A3 - Optics of Contact Lenses

The Optics of Contact Lenses
A3
© The International Association of Contact Lens Educators

2015-Apr-13 www.iacle.org
2015-Mar-09
Attributions
Lecture contributor Lewis Williams

Lecture editor** Lewis Williams, Sotiris Plainis
IACLE executive editor** Nilesh Thite
IACLE reviewer** Nilesh Thite, Lewis Williams
Lecture updated 2015-Mar-09
Lecture content rechecked 2015-Apr-13
* Original author(s) of lecture(s) **2014/2015 Editors and reviewers

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Published by
The International Association of Contact Lens Educators (IACLE)
Revised Edition 2015
© The International Association of Contact Lens Educators 2000-2015

All rights reserved. No part of this publication may be reproduced, stored in a retrieval
system, or transmitted, in any form or by any means, without the prior permission, in
writing, of:
The International Association of Contact Lens Educators
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Email: iacle@iacle.org

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INTRODUCTION:
• This lecture presents the optical theory of contact lenses (CLs). Where
relevant, practical applications to the fitting & wear of contact lens are
included
• Where appropriate, comparisons are drawn between contact lenses &

other forms of vision correction, especially spectacles
• The sign conventions, terminology, & symbols used in this lecture

conform to those in common use around the world. Where feasible,
terminology & abbreviations used mirror those in standard: ISO 18369-
1:2006 (last revised 2010)

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CONSTRAINTS:
• Fewer optical design ‘degrees-of-freedom’ (CL back surface must bear some
fitting relationship with the anterior eye leaving only lens thickness & material
refractive index [dependent largely on material selection] to define axial power)
• Refractive indices of CL materials are lower & span a narrower range that other
ophthalmic lenses
• Radii-of-curvature of CL surfaces are much steeper that alternative vision

corrections due largely to the topography of the anterior eye
• Rigid CLs, e.g. GP CLs, offer more predictable optics but normal on-eye rigid CL
movement means non-coaxial optics apply at least some of the time
• The on-eye shape of soft CLs (SCLs) is determined by anterior eye topography
& the degree of lens conformance

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SIGN CONVENTION USED: BI-CONVEX PLUS LENS SHOWN

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VERGENCE

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THE THIN LENS APPROXIMATION

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PLANE REFRACTING SURFACE (e.g. a glass block)
L '  L  F
n ' n
  Z
l ' l
1 n

l ' l
l
l '  (l '
n
or...
Physical Optical t
• Real thickness • Reduced thickness t ' = (t
• Apparent depth
n
• Absolute thickness
• Actual thickness • Reduced distance
• Absolute distance • Equivalent air distance
• Physical thickness • Apparent location
• Virtual position
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EFFECTIVITY n
Vergence @ D = L=
l
n
Vergence @ D' =L'=
(l  d )
Lxn Lxn
L'  
L(l  d ) n  dL
Dividing through by n
L
L' 
d
(1  L)
n
d
is the REDUCED DISTANCE
n
if n is NOT air
If medium is AIR (n  1.000)
L
then L ' 
(1  dL)

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CURVED REFRACTING SURFACE: CONVERGING
(n ' n)
F
r
If r in METRES then F is in DIOPTRES
n' n'
F or f 
f F
As r & f are POSITIVE, F is POSITIVE

A CONVERGING system
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CURVED REFRACTING SURFACE: SURFACE POWER + EXAMPLE
(n ' n)
FSurf 
rSurf
(1.44  1.00)
FSurf 
0.0078
0.44
FSurf 
0.0078
FSurf  56.41D
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CURVED REFRACTING SURFACE: DIVERGING
(n ' n)
F
r
If r in METRES then F is in DIOPTRES
n' n'
F or f 
f F
As r is POSITIVE & f is NEGATIVE, F is NEGATIVE

A DIVERGING system
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CURVED REFRACTING SURFACE: SURFACE POWER – EXAMPLE
(n ' n)
FSurf 
rSurf
(1.00  1.44)
FSurf 
0.0078
Note: Radius rSurf is in METRES
0.44
if answer is to be in DIOPTRES
FSurf 
0.0078
FSurf  56.41D
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LENS FORMS
Essential CL forms are in BLUE
Meniscus Plano-Convex Biconvex Meniscus Plano-Concave Biconcave

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REFRACTION BY A LENS: BACK VERTEX POWER (BVP): PLUS

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REFRACTION BY A LENS: FRONT VERTEX POWER (FVP): PLUS

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REFRACTION BY A LENS: BACK VERTEX POWER (BVP): MINUS

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REFRACTION BY A LENS: FRONT VERTEX POWER (FVP): MINUS

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PRINCIPAL FOCI: SUMMARY

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THE PARAXIAL EQUATION
L'  L  F l is NEGATIVE (opposite to light direction

l’ is POSITIVE (same direction as light)
1 1 1 f is POSITIVE (converging lens, same as light direction)
 
l' l f Vergence IN (L) + POWER of lens (F) = Vergence OUT (L’)
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POWER OF A THICK LENS: FIRST SURFACE

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POWER OF A THICK LENS: IMMEDIATELY AFTER THE FIRST SURFACE
Vergence (L ' 1) immediately after FIRST surface:

L '1  L  F 1
L '1  0  F 1
L '1  F 1

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POWER OF A THICK LENS: IMMEDIATELY BEFORE THE SECOND SURFACE
L 2  Effectivity of L ' 1 @ the BACK surface

