LOW VISION MAGNIFICATION SYSTEM

Khaled Al Raquib
Student, Final Year
B.Sc in Optometry &
Vision Science
ICO, CU
 INTRODUCTION

 Basic property of magnification is ratio.

 Ratio of image size to object size.

Image size Object vergence Image distance

M= = =
Object size Image vergence Object distance
RETINAL IMAGE MAGNIFICATION (RIM)

 Neither absolute retinal image size nor magnification

produced by eye is important in low vision.

 Change in retinal image size is more important.

 Magnified retinal image size

RIM=
Original retinal image size

 No use of magnification without its focus on retina.

 COMPONENTS OF RIM
RIM=RSM x RDM x LVM

RIM = Retinal image magnification

RSM = Relative size magnification
RDM = Relative distance magnification
LVM = Lens vertex magnification

All produce angular magnification.

RSM & RDM : Achieved without use of lens.

LVM : Achieved by use of lens.
 CLASSIFICATION
1.Specifically prescribed for low vision patients
RDM
RSM
LVM

2.By product
LVM

Optically LVM & SM are the same quantity.

 MAGNIFICATION IN LOW VISION

• Relative size magnification (RSM)

• Relative distance magnification (RDM)
• Lens vertex magnification (LVM)
• Angular magnification (AM)
• Projection magnification
• Iso-accommodative magnification (Conventional Power)
• Effective Magnification/ Relative magnification
• Magnification in term of Equivalent viewing power (EVP)
 RELATIVE SIZE MAGNIFICATION

h1 

h2
'

' tan ' h2

RSM = = tan  = h
 1

Relationship:
Direct relationship between object size & retinal image.
 RELATIVE SIZE MAGNIFICATION

Large Print Cards Large Print Calculator

• Eg: large print books and cheque
• larger television sets or computer terminals
• CCTV
 RELATIVE DISTANCE/APPROACH
MAGNIFICATION

Results in an increase in the angular subtended of the

object at the entrance pupil of the eye.

h
 E

l1

h
'
E
l2
RDM =
' = tan ' = l1
 tan  l2
 RDM CONTD….

 Either plus power / accommodation is needed to maintain

clear focus.

Relationship:
Indirect relationship between object size & retinal image.
M = 1X @ 40 cm
M = 2X @ 20 cm
M = 4X @ 10 cm
M = 8X @ 5 cm
Distance of object (cm) Magnification Lens needed (D)
40 1X 2.50
20 2X 5.00
10 4X 10.00
5 8X 20.00
4 10X 25.00
2 20X 50.00

Distance of object (cm) Magnification Lens needed (D)

25 1X 4
12.50 2X 8

6.25 4X 16

5.00 5X 20
`
4.25 6X 24

2.50 10X 40
RDM CONTD..
 ANGULAR MAGNIFICATION

 Produced by an increase in the angular subtended of

the object being viewed.

 Actual object size or object distance is not changed.

 M = /’
 AM CONTD…

Angle subtended by image viewed with aided

M=
Angle subtended by object viewed directly

 AM compares apparent increase in size of object seen

through optical system with size of object seen
through without optical system.
 PERCEIVED/ APPARENT
MAGNIFICATION

 Ratio between the angle subtended by the image at

entrance pupil of eye to the angle subtended by the
object without magnifier.

 Essentially angular magnification

 PROJECTION MAGNIFICATION

 Results from the formation of enlarged image of an

object on screen.

 Special form of RSM.

 May be used in the combination with RDM

 Eg. : CCTV
PROJECTION MAGNIFICATION
PROJECTION MAGNIFICATION

CCTV connected to a computer

 PROJECTION MAGNIFICATION

Max Port Magnifier with eyeglasses as display unit Flipper Port Magnifier for distant viewing
 LENS VERTEX MAGNIFICATION (LVM)
 Object is kept at the same place & lies in the same
focal length, a larger retinal image is formed.

 RDM & RSM are unity

Image size with aided eye

LVM = Image size with unaided eye

1-dU
LVM =
1-dV
 CLINICAL APPLICATION

 RIM=RSM x RDM x LVM

 RDM & LVM Combined

 RDM & LVM COMBINED
 RIM = Ur 1-dU
Ueye 1-dU

RIM = RDM LVM

Product formula

Most common method of providing magnification at near.

Case I
Magnifier held at spectacle plane
RIM value comes from LVM only
Clinically insignificant for low vision

Case II
Magnifier held close to eye (d= approx 0 )
LVM= 1
No benefit of magnification from presence of
lens
Specification of magnification Examples

Relative Size Magnification Larger print material, Print of 2M

instead of 1M

Relative Distance Magnification Spectacle Magnifier, Hand held

magnifier, Stand magnifier

Angular Magnification Telescope, microscopes, Hand held

magnifier, Stand magnifier

Projection magnification CCTV, Microcomputer screen

 MAGNIFICATION IN TERM OF EQUIVALENT VIEWING
POWER (EVP)

 RIM = - Ur x De

De = D1 + D2 – dD1 D2
(Gaussian equivalent formula)
 CALCULATION OF EQUIVALENT POWER

A low vision patient using +2.50 D bifocal & 10.00 D HHM

to read newspaper.

