Astigmatism and astigmatic imagery

Emmetropia Astigmatism
Astigmatism and astigmatic imagery
Astigmatism
Image is out of focus

In the examples I will discuss
today, the astigmatic meridians
are horizontal and vertical like in
the picture. The exact horizontal
is referred to as 180
o
(instead
of 0
o
) while the vertical is 90
o
.

In the clinic you will rarely find the
astigmatic meridians to be exactly
horizontal and vertical.

Blue = represents Vertical meridian

Red = represents Horizontal meridian
Astigmatic Eyes: two principal corneal meridians

a meridian of greatest corneal power
a meridian of least corneal power
Color Code


Emmetropic Eyes: The vertical and horizontal principal
meridians have the same power and focus a distant point
object as a point image on the retinal surface.

The vertical meridian will produce a horizontal line focus of a
distant point object.

In this example, the vertical meridian focuses a distant point object in
front of the retina. This is a myopic refractive error. Lets say the vertical
meridian has a refractive error of -5 D
Imagery in Astigmatic Eyes: Example 1

Looking at the vertical meridian alone!
-5
The horizontal meridian will produce a vertical line focus of a
distant point object.

In this example, the horizontal meridian focuses behind the retina.

This is a hyperopic refractive error. Lets say the horizontal meridian
has a refractive error of +3D
Imagery in Astigmatic Eyes : Example 1

Looking at the horizontal meridian alone!
+3
Imagery in Astigmatic Eyes : Example 1
The vertical and horizontal meridians together

Under normal viewing conditions, the imagery for
a point object has contributions from both
principal meridians:
The horizontal and vertical line foci are both far
away from the retina. What does the retinal image
look like for this example eye?
-5
+3
Imagery in Astigmatic Eyes : Example 1


The image formed by this uncorrected eye looks like a
blur ellipse

Blur
Ellipse
-5
+3
Imagery in Astigmatic Eyes : Example 1

The vertical meridian has greater myopia
(more focusing power) than the horizontal meridian.

This is the most common form of astigmatism
This is known as with-the-rule astigmatism

Next lecture we will talk about correcting astigmatic eyes
-5
+3
Imagery in Astigmatic Eyes : Example 1

-5
+3
The image on the retina for this eye is a blur ellipse.

However, at the dioptric midpoint between the two foci,
the image forms a perfect circle. This is known as the
circle of least confusion (CLC).

For the eye illustrated here, it will
Imagery in Astigmatic Eyes: Example 2
There are practically an infinite number of focal
length combinations for the principal meridians
so we cant discuss every possible astigmatic eye.

What does the image look like for this eye?
-5
plano
Imagery in Astigmatic Eyes: Example 2

The vertical line
focus is on the
retina
-5
plano
Imagery in Astigmatic Eyes: Example 3
plano
+3.0
Imagery in Astigmatic Eyes: Example 3

What the image looks like on the retina
plano
+3.0
Horizontal
Line Focus
Imagery in Astigmatic Eyes: Example 4
-5.0
-2.0
Imagery in Astigmatic Eyes: Example 4

What the image looks like on the retina
-5.0
-2.0
A vertically
elongated
blur ellipse
Imagery in Astigmatic Eyes: Example 5
+1.0
+3.0
Imagery in Astigmatic Eyes: Example 5

What the image looks like on the retina
+1.0
+3.0
A horizontally
elongated
blur ellipse
Imagery in Astigmatic Eyes: Example 6

The Circle of Least Confusion
-5.0
+5.0
At the dioptric midpoint between the two foci,
the image forms a perfect circle. This is known as the
circle of least confusion (CLC).

In this example eye, the CLC is at the retinal plane
Imagery in Astigmatic Eyes: Example 6

The Circle of Least Confusion
-5.0
+5.0
As the name implies, the image is a blur circle
The best visual performance for an uncorrected astigmatism
is said to occur when the CLC is on the retina
Imagery in Astigmatic Eyes: Example 7

Against-the-rule astigmatism
+3.0
-5.0
The horizontal meridian has relatively greater myopia
(more focusing power) than the vertical meridian

This is less common in the general population than
with-the-rule astigmatism
Imagery in Astigmatic Eyes: Example 7
+3.0
-5.0
What does the image look like?
Imagery in Astigmatic Eyes: Example 8

+3.0
plano
Imagery in Astigmatic Eyes: Example 8

What the image looks like on the retina
+3.0
plano
Horizontal
Line Focus
WTR
ATR
It is very important to note that the appearance of the
uncorrected retinal image does NOT provide information
about the type of astigmatism (WTR, ATR). The retinal image
tells you the relative position of the meridians.
Classifications of Astigmatism
Classified on the basis of the
positions of the line foci
formed for a distant point
source with respect to the
retina and the positions of the
principal meridians.
compound
myopic astig.
simple
myopic astig.
mixed astig.
simple
hyperopic astig.
compound
hyperopic astig.
Position of the most powerful meridian

with-the-rule = near vertical (30
deg)
against-the-rule = near horizontal
(30 deg)
oblique = near 45 or 135 (15 deg)
from Obstfeld, 1982
Retinal Image in uncorrected
astigmatic eyes
All the eyes have
against-the-rule
astigmatism.

C = compound
M = myopic
A= astigmatism
S = simple
H = hyperopic
Object is a distant
point source.