Physiology of eye

Name- Ayesha khatun

15 A, 4th yr
Ma‘am – gaiypova ma’am
vascular tract
Vision – complex process, consists of
visual acuity, peripheral vision, visual field,
contrast sensitivity, dark adaptation.

We distinguish central and peripheral

vision. Central vision includes VA and color
vision, peripheral vision – VF and dark
adaptation.
VISUAL ACUITY…?
Resolving power of the eye or
the ability to see two separate
objects as separate.
Visual Acuity (VA)- is ability of eye to
discriminate two points with minimal
distance between them.

Two objects are so close that two

adjacent cones are stimulated, between
them is located one unstimulated cone.
Visual Angle…
The angle subtended at the nodal point
of the eye by the physical dimensions of
an object in the visual field.
Theories of visual acuity…
Receptor theory:
If the images fell on two cones
separated by an unilluminated cone, then
the points of light would be perceived as
two distinct sources.

Means that two distinct points only can

be recognized as separate when they
subtend an angle of 1’ of arc.
3 types of Cone:
1. Green- Chlorolabe
2. Red- Erythrolabe
3. Blue- Cyanolabe

Diameter of each cone : 0.002µm

Rayleigh Criterion for resolution
Two “point” (unresolved) sources are resolved
from each other when separated by at least
the radius of the airy disk.

The central disk is surrounded by less intense

concentric rings. (airy disk)
Types of Visual Acuity
Minimum Detectable ( visible)

Minimum Separable (resolution)

Minimum cognizable (recognition)

Minimum Discriminable ( hyperacuity)

 ACUITY TASKS
MINIMUM DETECTABLE:
Ability to determine whether or not an object is
present in a visual field.
The limit for this kind of acuity is ~ 1 arc second.
Minimum Separable (resolution)
Discrimination of 2 spatially separated targets.
Normal angular threshold of discrimination
for resolution 30-60 seconds of an arc.
(minimum angle of resolution).
MINIMUM COGNIZIABLE: not only discrimination
of the spatial characteristics of the test pattern but
also the pattern with which he has previous
experience
(Identification of faces, letters, symbols, pictures etc.)
Minimum Discriminable
Ability to determine whether or not two
parallel and straight lines are aligned in the
frontal plane.
CLINICAL MEASUREMENT OF
VISUAL ACUITY
 Criteria:
Normal testing distance (distance VA): 6m
For near : 33cm/ 40cm.
Illuminated visual acuity chart.
Proper room illumination.
 Steps:
 Unaided VA
Aided VA
Pinhole VA
6m distance
Visual acuity (VA) is acuteness or
clearness of vision, especially form
vision, which is dependent on the
sharpness of the retinal focus within
the eye, the sensitivity of the nervous
elements, and the interpretative
faculty of the brain.
 VA – is angular measurement relating testing
distance to the minimal object size resolvable
at the distance.
1862 Hermann Snellen published his
famous letter chart with special targets -
optotypes.

Snellen defined “standard vision” as the

ability to recognize one of his optotypes
when it subtended 5 minutes of arc, thus
the optotype can only be recognized if the
person viewing it can discriminate a
spatial pattern separated by a visual angle
of 1 minute of arc.
1923 Soviet ophthalmologists Sergei Golovin and D. A.
Sivtsev developed the table for testing VA, that was used
in the USSR. It consisted of two parts, ten rows each,
both parts with visual acuity values incrementing by 0.1
from row to row. The left part contained Cyrillic letters
Ш, Б, М, Н, К, Ы, И in a definite order, with width of
each character equal to its height, and the size of a first
row character being 70mm, in the second row it was
35mm, and in the last row - 7mm. Right part of the table
contained Landolt C symbols. The distance was set to be
5 meters. This table is called Golovin-Sivtsev Table
Factors determined VA
Light travels from the fixation object to the fovea
through an imaginary path called the visual axis.

The eye's tissues and structures affect the quality of

the image are: tear film, cornea, anterior chamber,
pupil, lens, vitreous, and finally the retina.

 The posterior part of the retina, called the retinal

pigment epithelium (RPE) is responsible for, among
many other things, absorbing light that crosses the
retina so it cannot bounce to other parts of the retina.
Size of the pupil

Normal function of ON

The visual cortex is the part of the cerebral

cortex in the posterior (occipital) part of the
brain responsible for processing visual stimuli
Foot Metre Decimal LogMAR
20/200 6/60 0.10 1.00
20/160 6/48 0.13 0.90
20/120 6/36 0.17 0.78
20/100 6/30 0.20 0.70
20/80 6/24 0.25 0.60
20/60 6/18 0.33 0.48
20/50 6/15 0.40 0.40
20/40 6/12 0.50 0.30
20/30 6/9 0.63 0.18
20/25 6/7.5 0.80 0.10
20/20 6/6 1.00 0.00
If VA less than O,1 we use Snellens
formula to account VA

VA=d/D
d- distance from patient can read first
line
D- distance from patient must read first
line of chart
Formula