L '1
L2  (General effectivity equation)
tC
1  ( L ' 1)
n'
Therefore:
F1
L2 
tC
1  ( F 1)
n'

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POWER OF A THICK LENS: IMMEDIATELY AFTER THE SECOND SURFACE
L ' 2  L2  F 2
F1
L'2   F2
tC
1  ( F 1)
n'
Because L1 = ZERO (Parallel incident light)
L ' 2  The BACK VERTEX POWER (BVP)
Therefore:
F1
F ' BVP   F2
tC
1  ( F 1)
n'

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POWER OF A THICK LENS: COMPLETE PICTURE, BVP
L ' 2  L2  F 2
F1
L'2   F2
tC
1  ( F 1)
n'
Because L1 = ZERO (Parallel incident light)
L ' 2  The BACK VERTEX POWER (BVP)
Therefore:
F1
F ' BVP   F2
tC
1  ( F 1)
n'
Note: Because F1 & F2 feature separately in the BVP equation,

FRONT & BACK Vertex Powers are NOT equal
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POWER OF A THICK LENS: COMPLETE PICTURE, BVP
Given that:
F1
F ' BVP   F2
tC
1  ( F 1)
n'
tc
Multiplying throughout by: 1  (F1)
n'
tc tc
F ' BVP X (1  (F1)) = F 1  F 2 X (1  (F 1))
n' n'
tc tc
F ' BVP X (1  (F1)) = F 1  F 2  (F 1F2)
n' n'
tc
F1  F 2  (F 1F2)
F ' BVP = n '
tc
1  (F1)
Derivation of alternative equation n'
and, similarly...
tc
F1  F 2  (F 1F2)
FFVP = n'
tc
1 (F2)
n'
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POWER OF A THICK LENS: COMPLETE PICTURE, –BVP

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POWER OF A THICK LENS: PROOF OF THIN LENS ASSUMPTION AS tC  ZERO
As tc approaches ZERO:
F1
F ' BVP   F2
tC
1  ( F 1)
n'
approaches...
F '  F1  F 2

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POWER OF A THICK LENS: COMPLETE PICTURE, FVP (NEUTRALIZING POWER)
Similarly:
If L ' 2 = ZERO (Paral
L1  The FRONT VE
Therefore:
F2
FFVP   F1
tC
1 ( F 2)
n'

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POWER OF A THICK LENS: COMPLETE PICTURE, –FVP
Similarly:
If L ' 2 = ZERO (Paral
L1  The FRONT VE
Therefore:
F2
FFVP   F1
tC
1 ( F 2)
n'

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IMAGE FORMATION BY A SIMPLE LENS SYSTEM: PLUS
Note: Optically, the image is ‘inverted’, i.e. reversed L to R, Top to Bottom

The object & the image are said to be in conjugate planes
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IMAGE FORMATION BY A SIMPLE LENS SYSTEM: MINUS

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IMAGE FORMATION BY A COMPLEX SYSTEM
Note: Optically, the final image is ‘erect’, i.e. Left is Left, Top is Top
The object, the inverted intermediate image, & the final image
are said to be in conjugate planes
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SECOND PRINCIPAL PLANE: THICK, BICONVEX LENS

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FIRST PRINCIPAL PLANE: THICK, BICONVEX LENS

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PLUS CL PRINCIPAL POINTS: MENISCUS LENS FORM: PLUS

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MINUS CL PRINCIPAL POINTS: MENISCUS LENS FORM: MINUS

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CL BVP MEASUREMENT (LOCATION OF THE LENS BACK VERTEX)

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CALCULATING A CL’s FOZR: GIVEN ALL OTHER DATA

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CALCULATING A CL’s FOZR: GIVEN ALL OTHER DATA
By reversing the CL, the FOZR (r2) defines the last surface & is the only unknown. However, surface radii are
now negative (measured against direction of light) & reversed direction of light means that ‘incident’ light is
now convergent (before reversal, divergent [negative lens]). Therefore: L 1 = +4.00 (BVP = –4.00). By
definition, L2’= Zero (parallel exiting light rays)
(n ' n) (1.44  1.00)
F1  
r1 0.0078
F 1  56.41D
L1 '  L1  F 1  4.00  (56.41)
L1 '  52.41D
L 2  The EFFECTIVITY of L1' @ 2nd surface, 0.15 mm away
L1 ' 52.41
L2  
tc 0.00015
1 ( L1 ') 1 (52.41)
nLens 1.44
L 2  52.13D
Once CL is reversed again (returned to
normal orientation): L 2 '  L 2  F 2  52.13  F 2  0
(n  n ') (1.00  1.44)
FOZR = +8.44 mm (meniscus CL) F 2  52.31D  
r2 r2
r 2  8.44mm  FOZR
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SIMPLIFYING THE EYE TO CONSIDER THE AMETROPIAS
P is the reduced eye’s unified Principal Plane
A simple reduced eye will be used to study

the optics of ametropia correction

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CORRECTING HYPEROPIA
A
CLs vs. Specs
Note that CLs have a SHORTER
distance over which to bring light
to a focus than do spectacle
B
lenses, i.e.
fC Lens < fSpec Lens
Therefore, the BVP of a CL must C

be GREATER than the equivalent
CL to correct HYPEROPIA
D
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CORRECTING MYOPIA
CLs vs. Specs

