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Medical Forum / General / Vision / January 2009Wavefront glasses
My eye doc will soon be offering wavefront, or "high def" (or something) glasses. They have a fancy machine (aberometer) and make the lenses accordingly, instead of just doing sphere and cylinder. I'd be interested to hear opinions and experiences related to this. I'm a sucker for this type of thing, so I'll probably give it a shot, but does it really work noticeably better than the old way? -- > My eye doc will soon be offering wavefront, or "high def" (or > something) glasses. They have a fancy machine (aberometer) and make [quoted text clipped - 3 lines] > does it really work noticeably better than the old way? > -- I wear them. I like them, but ... don't particularly LOVE them. Much will depend on the amount of higher-order aberrations YOU have. The MORE you have, the MORE you will, theoretically, benefit. The wavefront aberrometry will determine this. Mine simply weren't that high, so ... no overnight miracles, but ... good, crisp vision. Neil Not a doctor In article <563e0235-b65c-4658-b2c8-afbe0cbce315@r15g2000prd.googlegroups.com>, > > My eye doc will soon be offering wavefront, or "high def" (or > > something) glasses. They have a fancy machine (aberometer) and make [quoted text clipped - 17 lines] > Neil > Not a doctor I am not a vision professional. But I do have reasons why wavefront (figured) corrected glasses are not a good idea. Wavefront correction can be carried out for looking in a particular direction. If done on the cornea of an eye, it will correct errors for looking in a particular direction. That would be for looking in the direction that images onto the fovea, As you look in different directions by turning the eye,the correction turns with the eye. Light that does not focus on-axis is likely to be aberrated more than if there were no wavefront correction. That would not be expected to be a problem because sharpest vision is desired for foveal vision. Off-axis aberration is not that great a problem because the eye's retina is losing acuity anyway. For wavefront corrected glasses, however, your eys turn to see through portions of the lens that are designed to correct best in another direction. Bill  SignaturePrivate Profit; Public Poop! Avoid collateral windfall! >I am not a vision professional. But I do have reasons why wavefront >(figured) corrected glasses are not a good idea. [quoted text clipped - 15 lines] > >Bill This may be of interest. http://www.optiboard.com/forums/showthread.php?t=19540 Robert Martellaro ~~~~~~~~~~~~~~~~~~ Optician/Owner Roberts Optical Wauwatosa Wi. ~~~~~~~~~~~~~~~~~~ "Science is a way of trying not to fool yourself." - Richard Feynman > My eye doc will soon be offering wavefront, or "high def" (or > something) glasses. They have a fancy machine (aberometer) and make > the lenses accordingly, instead of just doing sphere and cylinder. I'd > be interested to hear opinions and experiences related to this. I'm a > sucker for this type of thing, so I'll probably give it a shot, but > does it really work noticeably better than the old way? There are two kinds of wavefront lenses, those requirement special measurements, and those which use a regular Rx. The ones that require a special measurements with the machine you mentioned are mostly hype, although for certain kinds of problems it may be useful. Here is an article that explains it in more detail lists all the manufacturers of wavefront lenses individually ground to your Rx. http://www.allaboutvision.com/lenses/wavefront-lenses.htm The Hoya ID is considered by many to be the best. > My eye doc will soon be offering wavefront, or "high def" (or > something) glasses. They have a fancy machine (aberometer) and make [quoted text clipped - 3 lines] > does it really work noticeably better than the old way? > -- You might have better luck with wavefront soft contact lenses which actually move along with the eye. The correction of higher order aberrations requires very close registration of the optical correction, and this is difficult to accomplish in spectacle lenses. Some aberrations are more forgiving, however, such as spherical aberration, one of the more common and prevalent ones. WaveTouch Technologies is the manufacturer of the wavefront generated soft lens. I'm a little puzzled, however. If you are the same Chuck who is being fitted with some type of semi-scleral GP lens, wearing the contact lenses will change your aberrations profile enough to make the spectacles useless. What's going on here? > > My eye doc will soon be offering wavefront, or "high def" (or > > something) glasses. They have a fancy