PHYSIOLOGICAL OPTICS

58 PHYSIOLOGICAL OPTICS: Contents

The Eye
Structure of eye Anatomical structure 61
Optical function 63
Centres of eyeball rotation 64
Field of fixation, field of view and visual field 65

Accommodation Terminology 66
Presbyopia 67
Influence of luminance 67

Pupil Diameter 68
Interpupillary distance 68
Luminous intensity of pupil 68

Visual performance Sensitivity threshold 69

Resolving power 69
Visual acuity 70
Directional perception 71
Depth perception 72
Adaptation and dazzling 72

Colour vision Spectral sensitivity 73

Colour sensation 74
Trichromatic theory 74
Defective colour vision 76

Emmetropic eye Emmetropia 76

Schematic eye 76
Chromatic aberration 76
Focusing wavelength 76

Ametropic eye Ametropia 77

Myopia 77
Hypermetropia 78
Astigmatism 79
Aphakia 79

Monocular correction of eye Full refractive correction 80

Objective methods 80
Subjective methods 80
PHYSIOLOGICAL OPTICS: Contents 59

Binocular Vision
Fusion and vergence Binocular single vision 81
Vergence 81
Vergence positions 81
Fusion ranges S3
Vergence portions N4

Binocular space Directional perception 86

perception Stereovision 87
Depth of field 89
Stereoscopy 89
Stereo visual balance 90

Phoria and tropin Orthophoria 91

Heterophoria 91
Fixation disparity 92
Accommodation-vergence diagram 92
Heterotropia 94

Anisometropia and Anisometropia 94

aniseikonia Aniseikonia 95

Binocular correction Full prismatic correction 96

of eye Methods 96
Focusing balance 97
 P H Y S I O L O G I C A L O P T I C S : The Eye 61

The eye
Structure o f the eye

Anatomical The eyeball (bulbus oculi) is of an almost spherical shape, but it

structure is not a precisely centred system in the sense of geometrical
optics. The optical axis O A of the eye is thus by convention the
normal on the corneal front surface which passes through the
centre of the entrance pupil.
temporal
Fig. 51 shows a horizontal meridian section with a schematic
representation of the shell-like structure of the eye. The interior
of the eye is filled by the vitreous humour G (corpus vitreum). In
front of the vitreous is the crystalline lens L (lens cristallina) and
behind it is the multilayer retina N (retina). The retina is about
0.3 mm thick and contains photosensitive cells in the form of
rods (radii) and cones (coni). The area of the most acute vision
is in the central part of the fovea F (fovea centralis) which has a
diameter of approximately 1.5 mm (about 5°). (Note: The
degrees in brackets specify the nodal point angles.)
Roughly 4.5 mm (about 15°) nasally from the centre of the
nasal fovea is found the optic disc B (papilla nervi optici) which has a
Fig. 51 diameter of approximately 1.6 mm (about 6°). The point at
Horizontal section through a human which the optical axis touches the retina is called the posterior
eye (description in text) pole P (polus posterior).
The surrounding cover is the uvea (uvea) consisting of the
choroid A (chorioidea) which nourishes the eye, the ciliary body
Z (corpus ciliare) which changes the shape of the lens, and the
iris R (iris) which controls the amount of light entering the eye.
The outer layer of the eye is a 1 mm-thick continuous fibrous
tunic comprising a posterior portion, the sclera S (sclera), and a
transparent anterior portion, the cornea H (cornea) which is
about 0.5 mm thick at its centre; the transition zone is called the
limbus. The weakest point of the sclera is the cribiform plate C
(lamina cribosa) lying behind the optic disk, through which the
optic nerve O (fasciculus opticus) passes. The anterior chamber
V (camera oculi anterior) is located between the cornea and the
iris, while the posterior chamber W (camera oculi posterior) is
situated between the iris, the ciliary body and the lens. Both
chambers are filled with aqueous humour (humor aqueus).
Movement of the eye is achieved with six muscles which are
tangentially connected with the sclera (Fig. 52). The entire
eyeball has a diameter of about 24 mm and is located in the
osseous orbital cavity (orbita) which is padded with fatty tissue.
62 P H Y S I O L O G I C A L O P T I C S : The Eye

The conjunctiva (conjunctiva) is the connection between the

eyeball and the eyelids (palpebrae). The lacrimal apparatus with
the lacrimal gland (glandula lacrimalis) on the temporal side
serves mainly to clean the ocular surface.

b) right orbital cavity, profile

ig medial rectus
(musculus rectus nasalis)
ag lateral rectus
(musculus rectus temporalis)
og superior rectus
(musculus rectus superior)
ug inferior rectus
(musculus rectus inferior)
os superior oblique muscle
(musculus obliquus superior)
us inferior oblique muscle
(musculus obliquus inferior)
P H Y S I O L O G I C A L O P T I C S : The Eye 63

Optical function Light rays incident on the eye are most strongly refracted at the
cornea and are then transmitted through the aqueous humour
of the anterior chamber to the crystalline lens where they are
once again refracted. After traversing the vitreous, they finally
reach the photosensitive retinal elements. The cornea con-
stitutes a convergent meniscus with a refractive index of n = H

1.376 whose positive refractive power of about F = 43 D H

results from the difference between the refractive indices of the

adjacent media. In front of the cornea is air with n = 1, and
behind it the aqueous humour with n = 1 336. The strongest
K

refraction of the rays therefore occurs at the front surface of the

cornea. About 5 mm behind the cornea is the bi-convex crystal-
line lens with a refractive index of about n = 1.4. The vitreous
L

humour behind the lens has the same refractive index as the
aqueous humour in front of it. This results in a positive refrac-
tive power of about F = 19 D for the crystalline lens (with
L

static accommodation). The entire eye has a positive refractive

power of about F e = 59 D. The retina represents the image
E Y

area, and the aperture of the iris (in front of the crystalline lens)
is the aperture stop of the system.
The entire ocular system includes the following on the optical
axis behind the anterior corneal vertex in the order listed (Note:
The numbers in brackets give for the simplified schematic eye
after Gullstrand the distance of the respective point from the
anterior corneal vertex in mm.): the principal points H (1.5) and
H ' (1.6), the centres of entrance pupil EP (3) and exit pupil A P
(3.5), the nodal points K (7.1) and K ' (7.2) and the centre of the
approximately spherical eyeball (Fig. 53).
64 P H Y S I O L O G I C A L O P T I C S : The Eye

Centres of eyeball rotation
When the eye performs all the movements permitted by the six
extrinsic muscles, no point within the eye retains its position
within the orbital cavity. The point with the least positional
change in the possible ocular movements is called the mechan-
ical centre of rotation M . In an emmetropic eye it is normally
situated 13.5 mm posterior to the anterior corneal vertex. Fig.
53 shows the major points and lines of the eye, while Table 10
lists the symbols used in physiological optics.
The line of vision G L is the straight line connecting a fixated
object point and the conjugate image point in the centre of the
fovea. The line of vision can be taken to be roughly identical to
the nodal point ray.
The straight line connecting the centrally imaged object point
and the centre of the entrance pupil is called the fixation line F L
(or line of sight) and constitutes the object-side principal ray in
front of the eye. The fixation line is therefore the straight line
into which front and rear sights should be brought when aiming.
When an (infinitely) distant object is fixated, the line of vision
and the fixation line are parallel.
The direction of the fixation line when looking straight ahead
into the distance is called the zero visual direction. A n inward
movement of the eye is called adduction, and an outward
movement abduction (Fig. 73).
The direction of the fixation line changes with each viewing
movement of the eye. If all fixation lines are projected into the
eye, they are tangents to an approximately spherical surface
whose centre is the mechanical centre of rotation of the eye.
This spherical surface is usually located temporally to the mech-
anical centre of rotation of the eye, and the radius of the sphere
is approximately 0.8 mm.
The optical centre of rotation of the eye Z ' is the foot of the
perpendicular running from the mechanical centre of rotation
to the fixation line in the zero visual direction. It is the most
important point for the correct centration of a spectacle lens.
The fixation line does not normally coincide with the optical
axis of the eye; the angle between the two is called the y angle. As
the fixation line and the line of vision are parallel to each other
in distance vision, the y angle is a measure of the distance
between the centre of the fovea and the posterior pole. It is
positive if the fovea is located on the temporal side of the
posterior pole. Values between + 8 ° and - 3 ° are possible
(corresponding to a displacement of the fovea from the poste-
rior pole of about 2.5 mm temporally to about 1 mm nasally).
Only when y = 0 will the optical axis coincide with the fixation
Pi I Y S I O L O G I C A L O P T I C S : The
Field of fixation, field of
view and visual field
Eye 65
line and the line of vision, and the posterior pole with the centre
of the fovea: the optical centre of rotation of the eye is then
located on the optical axis.
All points which can be fixated by means of movements of the
eye while the head is kept motionless form the monocular field
of fixation. Every point in the field of fixation can be imaged at
the centre of the fovea by an appropriate movement of the eye.
The appertaining fixation lines intersect roughly at the optical
centre of rotation of the eye. As they are identical to the
object-side principal rays for the imaging of the points of the
field of fixation which are fixated one after another, the optical
centre of rotation constitutes the centre of perspective for the
viewing eye.
If a point in the field of fixation is fixated (with head and eye
motionless), all object points perceived around the fixated point
form the monocular field of view for this visual direction. The
area corresponding to the optic disc (blind spot) is missing in
this process. The centre of the entrance pupil is the centre of
perspective for the motionless eye, as it is the intersection point
of all object-side principal rays. The totality of all fields of view
for all possible directions is called the monocular visual field.
For a pair of eyes, the binocular fields are formed by superim-
position of the corresponding monocular fields.
66 P H Y S I O L O G I C A L O P T I C S : The Eye

