• A positive lens is a converging lens ,convex.
Light refraction Ametropia
A –Meter –Opia
Refractive Errors • The light radiates from it’s source in a straight lines as
long as it’s in the same medium, once it enters other
• When the parallel rays are not brought to a focus on
the retina in a non-accommodating eye .
Dr. Raed Shatnawi, MD, FRCS medium the velocity of the light and direction will • It can be in the form of :
Consultant Ophthalmologist change ,this will cause what known as light refraction
-Myopia
Hashemite University • Each medium has a refractive index -Hypermetropia
Jordan • The larger the refractive index => the more refraction of -Astigmatism
the light
Visible Spectrum Emmetropia
• Light can be defined as that part of the electro- emmetropia
magnetic spectrum to which the retina is • Refractive components of the eye (around 60 D) is :
sensitive.
** 2/3 cornea (around 40 D) • Emmetropia :
• The visible part lies between the wavelengths ** 1/3 lens (around 20 D) • Emmetropia is the term used to describe a person’s vision
390nm & 760nm. when absolutely no refractive error or de-focus exists in
• Ultraviolet (UV) < 390 nm the non-accommodative eye
• When an eye is emmetropic , light rays coming parallel
• Infrared (IR) > 760 nm into the eye from infinity come to perfect focus on the ametropia
retina with a rest eye (no Accommodation )
Visible Spectrum Optical System of the Human Eye • A negative lens is a diverging lens ,concave.
visible spectrum is a portion of narrow band between violet &red
Myopia.jpg
Myopia Astigmatism Correction of ametropia
Complications
shortsightedness
Severe myopia puts you at a slightly increased risk of
1- retinal detachment,
2-glaucoma, • Light rays aren’t refracted uniformly in all meridians • In the form of spectacle or contact lenses
3-cataracts and myopic maculopathy damage in the due to non spherical shape of cornea or lens.
• When the parallel rays are brought to a focus in front of central retinal area.
• Myopia (strong eye ) you need to weaken so you
the retina in the nonaccommoadating eye 4-The tissues in long eyeballs are stretched and thinned, • Parallel rays passing through theses different planes
causing tears, inflammation, new blood vessels that are are brought to different points of focus or a line. need minus lens (concave lenses )
• Can be : Refractive ( increased power of the eye – steep weak and bleed easily, and scarring.
cornea ) • The optical power of the cornea in different planes is not • Hypermetropia ( weak eye ) you need to
equal . strengthen so you need plus lens (convex)
Axial myopia ( the axial length of the globe is long )
• Astigmatism Cylindrical lenses
Hypermetropia (Hyperopia)
Accommodation & Presbyopia
• The parallel rays are brought to a focus behind the retina
in the nonaccommoadating eye • Accommodation : increase in the power of the
• Can be : Refractive ( weak power of the eye –flatter than eye as an object is brought nearer to the eye .
normal cornea)
• -2.0DS/+3.0DC@90. • Triad of convergence ,accommodation an d
Axial ( short axial length ) meiosis .
• +1.0DS/-3.0@180. • As we age we lose progressively the ability to
• The hypermetropic patient can see neither the far nor
the near objects sharply which causes constant headache • -2.0DC@180 accommodate, reaching a critical point at the age
due to prolonged accommodation. . • of 40y when we start to complain of difficulty in
near visual tasks (presbyopia )
• Occurs earlier in hypermetropes
Presbyopia
• Treatment with adding convex lenses
• Forms of correction :
1-Separate pairs
2-Bifocals
3- progressive glasses
Optical correction after cataract THANK YOU
extraction
Management depends on the stage
• Aphakia is an extreme case of hypermetropia § Myopia only à glasses
• Aphakic spectacles ( 133% magnification ) § Regular astigmatism à glasses or contact lenses
• Contact lenses (110% magnification ) § Irregular astigmatismà rigid contact lenses
§ Severely advanced à may need keratoplasty
• IOL ( 103% magnification ) § Role of corneal collagen cross-linking.
• When the eye has an inserted IOL it is said to be
PSEUDOPHAKIC
Aphakic spectacle disadvantages Refractive Surgeries
• Image magnification 133% § Surgeries on the cornea (PRK and LASIK)
• Aniseikonia § Surgeries on the lens (IOL and ICL
• Double vision § PRK – Photo-Refractive Keratectomy
• Image distortion § LASEK – Laser Assisted IN –SITU Keratomileusis
§ IOL – Intraocular Lenses
§ ICL – Intraocular Collamer Lens
Refractive surgery
Keratoconus contraindications
• Due to corneal ectasia
• Thinning of the central and paracentral cornea that will
lead to forward conical bulging of the central cornea 1-Keratoconus
• They will lead to myopia and irregular high 2-Corneal ectasia
astigmatism.
3-Abnormally flat cornea
• Keratoconus is more common in patients with Down
syndrome and those with collagen disease.
4-Abnormally steep
• More common among patients with vernal catarrh due cornea
to extensive rubbing of the eyes. 5-Severe refractive errors