machine (aberometer) and make [quoted text clipped - 19 lines] > > What's going on here? Yeah, I'm the same guy, and I'm just taking many stabs in the dark trying to find satisfaction. My eyeglass Rx has changed a bit since wearing RGP, so I understand that I might be wasting money on wavefront if I change my contact wearing habits. On the "macrolens" front, my eye doctor is not proficient enough to deal with the fact that my astigmatism is persisting. I went in for a follow-up today and we decided to just give up on them. I wasn't going to argue if he didn't feel confident going forward. I also was kind of down on them due to the difficulty of getting them in without bubbles and out without making my eyes bloodshot. I don't doubt these issues could be dealt with with practice though. I think wavefront soft lenses will be an option here, so I'll follow up on that next visit. He had some new (to him?) custom soft contact that he said he's had good luck with, so we're giving that a shot next. My experience with soft lenses so far is that they don't stay oriented right and are generally worse than nothing, but we'll see. He seems to think that these hold some promise that "off the shelf" ones don't. Back on the wavefront glasses, what I've read on-line is mostly a lot of skepticism and negativity, but I asked him today and he said that many of his patients (at his other office that already offers it) are really impressed and happy with it. I guess I'll just wait and see. -- > > > My eye doc will soon be offering wavefront, or "high def" (or > > > something) glasses. They have a fancy machine (aberometer) and make [quoted text clipped - 46 lines] > > -- What's your goal? What's your overall Rx? Have you considered wearing contacts to take care of the near/ farsighted, and then glasses (over the contacts) to take care of the astigmatism? This might give you a much broader choice of contacts, stable vision, and a good 'cosmetic' appearance. I wear my wavefront glasses over Boston Foundation Scleral Lenses. > > > > My eye doc will soon be offering wavefront, or "high def" (or > > > > something) glasses. They have a fancy machine (aberometer) and [quoted text clipped - 60 lines] > > I wear my wavefront glasses over Boston Foundation Scleral Lenses. I have a pretty mild Rx, basically all astigmatism, 0.75 diopter when I regularly wear RGP and 1.0-1.5 diopter when they settle out. I had some issues adapting to the astigmatism correction in glasses as my astigmatism creeped up past 1.0 (or possibly I have higher order stuff for which cylinder was the best approximation). Anyway, I tried RGP and life was great except that wind and AC irritate my eyes with them in and my night vision is marginal. Comfort is also not great, especially around 12 hours of wear. So, I'm just trying to find my best solution. Nothing complex, just comfort, vision, wear time, etc. -- > > > My eye doc will soon be offering wavefront, or "high def" (or > > > something) glasses. They have a fancy machine (aberometer) and make [quoted text clipped - 48 lines] > > - Show quoted text - I'm sorry to hear about your experiences. I know precisely what you are going through. It may be better, a little, if you're always looking through the center of the lenses. If I understand it correctly. Perhaps someone can enlighten me. -MT > My eye doc will soon be offering wavefront, or "high def" (or > something) glasses. They have a fancy machine (aberometer) and make > the lenses accordingly, instead of just doing sphere and cylinder. I'd > be interested to hear opinions and experiences related to this. I'm a > sucker for this type of thing, so I'll probably give it a shot, but > does it really work noticeably better than the old way? >It may be better, a little, if you're always looking through the center of >the lenses. > >If I understand it correctly. Perhaps someone can enlighten me. > >-MT No better than a spot on refraction along with lenses utilizing free-form technology for .01D accuracy. See the link I posted above, primarily the posts by Xiaowei and Meister. Robert Martellaro ~~~~~~~~~~~~~~~~~~ Optician/Owner Roberts Optical Wauwatosa Wi. ~~~~~~~~~~~~~~~~~~ "Science is a way of trying not to fool yourself." - Richard Feynman > > It may be better, a little, if you're always looking through the > > center of the lenses. [quoted text clipped - 14 lines] > "Science is a way of trying not to fool yourself." > - Richard Feynman I'm not an expert in this field, but why would you expect everyone's error to be fully corrected with only sphere and cyl corrections? Surely some people have other errors that remain uncorrected with only those. -- Wavefront glasses can't