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Refractive Errors

Raisa Janet Ariestha ( I 111 09 041)

Refraction is defined as the ratio of the


refractive power of the lens and cornea (the refractive media) to the axial length of the globe

Ametropia Emmetropia (refractive error): (normal sight) : The There is a mismatch ratio of the axial between the axial length of the eye to length of the eye the refractive and the refractive power of the power of the lens cornea and lens is and cornea balanced.

Accommodation
Refers to the ability to adjust the strength of the lens by changing its shape, which in turn is regulated by the ciliary muscle. Accommodation involves the lens, zonule fibers, and ciliary muscle.

Accommodation
When the ciliary muscle is relaxed, the ligaments (bands of tissue) attached to the lens pull the lens flat and therefore less curved and weakly refractive. Contracting the ciliary muscle reduces the tension in the ligaments, so that the lens assumes a more curved shape because of its elasticity. The greater curvature allows the lens to increase its strength, resulting in greater bending of the light rays. Therefore, in far vision, the ciliary muscle is relaxed and the lens is flat, but during near vision, the muscle contracts and allows the lens to become more convex.

Refractive Anomalies
Myopia (Shortsightedness) Hyperopia (Farsightedness) Astigmatism Presbyopia

Myopia(Shortsightedness)
A discrepancy between the refractive power and axial length of the eye such that parallel incident light rays converge at a focal point anterior to the retina Etiology: not clear. Familial patterns of increased incidence suggest the influence of genetic factors Causes
excessive long globe (axial myopia) : more common excessive refractive power (refractive myopia)

Myopia

Myopia
Forms: - Stasioner Myopia/school age myopia persistent when adult - Progressif Myopia progressif although in adult, because increase eye ball length - Malignant Myopia progressif, can make retinal ablasion and blindness Symptom : - Blurred distance vision - Squint in an attempt to improve uncorrected visual acuity when gazing into the distance - Space between palpebra is decreased - Headache

Myopia

Myopia
Correction of myopia

Hyperopia (Farsightedness)
In hyperopia, there is a discrepancy between the refractive power and axial length of the eye such that parallel incident light rays converge at a focal point posterior to the retina Classification : - an excessively short globe with normal refractive power (axial hyperopia) - or, less frequently, to insufficient refractive power in a normal-length globe (refractive hyperopia)

Hyperopia (Farsightedness)
Symptoms: - In young patients, accommodation can compensate for slight to moderate hyperopia. - Asthenopic symptoms such as eye pain or headache, burning sensation in the eyes, blepharoconjunctivitis, blurred vision, and rapid fatigue.

Hyperopia

Hyperopia
Correction of hyperopia

Astigmatism
The disorder is characterized by a curvature anomaly of the refractive media such that parallel incident light rays do not converge at a point but are drawn apart to form a line. Refractive media is not spherical refract differently along one meridian than along meridian perpendicular to it 2 focal points ( punctiform object is represent as 2 sharply defined lines)

Astigmatism
Classification : 1. External astigmatism: astigmatism of the anterior surface of the cornea. 2. Internal astigmatism: the sum of the astigmatic components of the other media. Astigmatism can also be classified according to the location of the meridian of greater refraction: 1. With-the-rule astigmatism (most common form): The meridian with the greater refractive power is vertical, i.e., between 70 and 110 degrees. 2. Against-the-rule astigmatism: The meridian with the greater refractive power is horizontal, i.e., between 160 and 20 degrees. 3. Oblique astigmatism: The meridian with the greater refractive power is oblique, i.e., between 20 and 70 degrees or between 110 and 160 degrees.

Astigmatism
Symptoms: Patients with astigmatism see everything distorted; asthenopic symptoms such as a burning sensation in the eyes or headache. Regular astigmatism involving only two meridians approximately perpendicular to each other. Irregular astigmatism the curvature and the refractive power of the refractive media are completely irregular. There are multiple focal points, which produces a completely blurred image on the retina

Astigmatism
Treatment of regular astigmatism: The purpose of the correction is to bring the focal lines of two main meridians together at one focal point. This requires a lens that refracts in only one plane. Cylinder lenses are required for this application. Treatment of irregular astigmatism: This form cannot be corrected with eyeglasses. External astigmatism may be managed with a rigid contact lens, keratoplasty, or surgical correction of the refractive error.

Presbyopia
Presbyopia is an age-related visual impairment Physiologic loss of accommodation in advancing age - Deposit of insoluble proteins in lens in advancing age elasticity of lens progressively decreasedecrease accommodation - Decrease cilliary muscle contraction Symptoms : Blurred vision, inability to see fine details , delays in focusing at near or distance, ocular discomfort, headache, asthenopia, squinting, fatigue or drowsiness from near work

Presbyopia
The lens of eyeglass that use of patient presbyopi depend on them age;
+ 1.0 D 40 th of age + 1.5 D 45 th of age + 2.0 D 50 th of age + 2.5 D 55 th of age + 3.0 D 60 th of age

Thankyou