Influence of adaptive-optics ocular aberration correction on visual acuity at different luminances and contrast polarities

12 pages, 10 figures.We evaluated the visual benefit of correcting astigmatism and high-order aberrations with adaptive optics (AO) on visual acuity (VA) measured at 7 different luminances (ranging from 0.8 to 50 cd/m2) and two contrast polarities (black letters on white background, BoW, and white letters on black background, WoB) on 7 subjects. For the BoW condition, VA increased with background luminance in both natural and AO-corrected conditions, and there was a benefit of AO correction at all luminances (by a factor of 1.29 on average across luminances). For WoB VA increased with foreground luminance but decreased for the highest luminances. In this reversed polarity condition AO correction increased VA by a factor of 1.13 on average and did not produce a visual benefit at high luminances. The improvement of VA (averaged across conditions) was significantly correlated (p = 0.04) with the amount of corrected aberrations (in terms of Strehl ratio). The improved performance with WoB targets with respect to BoW targets is decreased when correcting aberrations, suggesting a role of ocular aberrations in the differences in visual performance between contrast polarities.MEyC FIS2005-04382, MCeI FIS 2008-02065, and EURYI award to SM; MEyC FPI Predoctoral Fellowship to LS; CSIC I3P Predoctoral Fellowship to EG.Peer reviewe

Experimental simulation of simultaneous vision

Purpose. To present and validate a prototype of an optical instrument that allows experimental simulation of pure bifocal vision. To evaluate the influence of different power additions on image contrast and visual acuity. Methods. The instrument provides the eye with two superimposed images, aligned and with the same magnification, but with different defocus states. Subjects looking through the instrument are able to experience pure simultaneous vision, with adjustable refractive correction and addition power. The instrument is used to investigate the impact of the amount of addition of an ideal bifocal simultaneous vision correction, both on image contrast and on visual performance. The instrument is validated through computer simulations of the letter contrast and by equivalent optical experiments with an artificial eye (camera). Visual acuity (VA) was measured in four subjects (age: 34.3 ± 3.4 years; spherical error: -2.1 ± 2.7 diopters [D]) for low and high contrast letters and different amounts of addition. Results. The largest degradation in contrast and visual acuity (~25%) occurred for additions around ±2 D, while additions of ±4 D produced lower degradation (14%). Low additions (1-2 D) result in lower VA than high additions (3-4 D). Conclusions. A simultaneous vision instrument is an excellent tool to simulate bifocal vision and to gain understanding of multifocal solutions for presbyopia. Simultaneous vision induces a pattern of visual performance degradation, which is well predicted by the degradation found in image quality. Neural effects, claimed to be crucial in the patients' tolerance of simultaneous vision, can be therefore compared with pure optical effects. Copyright 2013 The Association for Research in Vision and Ophthalmology, Inc.Supported by Spanish Government Grant FIS2011-25637 and European Advanced Grant ERC-2011-AdG-294099 to SM.Peer Reviewe