A
Note that CLs have a LONGER
distance over which to bring light
to a focus than do spectacle
lenses, i.e.
B
fC Lens > fSpec Lens
Therefore, the BVP of a CL must

be LOWER than the equivalent CL C
to correct MYOPIA
A hint of differences in image

size according to mode of
correction (specs vs CLs) are
D
apparent

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COMPENSATING FOR VARIATIONS IN VERTEX DISTANCE
F Spec
F CL 
(1  dF Spec )
A common calculation is estimating the
BVP of a CL based on the eye’s spectacle
Rx. In effect, the CL BVP is the
effectivity of the spectacle Rx in the
corneal plane.
The separation of the two planes is
known as the vertex distance (both
lenses are assumed to be ‘thin’ in this
context however we have established
already that for accuracy, CLs must be
treated as ‘thick’ lenses
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GULLSTRAND-EMSLEY SCHEMATIC EYE (G-ESE)

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GULLSTRAND-EMSLEY SCHEMATIC EYE: SPECTACLE PLANE & DATA
Data set for G-E schematic eye
For our purposes d will be 14 mm.

Therefore, d2 will be +15.55 mm &
g will be +0.98 mm, i.e. spectacle
lenses are almost in the first focal
plane of the eye

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SPECTACLES vs CONTACT LENSES: MAGNIFICATIONS
Corrected ametropic image size

Spectacle Magnification (SM) =
Uncorrected ametropic image size
SM is a comparison of a clear retinal image with a blurred retinal image
Corrected image size with CLs

Contact Lens Magnification (CLM) =
Corrected image size with specs
CLM is a more realistic comparison of two clear retinal image sizes
(See next slide)
Distant objects assumed
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ENTRANCE PUPIL LOCATION (FOR CALCULATIONS, SEE LATER IN FIELD LIMITATIONS)

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SPECTACLE MAGNIFICATION (SM)
f ' Spec
SM  For thin spectacle lenses, P’Spec is
f ' Spec  x approximately the vertex
All angles assumed to be small
distance (14 mm) + 3.05 mm
1 away from the eye’s Entrance
SM 
1  xF ' Spec Pupil, i.e. x = 17.05 mm

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SPECTACLES vs CONTACT LENSES

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CONTACT LENS MAGNIFICATION (CLM)
This diagram is a derivative of the previous slide

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Referring to right angled triangles CFhC & SFhS
Image size with CL
CLM 
Image size with spectacles
FhC
CLM 
FhS
But image sizes are directly proportional to the focal lengths
Therefore...
f ' CL F ' Spec
CLM  or CLM 
f ' Spec F ' CL
However, we have already shown that:
F ' Spec
F ' CL 
(1  dF ' Spec )
F ' Spec
CLM 
F ' Spec
(1  dF ' Spec )
Simplifying...
CLM  1  dF ' Spec
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• From its derivation, CLM is a comparison of contact lens & spectacle lens
image sizes
CLM  1  dFSpec
• Calculating examples using a vertex distance of 14 mm (d = 14 mm):
• For a +10 D HYPEROPE, CLM = 0.86 (i.e. 14% SMALLER)
• For a –10 D MYOPE, CLM = 1.14 (i.e. 14% LARGER)
• These CLMs show that hyperopes experience a smaller image size with
contact lenses than with spectacles of equivalent
• Conversely, myopes experience a larger image size than with
spectacles

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SPECTACLE & CONTACT LENS MAGNIFICATIONS
Specs vs No Rx
CL vs Specs
CL vs No Rx

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RELATIVE SPECTACLE MAGNIFICATION (RSM)
Note: fEye = –(g + d2)
RSM:
For a distant object, the RSM is the ratio of image size in the
corrected ametropic eye to the image size in the NORMAL
emmetropic eye. However, RSM is complicated by the need
to consider the nature of the ametropia, i.e. does it have an
axial or a refractive origin?
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RELATIVE SPECTACLE MAGNIFICATION (RSM)
Approximations are:
RSM  1  d 2 FSpec for REFRACTIVE ametropia
RSM  1  gFSpec for AXIAL ametropia
More exacting equations are:

1
RSM  for REFRACTIVE ametropia
1  d 2 FSpec
1
RSM  for AXIAL ametropia
1  gFSpec
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RELATIVE SPECTACLE MAGNIFICATION: REFRACTIVE AMETROPIA
Spectacles
Contact lenses
-20 -15 -10 -5 0 +5 +10 +15 +20

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RELATIVE SPECTACLE MAGNIFICATION: AXIAL AMETROPIA
Contact lenses
Spectacles
-20 -15 -10 -5 0 +5 +10 +15 +20

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RELATIVE SPECTACLE MAGNIFICATION: REFRACTIVE AMETROPIA
Approximations in REFRACTIVE Rxs are:

 RSM  1  d 2 FSpec
With spectacles, d2  d = lens vertex distance
 Therefore, RSM  1 (NOT unity or 1X)
With contact lenses, d2=1.55 mm, very  0
 Therefore, RSM  1 (Unity or 1X)
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RELATIVE SPECTACLE MAGNIFICATION: AXIAL AMETROPIA
Approximations in AXIAL Rxs are:
 RSM  1  gFSpec
With spectacles, g  0 (d2  fEye)
Derivation of that approximation:
[g = fEye – (d + 1.55) ]
[g = 16.53 – (14 + 1.55) ]
(g = 0.98 mm [0.00098 m )
 Therefore, SPEC RSM  1 (Unity or 1X
With CLs, g =0.98 +14 mm
g = 14.98 mm (0.01498 m )
 Therefore, CL RSM  1 (NOT unity or 1

