Clinical Optic and Refraction

•Faculty of Medicine Brawijaya University

•Department of Ophthalmology dr Saiful Anwar
The visible light of EM spectrum, to which the retina
is sensitive, lies between 390 nm - 760 nm
The light should be focused on retina to generate
accurate visual information
 light travels in a straight line ,
when it reaches another medium it will bend

REFRACTION

This is how lenses work, and how we see

 Diopter is a refractive
measurement of the lens

P = 1/ f

P = power (D)
f = focal lenght in meter (m)
A negative lens is a diverging lens ,concave
,corrects for myopia

A positive lens is a converging lens ,convex

,corrects for hypermetropia.

Example: +1 D lens focuses light at 1m.

+2 D lens focuses light at 0.5m.
 Refraction component of the eye
The cornea and crystallin lens focus the ray onto retina
2/3 cornea and tear film
1/3 lens

Eye is a bunch of lenses

 Emmetropic Eye

pararel rays come from infinity come to focus in retina,

which the eye at rest (not accomodating)
Ammetropic Eye
when pararel rays of light are not brought to a focus
on retina when an eye at rest

Ametropic Eye is devided into :

1. Myopia ( nearsightness)
2. Hypermetropia ( farsightness)
3. Astigmatism
 Myopic Eye
Nearsightness

Pararel rays from infinity come to fokus in front of retina

Low Myopia -3.00 D or less

Medium Myopia - 3.00 D ~ -6.00 D

High Myopia -6.00 D or more

 How Myopia Ussualy See ?

correction : Spectacle (minus spherical lens)

contact lens
refractive surgery
HYPEROPIA / HYPERMETROPIA
Farsightness
 The eye’s optical system is
less powerful

rays of light converge behind the retina, which causes

blurring of vision for near objects and distant object
Correct : Spectacle (Spherical plus lens)
Contact lens
Refractive Surgery
Astigmatism makes it difficult to see fine detils, either
close up or from distance

corrected : Cylindrical lens

Contact Lens
Refractif Surgery
 DEFINITION
Aniseikonia: a difference of image size between the
2 eyes as perceived by the patient.
Anisometropia: a refractive power difference
between the 2 eyes (usually > 3D)

Aphakia: ( Phakos=lens), aphakia is no lens.

Pseudophakia: artificial lens in the eye.

Presbyopia, before corrected

Presbyopia, after corrected

Subjective Examination
align ,the same high

5 or 6 m
close one of the patient’s eye
 What will do you do if the patient can’t
read the biggest letter in snellen chart ?
 Counting Finger Testing

1-5m

- maximal distance is 5 m
- minimal distace is 1 m
- close one patient’s eye
- 1/ 60 means the patient can see the finger at 1 m
- 2/ 60 means the patient can see the finger at 2 m
- 5 / 60 means the patient can see the finger at 5 m
 Handmotion Test

1m

- The distance 1 m
- close one patient’s eye
- ask the patient to mention the hand motion dirrection
- 1/300 means the patient can see the hand motion
LIGHT PRESCEPTION TEST
Spectacle Prescription
THANK YOU