Accommodation

Terminology The ciliary muscle reduces the radius of curvature of the front
surface of the crystalline lens (and also, but to a lesser degree,
that of the back surface). This increases the refractive power of
the lens and therefore that of the entire eye. This process
permits adaptation to various object distances and is called
accommodation. When the eye does not accommodate (refrac-
tive power F of the eye), the far point M (punctum remotum)
R R

is in sharp focus. The distance of this point from the anterior

principal point of the eye is called the far point distance k; it can
be negative ( M real in front of the eye) or positive ( M virtual
R R

behind the eye).

The far point refraction is

(61) K = I (D).

With maximum accommodation (refractive power F of the P

eye) the near point P (punctum proximum) is seen in sharp

p

focus. The distance of this point from the anterior principal

point is called the near point distance b. It can be negative or
positive.
The near point refraction is

(62) B= I (D).

The far point and the near point limit the accommodation
range. Every point within the accommodation range is a focus-
ing point E (refractive power F of the eye). Its distance from
E

the anterior principal point is called the accommodation dis-

tance b . E

The focusing refraction is

(63) B = ± . (D).
E

b E

Table 5 gives the numerical relationship of the values in (61) to

(63) .
The accommodative effort A F is the increase in refractive
power of the eye through accommodation
(64) AF = F - F . E R

The maximum accommodative effort is

P H Y S I O L O G I C A L O P T I C S : The Eye 67

(65) AF m : l x — Fc

The magnitude of A F is a measure of the accommodative

m a x

power of the eye. The amplitude of accommodation A A is the

difference between the corresponding refractions
(66) AA = K - B . E

The maximum amplitude of accommodation (the breadth of

accommodation) is
(67) AA m a x = K. — B.

cc (cum correctione) is added to the corresponding terms for

0 10 20 30
Age in years
the eye with a correction lens. For the eye without corrective
Fig. 54
aids, A F practically equals A A . For the eye with a contact lens,
Average accommodative power as a A F is approximately A A , but A F and A A are different for
c c c c

function of age the eye with a spectacle lens.

^"fa'r point If the eye assumes a refractive power which is lower than F , R

this process is known as negative accommodation.

Real objects at close range may induce psychic (proximal)
accommodation because of the awareness of nearness (instru-
l e a r j >oint-
ment myopia).
0 0.01 0.03 Cd 0.05 If a pair of eyes is compelled to converge by optical devices with
2

Luminance L
m an unchanged object distance, accommodation may be induced
(convergence accommodation), although the retinal images are
Fig. 55
Range of accommodation as a blurred in the process.
function of the adaptation luminance A relative divergence effected in the same way facilitates nega-
tive accommodation.

Presbyopia The accommodative power A F is age-dependent. With

m a x

increasing age the elasticity of the crystalline lens decreases,

with the result that the range of accommodation becomes
smaller. Fig. 54 shows the average accommodative power as a
function of age. If A F is less than 4 D, the eye is presbyopic.
m a x

Influence of luminance
With decreasing luminance of the field the near point moves
away from the eye (night presbyopia), and the far point moves
closer to the eye (night myopia). This process which reduces the
accommodation range is shown in Fig. 55 and becomes notice-
able to the point of irritation in the early stages of presbyopia
before reading glasses are used (especially when reading small
print such as in railway timetables or telephone directories in
insufficient artificial lighting).
68 P H Y S I O L O G I C A L O P T I C S : The Eye

The pupil

Diameter The aperture of the iris (aperture diaphragm) is called the pupil
of the eye. Its diameter is dependent on illuminance (Table 11),
i— ion
;otopic vis age (Fig. 56) and the general physical condition of the subject.
Moreover, pupil size, accommodation and convergence are
interrelated. The change in diameter of the pupil (pupillary
reaction) ranges between 10 mm and 1 mm depending on the
- various influences.
The cornea and aqueous humour in front of the pupil act as a
magnifier and make the pupil appear 1.13 times larger (appar-
L_ Ph atopic visi an ent pupil size or entrance pupil of the eye). The average
; diameter of the entrance pupil is 3 to 5 mm.
i •

20 3 0 40 50 60 70 80 For observation through optical instruments, the entrance

Age in years
pupil of the eye should be located at the exit pupil of the
Fig. 56 instrument. If this exit pupil is wider than the entrance pupil of
Average size of the entrance pupil of
the eye, the luminous flux emerging from the instrument does
the eye as a function of age
not enter the eye in its entirety.
Myopic eyes usually have larger, and hypermetropic eyes
smaller pupils than emmetropic eyes (Table 11).

Interpupillary distance The interpupillary distance (the PD, formula designation p) is

the distance between the two pupil centres when a pair of eyes
fixates an (infinitely) distant point, i.e. with parallel fixation
lines. This (distance) P D is measured with interpupillometers
and is identical to the distance between the optical centres of the
rotation of the eyes. Table 12 gives a list of average P D values.

Luminous intensity Like luminance, the size of the pupil is important for the retinal
of the pupil illuminance and thus the sensation of brightness. It was for this
reason that the luminous intensity of the pupil I was introduced
p

as a measure of the retinal illumination in daylight. It is the

product of the luminance L and the surface area A of the pupil:
p

(68) I = L A .
P P

The luminous intensity of the pupil is obtained in the unit

2
troland (Trol) if the luminance is entered in cd/m and the
2
surface area of the pupil in mm .
P H Y S I O L O G I C A L O P T I C S : The
Visual performance
Sensitivity threshold
10" 1 10 1 0 c d i o
1 2
2
m
Luminance L
Fig. 57
Luminance threshold of the eye as a
function of the adaptation luminance
(a night vision, b twilight vision, c day-
light vision, d dazzle limit)
Resolving power
Eve 69
9
For a corneal illuminance of about 10 lx the absolute sensitiv-
ity threshold for light stimuli (minimum perceptible) lies in
indirect vision and is of no optometric significance. The relative
sensitivity threshold (contrast sensitivity) is known as the lumin-
ance threshold and specifies the least perceivable difference in
luminance. This difference is dependent on the luminance and
the state of adaptation of the eye and is higher the lower the
luminance (Fig. 57). The smallest visual angle at which an
object (with given difference in luminance and state of adapta-
tion) can be perceived gives the minimum visible.
Periodic flickering beyond a certain fusion frequency causes the
4
same sensation as a permanent stimulus, corresponding to the
evenly distributed luminance during the flicker period. The
fusion frequency is dependent on the flicker amplitude and in
most cases is lower than 30 Hz. It is lower in the area of the
fovea than outside it.
The resolving power of the eye or the minimum separable
points (minimum separabile) characterise the ability of the eye
to perceive details of an object separately. The resolving power
is influenced by various factors:
1. geometrically: by the shape and orientation of the object
details,
2. physically: by the luminance and colour of the object (Table
13) and the surrounding field, and by the length of time
during which the object is presented to the subject,
3. optically: by the quality of the retinal image,
4. anatomically: by the image position on the retina (Fig. 58)
100
>> % £100
o I
in 1
50 T> I
.y §
Q. /
- nasal °J \ temporal
0 i i r*r— 10 20 30 40 50 60
50° 0° 50° Age in years
Retinal location
Fig. 58 Fig. 59
Relative visual acuity as a function of Relative visual acuity as a function of
the location on the retina (0° is the age
centre of the fovea)
70 P H Y S I O L O G I C A L O P T I C S : The Eye

5. physiologically: by the state of adaptation and the condition

of the optic nerves,
6. psychologically: by the attentiveness and degree of familiari-
sation of the observer with the situation involved and
7. by age (Fig. 59).
The resolving power is measured by means of the smallest
angular separation (nodal point angle) at which the object
details in question can still be separately discriminated. This
critical angle of resolution measures about 40 to 60 seconds for
separable points and approximately 5 to 10 seconds (vernier
acuity) for lines such as those on a vernier scale.