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REFRACTIVE ANISOMETROPIA: HYPEROPIA (Spec image is LARGER)

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AXIAL ANISOMETROPIA: HYPEROPIA (Spec image is about the SAME)

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REFRACTIVE ANISOMETROPIA: MYOPIA (Spec image is SMALLER)

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AXIAL ANISOMETROPIA: MYOPIA (Spec image is about the same)

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RSM: APPLICATIONS
• Useful in clinical decision making in cases of

anisometropia
• any resulting aniseikonia must be considered
• origin of the ametropia, i.e. axial or refractive, is central
• unfortunately, the origin is difficult to determine & can even be a
combination of both
• If K readings mirror the ametropia, e.g. a steep cornea &
moderate - high myopia, it is probable that the ametropia
is refractive (conversely, a flatter cornea in hyperopia is
suggestive of the same refractive aetiology)

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RSM: SUMMARY
• AXIAL ametropia: correct with SPECTACLES
• REFRACTIVE ametropia: correct with CLs
Implication: CLs are not always the correction of choice

Clinical judgement is required
Refractive surgery procedures, e.g. LASIK, are
REFRACTIVE in origin (cornea-based corrections)
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AMETROPIAS: AXIAL OR REFRACTIVE
• Higher ametropias (4 to 8 D) are more likely to be

AXIAL
• spectacle correction may be better in cases of axial
anisometropia
• Importantly/fortunately, most ametropias are
approximately isometropic, not anisometropic
• other considerations may apply, e.g. cosmetic,
occupational, & safety issues

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HOW DO SM, CLM, & RSM RELATE TO ONE ANOTHER?
All are retinal image size comparisons

• SM compares corrected (focused) with uncorrected
(blurred) images – difficult!
• CLM compares images with CL & spectacle corrections -
more realistic
• RSM compares corrected with a theoretical, emmetropic,
schematic eye - hypothetical (axial, refractive, mixed, or
unknown?)

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WHAT ABOUT APHAKIA?
• APHAKIA is considered to be refractive in origin

• IOL implantation is considered to be the ideal
correction. Eye  pseudophakic (location of Rx
nearly ideal)
• IOLs impart optical & physiological advantages
• If IOLs are not implanted, CLs are preferable

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WHAT ABOUT ASTIGMATISM?
• Astigmatism is classed as a refractive ametropia

(one meridian can be considered ‘normal’, the other
meridian the ‘cause’ of the astigmatism)
• Spectacle lenses can induce significant meridional
aniseikonia, especially in high astigmatism
• CLs are the correction of choice in astigmatism
despite some fitting issues

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ACCOMMODATION WITH SPECTACLES

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ACCOMMODATION WITH CONTACT LENSES

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ACCOMMODATION: EMMETROPE
• Vergence of near pencil of light @ cornea 347.33 mm

1
away from reading material: –2.88 D ( 0.34733 )
• Ocular Rx @ cornea: Plano (emmetrope)
• Accommodation required: 2.88 D
• Accommodation in CLs is the same: 2.88 D

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ACCOMMODATION: +5.00 D HYPEROPE
• Vergence of near pencil of light after spectacle lens:

+2.00 D (–3.00 +(+5.00))
• Vergence @ cornea 14 mm away: +2.058 D
• Ocular Rx @ cornea: +5.376 D

• Accommodation in Specs: 3.32 D (5.376 – 2.058)
• Accommodation in CLs: 2.88 D (determined previously)

Difference: 0.44 D MORE in specs

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ACCOMMODATION: –5.00 D MYOPE
• Vergence of near pencil of light after spectacle lens: –

8.00 D (–3.00 +(–5.00))
• Vergence @ cornea 14 mm away: –7.194 D
• Ocular Rx @ cornea: –4.673 D

• Accommodation in Specs: 2.52 D (7.194 – 4.673)
• Accommodation in CLs: 2.88 D (determined previously)

Difference: 0.36 D MORE in CLs

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ACCOMMODATION: SPECTACLES vs CONTACT LENSES
READING DISTANCE: 333.33 mm ( –3.00 D )

( from spectacle lens )
Accommodation cf. an Emmetrope or CL wearer

ACCOMMODATION (D)
5.5
5
With specs
4.5
LESS MORE
4
3.5
3
With CLs
2.5 With CLs
2
1.5
With specs
-20 -15 -10 -5 0 +5 +10 +15 +20
SPECTACLE Rx ( @14 mm )

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ACCOMMODATION: INCIPIENT PRESBYOPIA
• If a myope is switched FROM spectacles TO contact lenses,

the change may PRECIPITATE the need for a near
correction
• in myopia, specs  CLs can  any existing problem
• If a hyperope is switched FROM spectacles TO contact

lenses, the change may POSTPONE the need for a near
correction
• in hyperopia, specs  CLs can  any existing problem

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NEAR VISION: SPECTACLES vs CLs
• A prismatic effect is induced when the line of sight does

not pass through a lens’ optical centre
• The prismatic effect can be calculated using Prentice’s

Rule:
─ prismatic effect, P∆ = Decentrationcm x FLens
─ calculation is an approximation only
− assumes paraxial rays & thin lenses

