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Optics Express

Optics Express

  • Editor: C. Martijn de Sterke
  • Vol. 16, Iss. 19 — Sep. 15, 2008
  • pp: 14731–14745
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Binocular correlation of ocular aberration dynamics

S. S. Chin, K. M. Hampson, and E. A. H. Mallen  »View Author Affiliations


Optics Express, Vol. 16, Issue 19, pp. 14731-14745 (2008)
http://dx.doi.org/10.1364/OE.16.014731


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Abstract

Fluctuations in accommodation have been shown to be correlated in the two eyes of the same subject. However, the dynamic correlation of higher-order aberrations in the frequency domain has not been studied previously. A binocular Shack-Hartmann wavefront sensor is used to measure the ocular wavefront aberrations concurrently in both eyes of six subjects at a sampling rate of 20.5 Hz. Coherence function analysis shows that the inter-ocular correlation between aberrations depends on subject, Zernike mode and frequency. For each subject, the coherence values are generally low across the resolvable frequency range (mean 0.11), indicating poor dynamic correlation between the aberrations of the two eyes. Further analysis showed that phase consistency dominates the coherence values. Monocular and binocular viewing conditions showed similar power spectral density functions.

© 2008 Optical Society of America

1. Introduction

When a subject fixates steadily on a target, their focus is not static but displays small temporal instabilities about a mean level of accommodation. This is known as the microfluctuations of accommodation. These fluctuations have been found to have an amplitude of a few tenths of a dioptre and a frequency spectrum extending out to a few Hertz, see for example [1

1. W. N. Charman and G. Heron, “Fluctuations in accommodation: a review,” Ophthalmic Physiol. Opt. 8, 153–164 (1988). [CrossRef] [PubMed]

, 2

2. B. Winn and B. Gilmartin, “Current perspective on microfluctuations of accommodation,” Ophthalmic Physiol. Opt. 12, 252–256 (1992). [CrossRef] [PubMed]

]. These fluctuations can be represented by two dominant regions of activity in the frequency domain, namely the low frequency component (LFC < 0.6 Hz) and the high frequency component (1 ≤ HFC ≤ 2.3 Hz). In addition, aberrations beyond defocus, although comprised of much smaller magnitudes, have also been shown to exhibit dynamic behavior with frequency components as high as 70 Hz [3

3. H. Hofer, P. Artal, B. Singer, J. L. Aragón, and D. R. Williams, “Dynamics of the eye’s wave aberration,” J. Opt. Soc. Am. A 18, 497–506 (2001). [CrossRef]

, 4

4. T. Nirmaier, G. Pudasaini, and J. Bille, “Very fast wave-front measurements at the human eye with a custom CMOS-based Hartmann-Shack sensor,” Opt. Express 11, 2704–2716 (2003). [CrossRef] [PubMed]

].

Some of the potential sources of the ocular wavefront aberration dynamics, for example the physiological fluctuations in pupil size [5

5. L. StarkF. W. CampbellJ. Atwood “Pupil unrest: An example of noise in a biological servomechanism,” Nature 182, 857–858 (1958). [CrossRef] [PubMed]

] and the ocular microtremor [6

6. A. Spauschus, J. Marsden, D. M. Halliday, J. R. Rosenberg, and P. Brown, “The origin of ocular microtremor in man,” Exp. Brain Res. 126, 556–562 (1999). [CrossRef] [PubMed]

], have been shown to be correlated between the two eyes. As a result, the dynamics of the ocular wavefront aberrations between the two eyes are expected to be correlated, especially at the LFC of accommodation microfluctuations since it is considered to be under neurological control [7

7. B. Winn, “Accommodation microfluctuations: a mechanism for steady-state control of accommodation,” in Accommodation and Vergence Mechanisms in the Visual System, O. Franzén, H. Richter, and L. Stark, eds. (Birkhäuser Verlag Basel, Switzerland, 2000), pp. 129–140.

]. A few studies with binocular infrared optometers that allow simultaneous measurement of steady-state accommodation in both eyes suggest significant correlation between the defocus term in the right and left eyes of the same subject [8

8. F. W. Campbell, “Correlation of accommodation between the two eyes,” J. Opt. Soc. Am. 50, 738 (1960). [CrossRef] [PubMed]

, 9

9. G. Heron, B. Winn, J. R. Pugh, and A. S. Eadie, “Twin channel infrared optometer for recording binocular accommodation,” Optom. Vision Sci. 66, 123–129 (1989). [CrossRef]

]. However, these conclusions are based on qualitative analysis of the time traces of focus variations during steady-state accommodation. Comparison of the coefficients of higher-order aberrations of the whole eye have also revealed mirror symmetry between the Zernike modes in both eyes, i.e. modes that are symmetrical about the vertical axis have similar magnitudes and signs, while modes that are asymmetrical about the vertical axis have similar magnitudes but are opposite in sign [10

10. J. Liang and D. R. Williams, “Aberrations and retinal image quality of the normal human eye,” J. Opt. Soc. Am. A 14, 2873–2883 (1997). [CrossRef]

16

16. J. R. Jiménez, J. J. Castro, R. Jiménez, and E. Hita, “Interocular differences in higher-order aberrations on binocular visual performance,” Optom. Vision Sci. 85, 174–179 (2008). [CrossRef]

]. Aforementioned studies compared the static monocular measurements of their subjects. Currently, little if anything is known about the dynamic correlation of focus, as well as higher-order aberrations, in the frequency domain.

In natural viewing conditions, the world is seen with both eyes. It is therefore important for the measurement of ocular wavefront aberrations to be performed under binocular viewing conditions to imitate the actual visual process that takes place in real life. The choice of monocular versus binocular viewing in experimental studies has been an issue of debate over many years. This is especially of concern since pupil diameter has been shown to increase from binocular to monocular viewing [17

17. B. S. BoxerWachler, “Effect of pupil size on visual function under monocular and binocular conditions in LASIK and non-LASIK patients,” J. Cataract Refract. Surg. 29, 275–278 (2003). [CrossRef]

19

19. T. Kawamorita and H. Uozato, “Effect of pupil size and ocular wavefront aberration under binocular and monocular conditions,” Invest. Ophthalmol. Visual Sci. 47, E-Abstract 1202 (2006).