Visual acuity In ophthalmic optics the resolving power of the eye is deter-
mined as visual acuity by using a special standard test type
known as the Landolt ring. This test type is a ring with a gap in
its circumference. The width of the ring and the gap are each
one fifth of its overall diameter (Fig 60). In an acuity test the
location of the gap in the ring must be identified.
The unit "visual acuity 1" is determined by a Landolt ring
whose gap appears with an angular separation of one minute
and whose overall diameter is then 5 minutes.
In a standard series of test types the size of the Landolt rings is
selected in such a way that a logarithmic scale of acuity values
results (Table 14).
The visual acuity grade is a property of the object observed and
Fig. 60 is denoted by the minimum acuity with which the characteristic
The Landolt ring as standard test type object details (here: the position of the gap of the Landolt ring)
are identified from a certain distance.
If other test types are used, they must be referred to the Landolt
ring (as the standard test type).
Familiarization with specific test types finds expression in the
so-called reading sensitivity or reading ability (minimum le-
gibile). Here, recognition of words as a whole is checked, as, for
example, in near vision tests with texts of different print sizes.
If a test type is used at a different distance (actual distance) from
that on which the acuity grade is based (nominal distance), the
visual acuity is obtained from:

actual distance
(69) acuity = x recognized acuity grade.
nominal distance

Example: If a series of test types is projected from a distance of

5 m (nominal distance), and if from a distance of 4 m (actual
P H Y S I O L O G I C A L O P T I C S : The Eye 71

distance) the smallest test types recognized are those with the
acuity grade 0.8, the visual acuity is 0.64.
Natural vision (visus naturalis) or the acuity s.c.(visus sin cor-
rectione) is the visual acuity of an eye without the use of a
corrective aid, and the corrected visual acuity or the acuity c.c.
(visus cum correctione) is the visual acuity with a corrective aid.
Binocular visual acuity is usually slightly better than monocular.

Directional perception The ability to recognize the different directions (from the point
of view of the eye) in which the various objects in the field of
view are located is called the (monocular) directional percep-
tion. Normally the object point whose image is produced in the
centre of the fovea is localised as being "straight ahead in front
of the eye" (central fixation). The sense of direction conveyed
by the other points of the retina refer to this "straight ahead"
direction of the fixation area of the retina.
In the retinal point with the directional value "straight ahead"
the so-called vertical and horizontal meridians of the retina
intersect. If a straight object line is imaged on one of these
retinal meridians, it is perceived as being vertically (or horizon-
tally) straight ahead. All retinal points on the right (left) of the
vertical retinal meridian therefore have the directional value
"left" ("right"), and all retinal areas above (below) the horizon-
tal retinal meridian the directional value "down" ("up").
In the (rare) case of excentric fixation the viewed object point is
not imaged in the middle of the fovea.

Depth perception The ability to recognize different object distances is called depth
perception (spatial perception). Here, a distinction is made
between laterally disparate depth perception (stereovision),
which is only possible binocularly, and laterally non-disparate
depth perception which is in the main monocular.
The following contribute to laterally non-disparate depth per-
ception:
1. arrangement of the objects in the image (further up is
experienced as further to the back),
2. geometric perspective,
3. contour sharpness (unsharp is experienced as further to the
back), especially due to atmospheric influences (aerial per-
spective),
72 P H Y S I O L O G I C A L O P T I C S : The Eye

4. distribution of light and shadow,

5. object overlapping (overlapping perspective),
6. motion parallax,
7. convergence stimulus,
8. accommodation stimulus,
9. size of retinal image (in conjunction with the conception of
size).

Adaptation and The ability of the eye to adjust to a wide range of luminance
dazzling values is called adaptation. Depending on the prevailing aver-
age luminance, the rods or cones or both participate in the
perception of light. The highly photosensitive rods react at
2
adaptation luminances of below 10 cd/m , while the less
photosensitive (but colour-sensitive) cones begin to react above
3 2
approximately 5 . 10 cd/m . Therefore, at a luminance of less
3 2
than 5 . 10 cd/m only the rods are active: night or scotopic
3
vision. At a luminance between approximately 5 . 10" and 10
2
cd/m both rods and cones are active: twilight or mesopic
2
vision. At a luminance of more than 10 cd/m only the cones are
active: daylight or photopic vision. These transitions run
smoothly one into another (Table 7).
Adaptation (of the cones) to higher luminance values is rela-
tively fast: brightness adaptation. Adaptation (of the rods) to
lower luminance values, however, occurs slowly: dark adapta-
tion. The stage of dark adaptation after 3 - 5 minutes is called
immediate adaptation, and after at least 30 minutes permanent
adaptation. These two adaptations may be independent of each
other; good immediate adaptation may be present (important
" 10- 2
for driving) with poor permanent adaptation. The adaptation
over the entire retina is called total adaptation, and that in
10" 3 certain areas local adaptation. As local adaptation is markedly
40 min less in the fovea than at the periphery of the retina, night vision
outside the fovea is better than inside it. This is shown in Fig. 61
Fig. 61 using the process of dark adaptation over a certain period of
The process of dark adaptation with time. So-called night blindness is a deficiency of dark adapta-
time (a. inside the fovea, b. outside the
fovea)
tion.
Adaptation can be measured with an adaptometer (scotopic
and mesopic vision), a mesoptometer (mesopic vision) or a
nyctometer (immediate adaptation in mesopic vision).
Dazzling occurs if the prevailing state of adaptation of the eye is
disturbed by a luminance which is higher by a certain minimum
amount than the adaptation luminance.
P H Y S I O L O G I C A L O P T I C S : The Eye 73

10'°
cd

10=

car h e a d l i g h t s

paraffin l a m p
f l u o r e s c e n t lamp

J,
c C
2 s
5
dark ll E Is Si
cloudy night
Fig. 62
Dazzling luminance as a function of i i i i

the adapted field-of-view luminance:

luminance above the dazzle line causes Field-of-view
luminance
dazzling
A distinction is made between:
1. absolute dazzle: the luminance is too high,
2. relative dazzle: the difference in luminance is too great
(Fig. 62) and
3. adaptation dazzle: the changes in luminance are too rapid.

