Ophthalmology Study Guide

5— Spherical Lenses

Definition of a Lens:

Lens: A portion of a refracting medium bordered by two curved surfaces with a

common axis.

Spherical Lens: A lens where each surface forms part of a sphere.

Plane Surface: Can be considered part of a sphere of infinite radius.

Light Interaction with Lenses:

Convex Lens: Causes convergence of incident light.

Concave Lens: Causes divergence of incident light.

Total Vergence Power of a Spherical Lens:

Dependence: Depends on the vergence power of each surface and the thickness
of the lens.

Thin Lenses (Ophthalmology): Thickness factor can be ignored.

Total Power of Thin Lens: Sum of the two surface powers.

Refraction in Thin Lenses: Occurs at the principal plane of the lens.

Thick Lenses: More complicated refraction, dealt with in Chapter 9 (relevant to

eye's refracting mechanism).

Principal Plane and Nodal Point:

Principal Plane (AB): Shown in ray diagrams to indicate the convex or concave
nature of a thin lens.
 Principal Point/Nodal Point (N): The point where the principal plane and
principal axis intersect.

Rays through Nodal Point: Undeviated.

Principal Focus:

Definition: Point where light parallel to the principal axis is converged to

(convex) or diverged from (concave).

Medium: If the medium on both sides is the same (e.g., air), there is a principal
focus on each side, equidistant from the nodal point.

First Principal Focus (F1):

Definition: Point of origin of rays which, after refraction by the lens, are parallel
to the principal axis.

First Focal Length (f1): Distance F1N.

Second Principal Focus (F2):

Definition: Point where incident light parallel to the principal axis is converged
to or diverged from.

Second Focal Length (f2): Distance F2N.

Sign Convention:

Convex Lens: f2 has a positive sign.

Concave Lens: f2 has a negative sign.

Lens Designation: Lenses are designated by their second focal length.

Convex/Converging Lenses: Called 'plus lenses', marked with +.

Concave/Diverging Lenses: Known as 'minus lenses', marked with –.

f1 vs. f2:

Same Medium: If the medium on either side of the lens is the same (e.g.,
air), then f1 = f2.

Different Medium: If the second medium differs from the first (e.g., contact
lens), then f1 will not equal f2.
Thin Lens Formula:

Formula: 1/v - 1/u = 1/f2

v: Distance of the image from the principal point.

u: Distance of the object from the principal point.

f2: Second focal length.

Image Construction (Two Rays):

Ray 1: A ray from the top of the object passing through the principal point is
undeviated.

Ray 2: A ray parallel to the principal axis, which after refraction:

Convex Lens: Passes through the second principal focus.

Concave Lens: Passes away from the second principal focus.

Dioptric Power of Lenses. Vergence:

Lens Power: Lenses with shorter focal length are more powerful.

Unit of Lens Power: Dioptre (D).

Calculation: Reciprocal of the second focal length expressed in metres.

Formula: F = 1/f2 (where F is vergence power in dioptres, f2 is second focal

length in metres).

Examples:

Converging lens, f2 = +5 cm (+0.05 m) -> Power = +20 D.

Diverging lens, f2 = –25 cm (–0.25 m) -> Power = –4 D.

Vergence Concept: Reciprocal of object and image distances in metres gives a

dioptric value, measuring the degree of convergence or divergence of rays.

Importance: Aids understanding of optics of accommodation and presbyopia.

Magnification Formulae:

Linear Magnification:

Formula: M = I/O = v/u

 I: Image size.

O: Object size.

v: Distance of the image from the principal plane.

u: Distance of the object from the principal plane.

Angular Magnification:

Ophthalmic Importance: Actual image and object size are less important than
the angle subtended at the eye, as this governs retinal image size.

Apparent Size: Given by the ratio of object (or image) size divided by its distance
from the eye (tan q).

Small Angles: For small angles, tan q ≈ q.

Image at Infinity: A convex lens with object at the first principal focus forms an
image at infinity.

Object and image subtend the same angle at the lens and eye (if eye is close
to lens).

Angular magnification is unity (apparent object size and apparent image

size are the same).

