Ophthalmic

Ophthalmic laser interferometry

laser interferometry
Fercher and
A.F. Fercher
A.F. Roth
E. Roth
and E.
University of Essen; P.O.
of Essen; 103764,D D-4300
Box 103764,
P.O. Box -4300 Essen, West-Germany
Essen, West -Germany

Abstract
the pupil
If the
If the eye is
of the
pupil of illuminated by
is illuminated collimated laser
by aa collimated the light
beam the
laser beam returning from
light returning the eye
from the exhibits
eye exhibits
Newton's interference
Newton's fringes. This
interference fringes. phenomenon can
This phenomenon be used
can be to measure
(1) to
used (1) fundus tissue
measure fundus pulsations and
tissue pulsations (2)
and (2)
measure the
to measure
to optical length
the optical of the
length of eye. AA first
the eye. of clinical
series of
first series measurements of
clinical measurements patients with
of patients angio-
with angio-
logical problems
logical has shown
problems has correlation of
clear correlation
shown aa clear the interferometrically
of the measured fundus
interferometrically measured with
pulsations with
fundus pulsations
circulation conditions.
circulation measurements of
conditions. First measurements the optical
of the length of
optical length human eyes
of human eyes indicate high potent-
very high
indicate aa very potent-
ial precision
ial of this
precision of technique.
new technique.
this new
Introduction
Introduction

The object of
The object of this contribution is
this contribution is to present two
to present two interferometric applicable to
techniques applicable
interferometric techniques ophthalmic
to ophthalmic
problems and
problems describe first
to describe
and to results obtained
first results healthy and
with healthy
obtained with sick subjects.
and sick subjects. In In the past interferometric
the past interferometric
techniques have already been
techniques have used in
been used ophthalmology. F.W.
in ophthalmology. Campbell and
F.W. Campbell D.G. Greens
and D.G. introduced two
Green 1 introduced two-beam laser
-beam laser
interferences for
interferences for measuring the the visual of cataract
acuity of
visual acuity patients. This
cataract patients. technique has
This technique developed toto aa
been developed
has been
clinical routine
clinical method. 2 It
routine method.2 relies on
It relies on the that two
fact that
the fact beams of
narrow beams
two narrow light can
of light penetrate even
can penetrate even aa
cataract eye
cataract eye and can create
and can patterns on
interference patterns
create interference on the patient's retina
the patient's independently of
retina independently optics of
the optics
of the of
eye. Another interferometric
the eye.
the technique has
interferometric technique used by
been used
has been by D.G. Green et
D.G. Green al. for
et al. measuring corneal
for measuring thick-
corneal thick-
in frog
ness in
ness and human
frog and corneas. 3 The
human corneas.3 The anterior surface of
anterior surface cornea is
the cornea
of the placed atat the
is placed focus ofof aa laser
the focus beam
laser beam
thickness is
the thickness
and the
and calculated from
is calculated from the between the
spacing between
the spacing the interference generated by
fringes generated
interference fringes by the light
the light
reflected from the anterior air epithelial and
air -- epithelial posterior endothelial
and posterior interface. This
aqueous interface.
endothelial -- aqueous technique,
This technique,
however, not offer
does not
however, does offer substantial advantages as
substantial advantages compared to