Colour vision

Spectral sensitivity
400 500 6 0 0 nm 700
Wavelength). in air
Fig. 63
Spectral luminous efficiency of the
human eye: V (X) for photopic vision,
V (X) for scotopic vision
Any radiation from the visible part of the electromagnetic
spectrum when incident on the eye produces a certain light
sensation. The relative spectral sensitivity of the eye for mono-
chromatic radiation of the same physical power (so-called equi-
energy spectrum) is shown in Fig. 63.
The sensitivity curve of the cones (photopic vision) is known as
the V(A,) curve; it lies approximately between 380 and 750 nm
with a maximum at 555 nm. For scotopic vision of the rods the
spectral sensitivity curve is shifted towards shorter wavelengths
by barely 50 nm relative to the V(a.) curve (maximum at 507
nm). This displacement accounts for the Purkinje effect: objects
which appear in different colours but with the same brightness
in photopic vision are perceived with different brightness in
mesopic and scotopic vision.
74 P H Y S I O L O G I C A L O P T I C S : The Eye

Colour sensation The colour in which an object appears is not a property of this
object, but a sensory impression. The colour response triggered
by a certain radiation (colour stimulus) is induced physiologi-
cally. The assignment of colour response to the frequency (or
wavelength) of the radiation is given in Table 6 for the various
regions of the spectrum. The transitions between the individual
spectral ranges run smoothly one into the other.
The hue is the means of distinguishing between a chromatic
colour and an achromatic colour (white, grey, black). The
saturation gives the proportion of colour in the colour response
(compared with the equally bright achromatic colour). The
brightness characterizes the intensity of the light response
correlated with every colour response. Hue and saturation
together give the chromaticity of a chromatic colour; an achro-
matic colour has a brightness characteristic only.
Colour vision is conveyed by the cones, whereas the rods only
effect an achromatic light sensation. The state of the eye in
which it is adapted to the prevailing colour stimulus is called the
colour adaptation. If objects are illuminated by a (not too
extremely) coloured source, they appear in their natural colours
again after a few minutes: physiologically induced colour con-
stancy.

Trichromatic theory Every colour can be produced by a specific mixture of three

primary colours which are independent of each other. Every
colour sensation is therefore clearly characterized by three
tristimulus values which are determined by colour measure-

101 1 1 1 1 1 1 1 1

Fig. 64
Curves of the tristimulus values for the 400 500 600 700 nm
equi-energy spectrum Wavelength X in air
P H Y S I O L O G I C A L O P T I C S : The Eye 75

ment with three defined primary colours. The tristimulus values

x, y and z of the standard chromaticity system which are
preferably used are plotted in Fig. 64 against the wavelength.

In the appertaining standard chromaticity diagram of Fig. 65

every chromaticity corresponds to a point (colour point) with
the coordinates x, y and z (x + y -I- z = 1). All points of the
spectral colours are on the spectrum locus. This is an open
curve; its ends are connected by the line of pure purples. The
points of all the colours which can be produced lie within the
bounds of the spectrum locus and the line of pure purples.
The point of the equi-energy spectrum is the achromatic point
with the coordinates x = y = z = 1/3. Points on the spectrum
locus which lie on a line with the achromatic point characterize
so-called compensating colours (incorrectly also called com-
plementary colours).

Fig. 65
Standard chromaticity diagram Chromaticity coordinate x
76 P H Y S I O L O G I C A L O P T I C S : The Eve

Defective colour vision As normal colour vision is conveyed by three types of receptors,
it is called trichromatic vision. If normal trichromatic vision is
disturbed, a distinction is made between the following colour
deficiencies:
1. colour weakness (anomalous trichromatism),
2. partial colour blindness (dichromatism),
3. total colour blindness (monochromatism).
Details are given in Tables 15 and 16.

The emmetropic eye

Emmetropia A n eye is defined as emmetropic if its far point lies at infinity.

Far point refraction is zero: K = 0. Irrespective of the magni-
tude of the refractive power F , only the correct ratio of this
R

refractive power to the overall length of the eyeball is important,

as the image-side focal point F g of the eye must be located on
ye

the retina. An (infinitely) distant object is imaged sharply on the

retina. As the near point of an emmetropic eye is at a real finite
distance in front of the eye, a real accommodation range results
(Table 17).

Schematic eye Based on a careful analysis of the geometrical and optical

dimensions of a number of emmetropic eyes, Gullstrand de-
signed two model eyes, the schematic eye and the simplified
schematic eye. The data of the latter is shown in Table 18, in
which the cornea and crystalline lens are assumed to be infi-
nitely thin.

Chromatic aberration The dispersion occurring in every optical medium leads to

chromatic aberration of the eye. This image aberration is shown
in Fig. 66, in which the eye is assumed to be emmetropic for the
wavelength 680 nm. This means that it is then myopic by 1 D for
approximately 490 nm. Violet illuminated advertisements ap-
pear unsharp to the emmetropic eye.

Focusing wavelength If white light serves to image an object on the retina, image
positions lying one behind the other result for the individual
colours due to chromatic aberration; the red image has the
largest and the blue image the smallest image distance. The
P H Y S I O L O G I C A L O P T I C S : The Eye 77

wavelength whose image is given priority by the eye is called the

focusing wavelength. The focusing wavelength of the eye is
dependent on the object distance (accommodation). If the eye is
adjusted to its far point (i.e. with static accommodation), in
most eyes the rays of the wavelength 685 nm (red light) are
concentrated on the retina; there is therefore no correspond-
ence with the maximum of spectral luminous efficiency. With
decreasing object distance the eye normally utilizes its chro-
matic aberration and adjusts to shorter focusing wavelengths
(in order to minimize the necessary increase in refractive
power). This relationship between object distance (accommo-
dation) and focusing wavelength is shown in Fig. 67.

Wavelength X in air Accommodation

Fig. 66 Fig. 67
Chromatic aberration of the eye Focusing wavelength of the eye in
white light as a function of the
object distance

The ametropic eye

Ametropia A n eye is defined as ametropic if its far point does not lie at
infinity. A n (infinitely) far object point is then no longer imaged
as a point on the retina. If the cornea and the crystalline lens
have spherical surfaces, identical optical conditions are present
in all meridian planes, and the eye is spherically ametropic.
If, however, the refracted rays only converge in two meridian
planes (principal meridians) perpendicular to each other, the
eye is termed astigmatically ametropic.

Myopia A n eye is defined as myopic if its far point is located at a real

finite distance in front of it (Fig. 68a). Far point refraction is
negative: K < 0. The myopic eye usually has an overall length
78

which is too long in comparison with the refractive power of

the average emmetropic eye (axial myopia). Occasionally, it
has a refractive power F which is too high in relation to the
R

overall length of the standard eye (refractive myopia). The

image-side focal point F e of the eye with static accommoda-
ye

tion lies inside the eye in front of the retina, and an (infinitely)
distant object is unsharply imaged in circles of confusion on the
retina (O'in Fig. 68b). As the near point of a myopic eye is also

Fig. 68
Myopic eye (with static accommodation): a) far point b) focal point

real in front of the eye, the accommodation range is real (Table

-3.0 D -2.0 -1.0 0
17). Fig. 69 shows the relative acuity as a function of the degree
Far point refraction K of myopia. The acuity of the myopic eye would be further
Fig. 69
reduced by accommodation, as the focal point F' would be R

Decrease in relative visual acuity in even further in front of the retina, and this would lead to larger
myopia circles of confusion for the distant object.

Hypermetropia A n eye is termed hypermetropic if its far point is virtual behind

it (Fig. 70a). Far point refraction is positive: K > 0. The overall
length of the hypermetropic eye is usually too short in relation
to the refractive power of the average emmetropic eye (axial
hypermetropia). Occasionally the refractive power F is too R

low in relation to the overall length of the average emmetropic

eye (refractive hypermetropia). The focal point Fe of the eye yc

with static accommodation lies behind the retina, and an

(infinitely) distant object is unsharply imaged in circles of
confusion on the retina (O' in Fig. 70b).