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NEAR VISION: CONVERGENCE – UNITS OF MEASURE
• Metre angle
• the reciprocal of the distance
from the fixation point to the line joining the Centres of
Rotation of the eyes
• MA is a clinical rather than an optical measure
• Prism dioptre ( ∆ )
• defined as a 1 cm lateral
image displacement at a 1 m working distance
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CONVERGENCE: CALCULATIONS, EMMETROPIA / CLs

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CONVERGENCE: CALCULATIONS, EMMETROPIA / CLs
In EMMETROPIA:
For a fixation distance of 333.33 mm (0.3 m) from the spe
(14 mm from the corneal apex), a PD of 64 mm, and an e
Centre of Rotation located 13.5 mm behind the corneal ap
the monocular convergence in prism dioptres (NB: PD
8.868
hRorL 3.2
Convergence  
q (0.33333  0.014  0.0135)
 Binocular convergence = 17.74

A CL wearer converges the same amou

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CONVERGENCE: HYPEROPIA – SPECS vs CL WEARER (or EMMETROPE)

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In HYPEROPIA:
For a fixation distance of 333.33 mm (0.333 m) from the spectacle plane,
(14 mm from the corneal apex), a PD of 64 mm, and an eye
Centre of Rotation located 13.5 mm behind the corneal apex,
the monocular convergence in prism dioptres (PD in cm) is:

h
Convergence  
l
h l 
From the general magnification formula m or
h l
hl 
We can derive that: h 
l
1 1
L  L  FSpec or   FSpec
l l
l  0.333 and FSpec  5.00
 l   0.5 m
32( 0.5)
h   48mm
0.333
h
Monocular convergence = where q is the distance from the
q
In HYPEROPIA image plane to the eye's C of R
A spectacle wearer converges 2.58∆ more Convergence =

4.8
 10.16
0.50  (0.014  0.0135)
than would an emmetrope or a CL wearer
This is MORE than for an EMMETROPE or CL wearer (17.74)

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CONVERGENCE: MYOPIA – SPECS vs CL WEARER (or EMMETROPE)

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In MYOPIA:
For a fixation distance of 333.33 mm (0.333 m) from the spectacle
(14 mm from the corneal apex), a PD of 64 mm, and an eye
Centre of Rotation located 13.5 mm behind the corneal apex,
the monocular convergence in prism dioptres (PD in cm) is:

h
Convergence  
l
h l 
From the general magnification formula m or
h l
hl 
We can derive that: h 
l
1 1
L  L  FSpec or   FSpec
l l
l  0.333 and FSpec  5.00
 l   0.125 m
32( .125)
h   12mm
0.333
In MYOPIA Monocular convergence =
h
where q is the distance from the
q
A spectacle wearer converges 2∆ less than image plane to the eye's C of R
would an emmetrope or a CL wearer Convergence =
1.2
 7.87
(0.125  0.014  0.0135)
This is LESS than for an EMMETROPE (17.74)

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CONVERGENCE: SPECTACLES vs CONTACT LENSES
PD: 64 mm CONVERGENCE: Specs vs CLs
CONVERGENCE ( Prism Dioptres ∆ )
( Reading distance: 333.33 mm from specs )
C of R: 13.5 mm
40
With specs
Convergence cf. an Emmetrope or CL wearer

35
30
25
LESS MORE
20
With CLs
15
With CLs
10
With specs
-20 -15 -10 -5 0 +5 +10 +15 +20
SPECTACLE RX ( @14 mm )
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NEAR VISION IN CLs: SUMMARY
Convergence:
• CL-wearing MYOPES converge MORE (cf. spectacles) X
• CL-wearing HYPEROPES converge LESS (cf. spectacles)
Accommodation:
• CL-wearing MYOPES accommodate MORE (cf. spectacles) X
• CL-wearing HYPEROPES accommodate LESS (cf. spectacles)
At NEAR:
• CL-wearing MYOPES CONVERGE more & ACCOMMODATE more than HYPEROPES

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CORNEAL RADIUS of CURVATURE
Range of normal radii of curvature ( R of C ):

7.1 mm to 8.7 mm
Using the common n = 1.3375 assumption

K range = 47.54 to 38.79
(This assumption has utility however, see next)

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CORNEAL RADIUS of CURVATURE: PURKINJE-SANSON IMAGE #1
• Ophthalmometers (keratometers) measure RADIUS OF

CURVATURE NOT dioptric power
• Power, if offered, is usually based on the approximation
that nCornea = 1.3375
• The average corneal R of C is 7.8 mm
• Dioptric power (1.376) = 48.205 D (front surface/air)
• ‘K reading’ (1.3375) = 43.269 D (= 89.76% of dioptric)
• That 90% figure approximates total corneal power once
the corneal back surface power is subtracted (10%)
• useful when estimating corneal astigmatism
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THE TEAR LENS
• When a soft lens rest on the anterior eye, any tear lens
trapped between the CL & the cornea is very thin
• because of CL conformity, the tear lens has no
significant dioptric power
• A rigid CL in situ can have a significant tear lens
depending on its fitting relationship to the cornea
• If a rigid CL decentres, any tear lens (spherical or
sphero-cylindrical) can acquire a prismatic component
as well

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TEAR LENS: DECENTRATION-INDUCED prism

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TEAR LENS: FITTING RELATIONSHIPS - GENERAL