]. It is well established that root-mean-square (rms) wavefront errors of the higher-order aberrations increase with larger pupil diameters [10

10. J. Liang and D. R. Williams, “Aberrations and retinal image quality of the normal human eye,” J. Opt. Soc. Am. A 14, 2873–2883 (1997). [CrossRef]

, 13

13. J. F. Castejón-Mochón, N. López-Gil, A. Benito, and P. Artal, “Ocular wave-front aberrations statistics in a normal young population,” Vision Res. 42, 1611–1617 (2002). [CrossRef] [PubMed]

, 14

14. L. N. Thibos, X. Hong, A. Bradley, and X. Cheng, “Statistical variation of aberration structure and image quality in a normal population of healthy eyes,” J. Opt. Soc. Am. A 19, 2329–2348 (2002). [CrossRef]

, 20

20. H. C. Howland, “High order wave aberration of eyes,” Ophthalmic Physiol. Opt. 22, 434–439 (2002). [CrossRef] [PubMed]

23

23. J. S. Pepose and R. A. Applegate, “Making sense out of wavefront sensing,” Am. J. Ophthalmol. 139, 335–343 (2005). [CrossRef] [PubMed]

]. Campbell first questioned the use of monocular optometers where he suggested that the amplitudes of accommodation microfluctuations could be smaller under binocular conditions, possibly due to the presence of the convergence-fixation reflex [8

8. F. W. Campbell, “Correlation of accommodation between the two eyes,” J. Opt. Soc. Am. 50, 738 (1960). [CrossRef] [PubMed]

]. Since then, binocular optometers have been produced to simultaneously measure the focus changes in two eyes [8

8. F. W. Campbell, “Correlation of accommodation between the two eyes,” J. Opt. Soc. Am. 50, 738 (1960). [CrossRef] [PubMed]

, 9

9. G. Heron, B. Winn, J. R. Pugh, and A. S. Eadie, “Twin channel infrared optometer for recording binocular accommodation,” Optom. Vision Sci. 66, 123–129 (1989). [CrossRef]

, 24

24. M. R. Clark and H. D. Crane, “Dynamic interaction in binocular vision,” in Eye Movement and the Higher Psychological Functions, J. W. Senders, D. F. Fisher, and R. A. Monty, eds. (Erlbaum, New York, 1978), pp. 77–88.

26

26. F. Okuyama, T. Tokoro, and M. Fujieda, “Binocular infrared optometer for measuring accommodation in both eyes simultaneously in natural-viewing conditions,” Appl. Opt. 32, 4147–4154 (1993). [CrossRef] [PubMed]

]. Recently, Seidel et al. observed a trend for greater fluctuations in accommodation among late-onset myopes as compared to emmetropes and early-onset myopes under monocular viewing conditions, although this did not reach statistical significance [27

27. D. Seidel, L. S. Gray, and G. Heron, “The effect of monocular and binocular viewing on the accommodation response to real targets in emmetropia and myopia,” Optom. Vision Sci. 82, 279–285 (2005). [CrossRef]

]. When the targets were seen binocularly, however, no difference was found between the three refractive groups. It is unclear whether the amplitudes of the higher-order aberrations vary depending on monocular or binocular viewing. This issue is important during refractive surgery because the pre-operative measurement of the ocular aberrations conducted monocularly may not reveal the actual imperfections of the eye under binocular viewing. If there is a significant difference between the monocular and binocular conditions, subsequent correction of the higher-order aberrations may not be precise enough to achieve best-corrected vision during daily life.

Studies have shown that aberration fluctuations can help to guide the accuracy of closed-loop accommodation responses [28

28. E. J. Fernández and P. Artal, “Study on the effects of monochromatic aberrations in the accommodation response by using adaptive optics,” J. Opt. Soc. Am. A 22, 1732–1738 (2005). [CrossRef]

, 29

29. L. Chen, P. B. Kruger, H. Hofer, B. Singer, and D. R. Williams, “Accommodation with higher-order monochromatic aberrations corrected with adaptive optics,” J. Opt. Soc. Am. A 23, 1–8 (2006). [CrossRef]

]. Since accommodation is controlled centrally, resulting in a concerted oculomotor response, highly correlated higher-order aberration dynamics may provide a more robust cue than uncorrelated aberration dynamics. Measurement of aberration correlations under binocular conditions may be a useful tool for the clinical evaluation of patients with accommodative dysfunction, e.g. lag of accommodation seen in progressive myopes [30

30. M. L. Abbott, K. L. Schmid, and N. C. Strang, “Differences in the accommodation stimulus response curves of adult myopes and emmetropes,” Ophthalmic Physiol. Opt. 18, 13–20 (1998). [CrossRef] [PubMed]

]. In the present study, a real-time binocular Shack-Hartmann sensor was constructed to allow the simultaneous measurement of ocular aberrations in both eyes. The high accuracy and repeatability of this type of sensor in the measurements of the ocular aberrations have been demonstrated in a number of studies [10

10. J. Liang and D. R. Williams, “Aberrations and retinal image quality of the normal human eye,” J. Opt. Soc. Am. A 14, 2873–2883 (1997). [CrossRef]

, 31

31. T. O. Salmon, L. N. Thibos, and A. Bradley, “Comparison of the eye’s wave-front aberration measured psychophysically and with the Shack-Hartmann wave-front sensor,” J. Opt. Soc. Am. A 15, 2457–2465 (1998). [CrossRef]

, 32

32. L. N. Thibos and X. Hong, “Clinical applications of the Shack-Hartmann aberrometer,” Optom. Vision Sci. 76, 817–825 (1999). [CrossRef]

], which makes it the device of choice for this study. We investigated the dynamic correlations of ocular aberrations in the right and left eyes of six subjects.

2. Method

2.1. Instrumentation

A binocular Shack-Hartmann wavefront sensor was constructed for the measurement of ocular wavefront aberrations [33

33. K. M. Hampson, S. S. Chin, and E. A. H. Mallen, “Binocular Shack-Hartmann sensor for the human eye,” J. Mod. Opt. 55, 703–716 (2008). [CrossRef]

]. A schematic diagram of the experimental set-up is shown in Fig. 1.

An infrared laser diode with central wavelength of 785 nm is used to create a point source on each retina. The output power of the laser source is controlled by aperture A 1. The average power of the laser at the corneae is 40 µW which is several orders of magnitude less than the maximum permissible exposure for up to 8 hours of continuous viewing at this wavelength [34

34. British Standards: Safety of Laser Products, 60825-1:1994.

]. One drawback with the use of a coherent laser source is the manifestation of laser speckle that affects the measurement of Shack-Hartmann spot centroids [3

3. H. Hofer, P. Artal, B. Singer, J. L. Aragón, and D. R. Williams, “Dynamics of the eye’s wave aberration,” J. Opt. Soc. Am. A 18, 497–506 (2001). [CrossRef]

]. A rotating diffuser is therefore introduced at the focal point of lens L 1, i.e. at a plane conjugate to the retina, to introduce random phase variations. The diffuser consists of a diffusion filter (Super Gel filter 132, Rosco Laboratories, UK) and a motor rotating at 5000 rpm. The laser beam is then re-collimated with L 2.

Fig. 1. (Color online) Binocular Shack-Hartmann wavefront sensor. A: aperture, L: lens (superscript represents focal length of the lens in mm), CBS: cube beamsplitter, PBS: pellicle beamsplitter PM: plane mirror, HM: hot mirror.

In order to create a laser beacon on each retina of the two eyes with a single laser source, the laser beam is split into two by pellicle beamsplitter PBS. Since there are two ingoing beams at cube beamsplitter CBS, two undesirable outgoing beams will be produced from the simultaneous reflection-transmission property of the beamsplitter. Black plastic tubes are used to absorb and dissipate these unwanted beams. The ingoing beams are angled such that they are slightly off-axis at the corneae so that back reflections can be removed by careful positioning of aperture A 2 at a plane conjugate to the retinae [3

3. H. Hofer, P. Artal, B. Singer, J. L. Aragón, and D. R. Williams, “Dynamics of the eye’s wave aberration,” J. Opt. Soc. Am. A 18, 497–506 (2001). [CrossRef]

]. The incident beams are 1 mm in diameter at the corneae.

