is calculated at 633 nm using
the definition

s ¼ expð−σ 2 Þ; ð5Þ

Fig. 4. Simplified fundus camera with the pupil of the eye dis-
placed from the objective focal point. Fig. 5. Strehl ratio of the eye as a function of pupil diameter.

6772 APPLIED OPTICS / Vol. 47, No. 36 / 20 December 2008


Fig. 7. Diagram showing the minimum angle, α, of illuminating
optics necessary for full illumination of the retina. RL is the inner
radius of the illumination annulus, and β is the angle subtended by
the illumination path focused on the pupil of the eye.

the WF# constant and varying the source angle


has a significant effect on the uniformity. Both source
distributions show decreasing the source angle yields
a decrease in uniformity and an annular illumination
distribution. These effects are shown in Figs. 6(a)
and 6(b). Percent of aperture filled is calculated by

0  1
d × tan 2θ 2

P¼@ A ;
DL
ð6Þ
2

where P is the percentage of the lens aperture filled,


d is the source distance, θ is the source angle, and DL
is the diameter of the objective; see Fig. 4.
Differences between source distributions become
Fig. 6. Effects of the source angle on retinal illumination for a more pronounced at larger angles due to vignetting
WF#1 system: (a) uniformity versus percent of aperture filled effects. A uniform source distribution shows a more
and (b) illumination patterns on the retina for different sources significant drop in illumination around the edges of
angles. For (b) the top left plot corresponds to 100% of the aperture the illumination pattern as the source angle in-
filled, while the bottom right plot corresponds to 8% of the aperture creases when compared to a Gaussian source distri-
filled. Intermediate plots range between 8% to 100% of the objec- bution. The only notable difference as a result of
tive’s aperture filled.
using a decentered eye model is the presence of vig-
netting at the edge of the positive x axis. Due the pu-
of the convergent beam is β. Through refraction at pil of the eye being decentered along the x axis with
the various surfaces of the eye, the angular subtense respect to the illumination annulus, some of the
of the beam is compressed to α. To achieve uniform along the light is clipped by misalignment. This is
illumination on the retina, α must cover from the cen- effect is further demonstrated in Fig. 8. The general
ter of the retina to the edge of the FOV. A smaller trend of uniformity changing with source angle is
angle α will fail to illuminate the central retina. still apparent. However, there is roughly a 20% drop
Based on the knowledge of the eye model, the re- in power distribution at the edge of the x axis of the
quired β can be calculated from α and, consequently, illumination profile due to the decentering of the pu-
the parameters of the objective lens defined. Know- pil from the visual axis by roughly 0:5 mm [13]. More
ing the angular flux distribution of the source, α can recent eye models incorporate a smaller decentration
be adjusted accordingly to ensure an acceptable de- value (∼0:3 mm) resulting in a smaller drop in power
gree of complete illumination. at the edge of the illumination profile [20]. Though
In our simulations using the centered eye model, the difference in the profile may seem significant,
lens diameter (WF#) and source angle (image space the percentage of total power lost is minimal, leaving
NA) are varied to determine their effects on the uni- little affect on the other illumination parameters. A
formity of the retinal illumination pattern. To simpli- situation in which the illumination annulus is vig-
fy our simulations, we used Gaussian and uniform netted due to the decentration of the pupil of the
angular source distributions. Leaving the source an- eye is unlikely considering the clinician who is taking
gle (divergence angle of the source) constant and the retinal image is likely to align the illumination
varying the WF#, we found little effect on the unifor- annulus concentric to the pupil of the eye. If this is
mity retinal illumination pattern. However, leaving the case, the vignetting effects due the decentration

20 December 2008 / Vol. 47, No. 36 / APPLIED OPTICS 6773


rated optical system the IR equals 1 because the spot
size on the pupil of the eye is small. This will allow
the illumination annulus to equal the imaging pupil
radius without the need for a buffer to eliminate
backreflections. In an aberrated system the spot size
increases, and RL must increase to eliminate backre-
flections because Ri is fixed by the diameter of the
hole in the mirror or iris behind the mirror. For a
fixed WF# and source angle it is clear that an in-
creased illumination ratio results in decreased effi-
ciency. From our results using the centered eye
model, shown in Fig. 7, we see that due to the optical
aberrations induced by the objective, the spot size on
the pupil enlarges, resulting in an increased illumi-
nation ratio. Figure 9 shows the presence of corneal
backreflections on the detector as a function of illu-
mination ratio for a WF#1 system. Figure 10 demon-
strates the effects of WF# and imaging pupil
diameter on the illumination ratio. Increasing WF#
results in a decreased illumination ratio. These re-
sults are expected considering the spot size at the pu-
pil plane of the eye is a function of the F# of the
objective [12]. Results also show that increasing
the imaging pupil diameter decreases the illumina-
tion ratio. The illumination ratio is unaffected by
the difference in eye models considering the radius
and conic value for the front surface of the cornea
vary little between eye models.
D. Efficiency and Normalized Detector Irradiance
Efficiency and normalized detector irradiance are
important metrics in determining the performance
of an illumination system. Ideally we want a system
that is highly efficient with maximum detector irra-
diance. Figures 11(a) and 11(b) show the relation-
ships between WF#, pupil diameter, normalized
detector irradiance, and efficiency for a fixed source
angle filling the aperture. As expected, the maximum
efficiency for each configuration is around a 5:2-mm
pupil diameter, consistent with our previous findings
[14]. In contrast, we see that detector irradiance de-
creases as a function of increased pupil diameter and
decreased WF#. An 80% Strehl ratio and WF#
consideration showed minimal changes for pupil
diameters up to 2 mm. Taking these results into ac-
count, we conclude there is minimal benefit to in-
creasing the imaging pupil diameter beyond 2 mm.