Fig. 70
Hypermetropic eye
(with static accommodation):
a) far point
b) focal point

The location of the near point is dependent on the maximum

amplitude of accommodation of the eye. If the latter is smaller
than the far point refraction ( A A < K ) , the near point is
m a x

virtual, and a virtual accommodation range also results (Table

17). For A A = K the near point lies at infinity, and for
m a x
P H Y S I O L O G I C A L O P T I C S : The
Astigmatism
different locations
on the retina
Fig. 71
Designation of the astigmatism
1 compound myopic astigma-
tism (astigmatismus myopicus
compositus)
2 simple myopic astigmatism
(astigmatismus myopicus sim-
plex)
3 mixed astigmatism (astigmatis-
mus mixtus)
4 simple hypermetropic astigma-
tism (astigmatismus hyperopi-
cus simplex)
5 compound hypermetropic
astigmatism (astigmatismus
hyperopicus compositus)
Aphakia
Eye 79
AA m a x> K the near point is real in front of the eye, with the
result that part of the accommodation range is real. Appropri-
ate accommodation increases the visual acuity of a hyperme-
tropic eye, as the focal point F e then comes closer to the retina,
ye
resulting in smaller circles of confusion for the distant object.
With an amplitude of accommodation of A A = K , F g lies onye
the retina, and the distant object is seen in sharp focus.
An astigmatically ametropic eye has two different far point
locations for the two principal meridians with the refractive
powers F i and F . The (first) principal meridian with the
R R I I
higher refractive power F is frequently almost vertical (about
R I
70° to 110° on the Tabo graduated arc scale). This is an
astigmatism with the rule (astigmatismus rectus). If the princi-
pal meridian with the higher refractive power is almost horizon-
tal (about 0° to 20° or 160° to 180°), an astigmatism against the
rule (astigmatismus inversus) is present. In all other directions
of the principal meridians, the astigmatism is called oblique
astigmatism (astigmatismus obliquus).
Each principal meridian itself can be emmetropic, myopic or
hypermetropic, with a line resulting as the image of an (infi-
nitely) distant object. Further designation of the astigmatism is
therefore dependent on the position of the two focal lines
relative to the retina. Fig. 71 shows the five possibilities. The ray
path subsequent to refraction resembles Sturm's conoid.
Corneal and lenticular astigmatism exist (with corneal astigma-
tism occurring more frequently). Both together (but not by
simple addition) give the total astigmatism. The difference
between the total astigmatism and the corneal astigmatism is
sometimes called the residual or physiological astigmatism.
Aphakia is the absence of the crystalline lens most frequently
due to its surgical removal. A n aphakic eye usually requires
correction lenses for distance and close range vision. The lens
removed from the eye can be replaced by a spectacle lens or a
contact lens with a high positive power. In the case of contact
lens correction for distance vision, a spectacle lens for near
vision can be used in addition. Table 19 gives the dimensions of
the schematic aphakic eye. Correction of unilateral aphakia
with a spectacle lens leads to very different image sizes in the
two eyes.
80 P H Y S I O L O G I C A L O P T I C S : The Eve

Monocular correction of the eye

Full refractive correction The purpose of a refraction test is normally the determination
MR.FSP, MR
of a fully correcting spectacle lens which entirely compensates
C C

the existing ametropia of the eye. This fully correcting lens

enables maximum visual acuity to be achieved, and the far point
M (of the lens/eye system) lies at infinity as in an emmetropic
R c c

eye. The image-side focal point F' of the spectacle lens and the
SP

far point M of the eye must coincide. This condition is shown

R

in Fig. 72.
As accommodation must be at rest for distance vision, the
following rule applies for correction:
The best lens is the strongest plus lens or weakest minus lens
with which the highest visual acuity is achieved.
b) In the case of astigmatic ametropia of the eye, full correction
Fig. 72
must be obtained for both principal meridians and can be
Full correction: achieved by using lenses with an astigmatic power. The best
a) in myopia spherical lens is the lens which (for distant objects) places the
b) in hypermetropia circle of least confusion onto the retina.

Objective methods With objective refraction methods the subject does not need to
play an active role in vision testing. The most important aids are
the retinoscope or skiascope and the refractometer. The oph-
thalmometer or keratometer is used to measure the radius of
curvature of the cornea.

Subjective methods The most common methods are based on the determination of
visual acuity and the improvement of visual acuity by the
appropriate corrective lenses. The subject has to describe the
change in visual acuity with the aid of test charts. Subjective
methods therefore require the subject to take an active part in
the refraction procedure. The most important aids apart from
the test charts are the trial frame with corrective lenses or the
phoropter.
PHYSIOLOGICAL OPTICS: Binocular vision 81

Binocular vision
Fusion and vergence

Binocular single vision Simultaneous vision means binocular vision with both eyes at
the same time. When in simultaneous vision the two monocular
impressions are fused to a single impression, binocular single
vision has been achieved. Fusion is the sum of all processes
which lead to binocular single vision as a result of the fusion
stimuli of the object. These processes occur largely involuntar-
ily (enforced fusion). A distinction is made between motor and
sensory fusion.
With the aid of the ocular muscles, motor fusion effects ver-
gence in order to align the eyes as exactly as possible with the
object of fixation.
Sensory fusion effects binocular single vision with the aid of
processes within the nervous system, even if minor disparaties
are present, i.e. even if the two related monocular images of the
two eyes are not exactly located on corresponding retinal
points.

Vergence Vergence is a movement of the fixation lines of the two eyes in

opposite directions (fixation line vergence) or of the retinal
meridians of the two eyes (cyclovergence):
The major types of vergence are:
1. convergence (positive horizontal vergence): inward move-
ment of the fixation lines.
2. divergence (negative horizontal vergence): outward move-
ment of the fixation lines.
3. positive (or negative) vertical vergence: the fixation line of
the right (or left) eye moves upwards relative to that of the
other eye.
Movements of the two eyes in the same direction (e.g. viewing
and peering movements) are known as versions.

Vergence positions The vergence position of a pair of eyes is determined by the

angle between the fixation lines of the two eyes (fixation line
vergence position) and by the angle between the vertical retinal
meridians of the two eyes (cyclovergence position).
The major vergence positions are:
1. convergence position K (positive horizontal vergence posi-
82 PHYSIOLOGICAL OPTICS: Binocular vision

tion): inward position of the fixation lines.

2. divergence position (negative horizontal vergence position):
outward position of the fixation lines.
3. positive (or negative) vertical vergence position: the fixation
line of the right (or left) eye lies above that of the other eye.
If the fixation lines of the two eyes intersect at the object point
observed and if the vertical meridians of the two eyes are
parallel to each other, the eyes are in the ortho position apper-
taining to this object distance. Binocular vision with bicentral
fixation is present in the ortho position. A vergence position
which requires the minimum possible effort - the (vergence)
rest position - exists for each accommodative adjustment of the
eyes to different distances. It is assumed that the eyes generally
assume this rest position in the absence of fusional stimuli. The
rest position for far point adjustment of accommodation is
known as the far point rest position. Different rest positions
may exist for different adaptation conditions of the eyes. The
brightness rest position in (photopic vision) is of particular
practical importance.
The vergence position required for vision with bicentral fixa-
tion can be changed by optical devices (e.g. prisms) (Fig. 73).
Adducent optical devices (e.g. base-out prisms, Fig. 73a)
change the vergence position necessary for vision with bicentral
fixation in the convergent direction, and abducent optical de-
vices (base-in prisms, Fig. 73b) in the divergent direction.
PHYSIOLOGICAL OPTICS: Binocular vision 83

Fusion ranges If the fusional ability of a pair of eyes is to be tested, a change in

the vergence position is forced by optical devices (e.g. prisms); a
constant accommodation stimulus and fusion stimuli are simul-
taneously provided by an object at an unchanged distance
which places high demands on visual acuity. The convergence
ability can be determined with base-out prisms, and the diver-
gence ability with base-in prisms (Fig. 73). With an increasing
change in the vergence position of the Fixation lines of the eyes
as a result of a gradual increase in power of the measuring
prism, the blur point is reached; this is the threshold value at
which the object seen in binocular single vision starts to become
blurred. This blurring occurs because the focusing refraction of
the eyes has changed due to coupling between vergence and
accommodation. When, with a further increase in the power of
the measuring prism and unchanged accommodation stimulus,
double vision starts to occur, the so-called break point (diplopia
point) is reached.
When the break point has been exceeded and the power of the
measuring prism is gradually decreased again, binocular single
vision is usually not immediately achieved at the break point
again, but slightly after it. This threshold value at which - with a
constant accommodation stimulus after the onset of diplopia -
binocular single vision is regained is termed as the recovery
point.
The relative convergence range and the relative divergence
range are calculated from the rest position of vergence to the
corresponding blur points, and the absolute ranges to the break
points. The horizontal fusion range comprises the convergence
range (positive part of the horizontal fusion range) and the
divergence range (negative part of the horizontal fusion range).
The vertical fusion range is determined in a similar way, and all
fusion ranges are given in the unit cm/m.
If the measurement is performed from the far point after
adjustment of accommodation, the absolute convergence range
is generally wider than the relative convergence range, while the
absolute divergence range is usually equal to the relative diver-
gence range (i.e. blur point and break point coincide), as
negative accommodation is barely possible by divergence
stimuli alone.
The fusion ranges vary considerably from subject to subject.
The convergence range is normally the widest range, and the
vertical fusion range the smallest.
The reserve convergence and the reserve divergence are
measured from the ortho position, a distinction being made
84 PHYSIOLOGICAL OPTICS: Binocular vision

here also between the relative and the absolute reserve. The sum
of reserve convergence and reserve divergence is always as
large as the sum of convergence and divergence ranges (Fig.
79).
The relative values therefore characterize the fusional vergence
range in which the fusional object can be seen (for a short time
at least) in binocular single vision and with sharp definition. The
absolute values also contain the range in which binocular single
vision is achieved, but where the fusional object appears un-
sharp due to the coupling between vergence and accommoda-
tion.