Laser beacons hit the retinae, reflect and propagate out of the eyes where they become aberrated due to optical imperfections. Plane mirrors PM 2 to PM 6 are used to balance the two optical paths so that the path length from both eyes to L 3 is equivalent to 500 mm. The system is designed so that the separation of both outgoing beams at CBS is 6 mm, enabling capture by a single camera, thus reducing cost and system complexity. This also avoids the problem of having to synchronize two cameras to capture the Shack-Hartmann spots at the same time.

Lenses L 3 and L 4 are used to relay the emerging wavefront at the pupils to the Shack-Hartmann wavefront sensor placed in a plane conjugate to the pupils. The ratio of the focal lengths between L 3 and L 4 determine the magnification factor of the pupil on the Shack-Hartmann sensor, which is equivalent to 0.4 for this system. Thus, a 6 mm pupil at the cornea is equivalent to a pupil size of 2.4 mm at the sensor. The sensor has a regular array of square lenslets, each with a focal length of 7mmand a width of 0.2 mm. The pupil is therefore sampled at an interval of 0.5 mm by the lenslet array. Typically, for a 6 mm pupil, there are 112 useable Shack-Hartmann spots. The Shack-Hartmann spots produced by the lenslets are captured by a CCD camera (Retiga Exi Fast 1394, QImaging, Canada) placed at the focal length of the lenslet array. The CCD chip resolution is 1392 × 1040 pixels and each pixel is equal to 6.45 µm × 6.45 µm (i.e. the chip size is 8.98 mm × 6.71 mm). The sampling frequency of the camera is 20.5 Hz.

Mirrors PM 7 to PM 8 are used to redirect the light paths so that all optical components can be fitted onto a 600 mm × 600 mm breadboard.

2.2. Target presentation

To permit open-view observation that stimulates accurate accommodation control, two hot mirrors HM 1 and HM 2 are placed in front of the eyes. These mirrors reflect infrared radiation but transmit visible light, thereby separating the infrared measuring rays from the visible light originating from the target. The distance between the hot mirrors is adjusted to match the inter-pupillary distance of the observer. The target was a Maltese cross presented on a LCD monitor (Sony Trinitron Multiscan 200 GS) placed at 2.7 m from the eyes, subtending 11.32 minutes of arc at the cornea. The luminance of the target was 255 cd/m 2.

2.3. Validation of both channels

Since we are interested in the dynamic changes of the ocular aberrations of the two eyes, a known aberration should induce the same changes in both channels. To demonstrate this, spherical trial lenses of equal power were inserted in the right and left channels to study the resultant change in the measurements registered by both channels. Results obtained are shown in Fig. 2(a). These measurements are significantly correlated with the actual power of trial lenses, where the correlation coefficient, r is 0.999 (p < 0.0001) and 0.997 (p < 0.0001) for the right and left channels, respectively. To study the agreement between the two channels, we used a Bland and Altman plot which is commonly used in clinical studies to compare two different methods of measurement [35

35. J. M. Bland and D. G. Altman, “Measuring agreement in method comparison studies,” Stat. Methods Med. Res. 8, 135–160 (1999). [CrossRef] [PubMed]

]. The Bland and Altman plot can be used to show the level of agreement between two different methods of measurement, and whether they can be used interchangeably. We used the same principle to compare the two channels, where the differences in the defocus term obtained with the two channels is plotted against their mean, as shown in Fig. 2(b). The mean of their differences is -0.005 D indicating negligible systematic bias, and the differences are within the 95% limits of agreement (mean ± 1.96 SD).

Cylindrical lenses of various powers (range +0.75 to -0.75 D) and axes (10 to 170 degrees) were also added to the artificial eyes with known spherical and cylindrical powers. The resultant spherocylindrical changes were compared with the ideal values calculated with power vector analysis [36

36. L. N. Thibos, W. Wheeler, and D. Horner, “Power vectors: an application of Fourier analysis to the description and statistical analysis of refractive error,” Optom. Vision Sci. 74, 367–375 (1997). [CrossRef]

], which allows the combination of two refractive components (the eye and the trial lens) that have different axis orientations. The r was found to be 0.997 (p < 0.0001) and 0.998 (p < 0.0001) for M, 0.991 (p < 0.0001) and 0.997 (p < 0.0001) for J 0 and 0.996 (p < 0.0001) and 0.939 (p < 0.002) for J 45, for the right and left channels respectively. These results shows that both channels can be used interchangeably, indicating the equivalence of both channels.

2.4. Experimental procedure

Fig. 2. (Color online) Validation of both channels with spherical trial lenses. (a) Measurements obtained in the right (blue) and left (red) channels against the actual power of trial lenses, (b) Bland and Altman plot showing the difference between the measurements of the two channels against their mean.

3. Data analysis

3.1. Wavefront reconstruction

j=n(n+2)+m2
(1)

where n is the radial order and m is the angular frequency of the standard double indexing scheme.

3.2. Removal of blink artefacts

3.3. Coherence function analysis

The coherence function is a valuable tool for the investigation of the synergy between two concurrent time series [33

33. K. M. Hampson, S. S. Chin, and E. A. H. Mallen, “Binocular Shack-Hartmann sensor for the human eye,” J. Mod. Opt. 55, 703–716 (2008). [CrossRef]

, 45

45. A. S. Eadie, J. R. Pugh, and B. Winn, “The use of coherence functions in the study of ocular mechanisms,” Ophthalmic Physiol. Opt. 15, 311–317 (1995). [CrossRef] [PubMed]

47

47. K. M. Hampson, E. A. H. Mallen, and C. Dainty, “Coherence function analysis of the higher-order aberrations of the human eye,” Opt. Lett. 31, 184–186 (2006). [CrossRef] [PubMed]

]. The main advantage of the coherence function is its ability to reveal the degree of correlation for each individual frequency component of the two signals. the coherence function of two signals is given by

γxy2(f)=Gxy(f)2Gxx(f)Gyy(f)
(2)

where Gxy is the cross-spectral density (CSD) and Gxx and Gyy are the power-spectral density functions (PSDs) [48

48. J. S. Bendat and A. G. Piersol, Random Data: Analysis and Measurement Procedures (Jon Wiley & Sons, Inc., New York, 2000).

]. A detailed explanation of coherence function analysis can be found in Hampson et al. [33

33. K. M. Hampson, S. S. Chin, and E. A. H. Mallen, “Binocular Shack-Hartmann sensor for the human eye,” J. Mod. Opt. 55, 703–716 (2008). [CrossRef]

]. The coherence function value varies between 0 and 1, where 0 indicates complete lack of correlation and values close to 1 means the two signals are highly correlated at a particular frequency.

