OCULAR REFRACTION

AND ACCOMODATION
▶ The correct interpretation of visual information
depends on the eye’s ability to focus incoming
rays of light on retina
TERMINOLOGY

Refraction - the deviation of light in passing obliquely from one

medium to another of different density
ocular refraction the refraction of light produced by the media of the
normal eye and resulting in the focusing of images upon the retina.
static refraction refraction of the eye when its accommodation is
paralyzed.
cycloplegic refraction a type of static REFRACTION, measured after
lens ACCOMMODATION is paralyzed by administration of 
CYCLOPLEGIC eye drops.
dynamic refraction refraction of the eye during accommodation.
one diopter ( measure of lens refractive power ) is the power of lens
the focus distance of which is one meter
TYPES OF CLINICAL REFRACTION

Emmetropy
Ametropy ( refractive error):
Myopia
Hyperopia
Astigmatism
• Emmetropy

• Ametropy

Hyperopia
Myopia

Astigmatism
MYOPIA When a parallel light of rays coming from infinity are
focused in front of the retina due to the mismatch between
the axial length of the eye and refractive power of the eye is
known myopia

It is also known as nearsightedness

 MYOPIA
• If the eye is longer than average, the error is called axial myopia ( for
additional millimeter of axial length the eye is app 3 Diopters more
myopic).
• If the refractive elements are more refractive than average , the error is
called curvature or refractive myopia.
• As the object is brought closer than 6 m, the image moves closer to the
retina and comes into sharper focus. ( the point reached where the
image is the most sharply focused on retina is called far point).
• The myopic person has advantage of being able to read without glasses
in the ages of presbyopia.
• Concave spherical lenses ( minus) are used to correct myopia
 CORRECTION OF MYOPIA

Myopia is corrected by
- eyeglasses – concave
- Contact lenses
- Surgical
Hyperopia or Farsightedness
Hyperopia or Farsightedness
Hyperopia or Farsightedness
Correction of Hyperopia
 HYPEROPIA
When a parallel rays of light coming form infinity are focused behind the retina duse to the
abnormalty between the refractive power of the eye and the axial length of the eye is know
as hyperopia

It is also known as farsightedness or hypermetropia

Three diopters of hyperopia may be tolerated in teenagers, but will require glasses later

The hyperopia that can’t be corrected by accommodation is termed manifest hyperopia.

This is one of te cause of ambiopia and esotropia
The degree of hyperopia overcome by accommocation is known as latent hyperopia ( it is
detected after cycloplegia)
Hyperopes require glasses for far and near vision. It can corrected by convex lenses.
 ASTIGMATISM

In astigmatism refraction varies in different meridians and the image has

multiple focal points or lines on retina

Types of Astigmatism
Regular astigmatism- refractive power
changes uniformly from one meridian to
next
Irregular astisgmatism – irregular change of refractive power
in different meridian ( multiple meridians are present)
ASTIGMATISM
 BASED ON THE REFRACTIVE
TYPE

Regular astigmatism

Simple Mixed Compound

Myipic Hyperopic Myopic Hyperopic

ACCOMODATION
PRESBYOPIA

▶ The loss of accommodation that comes with age is called presbyopia

▶ Hardening/reduced deformability of the lens results in decreased
accommodative ability.
▶ Near objects cannot be focused onto retina ( focus is behind retina as in
hyperopia)
▶ It starts at about age 44-46 and stibilizes at age 55-60.
▶ Emmetrops require reading glasses ( convex lenses).
▶ Myopes ( -2. 5 -3.0 D)doesn’t require reading glasses.
Aphakia
METHODS OF CORRECTION

▶ Lenses
▶ Contact lenses
▶ Surgery – Keratorefractive surgery
IOL implantation
LENSES
CONTACT LENSES
 KERATOREFRACTIVE SURGERY

▶ Radial Keratotomy

▶ LASIK
▶ PRK
▶ LASEK