Vergence portions Binocular single vision requires a specific work position of

vergence, the ideal one being the ortho position. (In vision with
fixation disparity the work position deviates from the ortho
position, depending on the direction and size of the fixation
disparity.)
In the vergence necessary to achieve a work position a distinc-
tion is made between four different components:
1. tonic vergence,
2. accommodative horizontal vergence,
3. psychic (proximal) horizontal vergence and
4. fusional vergence.
All vergence components are given in cm/m.
The tonic vergence is the change in the vergence position
between the sleeping position of the eyes and the far point rest
position.
The accommodative horizontal vergence describes the change
in the rest position with respect to the far point rest position
when an accommodation stimulus is received, triggering an
inward movement of the eyes coupled with accommodation.
The degree of coupling between accommodation and the in-
ward movement of the eyes is described by the A C A gradient:

(70) A C A gradient = accommodative vergence

accommodation
The A C A gradient is given in the unit cm (cm/m per D). It can
be measured by changing the accommodation stimulus for both
eyes using optical devices in the absence of fusion stimuli and
with a constant object distance.
A psychic horizontal vergence is caused by the subject imagin-
ing nearness or distance; in this process the proximal conver-
gence constitutes an inward movement of the eyes triggered by
PHYSIOLOGICAL OPTICS: Binocular vision 85

the "awareness of nearness" in the case of near real objects

(apparatus convergence, instrument convergence).
The magnitude of the psychic horizontal vergence is rep-
resented together with the accommodative vergence by the
A C A quotient:
. _. accommodative + psychic vergence
(71) ACA-quotient - accommodation

The A C A quotient is given in the same unit as the gradient and

is larger than it. The A C A quotient can be measured by chang-
ing the accommodation stimulus by altering the object distance
in the absence of fusion stimuli.
By tonic, accommodative and psychic vergence the eyes
achieve the rest position of vergence appertaining to the respec-
tive object distance. If this rest position is still not a work
position, a further vergence is necessary to achieve binocular
single vision, this being termed fusional vergence. If the fixation
lines of the two eyes are brought from the rest position into the
ortho position (ideal work position) by fusional vergence, vision
with bicentral fixation is achieved and therefore also binocular
single vision which is ideal from the sensory viewpoint. If,
however, the fusional vergence is not sufficient for this, fixation
disparity occurs, ensuring normal binocular single vision; this
is, however, not ideal from the sensory viewpoint.
86 PHYSIOLOGICAL OPTICS: Binocular vision

Binocular space perception

Directional perception Binocular directional perception refers to the centre between

the two eyes (to the cyclopean eye). The straight line connecting
the object point fixated by the two eyes and the centre between
the optical centres of eyeball rotation is called the mid-line M L
of the eyes (line of gaze of the cyclopean eye). The vertical plane
through this mid-line when looking straight ahead is the median
plane of the pair of eyes.
The retinal points of the two eyes which in binocular vision
transmit identical spatial directional values irrespective of the
images lying on them are designated corresponding retinal
points. Retinal points of the two eyes which transmit different
directional values are termed as disparate retinal points. The
interaction of corresponding retinal points is called corre-
spondence. The correspondence centres are the retinal points
of the two eyes which provide the directional value "straight
ahead" in binocular vision. Ideally, the correspondence centres
lie in the centres of the foveae (bicentral correspondence).
If the two retinae are imagined as lying one behind the other in
such a way that the centres of the two foveae and the two
vertical meridians coincide, the coinciding retinal points are
called coincident points. In bifoveal correspondence these coin-
cident points are quasi-corresponding retinal points.
The retinal points of the two eyes on which any object point is
imaged at the same time are known as identical-image retinal
points.
The horopter is the space through the fixation point whose
points (in bicentral correspondence) are imaged on corre-
sponding retinal points of both eyes (see Fig. 75). Object points
not located on the horopter are imaged on disparate retinal
points. The distance of a disparate retinal point from the retinal
point corresponding to the identical-image point in the other
eye is known as disparity. Lateral disparity is the horizontal
component of a disparity with upright head posture; the compo-
nent perpendicular to this is called vertical disparity. The apper-
taining retinal points are known as laterally disparate and
vertically disparate retinal points.
All object points lying on the horopter provide orthopetal
fusional stimuli, i.e. fusional stimuli moving towards the ortho
position. Objects not located on the horopter cause orthofugal
fusional stimuli, i.e. fusional stimuli moving away from the
ortho position. A distinction is made in horizontal orthofugal
 PHYSIOLOGICAL OPTICS: Binocular vision 87

fusional stimuli between esopetal (moving inwards) fusional

stimuli (from objects in front of the horopter) and exopetal
(moving outwards) fusional stimuli (from objects behind the
horopter).
Every retinal point corresponding to a retinal point of the other
eye is surrounded by an area in which, in spite of disparity,
monocular visual impressions are fused, provided adequate
equality of the images exists. These small areas are called
Panum's fusional areas and have roughly the shape of a hori-
zontal ellipse. Depending on the measuring method used, dif-
ferent sizes are given for the central Panum's area in literature,
varying from a few minutes of arc to about one degree (node
point angle). Panum's areas increase in size towards the periph-
ery of the retina.
If the correspondence centres of the two eyes lie within the
central Panum's area, normal correspondence is present. If,
however, one correspondence centre lies outside the central
Panum's area, this is termed as anomalous or abnormal corre-
spondence which only occurs as the result of a heterotropia.

Stereovision In normal binocular vision differences in distance between

objects visible at the same time can only be perceived due to
differences in lateral retinal disparity. This laterally disparate
non-fixated object point
I depth perception is called stereovision (stereopsis). Differences
\ in vertical disparity do not permit space perception. The stereo
angle 0 serves as a measure of the magnitude of lateral disparity.
This stereo angle is the node point angle at which the stereo-
scopic parallax y appears. Fig. 74 illustrates this relationship
p

and shows that the size of the stereoscopic parallax of a point in

space not located on the horopter is dependent on the distance /
of the reference plane from the eyes.:

(72) 9 = &

When applied to stereoscopic image pairs, the stereoscopic

parallax is measured in the image plane (see Fig. 77).
With identical arrangement of real objects, the stereo angle is
larger, the greater the interpupillary distance p. If the distance
fovea fovea
A/ between the fixation object and the stereo object is small
compared with the distance / of the fixation object, the stereo
Fig. 74 angle is then:
Relationship between the stereo angle
9 and the stereoscopic parallax y
p
= P' A /

(K: nodal point) (73) 3 = 2

I
With identical real object depth, the greater stereo angle nor-
mally provides better binocular space perception.
Objects lying in front of the horopter are imaged with temporal
lateral disparity, and those behind it with nasal lateral disparity.
The object points imaged within Panum's areas form Panum's
fusional space. For object points outside Panum's fusional
space, a stereoscopic evaluation of the spatial position is
possible to a certain degree, although double vision is already
present. These areas are shown in Fig. 75.

Stereopsis can be improved through binocular telescopes, as

the stereo angle with the instrument is larger by the factor of the
telescopic magnification than the stereo angle with the naked
eye if the objective base is the same as the eyepiece base. A n
additional improvement of depth perception can be obtained if
the objective base is larger than the eyepiece base.
 PHYSIOLOGICAL OPTICS: Binocular vision 89

Depth of field The smallest stereo angle resulting in stereopsis is called the
threshold of stereopsis 0 and is about 10 sec of arc for photopic
g

vision. Its reciprocal is known as the depth of field (stereo

acuity). The smallest depth perceivable with this is called the
depth discrimination t and is dependent on the fixation distance
and the interpupillary distance. Differences in depth smaller
than t result in stereo angles smaller than 0 and cannot there-
g

fore be perceived stereoscopically.