The Simple Magnifying Glass (The Loupe):

Function: Enables the eye to view an object at a much shorter distance than
unaided, while retaining a distinct image.

Effect of Closer Object: As the object approaches the eye, it subtends a greater
angle, and retinal image size increases.

Magnifying Power Formula:

Magnifying Power = (Angle subtended by image at eye) / (Angle subtended

by object at near point of unaided eye)

Commonly used × 8 loupe has a lens power of +32 dioptres.

Spherical Lens Decentration and Prism Power:

Prismatic Effect: Rays incident outside the axial zone of a lens are deviated,
causing the peripheral portion to act as a prism.
 Refracting Angle: Increases towards the edge of the lens, thus increasing the
prismatic effect towards the periphery.

Decentration: Use of a non-axial portion of a lens to gain a prismatic effect.

Applications: Frequently employed in spectacles to incorporate a prism.

Consequences of Poor Centration:

May produce unwanted prismatic effect, especially with high-power lenses.

Frequent cause of spectacle intolerance, particularly in patients with

aphakia or high myopia.

Prismatic Power Formula (Prentice's Rule):

Formula: P = F × D
P: Prismatic power in prism dioptres.

F: Lens power in dioptres.

D: Decentration in centimetres.

Clinical Significance:

Underlying mechanism of spherical aberration.

Causes troublesome ring scotoma and jack-in-the-box effect in high-

power spectacle lens wearers.

6— Astigmatic Lenses

Characteristics of Astigmatic Lenses:

Spherical Lens: All meridians of each surface have the same curvature;
refraction is symmetrical.

Astigmatic Lens: All meridians do not have the same curvature; a point image of
a point object cannot be formed.

Types: Cylindrical and toric lenses.

Cylindrical Lenses:
 Structure: One plane surface, the other forms part of a cylinder.

Axis of the Cylinder: Meridian with no vergence power.

Meridian at Right Angles to Axis: Acts as a spherical lens.

Effect: Formation of a line image of a point object.

Focal Line: Parallel to the axis of the cylinder.

The Maddox Rod:

Description: A device consisting of a series of powerful convex cylindrical lenses

mounted side by side in a trial lens.

Use: Diagnosis of extraocular muscle imbalance.

Patient View: Views a distant white point source of light (at least 6m away for
parallel rays) through the Maddox rod.

Optics - Light Parallel to Axis:

Light in the meridian parallel to the axis of each cylinder passes through
undeviated.

Brought to a focus by the eye.

A row of foci are formed on the retina, joining up to form a line of light.

This line lies at 90° to the axis of the Maddox rod.

Optics - Light at 90° to Axis:

Light incident on the Maddox rod in the meridian at 90° to its axis is
converged by each cylinder to a real line focus between the rod and the eye.

This focus is too close for a distinct image on the retina.

Light is scattered over a wide retinal area, not confusing the perception of
the composite line image.

Key Point: The line seen by the patient is formed by the focusing mechanism of
the eye and lies at 90° to the Maddox rod axis; it is not the real line image of the
Maddox rod.
 Color: The glass is tinted red, so the composite line image seen by the patient is
also red.

Use of the Maddox Rod to Test Muscle Balance:

Procedure: Maddox rod placed in front of one eye (conventionally right), distant
white spotlight viewed with both eyes.

Dissociation: The right eye sees a red line, the left eye sees the white spotlight,
causing dissociation and revealing muscle imbalance.

Testing Horizontal Imbalance: Rod must be horizontal to produce a vertical line.

Testing Vertical Imbalance: Rod must be vertical to produce a horizontal line.

Interpretation: The eye behind the Maddox rod (e.g., right eye) deviates in the
opposite direction to that indicated by the red line.

Horizontal Orthophoria: Red line aligned with white spotlight.

Exophoria: Crossed diplopia, red line appears nasal to white spotlight (eye
deviates temporally).

Esophoria: Uncrossed diplopia, red line appears temporal to white

spotlight (eye deviates nasally).

Right Hyperphoria: Red line appears below white spotlight (right eye
deviates upwards).

Right Hypophoria (= Left Hyperphoria): Red line appears above white

spotlight (right eye deviates downwards).