produce dramatic effects, and they can't anticipate changes in your wavefront morning-to-evening, nor those caused by wearing contacts. Are you a competition shooter? Professional driver, pizza delivery, or making glasses for stargazing? People with scars and keratoconus and cataracts and PK can benefit from wavefront designs in glasses too. If your vision demands are more mundane, think in terms of dollar-per-snellen-letter. The first $200 might take you from 20/200 to 20/15. How much improvement will you get for another $200? -MT >> > It may be better, a little, if you're always looking through the >> > center of the lenses. [quoted text clipped - 19 lines] > Surely some people have other errors that remain uncorrected with only > those. > Wavefront glasses can't produce dramatic effects, and they can't > anticipate changes in your wavefront morning-to-evening, nor those [quoted text clipped - 10 lines] > > -MT Snellen lines aren't the whole story though. I can see the 20/20 line, but the contrast is much worse on my right eye, and it gets worse the darker it is, with point sources smearing out. I keep thinking I want more cylinder for this, but the doctor tells me that I reject it in the batter/worse chair. With RGP's things look great until it gets dark, then I get uniform starbursts. It _seems_ like there's something going on that sphere/cyl isn't getting. Not that I'm bumping into stuff, it's just annoying. I just don't know enough about optics to have an informed opinion about the scientific merits. I'm in engineering though, and I keep wanting to make an analogy to fitting a curve with a polynomial. It's like we've been using a 1st order polynomial for hundreds of years and now we have the option of using a 6th order polynomial. Maybe 6 is overkill because of the alignment issues and variation over the day, etc, but perhaps 2nd or third order will make a noticeable difference to 10% of glasses wearers? Fine tuning the diopters would be analogous to dialing in the terms of the 1st order polynomial to ridiculous accuracy but not adding any more. There are cases where that wouldn't hack it. I'm not sure my analogy is right though... > > Wavefront glasses can't produce dramatic effects, and they can't > > anticipate changes in your wavefront morning-to-evening, nor those [quoted text clipped - 34 lines] > > - Show quoted text - Higher order aberrations are third order and above. Sphere and cylinder are second order. Higher order aberrations are pupil dependent. This has been well-documented, and tables are available. In fact, I have documented it myself (I have an aberrometer). The most common ones are spherical aberration (fourth order) and coma (third order). Coma often results in a cylindrical correction that never seems good enough. It also makes a difference as to where the aberrations are located. If the origin is corneal, then a GP lens with an optical zone that is sufficiently large should work. If the origin is not corneal, then the GP lens will not work. There is a company called WaveTouch Technologies that has the only commercially available wavefront-correcting soft contact lens. Their product can theoretically correct corneal and internal aberrations. I might pursue this route first. The Marco OPD and Tracey aberrometers are both approved to be used with the WaveTouch lenses. In article <83016fc9-aa8b-440a-b046-f254fe5d431f@f40g2000pri.googlegroups.com>, <snip> > > Snellen lines aren't the whole story though. I can see the 20/20 line, > > but the contrast is much worse on my right eye, and it gets worse the [quoted text clipped - 36 lines] > might pursue this route first. The Marco OPD and Tracey aberrometers > are both approved to be used with the WaveTouch lenses. I am not a vision professional. I have undergone cataract surgery and trabeculectomy in both eyes. My vision has deteriorated to the extent that I refuse to drive and let my license lapse. I seem to have a problem with light scattering. When I mention it to ophthalmologists, I get little response. I do not know if they have the capability of actual measurement of scattering from surfaces like the cornea. I presume that slit lamps are used to examine scattering in the interior of various eye structures. Maybe a different word is used to describe scattering. In any event, my guess is that the OP is having significant scatter and that is what is reducing contrasty. true scattering is not going to be helped by wavefront glasses. I can picture contact lenses sitting on a liquid film (equivalent to oil immersion in microscopy) in contact with the cornea possibly reducing scatter. Because of my impairment,I have great difficulty reading ordinary