Impact of astigmatism and high-order aberrations on subjective best focus

12 págs.; 9 figs.; 1 tab.© 2015 ARVO. We studied the role of native astigmatism and ocular aberrations on best-focus setting and its shift upon induction of astigmatism in 42 subjects (emmetropes, myopes, hyperopes, with-the-rule [WTR] and against-the-rule [ATR] myopic astigmats). Stimuli were presented in a custom-developed adaptive optics simulator, allowing correction for native aberrations and astigmatism induction (+1 D; 6-mm pupil). Best-focus search consisted on randomized-step interleaved staircase method. Each subject searched best focus for four different images, and four different conditions (with/without aberration correction, with/without astigmatism induction). The presence of aberrations induced a significant shift in subjective best focus (0.4 D; p < 0.01), significantly correlated (p = 0.005) with the best-focus shift predicted from optical simulations. The induction of astigmatism produced a statistically significant shift of the best-focus setting in all groups under natural aberrations (p = 0.001), and in emmetropes and in WTR astigmats under corrected aberrations (p < 0.0001). Best-focus shift upon induced astigmatism was significantly different across groups, both for natural aberrations and AO-correction (p < 0.0001). Best focus shifted in opposite directions in WTR and ATR astigmats upon induction of astigmatism, symmetrically with respect to the best-focus shift in nonastigmatic myopes. The shifts are consistent with a bias towards vertical and horizontal retinal blur in WTR and ATR astigmats, respectively, indicating adaptation to native astigmatism.The research leading to these results has received funding from the European Research Council under the European Union’s Seventh Framework Programme (FP/2007-2013)/ERC Grant Agreement n. [ERC-2011- AdC 294099]. This study was supported by grants FIS2011-24637 to SM and a collaborative research project funded by Essilor International. Optometric examinations were performed in the Faculty of Optometry Clinic of the University Complutense de Madrid (Madrid, Spain). GM and MH work for Essilor International.Peer Reviewe

Vision Is Adapted to the Natural Level of Blur Present in the Retinal Image

Background The image formed by the eye's optics is inherently blurred by aberrations specific to an individual's eyes. We examined how visual coding is adapted to the optical quality of the eye.Methods and Findings We assessed the relationship between perceived blur and the retinal image blur resulting from high order aberrations in an individual's optics. Observers judged perceptual blur in a psychophysical two-alternative forced choice paradigm, on stimuli viewed through perfectly corrected optics (using a deformable mirror to compensate for the individual's aberrations). Realistic blur of different amounts and forms was computer simulated using real aberrations from a population. The blur levels perceived as best focused were close to the levels predicted by an individual's high order aberrations over a wide range of blur magnitudes, and were systematically biased when observers were instead adapted to the blur reproduced from a different observer's eye.Conclusions Our results provide strong evidence that spatial vision is calibrated for the specific blur levels present in each individual's retinal image and that this adaptation at least partly reflects how spatial sensitivity is normalized in the neural coding of blur.This work was supported by the following: Ministerio de Ciencia e Innovación (MICINN), Formación de Personal Investigador (FPI) Predoctoral Fellowship to LS; Consejo Superior de Investigaciones Científicas (CSIC) I3P Predoctoral Fellowship to PdG; EY-10834 to MW; MICINN FIS2008-02065 and EURYI-05-102-ES (European Heads of Research Councils-European Science Foundation EUROHORCs-ESF) to SM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Peer reviewe

Visual simulators and programmable blur

CIP 2019, San Lorenzo de El Escorial, Madrid, 20th - 22nd, 2019Peer reviewe

Optical and visual quality with physical and visually simulated presbyopic multifocal contact lenses

16 pags. 6 figs., 1 tab.Purpose: As multifocal contact lenses (MCLs) expand as a solution for presbyopia correction, a better understanding of their optical and visual performance becomes essential. Also, providing subjects with the experience of multifocal vision before contact lens fitting becomes critical, both to systematically test different multifocal designs and to optimize selection in the clinic. In this study, we evaluated the ability of a simultaneous vision visual simulator (SimVis) to represent MCLs. Methods: Through focus (TF) optical and visual quality with a center-near aspheric MCL (low, medium and high near adds) were measured using a multichannel polychromatic Adaptive Optics visual simulator equipped with double-pass, SimVis (temporal multi-plexing), and psychophysical channels to allow measurements on-bench and in vivo. On bench TF optical quality of SimVis-simulated MCLs was obtained from double-pass (DP) images and images of an E-stimulus using artificial eyes. Ten presbyopic subjects were fitted with the MCL. Visual acuity (VA) and DP retinal images were measured TF in a 4.00 D range with the MCL on eye, and through SimVis simulations of the same MCLs on the same subjects. Results: TF optical (on bench and in vivo) and visual (in vivo) quality measurements captured the expected broadening of the curves with increasing add. Root mean square difference between real and SimVis-simulated lens was 0.031/0.025 (low add), 0.025/0.015 (medium add), 0.019/0.011 (high add), for TF DP and TF LogMAR VA, respectively. A shape similarity metric shows high statistical values (lag κ = 0), rho = 0.811/0.895 (low add), 0.792/0.944 (medium add), and 0.861/0.915 (high add) for TF DP/LogMAR VA, respectively. Conclusions: MCLs theoretically and effectively expand the depth of focus. A novel simulator, SimVis, captured the through-focus optical and visual performance of the MCL in most of the subjects. Visual simulators allow subjects to experience vision with multifocal lenses prior to testing them on-eye. Translational Relevance: Simultaneous visual simulators allow subjects to experience multifocal vision non-invasively. We demonstrated equivalency between real multifocal contact lenses and SimVis-simulated lenses. The results suggest that SimVis is a suitable technique to aid selection of presbyopic corrections in the contactology practice.Supported by the European Research Council (ERC-2011-AdC 294099) to SM; Spanish Government (FIS2017-84753R) to SM, and pre-doctoral fellowship (FPU16/01944) to SA; Collaborative agreement with Johnson & Johnson Vision, Inc., Research & Development, Jacksonville, FL, USA