The depth discrimination becomes increasingly larger, the
greater the fixation distance becomes; at distances over ap-
10-5
10- 3
10 proximately 600 m in particular, stereoscopic discrimination is
Luminance L
barely possible with the naked eye. Table 20 shows some
Fig. 76 theoretical figures for laterally disparate depth perception. One
Threshold of stereopsis 9 as a
g
of the factors on which the threshold of stereopsis depends is the
function of the luminance of the
object space
luminance of the object space, as is shown in Fig. 76.

Stereoscopy The production of a three-dimensional visual impression due to

differences in lateral disparity by presenting separate objects to
the two eyes is known as stereoscopy and is used to test
stereopsis.
The stereotest of the Zeiss Polatest vision-testing instrument
contains two test types arranged at the same height on both
sides of the binocularlyfixatedpoint O (as seen in the schematic
illustration in Fig. 77), but at a slightly different height from that
of the fixation point. The distance of the two test types from
each other constitutes the stereoscopic parallax y . Each of
P

these test types is imaged in one eye only. Depth perception is

induced by fusion of the test types imaged with lateral disparity
in a paracentral Panum's area. If the distance / (assumed
positive) of the object plane from the eyes is large enough, the
distance between the nodal points of the two eyes can be
assumed to be equal to the interpupillary distance p, and the
object depth AI to be perceived is

(74) A/= - ^ - ,
p ± y P

where the plus sign applies to the temporal lateral disparity of

the test type images, and the minus sign to nasal lateral disparity
(Fig. 77). As formula (74) shows, a pair of eyes with a larger
interpupillary distance p perceives the stereo object at a shorter
distance A/ from the fixation object than a pair of eyes with a
smaller interpupillary distance (due to the constant stereo-
scopic parallax in the test plane).
90 PHYSIOLOGICAL OPTICS: Binocular vision

Random dot stereoscopy has now attained special importance.

Here, the objects presented to the two eyes consist of random
dots containing a figure with a stereoscopic parallax (e.g. a hand
or a circle and rectangle, see Fig. 180). As there is no possibility
of recognizing the test type monocularly or binocularly without
stereopsis, a test of this type can be used to check pure laterally
disparate depth perception.

Fig. 77
Relationship between object
depth A/, the stereoscopic paral-
lax y , the distance a of the fixa-
p

tion point O from the eyes and

the interpupillary distance p with
lateral disparity of the test type:
a) temporal lateral disparity,
b) nasal lateral disparity
(K nodal point, F fovea, stereo
angles = 0 + 9R)
l

Stereo visual balance In German the degree to which each of the two eyes participates
in stereovision is termed "Valenz" (valence). If, in addition to
the fixation object, a stereo object is also located in the median
plane of the eyes (as in Fig. 77) and if it is localized binocularly
in the same (horizontal) direction as the fixation point, equi-
valence (isovalence) of the eyes is present. If, on the other hand,
one eye is dominant in stereo vision, the stereo object is per-
ceived laterally to the fixation point: a prevalence (aniso-
valence) of this eye is present. If, for example, the eye on the
right is prevalent, the stereo object appears to be shifted to the
left in temporal lateral disparity (Fig. 77a), and to the right in
nasal lateral disparity (Fig. 77b).
 PHYSIOLOGICAL OPTICS: Binocular vision 91

If equivalence is present for both directions of disparity, then

stereo visual balance is present. If deviations from this occur, a
suitable test (e.g. the stereo balance test in the Polatest vision
testing instrument, see Fig. 177d) can be used to provide a
rough quantitative estimate of the degree of prevalence of the
eye concerned.

Phoria and tropia

Orthophoria If the far point rest position of emmetropic or refractively fully

corrected eyes coincides with the parallel ortho position, dis-
tance orthophoria is present. The cooperation of the eyes is
ideal from the standpoint of their motor (and normally also
sensory) function if the vergence rest position and the ortho
position are identical in all visual directions irrespective of the
distance of the binocularly fixated object. In this case orthopho-
ria is achieved in the entire range of accommodation.
A positional error of the eyes consists in a deviation from the
ideal cooperation of the two eyes from the standpoint of their
motor function; the rest position of vergence does not then
coincide with the ortho position. A distinction is made here
between heterophoria (latent positional error) and heterotropia
(manifest positional error, strabismus, squinting). The term
orthotropia is used to describe the specific vergence behaviour
in which the two eyes always assume the ortho position; this can
be either orthophoria or a heterophoria which has been fully
motor-compensated.

Heterophoria Heterophoria is a positional error in which normal binocular

single vision is maintained due to the fusion stimuli present in
natural vision. The fusional vergence required to achieve the
ortho position is equal in amount to the heterophoria. If the rest
position deviates from the ortho position in an outward direc-
tion, exophoria then exists (fusional convergence requirement).
If the rest position deviates from the ortho position in an inward
direction, esophoria is present (fusional divergence require-
ment). In vertical phoria a vertical fusional vergence require-
ment exists. Horizontal and vertical heterophoria often appear
together. Moreover, the magnitude of the heterophoria may be
dependent on the visual direction and the object distance (ani-
sophoria).
92 PHYSIOLOGICAL OPTICS: Binocular vision

Cyclophoria is heterophoria in the sense of opposite rotations

of the vertical meridians of the two eyes about axes which
coincide approximately with the fixation lines.

Fixation disparity Fixation disparity is a phenomenon frequently found in hetero-

phoria, whereby normal (but no longer ideal) binocular single
vision is maintained when the work position of vergence does
not correspond precisely with the ortho position. In fixation
disparity the disparately imaged fixation point is seen in binocu-
lar single vision either due to the sensory fusional faculty in the
central Panum's fusional area (fixation disparity type I, dis-
parate fusion) or because of a reversible shift of the correspond-
ence centre within the central Panum's area (fixation disparity
type II, disparate correspondence). The central Panum's area
can also be extended in the direction defined by the heteropho-
ria (in esophoria therefore in the nasal direction, etc.).
A fixation disparity is not a strabismus, and suitable testing
equipment (e.g. the Zeiss Polatest) is required to distinguish
between two types of fixation disparity. Every fixation disparity
diminishes the quality of binocular vision, and has the conse-
quence that stereo visual balance is no longer possible.

Accommodation-vergence The individual values of horizontal vergences and their connec-