Each of the five 24 s measurement signals were divided into two 12 s signals, resulting in 10 data segments in total, hence 20 degrees of freedom. The frequencies that can be reliably resolved ranged from 0.08 to 10.25 Hz. Detrending was applied to each data segment to factor out the influence of sampling time on the PSDs by removing contributions from signals with periods longer than the segment length [48

48. J. S. Bendat and A. G. Piersol, Random Data: Analysis and Measurement Procedures (Jon Wiley & Sons, Inc., New York, 2000).

]. A Hanning window was then used to minimize the bias due to spectral leakage. We used the method proposed by Wang and Tang to obtain the 95% confidence intervals for the coherence function [49

49. S. Y. Wang and M. X. Tang, “Exact confidence interval for magnitude-squared coherence estimates,” IEEE Sig. Pro. Letters 11, 326–329 (2004). [CrossRef]

]. Modeling with twice the amount of the actual pupil movements shows that synchronized pupil translation due to instabilities in head position has minimal effect on the coherence values [33

33. K. M. Hampson, S. S. Chin, and E. A. H. Mallen, “Binocular Shack-Hartmann sensor for the human eye,” J. Mod. Opt. 55, 703–716 (2008). [CrossRef]

].

4. Results

The wavefront map for the right and left eyes of subjects YP (5 mm pupils) and JC (6 mm pupils) are shown in Fig. 3. The wavefront maps are different for each subject. The rms wavefront errors were found to be similar in the two eyes of the same subject, comparable to the values found in the study by Marcos and Burns [11

11. S. Marcos and S. A. Burns, “On the symmetry between eyes of wavefront aberrations and cone directionality,” Vision Res. 40, 2437–2447 (2000). [CrossRef] [PubMed]

].

Figure 4 plots the correlation between the Zernike coefficients (up to and including the fifth radial order) of the right and left eyes for four subjects. To avoid the confounding effect of dissimilar refractive errors on the absolute aberration measured, we disregard subjects CS and CV from this part of the analysis (however, this does not affect the coherence values due to the normalization of the CSD by the PSDs). The sign of Zernike modes with odd symmetry about the y-axis in the right eye have been inverted to allow for the comparison of mirror symmetry [40

40. L. N. Thibos, R. A. Applegate, J. T. Schwiegerling, and R. Webb, “Standards for reporting the optical aberrations of eyes,” J. Refract. Surg. 18, S652–S660 (2002). [PubMed]

]. Correlation coefficients for each subject vary from -0.22 to 0.94. Two subjects (YP and EM) show high degree of mirror symmetry, where the correlation of the Zernike coefficients between both eyes is statistically significant (p < 0.001). The solid black line represents a linear fit to all the data for the four subjects (r = 0.39).

Power spectral density (PSD) functions of the rms wavefront error of the right and left eyes are very similar within the same subject. The mean slope for the right and left eyes of the six subjects is 1.14 ± 0.21 (mean ± 1 SD). Figure 5 shows the typical PSDs for subjects KH and EM.

Fig. 3. (Color online) Wavefront maps for both eyes of subjects YP (top) and JC (bottom).
Fig. 4. (Color online) Zernike coefficients for the left and right eye for four subjects. Different colors represent different subjects. The value r represents the correlation coefficient between the two eyes of each subject. The solid black line represents a linear fit to all the data, where r is equal to 0.39. The dotted dashed line indicates the unity plot.
Fig. 5. (Color online) PSD of the rms wavefront error for the right (blue) and left (red) eyes of subjects KH and EM. Confidence intervals are omitted for clarity.

Figure 6 plots the coherence of the rms wavefront error for all subjects. Generally, the coherence values are fairly low, with the mean across frequency and subject equal to 0.11±0.02 (mean±1 SD).

Fig. 6. (Color online) Coherence function of the rms wavefront errors for all subjects. Dotted lines represent the 95% confidence intervals.

Figure 7 shows the coherence between each individual aberration of the two eyes of subject EM. The plots show minor differences for each individual subject but all of them display low coherence values (typically <0.1), except for the LFC region of defocus, where the mean coherence value is equal to 0.43. These plots vary for each individual.

The mean coherence values across subjects for each Zernike mode in the LFC region and across the resolvable frequency range are plotted in Fig. 8. The plot for HFC region is very similar to the one for the resolvable frequency range, hence it is omitted for clarity. In general, for most Zernike coefficients, the mean coherence values are slightly higher in the LFC region (mean 0.13) than the HFC region (mean 0.11) and the measurable frequency range (mean 0.11). Defocus (Z4) shows the highest coherence between both eyes (coherence value 0.30 for LFC region, 0.15 for HFC region and 0.13 across the resolvable frequency range).

Fig. 7. (Color online) Coherence value between each individual aberration (up to and including the fifth radial order) of the two eyes of subject EM.
Fig. 8. (Color online) The mean coherence values of the six subjects for the low frequency region (blue) and across the resolvable frequency range (red). The plot for the high frequency region is omitted for clarity.

PSDs of the accommodation fluctuations (specified by defocus Z4) for subject KH under monocular and binocular viewing conditions are shown in Fig. 9(a) and 9(c). PSDs of the higher-order aberrations (radial order third and above) are plotted in Fig. 9(b) and 9(d). There was no significant difference between the two viewing conditions for all six subjects in terms of accommodation microfluctuations and the higher-order aberration fluctuations, both at the LFC region and across the measurable frequency range (paired t-test, p > 0.05).

Fig. 9. (Color online) PSDs of the accommodation microfluctuations (a) and (c), and the rms wavefront errors of the higher-order aberrations (b) and (d), for the right (top) and left (bottom) eyes of subject KH, with both eyes open (blue) and one eye blocked (red).

5. Discussion

Phase consistency is important because a high phase correlation may be indicative of a central origin for aberration dynamics. In order to investigate the contribution of phase variations to the coherence values, we calculated the phase consistency [51

51. A. Bruns, “Fourier-, Hilbert- and wavelet-based signal analysis: are they really different approaches?,” J. Neurosci. Methods 137, 321–332 (2004). [CrossRef] [PubMed]

]. The spectrum S(f,t) of a signal s(t) is given by

S(f,t)=S(f,t)·eiφ(f,t)
(3)

where |S(f,t)| is the amplitude and φ(f,t) is the phase value. The coherence function from Eq. (2) can be rewritten as

γXY2(f,t)=Σn=1NSX,n(f,t)·SY,n*(f,t)2Σn=1NSX,n(f,t)2·Σn=1NSY,n(f,t)2
(4)

where N is the number of segments. The numerator of the coherence function consists of amplitude and phase information. In order to study the impact of phase alone on the coherence values, the contribution of the amplitudes are removed by setting it to a constant. Coherence from Eq. (4) becomes

γφ,XY2(f,t)=Σn=1NeiφX,n(f,t)·eiφY,n(f,t)2Σn=1N12·Σn=1N12
=1N2Σn=1Nei(φX,n(f,t)φY,n(f,t))2
(5)

where φX,n(f,t) and φY,n(f,t) represent the phases of signal X and Y, respectively. This is known as phase consistency [51

51. A. Bruns, “Fourier-, Hilbert- and wavelet-based signal analysis: are they really different approaches?,” J. Neurosci. Methods 137, 321–332 (2004). [CrossRef] [PubMed]

]. Figure 10 shows the coherence values for the rms wavefront errors between the two eyes for two subjects based on the coherence function and phase consistency calculations.

