PurposeTo propose a new objective scatter index (OSI) based in the analysis of double-pass images of a point source to rank and classify cataract patients. This classification scheme is compared with a current subjective system.MethodsWe selected a population including a group of normal young eyes as control and patients diagnosed with cataract (grades NO2, NO3 and NO4) according to the Lens Opacities Classification System (LOCS III). For each eye, we recorded double-pass retinal images of a point source. In each patient, we determined an objective scatter index (OSI) as the ratio of the intensity at an eccentric location in the image and the central part. This index provides information on the relevant forward scatter affecting vision. Since the double-pass retinal images are affected by both ocular aberrations and intraocular scattering, an analysis was performed to show the ranges of contributions of aberrations to the OSI.ResultsWe used the OSI values to classify each eye according to the degree of scatter. The young normal eyes of the control group had OSI values below 1, while the OSI for subjects in LOCS grade II were around 1 to 2. The use of the objective index showed some of the weakness of subjective classification schemes. In particular, several subjects initially classified independently as grade NO2 or NO3 had similar OSI values, and in some cases even higher than subjects classified as grade NO4. A new classification scheme based in OSI is proposed.ConclusionsWe introduced an objective index based in the analysis of double-pass retinal images to classify cataract patients. The method is robust and fully based in objective measurements; i.e., not depending on subjective decisions. This procedure could be used in combination with standard current methods to improve cataract patient surgery scheduling.

In most subjects, astigmatism less than 0.5 D did not degrade visual acuity. This suggests that under clinical conditions, the visual benefit of precise correction of astigmatism less than 0.5 D would be limited.

We studied the mechanism of compensation of aberrations within the young human eye by using experimental data and advanced ray-tracing modeling. Corneal and ocular aberrations along with the alignment properties (angle kappa, lens tilt, and decentration) were measured in eyes with different refractive errors. Predictions from individualized ray-tracing optical models were compared with the actual measurements. Ocular spherical aberration was, in general, smaller than corneal spherical aberration without relation to refractive error. However, horizontal coma compensation was found to be significantly larger for hyperopic eyes where angle kappa tended to also be larger. We propose a simple analytical model of the relationship between the corneal coma compensation effect with the field angle and corneal and crystalline shape factors. The actual shape factors corresponded approximately to the optimum shapes that automatically provide this coma compensation. We showed that the eye behaves as an aplanatic optical system, an optimized design solution rendering stable retinal image quality for different ocular geometries.

No significant correlations were found between VA measurements and the optical quality of the eye in young subjects with normal or excellent spatial vision. Some subjects with normal degrees of aberrations attained excellent VA.

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