as compared to visual methods that
visual methods use direct
that use observation of
direct observation of
reflections from
reflections the corneal
from the interfaces. The
corneal interfaces. The two mentioned so
techniques mentioned
two techniques so far two-beam
use two
far use interferences.
-beam interferences.
Multiple -beam interferences were used
Multiple-beam used to measure the
to measure the distribution
distribution of of thethe refractive
refractive indexindex in in the
the
crystalline lens
crystalline the eye.`'
lens of the measurements were
These measurements
eye. 1* These carried out
were carried out on lenses of
the lenses
on the of dogs, cattle and
dogs, cattle pigs
and pigs
confirmed that
and confirmed
and the refractive index
that the index varies across the
varies across the lens diameter.
lens diameter.
In this
In paper we
this paper we shall describe two
shall describe interferometric techniques
two interferometric that rely
techniques that rely on recently discovered
on aa recently inter-
discovered inter-
phenomenon of beams
ference phenomenon
ference reflected at
beams reflected the cornea
at the and at
cornea and the retina.5
at the The first
retina. 5 The technique makes
first technique possible
makes possible
measurement of
the measurement
the pulsations at
tissue pulsations
of tissue fundus of the
the fundus
at the the eye. interferometer that
An interferometer
eye. An can be
that can used in
be used the
in the
clinical environment
clinical has been
environment has built and
been built measurements on
first measurements
and first on patients with different
patients with diseases have
different diseases been
have been
carried out.
carried The second
out. The makes it
technique makes
second technique possible to
it possible measure optical
to measure distances within
optical distances eye. An
the eye.
within the An
experimental interferometer has been
interferometer has been built and first
built and measurements of
first measurements the optical
of the length of
optical length the eye
of the were
eye were
carried out
carried on several
out on subjects.
healthy subjects.
several healthy
of Fundus
Interferometric Measurement of
Interferometric Pulsations
Fundus Pulsations
The optical scheme of
optical scheme interferometer used
the interferometer
of the these measurements
in these
used in measurements is shown in
is shown Figure 1.
in Figure The beam
1. The of aa He-
beam of He-
directed via
Ne -laserisisdirected
Ne-laser two beam
via two towards the
splitters towards
beam splitters eye of
the eye subject. One
the subject.
of the of the
One of splitters is
beam splitters
the beam is aa
pellicle which
pellicle makes it
which makes possible to
it possible to simultaneously observe and
simultaneously observe photograph the
and photograph spot at
laser spot
the laser at the retina
the retina
using an
using an ophthalmoscope fundus camera.
ophthalmoscope or aa fundus The beam
camera. The power is
beam power adjusted to
is adjusted approximately 20
to approximately 20 µW at the
|iW at pupil
the pupil
of the eye.
of the incident laser
eye. The incident light is
laser light is partially reflected at
partially reflected cornea and
the cornea
at the part of
and part focused by
of itit isis focused the
by the
eye onto the
eye onto Superposition of
fundus. Superposition
the fundus. the light
of the remitted by
light remitted fundus and
the fundus
by the the light
and the reflected at
light reflected at the cor-
the cor-
PHOTOGRAPHIC TO HE- TO
FILM OBSERVER NE- FUNDUS
S~*\ LASER CAMERA
LASER CAMERA