Fig. 10. (Color online) Coherence values for coherence function (blue) and phase consistency (red) for subject KH and EM.

Paired t-test shows that for each observer, there is no significant difference between the coherence function and phase consistency (p > 0.05), indicating the coherence values are dominated by phase.

RMS wavefront error represents the effect of a combination of all the aberration modes. This method of data representation might mask an individual aberration which could have shown a high coherence value. To avoid the masking effect, coherence values for each individual Zernike mode between the two eyes of subject EM are plotted in Fig. 7. The overall coherence is fairly weak for all aberrations and none of these Zernike modes displays high coherence, apart from defocus in the low frequency region.

In the Zhu et al. study, they note that their coherence function analysis has low reliability given that for each aberration they only used a data record of 128 measurements. In contrast, over 1500 data points were used by Hampson et al., and 2400 data points in this study for data analysis. We found that by calculating the coherence function based on less data segments and hence less data points considerably raises the coherence values. However, we believe it is necessary to use more data segments to reduce the variance of the estimate. A further difference between the two studies is that the coherence function values in the Zhu et al. study were an average of normal and controlled breathing condition, whereas Hampson et al. and our studies used normal breathing.

The absence of peaks in the HFC in the PSDs of accommodation microfluctuations as shown in Fig. 9(a) and 9(c), can potentially be explained by several factors. It should be noted that most of the earlier studies used an infrared optometer to measure accommodation changes, which has a different measurement principle to the Shack-Hartmann sensor. Unlike the Shack-Hartmann sensor, it cannot distinguish the difference between Zernike modes and may have misinterpreted the fluctuations in other aberrations as the microfluctuations in the defocus term. Also, the magnitudes of the HFC have been shown to increase with target vergence, for example it has been found to increase by 22 times when he stimulus is moved from infinity to 25 cm from the subject [57

57. M. Zhu, M. J. Collins, and D. R. Iskander, “The contribution of accommodation and the ocular surface to the microfluctuations of wavefront aberrations of the eye,” Ophthalmic Physiol. Opt. 26, 439–446 (2006). [CrossRef] [PubMed]

]. Since our subjects fixated at a target vergence of 0.37 D, these powers might be low, hence the absence of an obvious peak at the the HFC. Hofer et al. claim that the peak at the HFC was only detected occasionally in their subjects [3

3. H. Hofer, P. Artal, B. Singer, J. L. Aragón, and D. R. Williams, “Dynamics of the eye’s wave aberration,” J. Opt. Soc. Am. A 18, 497–506 (2001). [CrossRef]

]. Careful inspection of the PSDs of accommodation microfluctuations of our subjects shows the presence of a HFC peak in some but not all of the data segments. Therefore, averaging across segments would probably have averaged this peak out. The variation of HFC with pupil size is controversial, where one study indicated the disappearance of HFC with reducing pupil size [58

58. F. W. Campbell, J. G. Robson, and G. Westheimer, “Fluctuations of accommodation under steady viewing conditions,” J. Physiol. 145, 579–594 (1959). [PubMed]

] and another found an increased in the HFC as pupil size decreased [59

59. L. R. Stark and D. A. Atchison, “Pupil size, mean accommodation response and the fluctuations of accommodation,” Ophthalmic Physiol. Opt. 17, 316–323 (1997). [CrossRef] [PubMed]

]. The authors of the later study therefore suggest that HFC may be the result of instability in the accommodation system, although the reason behind this is currently unknown.

There is no significant difference between the PSDs of the rms wavefront errors under monocular and binocular viewing conditions for all subjects. This is in contrast to the prediction made by Campbell [8

8. F. W. Campbell, “Correlation of accommodation between the two eyes,” J. Opt. Soc. Am. 50, 738 (1960). [CrossRef] [PubMed]

] where he suggested smaller fluctuations may be observed when the subject viewed with both eyes due to the presence of the convergence-fixation reflex. In a study carried out by Seidel et al., late-onset myopes demonstrated reduced fluctuations in accommodation under binocular observations, but the results were not significant [27

27. D. Seidel, L. S. Gray, and G. Heron, “The effect of monocular and binocular viewing on the accommodation response to real targets in emmetropia and myopia,” Optom. Vision Sci. 82, 279–285 (2005). [CrossRef]

]. Our study supports their findings since no difference was found in the magnitude of the PSDs of the accommodation microfluctuations and higher-order aberrations for all six subjects.

6. Future work

We wish to study the effect of adaptive optics correction of higher-order aberrations on steady-state and dynamic accommodation accuracy. The trend for increased microfluctuations under monocular viewing condition observed by Seidel and colleagues suggest that higher-order aberrations may play a lesser role in accommodation accuracy under binocular conditions. This work will be applicable to the practical study of accommodation responses in individuals at risk of myopia progression, e.g. clinical microscopists [60

60. N. A. McBrien and D. W. Adams, “A longitudinal investigation of adult-onset and adult-progression of myopia in an occupational group. Refractive and biometric findings,” Invest. Ophthalmol. Visual Sci. 38, 321–333 (1997).

]. Differentiating the usefulness of aberration dynamics as a guide to accommodation response accuracy under monocular compared to binocular conditions is therefore of significant value.

7. Conclusion

This study investigated the dynamic correlation between the ocular wavefront aberrations of the two eyes with a binocular Shack-Hartmann wavefront sensor. Coherence function analysis showed that the coherence values vary according to the subject, aberration mode and frequency component. In general, inter-ocular correlations of the aberrations are fairly weak for all subjects. Phase consistency between each data segment dominates most of the coherence values as compared to the effect of amplitude ratio. Monocular and binocular observations result in similar rms wavefront error dynamics.

References and links

1.

W. N. Charman and G. Heron, “Fluctuations in accommodation: a review,” Ophthalmic Physiol. Opt. 8, 153–164 (1988). [CrossRef] [PubMed]

2.

B. Winn and B. Gilmartin, “Current perspective on microfluctuations of accommodation,” Ophthalmic Physiol. Opt. 12, 252–256 (1992). [CrossRef] [PubMed]

3.

H. Hofer, P. Artal, B. Singer, J. L. Aragón, and D. R. Williams, “Dynamics of the eye’s wave aberration,” J. Opt. Soc. Am. A 18, 497–506 (2001). [CrossRef]

4.

T. Nirmaier, G. Pudasaini, and J. Bille, “Very fast wave-front measurements at the human eye with a custom CMOS-based Hartmann-Shack sensor,” Opt. Express 11, 2704–2716 (2003). [CrossRef] [PubMed]

5.

L. StarkF. W. CampbellJ. Atwood “Pupil unrest: An example of noise in a biological servomechanism,” Nature 182, 857–858 (1958). [CrossRef] [PubMed]

6.

