Validation of the Iowa Head-Mounted Open-Source Perimeter.

Purpose: To assess the validity of visual field (VF) results from the Iowa Head-Mounted Display (HMD) Open-Source Perimeter and to test the hypothesis that VF defects and test-retest repeatability are similar between the HMD and Octopus 900 perimeters.

Methods: We tested 20 healthy and nine glaucoma patients on the HMD and Octopus 900 perimeters using the Open Perimetry Interface platform with size V stimuli, a custom grid spanning the central 26° of the VF, and a ZEST thresholding algorithm. Historical data from the Humphrey Field Analyzer (HFA) were also analyzed.

Using high-density perimetry to explore new approaches for characterizing visual field defects.

High-density threshold perimetry has found that conventional static threshold perimetry misses defects due to undersampling. However, high-density testing can be both slow and limited by normal fixational eye movements. We explored alternatives by studying displays of high-density perimetry results for angioscotomas in healthy eyes-areas of reduced sensitivity in the shadows of blood vessels.

The Open Perimetry Initiative: A framework for cross-platform development for the new generation of portable perimeters.

The Open Perimetry Initiative was formed in 2010 with the aim of reducing barriers to clinical research with visual fields and perimetry. Our two principal tools are the Open Perimetry Interface (OPI) and the visualFields package with analytical tools. Both are fully open source.

Visual Field Progression in Glaucoma: Comparison Between PoPLR and ANSWERS.

Purpose: It has been suggested that the detection of visual field progression can be improved by modeling statistical properties of the data such as the increasing retest variability and the spatial correlation among visual field locations. We compared a method that models those properties, Analysis with Non-Stationary Weibull Error Regression and Spatial Enhancement (ANSWERS), against a simpler one that does not, Permutation of Pointwise Linear Regression (PoPLR).

Methods: Visual field series from three independent longitudinal studies in patients with glaucoma were used to compare the positive rate of PoPLR and ANSWERS.

Objective changes in astigmatism during accommodation.

Purpose: Previous studies have shown small but clinically significant changes in the power and axis of astigmatism when the eye accommodates. Monocular objective measurements of the eye during accommodation, when the object approaches the eye without convergence, also reveal small astigmatic changes. Moreover, it is known that the eye exhibits ocular cyclotorsion at different gaze angles.

Predictability of sinusoidally moving stimuli does not improve the accuracy of the accommodative response.

Previous research work suggests that predictable target motion such as sinusoidal movement can be anticipated by the visual system, thereby improving the accommodative response. The validity of predictable motion for studying human dynamic accommodation is sometimes put into question. The aim of this work was to assess the effect of anticipation along with learning (and motivation, etc.

Detecting Progression in Patients With Different Clinical Presentations of Primary Open-angle Glaucoma.

Prcis: Glaucoma progression was more frequently identified by assessing retinal fiber layer thickness than by monitoring visual field (VF) loss for different baseline classifications in primary open-angle glaucoma.

Purpose: The aim was to compare the detection of glaucoma progression by retinal nerve fiber layer thickness (RNFLT) and VF assessments for different baseline classifications of primary open-angle glaucoma.

Methods: This study included 194 eyes from 194 patients with a minimum of 9 follow-up visits selected from the Diagnostic Innovation in Glaucoma Study (DIGS) and the African Descent and Glaucoma Evaluation Study (ADAGES).

The Effect of Retinal Illuminance on the Subjective Amplitude of Accommodation.

Significance: We show that the amplitude of accommodation decreases with retinal illumination even under photopic reading conditions and a constant pupil size. This result provides a basis for clinical approaches that are not based on an optical explanation.

Purpose: We investigated the effect of retinal illuminance on the amplitude of accommodation while the pupil of the eye remained constant.

A framework for assessing glaucoma progression using structural and functional indices jointly.

Purpose: While many tests and indices are available to identify glaucoma progression, using them in combinations may decrease overall specificity. The aim of this study was to develop a framework for assessing glaucoma progression using structural and functional indices jointly for a fixed specificity.

Methods: The study included 337 eyes of 207 patients with ocular hypertension or primary open-angle glaucoma selected from the Diagnostic Innovations in Glaucoma Study or the African Descent and Glaucoma Evaluation Study.

Threshold Automated Perimetry of the Full Visual Field in Patients With Glaucoma With Mild Visual Loss.

Precis: The authors used the Open Perimetry Interface to design a static automated perimetry test of the full field. Abnormal test locations in the nasal midperiphery and temporal inferior sector area best separated glaucomas from normals.

Purpose: The peripheral visual field in glaucoma outside 30 degrees is largely unexplored with static perimetry.

Threshold Static Automated Perimetry of the Full Visual Field in Idiopathic Intracranial Hypertension.

Purpose: To characterize visual loss across the full visual field in idiopathic intracranial hypertension (IIH) patients with mild central visual loss.

Methods: We tested the full visual field (50° nasal, 80° temporal, 30° superior, 45° inferior) of 1 eye of 39 IIH patients by using static perimetry (size V) with the Open Perimetry Interface. Participants met the Dandy criteria for IIH and had at least Frisén grade 1 papilledema with better than -5 dB mean deviation (MD) centrally.