A I -r /v* PELLICLE

\ \ ^
^ BEAM
SPLITTER

O
D
SLIT
SLIT BEAM X- SUBJECT'S
STOP SPLITTER / V. EYE

^^^ i

1.
Figure 1. Interferometer for the time
recording the
for recording of fundus
course of
time course dilatation.
tissue dilatation.
fundus tissue

48 / SPIE
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658Optical
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 nea produces Newton's
nea produces fringes as
interference fringes
Newton's interference shown in
as shown Figure 2.
in Figure normal subjects
2. With normal the best
subjects the fringe
best fringe
contrast was
contrast found in
was found plane approximately
in aa plane 80 mm
approximately 80 in front
mm in the exit
of the
front of pupil of
exit pupil eye. These
the eye.
of the fringes
These fringes
pulsate
pulsate with the subject's
with the -beat, and
heart-beat,
subject's heart and a count of
a count pass aa particular
fringes pass
many fringes
how many
of how point in
particular point the
in the
fringe
fringe pattern gives the
pattern gives optical path
the optical path variation between the
variation between the cornea and and the retina. Unfortunately aa
the retina.

2.
Figure 2. Interference caused by
pattern caused
Interference pattern the light
by the by the
remitted by
light remitted fundus and
the fundus and the reflected at
the light reflected the
at the
cornea.
cornea.

straightforward electronic
straightforward fringe-counting
electronic fringe technique is
-counting technique hindered by
is hindered some noise
by some noise caused by the
caused by film on
tear film
the tear on
the cornea and
the cornea and by saccadic eye
by saccadic Hence we
movements. Hence
eye movements. we use slit stop
use aa slit stop located at the plane and
interferogram plane
the interferogram and
through the
passing through
passing centre of
the centre fringe pattern.
the fringe
of the The slit
pattern. The imaged on
is imaged
slit is on to moving photographic
to aa moving film, and
photographic film, and
thus yields aa synthetic
thus yields synthetic interferogram with fringes describing the
fringes describing the temporal development of
temporal development of the optical path
the optical path
variation.
variation.5,6 Using an
5 ' 6 Using -clip photometer it
ear-clip
an ear it is possible to
is possible correlate the
to correlate time-dependence
the time -dependence of of the optical
the optical
path with
path with the mechanical events
the mechanical during the
events during cardiac cycle.
the cardiac During the
cycle. During systole the
the systole optical path
the optical difference
path difference
between the
between fundus and the
the fundus cornea decreases.
the cornea Hence the
decreases. Hence optical path
the optical variation is
difference variation
path difference is obviously domi-
obviously domi-
by aa swelling
nated by
nated swelling or dilatation of
or dilatation of the tissue and
fundus tissue
the fundus can be
and can used as
be used figure of
plethysmographic figure
as aa plethysmographic of
blood supply.
fundus blood
fundus supply. In In this "dilatation" is
this paper "dilatation" defined as
is defined the optical
as the path variation
optical path cornea and
between cornea
variation between and
fundus as
fundus measured by
as measured by the interferometer, i.e.
the interferometer, i.e. the variation of
the variation twice the
of twice the refractive index for
refractive index the wave-
for the wave-
length of the
length of the laser in the
used in
laser used interferometer (He
the interferometer -Ne- laser: 633
(He-Ne-1aser: 633 nm) integrated along
nm) integrated the path
along the path ofof the light
the light
from the cornea
from the cornea to fundus.
the fundus.
to the

step we
first step
In aa first
In we measured the dilatation on
fundus dilatation
the fundus on normal There is
subjects. There
normal subjects. typical dependence
is aa typical dependence of the
of the
magnitude of
magnitude the dilatation
of the the position
on the
dilatation on at the
position at minor maximum
retina. AA minor
the retina. occurs at
maximum occurs the fovea
at the and aa larger
fovea and larger
occurs at
maximum occurs
maximum at the
the papilla.6 The maximum
papilla. 6 The at the
maximum at may be
papilla may
the papilla mainly due
be mainly the blood
to the
due to supply of
blood supply of the
the
prelaminar part of
prelaminar part of the optic nerve,
the optic whereas, at
nerve, whereas, fovea centralis
the fovea
at the the volume
central is the pulsation of
volume pulsation of the choroid
the choroid
seems to
vessels seems
vessels to be the main
be the The corresponding
cause. The
main cause. variations are
corresponding variations order of
the order
of the
are of \im at
of 66 pm the fovea
at the and
fovea and
15 |im
of 15 pm at the papilla.
at the The standard
papilla. The deviation of
standard deviation measurements at
these measurements
of these subjects is
particular subjects
at particular is of the
of the
of 0.3
order of
order \m.
0.3 pm.

characteristic feature
Another characteristic
Another feature ofof the optical path
the optical variation is
path variation its time
is its course during
time course the cardiac
during the cycle.
cardiac cycle.
fovea central
the fovea
At the the maximum of
is the
centralis the optical
of the length (=
optical length minimum of
(= minimum of dilatation) occurs at
dilatation) occurs end of
the end
at the the
of the
diastole whereas
diastole whereas at the papilla the
the papilla occurs at
maximum occurs
the maximum at the middle of
the middle the diastole.6
of the Besides the
diastole. 6 Besides dilatation
the dilatation
of the
of fundus tissue
the fundus also retinal
tissue also contribute to
vessels may contribute
retinal vessels optical path
the optical
to the path length variation. E.g.
length variation. E.g. inin aa
particular subject
particular half-way
subject half between fovea
-way between papilla the
and papilla
fovea and path length
the path variation at
length variation at an artery of
an artery approx.
of approx.
diameter was 6 pm,
|iin diameter
60 pm pm, at vein of
at aa vein approx. the
of approx. diameter 44 pm
same diameter
the same and at
p,m and an area
at an without visible
area without vessels
visible vessels
the path
the variation was
length variation
path length 3pm. In
was 3pm. series of
first series
In aa first of clinical measurements 12
clinical measurements patients with
12 patients angiological
with angiological
problems were
problems were studied and dilatation
studied and measurements were
dilatation measurements made at
were made the fovea
at the centralis. Two
fovea centralis. examples are
Two examples pre-
are pre-
sented in in the Figures 33 and
the Figures and 4.4. Additional with the
examples with
Additional examples corresponding clinical
the corresponding will be
findings will
clinical findings be
published elsewhere.
published elsewhere.