A. Spauschus, J. Marsden, D. M. Halliday, J. R. Rosenberg, and P. Brown, “The origin of ocular microtremor in man,” Exp. Brain Res. 126, 556–562 (1999). [CrossRef] [PubMed]

7.

B. Winn, “Accommodation microfluctuations: a mechanism for steady-state control of accommodation,” in Accommodation and Vergence Mechanisms in the Visual System, O. Franzén, H. Richter, and L. Stark, eds. (Birkhäuser Verlag Basel, Switzerland, 2000), pp. 129–140.

8.

F. W. Campbell, “Correlation of accommodation between the two eyes,” J. Opt. Soc. Am. 50, 738 (1960). [CrossRef] [PubMed]

9.

G. Heron, B. Winn, J. R. Pugh, and A. S. Eadie, “Twin channel infrared optometer for recording binocular accommodation,” Optom. Vision Sci. 66, 123–129 (1989). [CrossRef]

10.

J. Liang and D. R. Williams, “Aberrations and retinal image quality of the normal human eye,” J. Opt. Soc. Am. A 14, 2873–2883 (1997). [CrossRef]

11.

S. Marcos and S. A. Burns, “On the symmetry between eyes of wavefront aberrations and cone directionality,” Vision Res. 40, 2437–2447 (2000). [CrossRef] [PubMed]

12.

J. Porter, A. Guirao, I. G. Cox, and D. R. Williams, “Monochromatic aberrations of the human eye in a large population,” J. Opt. Soc. Am. A 18, 1793–1803 (2001). [CrossRef]

13.

J. F. Castejón-Mochón, N. López-Gil, A. Benito, and P. Artal, “Ocular wave-front aberrations statistics in a normal young population,” Vision Res. 42, 1611–1617 (2002). [CrossRef] [PubMed]

14.

L. N. Thibos, X. Hong, A. Bradley, and X. Cheng, “Statistical variation of aberration structure and image quality in a normal population of healthy eyes,” J. Opt. Soc. Am. A 19, 2329–2348 (2002). [CrossRef]

15.

L. Wang and D. D. Koch, “Ocular higher-order aberrations in individuals screened for refractive surgery,” J. Cataract Refract. Surg. 29, 1896–1903 (2003). [CrossRef] [PubMed]

16.

J. R. Jiménez, J. J. Castro, R. Jiménez, and E. Hita, “Interocular differences in higher-order aberrations on binocular visual performance,” Optom. Vision Sci. 85, 174–179 (2008). [CrossRef]

17.

B. S. BoxerWachler, “Effect of pupil size on visual function under monocular and binocular conditions in LASIK and non-LASIK patients,” J. Cataract Refract. Surg. 29, 275–278 (2003). [CrossRef]

18.

T. Kawamorita and H. Uozato, “The effect of pupil size on binocular summation,” Invest. Ophthalmol. Visual Sci. 45, E-Abstract 4322 (2004).

19.

T. Kawamorita and H. Uozato, “Effect of pupil size and ocular wavefront aberration under binocular and monocular conditions,” Invest. Ophthalmol. Visual Sci. 47, E-Abstract 1202 (2006).

20.

H. C. Howland, “High order wave aberration of eyes,” Ophthalmic Physiol. Opt. 22, 434–439 (2002). [CrossRef] [PubMed]

21.

B. J. Wilson, K. E. Decker, and A. Roorda, “Monochromatic aberrations provide an odd-error cue to focus direction,” J. Opt. Soc. Am. A 19, 833–839 (2002). [CrossRef]

22.

Y. Wang, K. Zhao, Y. Jin, Y. Niu, and T. Zuo, “Changes of higher order aberration with various pupil sizes in the myopic eye,” J. Refract. Surg. 19, S270–S274 (2003). [PubMed]

23.

J. S. Pepose and R. A. Applegate, “Making sense out of wavefront sensing,” Am. J. Ophthalmol. 139, 335–343 (2005). [CrossRef] [PubMed]

24.

M. R. Clark and H. D. Crane, “Dynamic interaction in binocular vision,” in Eye Movement and the Higher Psychological Functions, J. W. Senders, D. F. Fisher, and R. A. Monty, eds. (Erlbaum, New York, 1978), pp. 77–88.

25.

G. Heron and B. Winn, “Binocular accommodation reaction and response times for normal observers,” Ophthalmic Physiol. Opt. 9, 176–183 (1989). [CrossRef] [PubMed]

26.

F. Okuyama, T. Tokoro, and M. Fujieda, “Binocular infrared optometer for measuring accommodation in both eyes simultaneously in natural-viewing conditions,” Appl. Opt. 32, 4147–4154 (1993). [CrossRef] [PubMed]

27.

D. Seidel, L. S. Gray, and G. Heron, “The effect of monocular and binocular viewing on the accommodation response to real targets in emmetropia and myopia,” Optom. Vision Sci. 82, 279–285 (2005). [CrossRef]

28.

E. J. Fernández and P. Artal, “Study on the effects of monochromatic aberrations in the accommodation response by using adaptive optics,” J. Opt. Soc. Am. A 22, 1732–1738 (2005). [CrossRef]

29.

L. Chen, P. B. Kruger, H. Hofer, B. Singer, and D. R. Williams, “Accommodation with higher-order monochromatic aberrations corrected with adaptive optics,” J. Opt. Soc. Am. A 23, 1–8 (2006). [CrossRef]

30.

M. L. Abbott, K. L. Schmid, and N. C. Strang, “Differences in the accommodation stimulus response curves of adult myopes and emmetropes,” Ophthalmic Physiol. Opt. 18, 13–20 (1998). [CrossRef] [PubMed]

31.

T. O. Salmon, L. N. Thibos, and A. Bradley, “Comparison of the eye’s wave-front aberration measured psychophysically and with the Shack-Hartmann wave-front sensor,” J. Opt. Soc. Am. A 15, 2457–2465 (1998). [CrossRef]

32.

L. N. Thibos and X. Hong, “Clinical applications of the Shack-Hartmann aberrometer,” Optom. Vision Sci. 76, 817–825 (1999). [CrossRef]

33.

K. M. Hampson, S. S. Chin, and E. A. H. Mallen, “Binocular Shack-Hartmann sensor for the human eye,” J. Mod. Opt. 55, 703–716 (2008). [CrossRef]

34.

British Standards: Safety of Laser Products, 60825-1:1994.

35.

J. M. Bland and D. G. Altman, “Measuring agreement in method comparison studies,” Stat. Methods Med. Res. 8, 135–160 (1999). [CrossRef] [PubMed]

36.

L. N. Thibos, W. Wheeler, and D. Horner, “Power vectors: an application of Fourier analysis to the description and statistical analysis of refractive error,” Optom. Vision Sci. 74, 367–375 (1997). [CrossRef]

37.

S. Giessler, T. Hammer, and G. I. Duncker, “Aberrometry due dilated pupils- which mydriatic should be used?” Klin. Monatsbl. Augenheilkd. 219, 655–659 (2002). [PubMed]

38.