diagram tions with accommodation can be graphically illustrated in an
accommodation-vergence diagram (graphical analysis after
Hofstetter). As, however, the existence of fixation disparities is
neglected, diagrams of this type can only provide a rough idea
of real conditions.
The fixation lines of the two eyes are parallel in the ortho
position when the gaze is directed into the distance. For an
emmetropic eye with no positional errors this corresponds to
the zero point in the accommodation-vergence diagram, in
which the accommodation stimulus is plotted against the hori-
zontal vergence position of the two eyes (Fig. 78); positive
values of the horizontal vergence position mean convergence
position, negative values divergence position. The ortho posi-
tion for near objects is a convergence position and is dependent
on the object distance and the interpupillary distance. If the
interpupillary distance p is entered in cm and the inverse value
E of the object distance (assumed positive) from the line con-
necting the two optical centres of eyeball rotation in dioptres,
 PHYSIOLOGICAL OPTICS:
(D(2) D the required convergence position results in cm/m:
AV
V i i
< - 1 2 - 6 0 6 12 24 3600148
Horizontal vergence position
Fig. 78
Accommodation-vergence-dia-
gram
Donders' line for an interpupil-
lary distance of 60 mm,
(1) Phoria line for distance ortho-
phoria and increasing near exo-
phoria for decreasing object
distance (e. g. 6 cm/m for
E = 3 D),
(2) Phoria line for distance esopho-
ria (9 cm/m), decreasing eso-
phoria for decreasing object dis-
tance, orthophoria for E = 3 D
and increasing exophoria for
further decreasing object dis-
tance,
(3) Phoria line for distance-inde-
pendent esophoria (15 cm/m)
PD
A C -
*AS
x
f i / 1
- 1 2 - 6 0 6 12 24 36cm48
Horizontal vergence position
Fig. 79
Accommodation-vergence-diagram
O Donders'line for an interpupil-
lary distance of 60 mm
P Phoria line for distance-inde-
pendent exophoria (3 cm/m)
AF ax Maximum accommodative
m
effort
Binocular vision 93
(3|
(75) K = p E.
Table 21 shows a list of values using (75). These ortho positions
are represented by Donder's line in the accommodation-ver-
gence diagram (Fig. 78).
The horizontal phoria measured for each accommodation
m
stimulus (object distance) is entered from Donder's line and
gives the appertaining rest position of vergence. (Vertical pho-
rias cannot be included in this diagram; they should already be
prismatically corrected prior to measurement of the horizontal
values.) The line connecting the rest positions is known as the
phoria line and is usually a straight line. If orthophoria is
present in the entire accommodation range, the phoria line and
Donder's line coincide. In exophoria the phoria line lies to the
left of Donder's line, and in esophoria to its right. If the phoria
line runs parallel to Donder's line, this is a heterophoria which is
independent of the object distance; the A C A quotient is then (as
in orthophoria) equal to the interpupillary distance given in cm.
Fig. 78 shows three examples.
The divergence and convergence ranges (with a constant ac-
commodation stimulus!) are entered in the accommodation-
vergence diagram from the corresponding rest positions (pho-
ria line). The range in which clear binocular single vision is
possible for a short time at least lies within the relative fusion
ranges. With increasing accommodation stimuli, this range is
limited by the maximum accommodative effort A F m a x(shaded
grey in Fig. 79).
/
The reserve divergence and convergence result from the distan-
ces between the respective ortho position (Donder's line) and
the lateral limits of the fusion range. In the example used in Fig.
79 one part (3 cm/m) of the distance-independent relative
convergence range (15 cm/m) is constantly required for fu-
i
sional compensation of exophoria (3 cm/m); the remaining part
m
(12 cm/m) constitutes the reserve convergence. The reserve
divergence (8 cm/m) is larger by the amount of the heterophoria
(3 cm/m) than the distance-independent relative divergence
range (5 cm/m).
94 PHYSIOLOGICAL OPTICS: Binocular vision

Heterotropia In heterotropia (strabismus) the fixation line of one of the two

eyes deviates from the ortho position defined by the respective
object distance - despite the presence of fusional stimuli - to such
an extent that the image of the fixation point lies outside the
central Panum's area in the deviating eye. This means that
normal binocular single vision is no longer possible.
The squint angle is the deviation of the fixation line vergence
position of the squinting pair of eyes from the ortho position for
the object distance concerned. If the deviating eye takes part in
all viewing movements of the fixating eye in such a way that the
squint angle always remains constant, concomitant strabismus
(strabismus concomitans) is present. If the two eyes have ap-
proximately the same acuity, they normally deviate in alterna-
tion from the fixation direction, and alternating strabismus is
present. If the same eye always deviates from the fixation
direction, unilateral strabismus is present. Paralytic strabismus
(strabismus paralyticus), in which the squint angle changes with
the direction of gaze, is caused by paralysis of ocular muscles.
Strabismus causes double vision unless the visual impression of
the squinting eye is suppressed or if binocular single vision is
achieved by abnormal retinal correspondence. A microstrabis-
mus is an irreversible form of a monolateral strabismus caused
by sensory factors with a squint angle smaller than 5°.

Anisometropia and aniseikonia

Anisometropia If the two eyes have different far point refractions, anisometro-
pia exists. The difference in vertex power of the two best
spherical correction lenses is called the anisometropic dif-
ference A F' :v

(76) A F ' = F' - F' ,

V v2 vl

where F' is the mathematically larger back vertex power. A F y

v2

is therefore always positive.

In axial anisometropia both eyes have the same refractive
power, but different lengths; in refractive anisometropia the
lengths of the two eyes are equal, but the refractive powers are
different.
Viewing movements of an anisometropic eye behind fully cor-
recting spectacle lenses require different fusional vergences
depending on the fixation direction, this being due to the
PHYSIOLOGICAL OPTICS: Binocular vision 95

different binocular prismatic powers* in the respective visual

points of the lenses. This heterophoria, which alters when the
visual direction changes, increases as the anisometropic dif-
ference becomes larger and may lead to difficulties in vision.
Special attention must be paid to anisometropia in the fitting of
ophthalmic lenses.

* Note: The "binocular prismatic power" is the geometric

difference between the prismatic powers in the visual points of
the two lenses.

Aniseikonia If the size or shape of an object is perceived differently by the

two eyes, aniseikonia exists. Aniseikonia thus means a dif-
ference in size or shape between the two monocular visual
impressions. This difference is not necessarily due to different
retinal images. Aniseikonia can be caused by anatomical, func-
tional (sensory) or geometric-optical factors.
In aniseikonia of anatomical (retinal) origin the visual elements
of the two retinae are differently structured, with the result that
the two eyes obtain different perceptions despite identical far
point refractions (isometropia) and identical retinal images.
Functional aniseikonia is caused by the central nervous system
and can be produced by, for example, fixation disparity. Optical
aniseikonia is due to different retinal images in the two eyes.
Different sizes of images on the retinas of the two eyes may be
caused by:
1. different overall lengths of the two eyes despite isometropia;
2. different magnifications through fully correcting spectacle
lenses in the case of anisometropia;
3. aphakia of one of the two eyes;
4. different distances of a near object from the two eyes as a
result of oblique fixation of the object.
96 PHYSIOLOGICAL OPTICS:
Binocular correction of the eye
Full prismatic correction
Methods
Binocular vision
A prerequisite for testing binocular vision is a monocular test
and full refractive correction of both eyes. Heterophoriae are
measured by subjective methods and are compensated optically
by prismatic lenses. Full prismatic correction of heterophoria
covers both the motor compensation component and any fixa-
tion disparity which may be present. While full refractive cor-
rection provides emmetropia cc (the far point cc lies at infinity),
full prismatic correction produces orthophoria cc (the ortho
position cc is identical to the rest position of the eyes).
Different principles are applied in heterophoria tests in order to
eliminate fusion stimuli (to a large extent):
1. distortion method (after Maddox),
2. displacement method (after von Graefe),
3. anaglyphic method,
4. separation method.
In the distortion method after Maddox the retinal image of one
eye is changed (distorted) by an optical device (e.g. very strong
piano cylinder lenses) in such a way that no fusion stimuli exist.
In the displacement method the absolute vertical fusion range is
exceeded for horizontal phoria testing (or the absolute diver-
gence range for vertical phoria testing) with the use of prisms in
such a way that fusion is rendered impossible. The displacement
(the generation of vertically or horizontally displaced double
images) can be performed with the aid of prisms in the case of
one test object or by the polarization separation of two identical
polarizing test objects.
In the anaglyphic method differently coloured visual impres-
sions are presented to the two eyes with the aid of colour filters,
this causing a marked reduction in fusion stimuli. Moreover,
differently shaped test types are normally used for the two eyes.
In the separation method the two eyes are presented with test
types which are different in shape but identical in brightness,
colour, contrast and size. Image separation is performed by
stops or screens (geometrical separation) or by the use of
polarizing light (physical separation, e.g. in the Zeiss Pokitest
instrument). Here, fusion stimuli are not fully eliminated, as the
field surrounding the test types is perceived binocularly (periph-
eral fusion stimulus).
PHYSIOLOGICAL OPTICS: Binocular vision 97

Focusing balance Binocular testing of vision is indispensable and just as import-

ant as monocular vision testing; only when both have been
performed is a vision test complete. Here, a distinction is made
between various conditions of balance which are generally
achieved by the appropriate means of correction.
For distance vision, the aim is accommodation balance at least.
To achieve this, the two eyes must be corrected with the best
spherical lens in each case. Refractive balance should, however,
also be present wherever possible. This means that the best
possible visual acuity must be present in both eyes (full refrac-
tive correction).
In order to obtain muscle balance, a distant object must nor-
mally be imaged in the centre of the fovea of both eyes when
they are in their vergence rest position for distance vision (full
prismatic correction).
When refraction balance and muscle balance have been
achieved by full refractive and prismatic correction, focusing
balance has been obtained for the two eyes.