The patient of
The patient Figure 33 was
of Figure 85, had
aged 85,
was aged hypertension and
had hypertension and was suspected to
was suspected have generalized
to have arterio-
generalized arterio-
sclerosis of
sclerosis the larger vessels.
of the dilatation measurements
The dilatation
vessels. The presented in
measurements presented Figure 33 show
in Figure agree-
remarkable agree-
show aa remarkable
ment between the
ment between two eyes.
the two Compared to
eyes. Compared normal subjects,
to normal however, the
subjects, however, maximum of
the maximum the observed
of the dilatation
observed dilatation
(- is increased
\m) is
(~ 99 pm) approximately 50
increased by approximately %.
50 %.

Figure 44 was
of Figure
patient of
The patient
The aged 55
was aged and was
55 and suspected to
was suspected to have stenosis ofof the
have a a stenosis right internal
the right carotis
internal carotis
artery. This
artery. has been
This has confirmed by
been confirmed by Doppler measurements and
ultrasound measurements
Doppler ultrasound and by angiography. Graph
by angiography. shows the
Graph aa shows the
dilatation of
dilatation and graph
of the left eye and shows the
graph bb shows dilatation of
the dilatation the right
of the There is
eye. There
right eye. dramatic reduction
is aa dramatic reduction

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aser Applications (1986)
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 10pm
10 pm -- 10 urn
10 pm T

2
Q /
O
55pm
p -- 5 pm --

`
• 5pm
<
j
Q

00pm
p -^ •
` 0O pm
Nm -^
^^*-»

I f I
I
I
I
I
I
I

0 0.5
0,5 1 0 0.5 1
1

TIME TIME

Figure
Figure 3. 3. Time course of
Time course of dilatation
dilatation atat the
the fovea
fovea centralis
central is of
of aa patient
patient aged
aged 85
85 years
years with
with generalized
generalized
arteriosclerosis
arteriosclerosis of thethe larger
larger vessels.
vessels.
Abscissa
Abscissa == time,
time, normalized
normalized toto one
one heart
heart cycle;
cycle; Ordinate
Ordinate == dilatation
dilatation ofof fundus
fundus tissue,
tissue.
a:
a: left
left eye; b: right
eye; b: right eye.
eye. Note
Note the
the remarkable
remarkable agreement
agreement between
between the
the two
two eyes.
eyes.
of the dilatation
of the dilatation ofof the
the right
right eye
eye due
due to
to the
the reduced
reduced blood
blood pressure
pressure amplitude
amplitude caused
caused by
by the
the stenosis.
stenosis.
Graph cc shows
Graph shows again
again the
the dilatation
dilatation of
of the
the right
right eye,
eye, but
but after
after surgery
surgery of
of the
the stenosis
stenosis with
with aa replacement
replacement
of the bad
of the bad arterial
arterial part
part by
by aa vein
vein-graft.
-graft.

10 pm --
10pm- 10pm-
10pm -

bb
//
.

-
55pm
um~- 5pm-
5 p

Opm
O pm-L-
I

0
I
.
..............

0.5
0,5
I
` I

1
O pm -
0 pm- a«
I

0
4
o
0
*
o.
<V
c*
a.
0"^
o

»^
^*.