A. Carkeet, S. Velaedan, Y. K. Tan, D. Y. J. Lee, and D. T. H. Tan, “Higher order ocular aberrations after cycloplegic and non-cycloplegic pupil dilation,” J. Refract. Surg. 19, 316–322 (2003). [PubMed]

39.

Y. Yang and F. Wu, “Technical Note: Comparison of the wavefront aberrations between natural and pharmacological pupil dilations,” Ophthalmic Physiol. Opt. 27, 220–223 (2007). [CrossRef] [PubMed]

40.

L. N. Thibos, R. A. Applegate, J. T. Schwiegerling, and R. Webb, “Standards for reporting the optical aberrations of eyes,” J. Refract. Surg. 18, S652–S660 (2002). [PubMed]

41.

J. R. Pugh, A. S. Eadie, B. Winn, and G. Heron, “Power spectrum analysis in the study of ocular mechanisms,” Ophthalmic Physiol. Opt. 7, 321–324 (1987). [CrossRef] [PubMed]

42.

M. Collins, B. Davis, and J. Wood, “Microfluctuations of steady-state accommodation and the cardiopulmonary system,” Vision Res. 35, 2491–2502 (1995). [PubMed]

43.

D. R. Iskander, M. J. Collins, M. R. Morelande, and M. Zhu, “Analyzing the dynamic wavefront aberrations in the human eye,” IEEE Trans. Biomed. Eng. 51, 1969–1980 (2004). [CrossRef] [PubMed]

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46.

M. Zhu, M. J. Collins, and R. D. Iskander, “Microfluctuations of wavefront aberrations of the eye,” Ophthalmic Physiol. Opt. 24, 562–571 (2004). [CrossRef] [PubMed]

47.

K. M. Hampson, E. A. H. Mallen, and C. Dainty, “Coherence function analysis of the higher-order aberrations of the human eye,” Opt. Lett. 31, 184–186 (2006). [CrossRef] [PubMed]

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L. Diaz-Dantana, C. Torti, I. Munro, P. Gasson, and C. Dainty, “Benefit of higher closed-loop bandwidths in ocular adaptive optics,” Opt. Express 11, 2597–2605 (2003). [CrossRef]

51.

A. Bruns, “Fourier-, Hilbert- and wavelet-based signal analysis: are they really different approaches?,” J. Neurosci. Methods 137, 321–332 (2004). [CrossRef] [PubMed]

52.

K. M. Hampson, I. Munro, C. Paterson, and C. Dainty, “Weak correlation between the aberration dynamics of the human eye and the cardiopulmonary system,” J. Opt. Soc. Am. A 22, 1241–1250 (2005). [CrossRef]

53.

S. Koh, N. Maeda, T. Kuroda, Y. Hori, H. Watanabe, T. Fujikado, Y. Tano, Y. Hirohara, and T. Mihashi, “Effect of tear film break-up on higher-order aberrations measured with wavefront sensor,” Am. J. Opthal. 134, 115–117 (2002). [CrossRef]

54.

R. Montés-Micó, J. L. Alió, G. Muñoz, J. J. Pérez-Santonja, and W. N. Charman, “Postblink changes in total and corneal ocular aberrations,” Ophthalmology 111, 758–767 (2004). [CrossRef] [PubMed]

55.

S. Gruppetta, F. Lacombe, and P. Puget, “Study of the dynamic aberrations of the human tear film,” Opt. Express 13, 7631–7636 (2005) [CrossRef] [PubMed]

56.

S. Koh, N. Maeda, Y. Hirohara, T. Mihashi, S. Ninomiya, K. Besscho, H. Watanabe, T. Fujikado, and Y. Tano, “Serial measurements of higher-order aberrations after blinking in normal subjects,” Invest. Ophthalmol. Visual Sci. 47, 3318–3324 (2006). [CrossRef]

57.

M. Zhu, M. J. Collins, and D. R. Iskander, “The contribution of accommodation and the ocular surface to the microfluctuations of wavefront aberrations of the eye,” Ophthalmic Physiol. Opt. 26, 439–446 (2006). [CrossRef] [PubMed]

58.

F. W. Campbell, J. G. Robson, and G. Westheimer, “Fluctuations of accommodation under steady viewing conditions,” J. Physiol. 145, 579–594 (1959). [PubMed]

59.

L. R. Stark and D. A. Atchison, “Pupil size, mean accommodation response and the fluctuations of accommodation,” Ophthalmic Physiol. Opt. 17, 316–323 (1997). [CrossRef] [PubMed]

60.

N. A. McBrien and D. W. Adams, “A longitudinal investigation of adult-onset and adult-progression of myopia in an occupational group. Refractive and biometric findings,” Invest. Ophthalmol. Visual Sci. 38, 321–333 (1997).

OCIS Codes
(010.7350) Atmospheric and oceanic optics : Wave-front sensing
(330.4460) Vision, color, and visual optics : Ophthalmic optics and devices

ToC Category:
Vision, color, and visual optics

History
Original Manuscript: May 30, 2008
Revised Manuscript: August 12, 2008
Manuscript Accepted: August 27, 2008
Published: September 4, 2008

Virtual Issues
Vol. 3, Iss. 11 Virtual Journal for Biomedical Optics

Citation
S. S. Chin, K. M. Hampson, and E. A. H. Mallen, "Binocular correlation of ocular aberration dynamics," Opt. Express 16, 14731-14745 (2008)
http://www.opticsinfobase.org/oe/abstract.cfm?URI=oe-16-19-14731


