Advanced Optics for Ophthalmology Jim Schwiegerling, PhD Optical Sciences Ophthalmology & Vision Sciences University of Arizona

Accommodation Relaxed ciliary muscle pulls zonules taut an flattens crystalline lens. Constrict ciliary muscle releases tension on zonules and crystalline lens bulges.

Presbyopia solidsmack.com/cad/the-mystery-of-the-disappearing-solidworks-drawing-view/ visionhelp.wordpress.com/2012/07/21/presbyopia-old-man-look-at-my-life/presbyopia2/

Presbyopia Your ability to accommodate reduces steadily with age. Typically, you don’t notice the effects until it affects your ability to read comfortably. This is presbyopia.

Scatter Scatter creates a large halo around light sources and reduces contrast of a scene. Tom van den Berg Netherlands Institute for Neuroscience

Cataract Cataracts are an opacification of the crystalline lens in the eye. Early stages cause reduce light levels and scatter. Advanced stages cause (preventable) blindness. Cataract extraction with intraocular lens implantation is the most widely performed surgery in the US. Roughly 20 million blind people worldwide due to cataracts. http://webeye.ophth.uiowa.edu/eyeforum/cases/128-Posterior-Polar-Cataract.htm

Couching telemedicine.orbis.org & Wellcome Library London

Cataract Extraction 1735 – The French oculist Jacques Daviel (1693–1762) developed a method for the removal of cataracts from the eye www.daviddarling.info/encyclopedia/S/science_in_the_eighteenth_century.html

Aphakia http://www.righttosightandhealth.org/senegal-pictures-2011/

Harold Ridley Ridley noticed that shards from the canopy (PMMA) of RAF pilots lodge in their eyes did not get rejected by the body’s immune system. Proposed making an implantable lens out of the material.

Intraocular Lenses (IOLs)

Reading Glasses Conventional IOLs fix cataracts, but not presbyopia. Still need reading glasses to see up close.

Multifocal IOLs Multifocal come in a variety of forms, Far Near Far Multifocal come in a variety of forms, but the basic concept is to have two different powers simultaneously on a single lens. One power allows for distance vision, while the other allows for near vision. Variations in zone size, number of zones, power distribution, progressives, aspherics and diffractives all exist.

Simulated Images Multifocal Lens Single Vision Lens Distance Vision Near Vision

Refractive Multifocal

Diffraction Grating

Diffractive Lens Addition of refractive lens causes light to converge to two points +1

Diffractive Multifocal http://www.midlandseyespecialist.com

Diffractive IOLs Refractive IOLs tend to have more visual artifacts compared to diffractive lenses. Most multifocal IOLs today are diffractive lenses. These lenses are also limited because they give two distinct planes of focus.

Trifocal Diffractive Lens Alternating step heights causes light to converge to three points +2 +1

Diffractive IOLs Bifocal Diffractive Trifocal Diffractive

Tech Launch Arizona

Accommodating IOL

Accommodating IOL

Cataract Treatment Evolution Lens displacement or removal – Blindness to light perception. Aphakic Spectacles – Vision, limited field of view. IOL – Normal distance vision. Multifocal IOL – Distance and reading vision. Trifocal IOL – Distance, intermediate and reading vision. Accommodating IOL – Can focus at all ranges, like young healthy eye (in progress).

What’s Needed in General 76 million baby boomers. An understanding that people want “normal” or even enhanced abilities in their medical devices and treatments. Communication between physicians, scientists and engineers. Time & Support.

What’s Needed Materials which are biocompatible and mechanical properties can be defined. (e.g. curvature changing IOL and phaco ersatz). Chemistry & Biochemistry, BME, AME.

What’s Needed New imaging modalities to visualize crystalline lens in vivo. e.g. OCT, High-frequency Ultrasound, MRI. Medical Imaging, Optical Sciences, ECE

What’s Needed Miniature electronics, batteries, wireless recharging, solar power. ECE, Material Science, Optical Sciences

What’s Needed Drugs which slow the formation of cataracts, or reduce the scatter from cataracts after they have formed. Biochemistry, Pharmacology

What’s Needed Portable diagnostics & treatments. Telemedicine, ECE, Optical Sciences

Summary Thin slice of cataracts and their treatment, but many other medical conditions can be analyzed in the same way. Many of the solutions are multidisciplinary. How to communicate needs and capabilities? Strong and flexible Tech Transfer to work with medical device companies.