A fundamental problem facing sensory systems is to recover useful information about the external world from signals that are corrupted by the sensory process itself. Retinal images in the human eye are affected by optical aberrations that cannot be corrected with ordinary spectacles or contact lenses, and the specific pattern of these aberrations is different in every eye. Though these aberrations always blur the retinal image, our subjective impression is that the visual world is sharp and clear, suggesting that the brain might compensate for their subjective influence. The recent introduction of adaptive optics to control the eye’s aberrations now makes it possible to directly test this idea. If the brain compensates for the eye’s aberrations, vision should be clearest with the eye’s own aberrations rather than with unfamiliar ones. We asked subjects to view a stimulus through an adaptive optics system that either recreated their own aberrations or a rotated version of them. For all five subjects tested, the stimulus seen with the subject’s own aberrations was always sharper than when seen through the rotated version. This supports the hypothesis that the neural visual system is adapted to the eye’s aberrations, thereby removing somehow the effects of blur generated by the sensory apparatus from visual experience. This result could have important implications for methods to correct higher order aberrations with customized refractive surgery because some benefits of optimizing the correction optically might be undone by the nervous system’s compensation for the old aberrations.

Purpose.: To establish, using adaptive optics scanning laser ophthalmoscopy (AOSLO), that the retinal parafoveal capillary network is altered before the onset of diabetic retinopathy in adult patients with type 2 diabetes. Methods.: AOSLO videos were acquired in the parafoveal region of one eye from control subjects and from patients with type 2 diabetes and no retinopathy. Detailed images of the parafoveal capillary network were generated with custom motion contrast enhancement algorithms. The combination of AOSLO images and videos enabled the simultaneous assessment of several features of the parafoveal capillary network. Arteriovenous (AV) channels were identified by finding the least tortuous capillary channels connecting terminal arterioles to postcapillary venules. Measures of capillary dropout and capillary hemodynamics were also quantified. Results.: The average tortuosity of AV channels was 26% higher in patients with type 2 diabetes when compared with controls, even though there were no signs of diabetic retinopathy in any of the eyes that were assessed (P < 0.05). In addition, the metrics of capillary dropout showed small changes (between 3% and 7%), leukocyte speed 14% lower, and pulsatility 25% higher, but none of these differences was statistically significant. Conclusions.: It is often difficult to find consistent changes in the retinal microvasculature due to large intersubject variability. However, with a novel application of AOSLO imaging, it is possible to visualize parafoveal capillaries and identify AV channels noninvasively. AV channels are disrupted in type 2 diabetes, even before the onset of diabetic retinopathy.

An instrument permitting visual testing in white light following the correction of spherical aberration (SA) and longitudinal chromatic aberration (LCA) was used to explore the visual effect of the combined correction of SA and LCA in future new intraocular lenses (IOLs). The LCA of the eye was corrected using a diffractive element and SA was controlled by an adaptive optics instrument. A visual channel in the system allows for the measurement of visual acuity (VA) and contrast sensitivity (CS) at 6 c/deg in three subjects, for the four different conditions resulting from the combination of the presence or absence of LCA and SA. In the cases where SA is present, the average SA value found in pseudophakic patients is induced. Improvements in VA were found when SA alone or combined with LCA were corrected. For CS, only the combined correction of SA and LCA provided a significant improvement over the uncorrected case. The visual improvement provided by the correction of SA was higher than that from correcting LCA, while the combined correction of LCA and SA provided the best visual performance. This suggests that an aspheric achromatic IOL may provide some visual benefit when compared to standard IOLs.

Purpose. Adaptive optics systems can be used to investigate the potential visual benefit associated with correcting ocular wave-front aberration. In this study, adaptive optics techniques were used to evaluate the potential advantages and disadvantages associated with intraocular lenses (IOLs) with modified spherical aberration profiles.

Adaptive optics for the human eye has two main applications: to obtain high-resolution images of the retina and to produce aberration-free retinal images to improve vision. Additionally, it can be used to modify the aberrations of the eye to perform experiments to study the visual function. We have developed an adaptive optics prototype by using a liquid crystal spatial light modulator (Hamamatsu Programmable Phase Modulator X8267). The performance of this device both as aberration generator and corrector has been evaluated. The system operated either with red (633nm) or infrared (780nm) illumination and used a real-time Hartmann-Shack wave-front sensor (25 Hz). The aberration generation capabilities of the modulator were checked by inducing different amounts of single Zernike terms. For a wide range of values, the aberration production process was found to be linear, with negligible cross-coupling between Zernike terms. Subsequently, the modulator was demonstrated to be able to correct the aberrations of an artificial eye in a single step. And finally, it was successfully operated in close-loop mode for aberration correction in living human eyes. Despite its slow temporal response, when compared to currently available deformable mirrors, this device presents advantages in terms of effective stroke and mode independence. Accordingly, the programmable phase modulator allows production and compensation of a wide range of aberrations, surpassing in this respect the performance of low-cost mirrors and standing comparison against more expensive devices.

Ophthalmoscopes to image the retina are widely used diagnostic tools in ophthalmology and are vital for the early detection of many eye diseases. Although there are various effective optical implementations of ophthalmoscopes, new, robust systems may have a future practical importance in cases where ocular media present significant opacities. Here, we present, as a proof of concept, a novel approach for imaging the retina in real time using a single pixel detector combined with spatially coded illumination. Examples of retinal images in both artificial and real human eyes are presented for the first time to our knowledge.