Defocus vibrations in optical systems-considerations in reference to the human eye.

Experimental visual acuity (VA) of eight subjects was measured using the Freiburg vision test in a custom-made adaptive optics system. Measurements were conducted under one control and five defocus-induced conditions. In the defocus-induced conditions, 1 diopter of myopic defocus was added to the system using the Badal stage, and defocus vibrations with five different levels of amplitude were generated by a deformable mirror at 50 Hz.

Impact of higher-order aberrations on depth-of-field.

It is well known that depth-of-focus (DOF) is influenced by optical factors (such as pupil size and monochromatic aberrations). However, neural factors such as blur sensitivity and defocus adaptation may play an important role on the extent of DOF. A series of experiments were conducted to study if optical or neural factors are most pertinent in explaining the variability of DOF across subjects.

Data obtained with an open-source static automated perimetry test of the full visual field in healthy adults.

The data were gathered from 98 eyes of 98 ocular healthy subjects. The subject ages ranged from 18 to 79 years with a mean (and standard deviation) of 47 (17) years. Each subject underwent two visual field tests, one of the central visual field (64 locations within 26° of fixation) and one of the peripheral visual field (64 locations with eccentricity from 26° to up to 81°).

Prediction Accuracy of the Dynamic Structure-Function Model for Glaucoma Progression Using Contrast Sensitivity Perimetry and Confocal Scanning Laser Ophthalmoscopy.

Purpose: The purpose of this study was to determine whether combining a structural measure with contrast sensitivity perimetry (CSP), which has lower test-retest variability than static automated perimetry (SAP), reduces prediction error with 2 models of glaucoma progression.

Methods: In this retrospective analysis, eyes with 5 visits with rim area (RA), SAP, and CSP measures were selected from 2 datasets. Twenty-six eyes with open-angle glaucoma were included in the analyses.

Associations between structure and function are different in healthy and glaucomatous eyes.

Purpose: To assess if there are differences in the structure-function associations between healthy and glaucomatous eyes.

Methods: Structure-function associations were assessed in healthy and glaucomatous eyes in three datasets, globally and in the six sectors of the optic nerve head. Structural parameters included rim area (RA) and retinal nerve fiber layer thickness (RNFLT).

Effect of phenylephrine on static and dynamic accommodation.

Purpose: We tested the hypothesis that changes in accommodation after instillation of Phenylephrine Hydrochloride (PHCl) observed in some studies could be caused by changes in optics.

Methods: We performed two experiments to test the effects of PHCl on static and on dynamic accommodation in 8 and 6 subjects, respectively. Objective wavefront measurements were recorded of the static accommodation response to a stimulus at different distances or dynamic accommodation response to a sinusoidally moving stimulus (between 1 and 3 D of accommodative demand at 0.

The effect of spherical aberration on visual performance and refractive state for stimuli and tasks typical of night viewing.

Purpose: The aim of this work was to examine the impact of Seidel spherical aberration (SA) on optimum refractive state for detecting and discriminating small bright lights on a dark background.

Methods: An adaptive-optics system was used to correct ocular aberrations of cyclopleged eyes and then systematically introduce five levels of Seidel SA for a 7-mm diameter pupil: 0,±0.18, and±0.

There is more to accommodation of the eye than simply minimizing retinal blur.

Eyes of children and young adults change their optical power to focus nearby objects at the retina. But does accommodation function by trial and error to minimize blur and maximize contrast as is generally accepted? Three experiments in monocular and monochromatic vision were performed under two conditions while aberrations were being corrected. In the first condition, feedback was available to the eye from both optical vergence and optical blur.

Drifts in real-time partial wavefront correction and how to avoid them.

In visual experiments that require real-time partial correction of wavefront aberrations, small errors occur that accumulate over time and lead to drifts in Zernike coefficients of the uncorrected aberrations. A simple algorithm that does not require the inclusion of an additional optical path to obtain independent measurements of the eye's aberrations is described here, and its effectiveness in preventing these drifts is demonstrated.

Human eyes do not need monochromatic aberrations for dynamic accommodation.

Purpose: To determine if human accommodation uses the eye's own monochromatic aberrations to track dynamic accommodative stimuli.

Methods: Wavefront aberrations were measured while subjects monocularly viewed a monochromatic Maltese cross moving sinusoidally around 2D of accommodative demand with 1D amplitude at 0.2 Hz.

Dynamic accommodation without feedback does not respond to isolated blur cues.

The aim of this study was to determine whether dynamic accommodation responds to isolated blur cues without feedback, and without changes in the distance of the object. Nine healthy subjects aged 21-40years were recruited. Four different aberration patterns were used as stimuli to induce blur with (1) the eye's natural, uncorrected, optical aberrations, (2) all aberrations corrected, (3) spherical aberration only, or (4) astigmatism only.

Accommodation Responds to Optical Vergence and Not Defocus Blur Alone.

Purpose: To determine whether changes in wavefront spherical curvature (optical vergence) are a directional cue for accommodation.

Methods: Nine subjects participated in this experiment. The accommodation response to a monochromatic target was measured continuously with a custom-made adaptive optics system while astigmatism and higher-order aberrations were corrected in real time.