Testing distance
VA=
distance at which letter subtends 5min of arc
Name Abbreviation Definition
Counting CF Ability to count fingers
Fingers at a given distance.
Hand HM Ability to distinguish a
Motion hand if it is moving or
not in front of the
patient's face.
Light LP Ability to distinguish if
Perception the eye can perceive
any light.
No Light NLP Inability to see any
Perception light. Total blindness.
 Place the chart at 20 feet (or 6 meters).
 If the patient uses glasses, using them.
 Place the occluder in front of the eye that is not
being evaluated.
 Start first with the big optotypes and proceed to the
smaller ones.
 If the measurement is reduced (below 20/20) then
the test using a pinhole should be done
 Change the occluder to the other eye and proceed
again from the 4th step.
 After both eyes have been evaluated in distant
visual acuity, proceed to evaluate near visual acuity
placing a modifid snellen chart for near vision at
15.7 inches (or 40 centimeters). Then repeat the test
from the 2nd step.
 Factors affecting visual acuity
Overall
Illumination of test object.
Contrast of letters.
Pupil size
Cognitive ability
Ocular health
Refractive Status
 Physical factor

Those which influence the light

characteristics of the distribution &
hence influence the nature of retinal
image.
Physiological factor
Stimulus related
Luminance of test object
Geometrical configuration
Contrast difference of stimulus from
background
Influence of wavelength
Exposure duration of stimulus
Interaction effects of 2 targets
Observer related
Retinal locus of stimulation
Pupil size
Accommodation
Effect of eye movement
Optical elements of eye
Development of aspects
Distance Acuity chart
Snellen’s distance acuity chart

Bailey-Lovie charts

Landolt ring (or C) chart

Feinbloom Distance Test Chart

 Chronister Pocket Acuity Chart

 NEAR ACUITY CHARTS
Single letter chart
Reduced Snellen’s chart:
lighthouse near visual acuity test
Designs for Vision Number chart
Reduced Ferris-Bailey ETDRS Chart
Word & Continuous Text charts
Jaeger’s chart
Roman test types
Lighthouse game card
Lighthouse continuous text card for
adults
MNREAD card
Optotypes
Landolt Rings (Landolt ‘C’)
Numbers
Figures
Tumbling E
Letters (snellen)
Distance test charts & Acuity
 Basics of snellen acuity chart…
Snellen Fraction is the most common notation of acuity.
The distant acuity is usually tested by snellen chart.
Consist of a series of black capital letters on a white
board,arranged in lines,each progressively diminishing
in size.
Each letters fits in a square.
Assume 5x5 grid for letters with detail separation of
1/5 of letter size.
..
…
The number used to indicate the “size” of the
letter is the distance at which the letter height
subtends 5 min of arc.
A “6 meter letter” is one that subtends 5
min of arc at 6 m.
A “12 meter letter” is one that subtends 5
min of arc at 12 m.
A “30 meter letter’ is one that subtends 5
min of arc at 30 m.
Snellen chart…6/60, 6/36, 6/24, 6/18, 6/12, 6/9, 6/6

tan θ = h / d

θ
d
Position/LIMITATION OF V/A
Standard visual acuity depends on two limitation .
1.Anatomical
 two cones stimulate but one cone
separated by one minute of arc angle
 two separate object as separate

2.Optical
 Airy disc form by diffraction
 Diffraction form in smaller in size of pupil
 Aberration
Visual field- VF
The term visual field is sometimes used
as a synonym to field of view
 Field of view is everything that (at a
given time) causes light to fall onto the
retina. This input is processed by the
visual system, which computes the visual
field as the output.
VF – is a space which we can see without
movement eyes and head
Normal limits
The normal human visual field extends
to approximately 60 degrees nasally
(toward the nose, or inward) in each
eye, to 90 degrees temporally (away
from the nose, or outwards), and
approximately 60 degrees above and 75
below the horizontal meridian.
 Measuring the visual field

Confrontation test
Perimetry
Spheroperimetry
Kinetic Perimetry
Static perimetry
Automated perimetry
Lesions along the visual pathway
a lesion may arise at different points along the visual
pathway
gives rise to different types of visual field defects
known as hemianopia (half blindness)

perimetry is a test which can detect visual field defects

Left Right

normal visual fields

left eye blindness

bitemporal hemianopia

right homonymous hemianopia

right homonymous hemianopia

Abnormalities of VF
Scotoma – physiologic and
pathologic Blind spot (Mariotte
spot), angioscotomas – physiologic
scotoma
Pathologic- central, periphery,
relative, absolute, positive, negative
Constriction of VF
Hemianopsia – homonymic,
Paris as seen with full visual fields
Paris as seen with bitemporal hemianopsia
Paris as seen with binasal hemianopsia
Paris as seen with left homonymous hemianopsia
Paris as seen with right homonymous
hemianopsia
References…..
THEORY AND PRACTICE OF OPTICS &
REFRACTION…A.K.KHURANA

CLINICAL PROCEDURE OF OPTOMETRY

INTERNET