Short-term neural adaptation to simultaneous bifocal images

Simultaneous vision is an increasingly used solution for the correction of presbyopia (the age-related loss of ability to focus near images). Simultaneous Vision corrections, normally delivered in the form of contact or intraocular lenses, project on the patient's retina a focused image for near vision superimposed with a degraded image for far vision, or a focused image for far vision superimposed with the defocused image of the near scene. It is expected that patients with these corrections are able to adapt to the complex Simultaneous Vision retinal images, although the mechanisms or the extent to which this happens is not known. We studied the neural adaptation to simultaneous vision by studying changes in the Natural Perceived Focus and in the Perceptual Score of image quality in subjects after exposure to Simultaneous Vision. We show that Natural Perceived Focus shifts after a brief period of adaptation to a Simultaneous Vision blur, similar to adaptation to Pure Defocus. This shift strongly correlates with the magnitude and proportion of defocus in the adapting image. The magnitude of defocus affects perceived quality of Simultaneous Vision images, with 0.5 D defocus scored lowest and beyond 1.5 D scored >sharp>. Adaptation to Simultaneous Vision shifts the Perceptual Score of these images towards higher rankings. Larger improvements occurred when testing simultaneous images with the same magnitude of defocus as the adapting images, indicating that wearing a particular bifocal correction improves the perception of images provided by that correction. © 2014 Radhakrishnan et al.The research leading to these results has received funding from the European Research Council under the European Union's Seventh Framework Programme (FP7/2007-2013)/ERC Grant Agreement n° 294099, Spanish Government grant FIS2011-264605 and 7th Framework Programme of the European Community through the Marie Curie Initial Training Network OpAL (OpAL is an Initial Training Network funded by the European Commission under the Seventh Framework Programme (PITN-GA-2010-264605))Peer Reviewe