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References

  1. W. N. Charman and G. Heron, "Fluctuations in accommodation: a review," Ophthalmic Physiol. Opt. 8, 153-164 (1988). [CrossRef] [PubMed]
  2. B. Winn and B. Gilmartin, "Current perspective on microfluctuations of accommodation," Ophthalmic Physiol. Opt. 12, 252-256 (1992). [CrossRef] [PubMed]
  3. H. Hofer, P. Artal, B. Singer, J. L. Aragón, and D. R. Williams, "Dynamics of the eye???s wave aberration," J. Opt. Soc. Am. A 18, 497-506 (2001). [CrossRef]
  4. T. Nirmaier, G. Pudasaini, and J. Bille, "Very fast wave-front measurements at the human eye with a custom CMOS-based Hartmann-Shack sensor," Opt. Express 11, 2704-2716 (2003). [CrossRef] [PubMed]
  5. L. Stark, F. W. Campbell and J. Atwood "Pupil unrest: An example of noise in a biological servomechanism," Nature 182, 857-858 (1958). [CrossRef] [PubMed]
  6. A. Spauschus, J. Marsden, D. M. Halliday, J. R. Rosenberg, and P. Brown, "The origin of ocular microtremor in man," Exp. Brain Res. 126, 556-562 (1999). [CrossRef] [PubMed]
  7. F. W. Campbell, "Correlation of accommodation between the two eyes," J. Opt. Soc. Am. 50, 738 (1960).
  8. G. Heron, B. Winn, J. R. Pugh, and A. S. Eadie, "Twin channel infrared optometer for recording binocular accommodation," Optom. Vision Sci. 66, 123-129 (1989). [CrossRef] [PubMed]
  9. J. Liang and D. R. Williams, "Aberrations and retinal image quality of the normal human eye," J. Opt. Soc. Am. A 14, 2873-2883 (1997). [CrossRef]
  10. S. Marcos and S. A. Burns, "On the symmetry between eyes of wavefront aberrations and cone directionality," Vision Res. 40, 2437-2447 (2000). [CrossRef]
  11. J. Porter, A. Guirao, I. G. Cox, and D. R. Williams, "Monochromatic aberrations of the human eye in a large population," J. Opt. Soc. Am. A 18, 1793-1803 (2001). [CrossRef] [PubMed]
  12. J. F. Castejon-Mochon, N. Lopez-Gil, A. Benito and P. Artal, "Ocular wave-front aberrations statistics in a normal young population," Vision Res. 42, 1611-1617 (2002). [CrossRef]
  13. L. N. Thibos, X. Hong, A. Bradley, and X. Cheng, "Statistical variation of aberration structure and image quality in a normal population of healthy eyes," J. Opt. Soc. Am. A 19, 2329-2348 (2002). [CrossRef] [PubMed]
  14. L. Wang and D. D. Koch, "Ocular higher-order aberrations in individuals screened for refractive surgery," J. Cataract Refract. Surg. 29, 1896-1903 (2003). [CrossRef]
  15. J. R. Jimenez, J. J. Castro, R. Jimenez, and E. Hita, "Interocular differences in higher-order aberrations on binocular visual performance," Optom. Vision Sci. 85, 174-179 (2008). [CrossRef] [PubMed]
  16. B. S. BoxerWachler, "Effect of pupil size on visual function under monocular and binocular conditions in LASIK and non-LASIK patients," J. Cataract Refract. Surg. 29, 275-278 (2003). [CrossRef]
  17. T. Kawamorita and H. Uozato, "The effect of pupil size on binocular summation," Invest. Ophthalmol. Visual Sci. 45, 4322 (2004). [CrossRef]
  18. T. Kawamorita and H. Uozato, "Effect of pupil size and ocular wavefront aberration under binocular and monocular conditions," Invest. Ophthalmol. Visual Sci.  47, 1202 (2006).
  19. H. C. Howland, "High order wave aberration of eyes," Ophthalmic Physiol. Opt. 22, 434-439 (2002).
  20. B. J. Wilson, K. E. Decker, and A. Roorda, "Monochromatic aberrations provide an odd-error cue to focus direction," J. Opt. Soc. Am. A 19, 833-839 (2002). [CrossRef] [PubMed]
  21. Y. Wang, K. Zhao, Y. Jin, Y. Niu, and T. Zuo, "Changes of higher order aberration with various pupil sizes in the myopic eye," J. Refract. Surg. 19, S270-S274 (2003). [CrossRef]
  22. J. S. Pepose and R. A. Applegate, "Making sense out of wavefront sensing," Am. J. Ophthalmol. 139, 335-343 (2005). [PubMed]
  23. M. R. Clark and H. D. Crane, "Dynamic interaction in binocular vision," in Eye Movement and the Higher Psychological Functions, J. W. Senders, D. F. Fisher and R. A. Monty, eds., (Erlbaum, New York, 1978), pp. 77-88. [CrossRef] [PubMed]
  24. G. Heron and B. Winn, "Binocular accommodation reaction and response times for normal observers," Ophthalmic Physiol. Opt. 9, 176-183 (1989).
  25. F. Okuyama, T. Tokoro, and M. Fujieda, "Binocular infrared optometer for measuring accommodation in both eyes simultaneously in natural-viewing conditions," Appl. Opt. 32, 4147-4154 (1993). [CrossRef] [PubMed]
  26. D. Seidel, L. S. Gray, and G. Heron, "The effect of monocular and binocular viewing on the accommodation response to real targets in emmetropia and myopia," Optom. Vision Sci. 82, 279-285 (2005). [CrossRef] [PubMed]
  27. E. J. Fernández and P. Artal, "Study on the effects of monochromatic aberrations in the accommodation response by using adaptive optics," J. Opt. Soc. Am. A 22, 1732-1738 (2005). [CrossRef]
  28. L. Chen, P. B. Kruger, H. Hofer, B. Singer, and D. R. Williams, "Accommodation with higher-order monochromatic aberrations corrected with adaptive optics," J. Opt. Soc. Am. A 23, 1-8 (2006). [CrossRef]
  29. M. L. Abbott, K. L. Schmid, and N. C. Strang, "Differences in the accommodation stimulus response curves of adult myopes and emmetropes," Ophthalmic Physiol. Opt. 18, 13-20 (1998). [CrossRef]
  30. T. O. Salmon, L. N. Thibos, and A. Bradley, "Comparison of the eye???s wave-front aberration measured psychophysically and with the Shack-Hartmann wave-front sensor," J. Opt. Soc. Am. A 15, 2457-2465 (1998). [CrossRef] [PubMed]
  31. L. N. Thibos and X. Hong, "Clinical applications of the Shack-Hartmann aberrometer," Optom. Vision Sci. 76, 817-825 (1999). [CrossRef]
  32. K. M. Hampson, S. S. Chin, and E. A. H. Mallen, "Binocular Shack-Hartmann sensor for the human eye," J. Mod. Opt. 55, 703-716 (2008). [CrossRef]
  33. British Standards: Safety of Laser Products, 60825-1:1994. [CrossRef]
  34. J. M. Bland and D. G. Altman, "Measuring agreement in method comparison studies,"Stat. Methods Med. Res. 8, 135-160 (1999).
  35. L. N. Thibos, W. Wheeler, and D. Horner, "Power vectors: an application of Fourier analysis to the description and statistical analysis of refractive error," Optom. Vision Sci. 74, 367-375 (1997). [CrossRef] [PubMed]
  36. S. Giessler, T. Hammer, and G. I. Duncker, "Aberrometry due dilated pupils- which mydriatic should be used?" Klin. Monatsbl. Augenheilkd. 219, 655-659 (2002). [CrossRef]
  37. A. Carkeet, S. Velaedan, Y. K. Tan, D. Y. J. Lee, and D. T. H. Tan, "Higher order ocular aberrations after cycloplegic and non-cycloplegic pupil dilation," J. Refract. Surg. 19, 316-322 (2003). [PubMed]
  38. Y. Yang and F. Wu, "Technical Note: Comparison of the wavefront aberrations between natural and pharmacological pupil dilations," Ophthalmic Physiol. Opt. 27, 220-223 (2007). [PubMed]
  39. L. N. Thibos, R. A. Applegate, J. T. Schwiegerling, and R. Webb, "Standards for reporting the optical aberrations of eyes," J. Refract. Surg. 18, S652-S660 (2002). [CrossRef] [PubMed]
  40. J. R. Pugh, A. S. Eadie, B. Winn, and G. Heron, "Power spectrum analysis in the study of ocular mechanisms," Ophthalmic Physiol. Opt. 7, 321-324 (1987). [PubMed]
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