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TEAR LENS: POWER WITH RIGID CLs - ALIGNED
Assumptions: nTears = 1.336, nCL = 1.490, nAir = 1.000
Assumptions: R of CCornea = 7.8 mm
Tear Lens is treated as being in air (See Appendix for validation)
Tear Lens  Air Front surface interface: To
If CL is fitted ALIGNED (Tear Lens FS R of C = +7.80 mm):Appendix
n  n 1.336  1.000
Power    43.077 D
r 0.0078
Tear Lens  Air Back surface interface:

BS R of C = –7.80 mm (defined by corneal curvature):
n  n 1.000  1.336
Power    43.077 D
r 0.0078
Tear Lens power = +43.077 + (–43.077) = 0, zero, or plano
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TEAR LENS: POWER WITH RIGID CLs - FLATTER
Tear Lens  Air Front surface interface:
If CL is fitted 0.05 mm FLATTER (FS R of C = +7.85 mm):
n  n 1.336  1.000
Power    +42.803 D
r 0.00785

BS R of C = –7.80 mm (defined by corneal curvature)
n  n 1.000  1.336
Power    43.077 D
r 0.0078
Tear Lens power = +42.803 + (–43.077) = –0.274 D

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TEAR LENS: POWER WITH RIGID CLs - STEEPER
Tear Lens  Air Front surface interface:
If CL is fitted 0.05 mm STEEPER (Tear Lens FS R of C = +7.75 mm):
n  n 1.336  1.000
Power    +43.355 D
r 0.00775

BS R of C = –7.80 mm (defined by corneal curvature)
n  n 1.000  1.336
Power    43.077 D
r 0.0078
Tear Lens power = +43.355 + (–43.077) = +0.278 D

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TEAR LENS: RULE-OF-THUMB
When the BOZR of a rigid CL is FLATTENED by 0.05 mm:

• The Tear Lens power is altered (decreased) by –0.274 D
When the BOZR of a rigid CL is STEEPENED by 0.05 mm:

• The Tear Lens power is altered (increased) by +0.278 D
RULE-OF-THUMB:
• ∆s in a CL’s BOZR of 0.05 mm  ∆s in the Tear Lens power
by approximately 0.25 D Note: The Tear Lens is treated as being THIN
• FLATTER  –0.25 D in these calculations However, in the case of
haptic/scleral CLs, the tear film thickness can
• STEEPER  +0.25 D be significant & treatment as a THICK lens
may be more appropriate

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TEAR LENS: NEUTRALIZATION OF ANTERIOR CORNEAL ASTIGMATISM
• The tears  cornea interface is less significant optically

 1.336
• nTears = 1.336 & nCornea = 1.376 1.3760.0078  5.13 D or 10.64% of the cornea in air
• Tear lens is ‘sphericalized’ by the back surface of a spherical

rigid CL
• These factors combined  a major  in corneal astigmatism
when a spherical rigid CL is worn
• However, gross differences in CL & corneal curvatures are
dysfunctional/physically unacceptable, practical limits
apply to the amount of corneal astigmatism that can be
corrected by a simple rigid spherical CL
• practical limits depend on the topography of the cornea
but a limit of about 2.5 - 3.0 D is widely accepted
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TEAR LENS:
NEUTRALIZATION OF ANTERIOR CORNEAL ASTIGMATISM

Ks (mm)( ∆0.3 ) 8.4/8.7 7.5/7.8 6.8/7.1
Astigmatism ( D ) 1.544 1.928 2.336
With CL in situ ( D ) 0.164 0.205 0.249
Residual ( % ) 10.64 10.64 10.64

n  n
Meridional Power 
r RULE-OF-THUMB: Approximately 90% of anterior corneal
Using the first column's data in air: astigmatism is neutralized by the presence of a spherical
n  n 1.376  1.000
Power1 
r

8.4
 44.762 D rigid CL.
Power1 
n  n 1.376  1.000
r

8.7
 43.218 D However, all other sources of ocular astigmatism remain
AstigmatismAir=1.544 unaltered. If the anterior cornea is astigmatic but the
Using the first column's data in situ:
manifest ocular Rx is spherical, a spherical rigid CL in situ will
n  n 1.376  1.336
Power1 
r

8.4
 4.762 D disclose the ‘internal astigmatism’ as a residual astigmatism
Power1 
n  n 1.376  1.336
r

8.7
 4.598 D with an axis at 90 ° to the corneal astigmatism & of about
Astigmatismin situ =0.164 D 90% its magnitude
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CL OVER-REFRACTION: RIGID CLS
Ocular Rx = BVPTrial + Tear Lens Power + Over-Rx

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CL OVER-REFRACTION: SOFT CLS
Ocular Rx = BVPTrial + Over-Rx

Assumptions:
• Complete soft CL conformance
• Thin Tear Lens has ZERO power
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CL OVER-REFRACTION: REASONS FOR DISCREPANCIES (all CL types)
1. Failure to correct for spectacle vertex distance when deriving ocular Rx

2. Failure to correct for over-Rx vertex distance if >4 D
3. K readings only represent the central 3 mm of the cornea
4. Incorrect/inaccurate K readings
5. Tear Lens power varies slightly from Rule-of-Thumb with different Ks
6. BVPTrial CL may be incorrectly labelled – verify it to be sure
7. Subjective over-Rx may be incorrect
8. BOZR of trial CL may be incorrect – verify it
9. Trial CL may be decentred and/or tilted
10. Trial CL flexure in situ - rigid & soft