Case I:HHM held at spectacle plane

De = D1 + D2 – dD1 D2
= 10+ 2.50 – 0x10x2.50

= 12.50 D
Case II: HHM held at 5cm spectacle plane
De = D1 + D2 – dD1 D2
De = 10+ 2.50 – 0.05x10x2.50
= 11.50 DS

Case III: HHM held at 10cm spectacle plane.

De = D1 + D2 – dD1 D2
De = 10+ 2.50 – 0.10x10x2.50
= 10.00 DS
 EFFECTIVE/ RELATIVE
MAGNIFICATION (D/4)
 Unaided reading distance is 25 cm
 Object is held at one focal length

 Image is formed at infinity

 RM = angle subtended at eye by image produced by lens

angle subtended at unaided eye by object at LDDV

= ' / 25

= D/4
 Eg: if reading distance is 25 cm is used with magnifier
of 10.00 D
RIM = - Ur x De
= -(-0.25) x 10
= 2.5 X
Alt:
D/4
=10/4
=2.5 X
ISO-ACCOMMODATIVE MAGNIFICATION (CONVENTIONAL
POWER)
(D/4+1 )
 Unaided reading distance is 25 cm
 Magnifier is placed very close to eye (d=0 )

 Image produced is also at 25 cm

 M iso-acc = 1 + (D/ 4)
 Eg: if reading distance is 25 cm is used with magnifier
of 10.00 D

For: Effective magnification

De = D1 + D2 – dD1 D2
De = 10+4 – 0.1x10 x 4
= 10
RIM = 0.25 x 10
= 2.5 X
 For iso-accommodative magnification d = 0
De = D1 + D2 – dD1 D2
De = 10+ 4 -0
= 14
RIM = - Ur x De
RIM = 0.25 x 14
= 3.5
Alt:
(D/4)+1
= 10/4 +1
= 3.5 X
 METHODS TO DETERMINE MAGNIFICATION
1. Lebenson’s Method of reciprocal vision

2. Kestenbaum’s Method

3. Ratio between Best near VA to target VA

4. Reading power needed to read 1 M print

5. Ian Bailey method:

Equivalent Viewing Power(EVP)
 LEBENSON’S METHOD OF RECIPROCAL VISION

 M = ratio of denominator of distance Snellen fraction

to denominator of near Snellen fraction of target
acuity

 Eg:
 BDA = 20/400
 TNA = 20/50 (1M)
 M = 400/50 = 8X
 KESTENBAUM’S METHOD

 Required Dioptric power of add =

Reciprocal of best corrected distance acuity

 E.g.:

If BCDA = 20/160
Power of add = 160/20 = + 8.0Ds
 RATIO BETWEEN BEST NEAR VA TO
TARGET VA

Patient BNA at testing distance (TD) is recorded in M

notation

Target near acuity (TNA) is determine, let “X” be new

reading distance

BNA/ TNA = TD/ X

X = TNA/BNA x TD

Power required = 1/X in m

 RATIO BETWEEN BEST NEAR VA TO
TARGET VA: EXAMPLE
 BNA = 4M at 0.4 m
 TNA = 1M
 X=?

X = TNA/ BNA x TD
= ¼ x 40 = 10 cm

Power required (D) = 100/X = 100/10 = +10 Ds

Patient need to hold the reading material at 10 cm with + 10 Ds

magnifier
READING POWER NEEDED TO READ1 M PRINT

 Measure BNA at 40 cm (16 inches)

 Theoretical add power to read 1M print

= Multiply BNA value by 2.50 Ds

 Eg:
 If4 M is read at 40 cm
 Add power = 2.50 x 4 = + 10.00 Ds
 EQUIVALENT VIEWING POWER(EVP)
 Defn:
 Itis the distance at which the object itself would subtend an
angle that is equal to the angle that is being subtended by the
image.
 Actual working distance from the spectacle plane
 EQUIVALENT VIEWING POWER(EVP)
EVP = X D of a lens system
Provides the same resolution as if the naked eye were viewing
the object at ‘x’ m away without magnifier.
Where, X = 1/x
CALCULATION OF EVD FOR THE PATIENT

 EVD = Eye to Image distance \ Enlargement ratio

 Eye to image distance = Viewing distance

 Enlargement ratio (ER) = Best near Acuity (BNA)

Target near Acuity (TNA)

 Equivalent viewing power = 1/ EVD (m)

 A patient is 80 yrs has BNA of 4 M at 25 cm and his
TNA is 1 M
ER= 4M/1M
=4

EVD= 25/4
6.25

EVP =1/6.25 X100

16D
GIVE THE SIGHT OF NATURE