Perceptual Adaptation to the Correction of Natural Astigmatism

Background: The visual system adjusts to changes in the environment, as well as to changes within the observer, adapting continuously to maintain a match between visual coding and visual environment. We evaluated whether the perception of oriented blur is biased by the native astigmatism, and studied the time course of the after-effects following spectacle correction of astigmatism in habitually non-corrected astigmats. Methods and Findings: We tested potential shifts of the perceptual judgments of blur orientation in 21 subjects. The psychophysical test consisted on a single interval orientation identification task in order to measure the perceived isotropic point (astigmatism level for which the image did not appear oriented to the subject) from images artificially blurred with constant blur strength (B = 1.5 D), while modifying the orientation of the blur according to the axis of natural astigmatism of the subjects. Measurements were performed after neutral (gray field) adaptation on naked eyes under full correction of low and high order aberrations. Longitudinal measurements (up to 6 months) were performed in three groups of subjects: non-astigmats and corrected and uncorrected astigmats. Uncorrected astigmats were provided with proper astigmatic correction immediately after the first session. Non-astigmats did not show significant bias in their perceived neutral point, while in astigmatic subjects the perceived neutral point was significantly biased, typically towards their axis of natural astigmatism. Previously uncorrected astigmats shifted significantly their perceived neutral point towards more isotropic images shortly (2 hours) after astigmatic correction wear, and, once stabilized, remained constant after 6 months. The shift of the perceived neutral point after correction of astigmatism was highly correlated with the amount of natural astigmatism. Conclusions: Non-corrected astigmats appear to be naturally adapted to their astigmatism, and astigmatic correction significantly changes their perception of their neutral point, even after a brief period of adaptation. © 2012 Vinas et al.The study was supported by grants MICINN FIS2008-02065, FIS2011-25637; EURHORCs-ESF (European Heads of Research Councils); EURYI-05-102-ES (The European Young Investigator Awards) & ERC-2011-AdG-294099 (European Research Council) to SM.Peer Reviewe

Single neural code for blur in subjects with different interocular optical blur orientation

13 págs.; 5 figs.© 2015 ARVO. The ability of the visual system to compensate for differences in blur orientation between eyes is not well understood. We measured the orientation of the internal blur code in both eyes of the same subject monocularly by presenting pairs of images blurred with real ocular point spread functions (PSFs) of similar blur magnitude but varying in orientations. Subjects assigned a level of confidence to their selection of the best perceived image in each pair. Using a classification-images–inspired paradigm and applying a reverse correlation technique, a classification map was obtained from the weighted averages of the PSFs, representing the internal blur code. Positive and negative neural PSFs were obtained from the classification map, representing the neural blur for best and worse perceived blur, respectively. The neural PSF was found to be highly correlated in both eyes, even for eyes with different ocular PSF orientations (rPos = 0.95; rNeg = 0.99; p < 0.001). We found that in subjects with similar and with different ocular PSF orientations between eyes, the orientation of the positive neural PSF was closer to the orientation of the ocular PSF of the eye with the better optical quality (average difference was ∼10°), while the orientation of the positive and negative neural PSFs tended to be orthogonal. These results suggest a single internal code for blur with orientation driven by the orientation of the optical blur of the eye with better optical quality.The authors acknowledge the funding received from the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007- 2013) / ERC Grant Agreement n8 294099 (SM), Spanish Government grant FIS2011-264605 (SM), the 7th Framework Programme of the European Community through the Marie Curie Initial Training Network OpAL (OpAL is an Initial Training Network funded by the European Commission under the Seventh Framework Programme (PITN-GA-2010- 264605, AR) and USA NIH grant R01EY05957 (EP).Peer Reviewe

Adaptation to contralateral differences in ocular blur

1st World Meeting in Visual and Physiological Optics, Wroclaw, Poland, August 25-27 2014Previous studies have shown that the visual system appears naturally adapted to the blur imposed by the ocular optics. Also, shifts in the best-perceived-focus (after-effects) occur after blur adaptation. We explored the potential differences in the natural states of blur adaptation between the eyes of 5 subjects with interocular differences in optical degradation (Ocular Strehl Ratio, OSR). The perceived-best-focus was measured in both eyes using a QUEST protocol, after adapting to images with different blur levels, spanning those of the subject’s eyes. Test and adapting images were face images convolved with scaled versions of the subjects' ocular aberrations. After-effects were estimated as the shifts in perceived-best-focus following adaptation to a blurred image, compared to adaptation to a gray-field. Irrespective of the eye tested, perceived-bestfocus matched the natural blur of the better eye. Moreover, no after-effects were observed when the eyes were adapted to the better eye OSR and marked after-effects when adapted to the worse eye OSR. Our results indicate that in eyes with interocular optical blur differences, the perceived-best-focus is unique, and is driven by the eye with better optical quality.Peer Reviewe