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CL OVER-REFRACTION: REASONS FOR DISCREPANCIES (all CL types)
11. Corneal molding by the trial CL or the Rx CL
12. Corneal shape neither spherical nor sphero-cylindrical
13. Variable toric Tear Lens due to trial lens movement/decentration/tilting/rotation
14. Unexpected Tear Lens under a thick, high power, low water SCL
15. Environment-induced changes in thick, trial SCL
16. One or more of the above in combination

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LIGHT LOSS BY REFLECTION: MATERIAL REFRACTIVE INDICES
• PMMA CLs (trial lenses) 1.49
• GP CLs 1.48 – 1.41
• SCLs 1.44 –
1.38
• SiHy CLs 1.40 –

1.426

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LIGHT LOSS BY REFLECTION: FRESNEL’S FORMULA FOR REFLECTION
Fresnel's Formula: REFLECTION
 (n  n)  2
R 
 ( n  n ) 
R  Fraction of light reflected
n  Refractive index: medium of incident & reflected light
i.e. the 'outside' medium
n  Refractive index: medium partially reflecting & partially transmitting
i.e. the 'inside' material
Assumptions:
• Nearly normal angle of incidence

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LIGHT LOSS BY REFLECTION: PURKINJE-SANSON IMAGE #1
• nAir = 1.000
• nTears = 1.336
• R = 0.0207
 Light loss  2.1%

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LIGHT LOSS BY REFLECTION: ADDITIVE LOSSES WITH CLs
Reflective losses are the sum of all losses at:

• Air/Tears Additional losses from reflected light being re-reflected
by more-anterior interfaces & that ‘newly’ incident light
• Tears/CL reflecting again from more-posterior interfaces are
• CL/Tears incurred. Subsequent reflections are less significant,
e.g. 2% of 2% is not a large loss, & further reflections
• Tears/Cornea are proportionally even less significant

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LIGHT LOSS BY REFLECTION: ADDITIVE LOSSES WITH CLs
The main contributor to

reflective light losses is
the air/tear interface
Some examples of reflective losses:

• GP n = 1.48  = 2.6%
• GP n = 1.44  = 2.4%
• SCL n = 1.41  = 2.2%
• SCL n = 1.38  = 2.1%
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WET-CELL SCL BVP DETERMINATION: FEASIBLE or NOT?
• Instrument image quality is improved vastly
• But… conversion factor is NOT LINEAR
• Conversion factor is LARGE for high-water SCLs
• inaccuracies, once converted   utility
• CL sagittal height affects results
• CL centre thickness (tc) also affects results
• Wet-cell parameters also affect results
• A wet-cell parameter measuring instrument was developed
(Steel & Freund, 1985)
• BVP could be ‘estimated’ from physical measurements
Wichterle, 1965
Williams & Holden, 1977, Williams, 1978 Williams, 1977
Yumori & Mandell, 1981
Campbell, 1984
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WET-CELL SCL BVP DETERMINATION: WET CELL
Holden wet cell

(mid-1970s)
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WET-CELL SCL BVP DETERMINATION: NOT FEASIBLE !
Derivation of erroneous conversion
nCL  nAir
FactorConversion 
nCL  nSaline
1.43  1.00
1.43  1.336
0.43
0.094
FactorConversion  4.574X
A SINGLE
CONVERSION
FACTOR IS INVALID
SCL model used:
• n = 1.43
• BOZR = 8.6 mm
• tC = 0.2 mm
Williams,
Williams,1977
1977 • TD = 13.5 mm
• Monocurve design
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FIELDS-OF-VIEW: ENTRANCE PUPIL

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FIELDS-of-VIEW: ENTRANCE PUPIL: POSITION
The Entrance Pupil is the image of the anatomica
formed by the optical system of the anterior eye
n is refractive index of the object medium (aqueo
n is refractive index of the image medium (air =
n
L (l is +ve: measured from cornea to pupil)
l
1.3333
L
0.0036
L  370.361 D
( n  n ) (1.000  1.3333)
FAnterior eye  
rCornea 0.0078
FAnterior eye  42.731 D
L  L  F
L  370.361  ( 42.731)
L  327.630 D
n 1.000
l  
L 327.630
l   3.052 mm
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FIELDS-of-VIEW: ENTRANCE PUPIL: SIZE
To calculate the size of the Entrance Pupil:

L
Magnification 
L
370.361
m
327.630
m  1.1304
This represents a magnification of about +13%
Therefore, for a 4 mm pupil,
the Entrance Pupil is about: 4.52 mm

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FIELDS-of-VIEW: FIELD LIMITATIONS IN SPECTACLES: HYPEROPIA
As CLs move with the eye, no such limitations apply to their use
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FIELDS-of-VIEW: FIELD LIMITATIONS IN SPECTACLES: MYOPIA
As CLs move with the eye, no such limitations apply to their use

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OPTICAL ADVANTAGES OF CLs
• No distortion
• No chromatic aberration
• No limitations on the field-of-view
• No spectacle frame scotomata
• No spectacle frame diplopia

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OPTICAL DISADVANTAGES OF CLs
• CL decentration  ‘ghosting’
• Mislocating toric CL  toric over-Rx &  VA
• Moving CL may  disturbances of vision
• If ametropia is AXIAL, spectacles are better
• Some oblique astigmatism is present in CLs
• no degrees of optical design freedom
• spectacles can eliminate oblique astigmatism, e.g. via

Tscherning’s ellipses
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IACLE SPONSORS