Fig. 8. (a) Illumination annulus at the decentered pupil. (b),


(c) Profiles of illumination distribution on the retina for various
source angles using a Gaussian angular source. Power and x axis
are normalized for comparison of eye models. Percentages refer to
the percentage of the objective aperture filled. (b) Escudero and
Navarro eye model. (c) Decentered eye model.

of the pupil of the eye disappear, leaving the illumi-


nation profile undisturbed.
Fig. 9. Illumination pattern on the detector as a result of corneal
C. Illumination Ratio
backreflections for a WF#1 with a 2-mm imaging pupil at the fol-
Determining the proper illumination ratio is one of lowing illumination ratios: (a) 1.0, (b) 1.2, and (c) 1.4. Higher IR to
the first steps in the design process. In an unaber- eliminate backreflections results in lower efficiency.

6774 APPLIED OPTICS / Vol. 47, No. 36 / 20 December 2008


Fig. 10. Illumination ratio versus pupil diameter for different
WF# systems.

The results from the decentered eye models showed


slightly lower values due to the vignetting of the il-
lumination annulus but followed the same trends
in Fig. 11.
E. Pupil Defocus
For the previous simulations the focus of the objec-
tive is fixed at the pupil of the eye. In this series
of simulations the pupil of the eye is moved away
from the focus of the objective to determine the ef-
fects of relocating the focus of the illumination annu-
lus. The source distance, source angle, and WF# of
the system are fixed for this series of experiments.
In our simulations, moving the focus inside the eye
is regarded as a negative, and moving the focus out-
side the eye is regarded as positive. For each defo-
cused position, efficiency, NDI, illumination ratio,
and uniformity are measured. Figures 12(a) and
12(b) show the illumination ratio and NDI as a func- Fig. 11. (a) Efficiency versus pupil diameter for varying WF#s.
tion of pupil position. The illumination ratio appears (b) Normalized detector irradiance versus pupil diameter for vary-
ing WF#s.
to increase quadratically with pupil distance from
the focus. This outcome is expected because spot size
increases quadratically with displacement from fo- noted that this particular parameter is adjusted in
cus [12]. NDI increases as the focus is brought inside the clinic and most likely varies between patients
the eye. Interestingly, the optimal position appears since it is highly dependent on shapes of the various
to be between the principal planes and nodal points parts of the eye.
of the eye [9]. An efficiency versus pupil position plot,
not shown, shows the same results as the NDI plot. 4. Conclusion
Results using the decentered model did not deviate Analysis of our results can be used to derive general
significantly from the centered eye model. principles useful for implementing the design of the
Results from the efficiency and NDI versus fundus camera. Examination of the Strehl ratio and
pupil position mean that moving the illumination an- normalized detector irradiance versus imaging pupil
nulus into the eye will improve performance. How- diameter demonstrate the need to limit the imaging
ever, when the uniformity versus pupil position is pupil diameter to 2 mm or less. This is due to the de-
examined, we find this not necessarily true. Fig- crease in both image quality and detector irradiance.
ures 13(a) and 13(b) show the uniformity of the illu- The illumination ratio should be determined in order
mination pattern decreases as the focus is moved to null corneal backreflections that overpower the
inside the eye. To find the optimal position, it is ne- signal from the retina on the detector. The illumina-
cessary to determine the acceptable level of unifor- tion ratio of the system is controlled by reducing the
mity. Based on our results, we conclude an optimal aberrations induced by the objective. For this reason,
focal position is between the pupil and 1 mm inside it is important to consider the image quality of the
the pupil. For practical purposes it should also be objective in image and object space. Ideally when

20 December 2008 / Vol. 47, No. 36 / APPLIED OPTICS 6775


Fig. 13. Effects of moving the pupil from the objective focus on
retinal illumination uniformity. (a) Plot of uniformity versus pupil
position. (b) Illumination patterns at the retina top left correspond
to the objective focus 5 mm behind the pupil; bottom right corre-
Fig. 12. (a) Illumination versus pupil position for a WF#1 system. sponds to the objective focus at the pupil. Intermediate images are
(b) Normalized detector irradiance pupil position for a WF#1. taken at 1 mm intervals between 5 and 0 mm behind the pupil.

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