0.5
0.5
'i I

TIME TIME

Figure 4.
Figure 4. Time
Time course
course ofof dilatation
dilatation at
at the
the fovea
fovea central is of
centralis of aa patient
patient aged
aged 55
55 years and suffering
years and suffering from
from aa
stenosis at
stenosis at the
the right
right internal
internal carotis
carotis artery.
artery.
Abscissa
Abscissa == time,
time, normalized
normalized to
to one
one heart
heart cycle;
cycle; Ordinate
Ordinate == dilatation
dilatation of fundus tissue,
of fundus tissue.
a: left eye;
a: left eye; b:
b: right
right eye;
eye; c:
c: right
right eye
eye after
after surgery.
surgery.

Interferometric measurement
Interferometric measurement of
of the
the optical
optical length
length of
of the
the eye
eye

At present the
At present the axial
axial length
length of of the
the living
living eyeeye cancan only
only bebe measured
measured by by ultrasonic
ultrasonic echography.
echography. This This technique
technique
yields relative
yields relative figures
figures only, only, because
because thethe sound
sound impedances
impedances of of the
the human
human eyeeye are
are not
not known
known veryvery exactly
exactly andand
cannot
cannot be determined in
be determined in vivo.
vivo. However,
However, the the clinician
clinician is is primarily
primarily interested
interested in in the
the deviation
deviation from from normal,
normal,
hence this
hence this technique
technique is is well
well-established
-established as as aa diagnostic
diagnostic tool.tool. Some
Some disadvantages
disadvantages of of this
this technique
technique areare the
the
need of
need of anaesthesia,
anaesthesia, the the need
need ofof mechanical
mechanical contactcontact between
between cornea
cornea andand transducer
transducer and and the
the very
very low
low trans-
trans-
versal resolution
versal resolution at at the
the fundus
fundus of of the
the eye.
eye. TheThe interferometric
interferometric technique
technique being
being investigated
investigated in in our
our labora-
labora-
tory on
tory on the
the contrary,
contrary, does does neither
neither need
need anaesthesia
anaesthesia nor nor mechanical
mechanical contact
contact withwith thethe eyeeye and
and inin addition
addition
offers high
offers high transversal
transversal resolution
resolution at at the
the fundus.
fundus. The The optical
optical scheme
scheme is is depicted
depicted in in Figure
Figure 5. 5. The
The subject
subject
is sitting
is sitting withwith his
his head
head fixed fixed with
with the
theaid aidofofa abite biteboard.
board.A He
A He-Ne-laser
-Ne -laser is is used
used forfor thethe adjustment
adjustment of of
the subject's eye
the subject's eye and
and the the interferometer.
interferometer. If If the
the subject's
subject's eye is is at
at the
the right
right position
position the the examiner
examiner willwill
see the pulsating
see the pulsating Newton's
Newton's rings rings in in the
the IR- IR-scope.
scope. Subsequently
Subsequently the the subject's
subject's eye eye is is illuminated
illuminated by by the
the
seminconductor
seminconductor injection
injection laser (Hitachi 7801).
laser (Hitachi 7801). The The eye
eye represents
represents aa Fizeau
Fizeau interferometer
interferometer with with the
the cornea
cornea
and the
and the fundus
fundus forming
forming the the interferometer
interferometer mirrors.
mirrors. The The optical
optical path
path length
length between
between these
these two two mirrors
mirrors is is to
to
be determined.
be determined. This This isis donedone with
with the
the help
help of of the
the Fabry
Fabry-Perot interferometer in
-Perot interferometer in the
the illuminating
illuminating beam. beam. It It
should
should be be mentioned
mentioned here, here, that that aa very
very similar
similar arrangement
arrangement was was used
used in in the
the past for for measuring
measuring the

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Vol. 658 Optical Instrumentation for Biomedical
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 HE-NE-LASER
HE - NE - LASER IR SCOPE
IR - SCOPE