Industry
Supporters
Donor Sponsor

© The
© The International
International Association
Association of
of Contact
Contact Lens
Lens Educators
Educators
www.iacle.org
www.iacle.org
Please visit us online at:
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The Optics of Contact Lenses: APPENDIX
TREATING A CL  TEAR LENS  CORNEA OPTICAL ‘SYSTEM’ AS HAVING
EACH COMPONENT SEPARATED BY AN INFINITELY THIN AIR LAYER
Considering the following central cross-section of a CL
optical system imaging incident light of zero vergence:

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Focusing on the centre section only:

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CL texts suggest that each component be considered as
being separated by an infinitely-thin layer of air:
Drawn approximately to scale

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The validity of that suggestion can be tested using real
data. Firstly by the in situ Step-Along method (no air
assumed) treating each surface in succession & secondly,
by adding air gaps & treating each component separately:

DATA USED

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Note
circled
data

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M E
SA l places)
e cima
d
(to 8

Note
circled
data

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TRAPS FOR YOUNG PLAYERS !
It is incorrect to
treat the Tear
Lens & Cornea
as having zero
vergence

incident light
Return Note
to
Lecture circled
data

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The Optics of Contact Lenses: REFERENCES
Bennett AG, 1966. OPTICS OF CONTACT LENSES. Assoc. of Dispensing Opticians.
London.
Campbell CE, 1984. Converting Wet Cell Measured Soft Lens Power to Vertex Power in
Air. ICLC 11(3): 168 – 171.
Douthwaite W, 1995. CONTACT LENS OPTICS & LENS DESIGN, Butterworth-Heinemann,
Oxford.
Fannin TE, Grosvenor T, 1996. Clinical Optics. Butterworth-Heinemann, Boston.
Freeman MH, Hull CC, 2003. Optics 11th edition. Butterworth-Heinemann, Edinburgh.
Grosvenor TP, 1963. Contact Lens Theory and Practice. Professional Press, Chicago.
Pearson RM, 2008. Aspects of wet cell measurement of back vertex power of contact
lenses. Clin Exp Optom. 91(5): 461 – 468.
Wichterle O, 1965. ‘Geltakt’ soft contact lenses. Technical and chemical problems. (In
French). Les Cahiers des Verres de Contact 6: 4 – 7. Cited in Pearson, 2008.
Williams LJ, Holden BA, 1977. The BVP of a flexible optical system in a medium other
than air. Submitted as report to the Contact Lens Soc. of Australia, October, 1978 as:
Williams LJ, 1978. Measuring soft contact lens back vertex power in a Holden wet cell.
Yumori RW, Mandell RB, 1981. Optical Power Calculation for Contact Lens Wet Cells.
Am J Optom & Physiological Optics. 58(8): 737 – 639.

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The Optics of Contact Lenses: RESOURCES USED
• Microsoft Powerpoint 2010

• Corel CorelDRAW Version X6 (16)
• Design Science MathType 6.9
• Sharp programmable calculator EL-5250 (Casio fx-5800P
equally suitable)
• OpenOffice Calc 4.1.1 (anyone who has tried to use Excel for
the purpose of plotting/graphing calculated data will
understand this choice)

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IACLE SPONSORS

Industry
Supporters
Donor Sponsor

© The
© The International
International Association
Association of
of Contact
Contact Lens
Lens Educators
Educators
www.iacle.org
www.iacle.org
THANK YOU
www.iacle.org

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The Optics of Contact Lenses

© The International Association of Contact Lens Educators

Lecture contributor Lewis Williams

* Original author(s) of lecture(s) **2014/2015 Editors and reviewers

© The International Association of Contact Lens Educators

Development and delivery of contact lens education by IACLE is

Platinum Sponsor Silver Sponsors

CIBA Vision Wesley Jessen

© The International Association of Contact Lens Educators

Revised Edition 2015

© The International Association of Contact Lens Educators 2000-2015

© The International Association of Contact Lens Educators

• Where appropriate, comparisons are drawn between contact lenses &

• The sign conventions, terminology, & symbols used in this lecture

© The International Association of Contact Lens Educators

• Radii-of-curvature of CL surfaces are much steeper that alternative vision

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

As r & f are POSITIVE, F is POSITIVE

As r is POSITIVE & f is NEGATIVE, F is NEGATIVE

Meniscus Plano-Convex Biconvex Meniscus Plano-Concave Biconcave

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

REFRACTION BY A LENS: FRONT VERTEX POWER (FVP): PLUS

© The International Association of Contact Lens Educators

REFRACTION BY A LENS: BACK VERTEX POWER (BVP): MINUS

© The International Association of Contact Lens Educators

REFRACTION BY A LENS: FRONT VERTEX POWER (FVP): MINUS

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

L'  L  F l is NEGATIVE (opposite to light direction

© The International Association of Contact Lens Educators

Vergence (L ' 1) immediately after FIRST surface:

© The International Association of Contact Lens Educators

L 2  Effectivity of L ' 1 @ the BACK surface

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

Note: Because F1 & F2 feature separately in the BVP equation,

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

Note: Optically, the image is ‘inverted’, i.e. reversed L to R, Top to Bottom

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

© The International Association of Contact Lens Educators

P is the reduced eye’s unified Principal Plane

A simple reduced eye will be used to study

© The International Association of Contact Lens Educators

Therefore, the BVP of a CL must C

CLs vs. Specs