PEROT
FABRY - PEROT
FABRY SUBJECT'S
INTERFEROMETER EYE
INJECTION- POLARIZER \
LASER _ ...L ._.
\
-r
N/4 -PLATE
- PLATE
\

/ PHOTODETECTOR

SPECTROMETER SPECTROMETER
DIODE
DIODE ARRAY GRATING

5.
Figure 5. Interferometer
Interferometer for the axial
for measuring the length of
optical length
axial optical eye.
the eye.
of the

thickness of
thickness of air using the
layers using
air layers the superposition technique. 7 If
fringes technique.?
superposition fringes light of
If light of coherence length o/
coherence length is
Ai is
used, the
the examiner will see
examiner will see the Newton's rings
the Newton's only, if
rings only, if the separation dd of
the separation the two
of the Fabry-Perot
two Fabry plates
-Perot plates
coincides with
coincides the optical
with the length of
optical length of the within AA.
eye within
the eye The optical
A/. The length of
optical length of the eye equals
the eye the refractive
equals the refractive
index of
index of the eye media at the laser
at the (approx. 800
wavelength (approx.
laser wavelength 800 nm) integrated from
nm) integrated from the cornea to
the cornea to the fundus.
the fundus.
The length of the
coherence length
The coherence light beam
the light beam of an injection
of an laser is
injection laser is highly dependant on
highly dependant the injection
on the current.
injection current.
With the index
With the semiconductor laser
-guided semiconductor
index-guided used in
laser used experiment we
our experiment
in our we have longitudinal multi
have longitudinal multi-mode operation
-mode operation
levels and
at low current levels single-mode
and single operation at
-mode operation at the nominal injection
the nominal current. In
injection current. multi-mode
the multi
In the opera-
-mode opera-
tion the
tion can be
length can
coherence length
the coherence as short
be as as AA
short as whereas, in
mm, whereas,
.01 mm,
Ai -~ .01 in the operation the
-mode operation
single-mode
the single the coher-
coher-
ence can be of
length can
ence length of the order of
the order several meters.
of several spectrometer is
grating spectrometer
meters. AA grating used to
is used monitor the
to monitor spectral
the spectral
mode structure of
mode structure of the laser. The
the laser. The quarter plate and
-wave plate
quarter-wave and the polarizer at
the polarizer injection laser
the injection
at the laser exit form aa
exit form
in order to avoid
valve in
light valve hopping noise
mode hopping
avoid mode caused by
noise caused by external feedback.
optical feedback.
external optical

No extensive
No series measurements
extensive series carried out
were carried
measurements were out so far. But
so far. the first
But the measurements have
first measurements indicated aa
have indicated
resolution inin the measurement of the
the measurement the optical length of
optical length of the eye of
the eye .01 mm.
approx. ±± .01
of approx. Using the
mm. Using high
the high
transversal resolution
transversal of this
resolution of technique, we
this technique, expect to
we expect measure the
to measure of the
length of
the length optical axis
the optical of the
axis of eye
the eye
and in addition
and in the surface
addition the profile of
surface profile of the fundus, in
the fundus, the profile
particular the
in particular of the
profile of nerve head
optic nerve
the optic which
head which
is very
is for the
important for
very important diagnosis of
the diagnosis glaucoma.
of glaucoma.

Conclusion

We
We have that the
shown that
have shown length of
optical length
the optical of the eye as
the eye as its
well as
as well variation can
its variation measured by
be measured
can be adequate
by adequate
techniques. Both
interferometric techniques.
interferometric Both techniques rely on
techniques rely discovered interference
recently discovered
on aa recently first
phenomenon. AA first
interference phenomenon.
clinical application
clinical also been
has also
application has described and
been described shows a
and shows a reasonable correlation of
reasonable correlation the measured
of the optical
measured optical
variation of
length variation
length the eye
of the with angiological
eye with findings.
angiological findings.

Acknowledgements

Part of
Part of this work was
this work carried out
was carried at the
out at Abteilung fur
the Abteilung Gefapchirurgie der
fur Gefüpchirurgie Universitat Düsseldorf.
der Universitgt The
DUsseldorf. The
authors thank Prof.
authors thank Dr. W.
Prof. Dr. for his
Sandmann for
W. Sandmann kind cooperation.
his kind authors wish
The authors
cooperation. The also to
wish also thank K.
to thank Mengedoht
K. Mengedoht
for his participation
for his participation in the length measurement
in the project.
measurement project.

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SPIE Vol 658

SPIE Vol. 658 Optical
OpticalInstrumentation
Instrumentation for
forBiomedical
BiomedicalLLaser Applications(1986)
aser Applications / / 51
(1986)

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