books and displays showing dark text on a white background. I have taken to looking at displays in inverse video. If sun is shining an my eyes, even at large angles wrt my visual axis, contrast is greatly reduced. Aberrations will reduce contrast, but even if corrected are not likely to be improved with wavefront correction. Because of various wavefront techniques, the use of Zernike functions appear to be entering the field of optometry. It is about time. Wavefront error can be represented as a sum of Zernike function. Each function corresponding to a different aberration. The lower order ones are given distinct names such as spherical aberration. I can picture that being of benefit is special situations. Sooting was mentioned. In that case, you will be looking mostly through the same portion of the lens most of the time. But for general use, different portions of the lens will be used as your eye swivels in different directions. In such cases, the wavefront correction is more to degrade vision than to improve it. Bill SignaturePrivate Profit; Public Poop! Avoid collateral windfall! > In any event, my guess is that the OP is having significant scatter and > that is what is reducing contrasty. true scattering is not going to be > helped by wavefront glasses. I can picture contact lenses sitting on a > liquid film (equivalent to oil immersion in microscopy) in contact with > the cornea possibly reducing scatter. My educated guess is that this is not the case. The OP clearly stated that this effect was more pronounced in low light situations, and this is an entirely different phenomenon than clouding of the media. Terms like "smear," "low contrast," "worsening at night" are very familiar to anybody who has worked with eyes having elevated spherical aberration, coma, etc. Otherwise, you are correct in that wavefront corrections are not going to help eliminate scatter from cloudy media. > > In any event, my guess is that the OP is having significant scatter > > and that is what is reducing contrasty. true scattering is not [quoted text clipped - 11 lines] > Otherwise, you are correct in that wavefront corrections are not going > to help eliminate scatter from cloudy media. Since I see great in my GP's in all but dark situations, and based on Dr. L's comments, my theory is that I have a little bit of higher order abberation in the cornea. If I could get a big enough optical zone in GP's, life would be pretty good, though my eyes do still get irritated in the wind, etc, as I've posted before. Oh, and ideally I wouldn't be getting residual astigmatism in my other eye... I will pursue the wavefront glasses and soft contacts (if the latter is an option), and see if I get lucky. Dr. L, is it possible for the GP's to induce higher order abberations? Specifically, I was as high as -1.5D cylinder prior to GP's, and now I'm at -0.75D. Is it possible the 1.5 was pure cylinder and now I'm at 0.75 cylinder plus higher order junk? -- > > > In any event, my guess is that the OP is having significant scatter > > > and that is what is reducing contrasty. true scattering is not [quoted text clipped - 30 lines] > > - Show quoted text - Any change to the cornea can increase higher orders. Orthokeratology and refractive surgery increase higher orders while simultaneously reducing lower orders. In article <1be7ac7c-c14e-468b-8796-cc3c1e2e893a@r24g2000vbp.googlegroups.com>, > Any change to the cornea can increase higher orders. Orthokeratology > and refractive surgery increase higher orders while simultaneously > reducing lower orders. For someone who wants to dig a bit deeper, look up aplanatic lenses. Aplanatic lenses work well for a pair of conjugate points but reduce resolution as you go to points away from the design. In microscopy, a spherical element is often the the one closest to the object and is free from monochromatic aberration. Oil with the same index as the glass contacts the object. This oil increases the numerical aperture compared to lenses without oil, As indicated by Dr. Leukoma for eyes, the "perfect" performance degrades faster away from the design point than if there were no aplanaticity. Bill SignaturePrivate Profit; Public Poop! Avoid collateral windfall! In article <dfd155d2-850f-46e3-b9b5-e529b9ab7ed5@n10g2000yqm.googlegroups.com>, > My educated guess is that this is not the case. The OP clearly stated > that this effect was more pronounced in low light situations, and this [quoted text clipped - 5 lines] > Otherwise, you are correct in that wavefront corrections are not going > to help eliminate scatter from cloudy media. Even if the problem arises out of enhanced aberrations from increased pupil size, wavefront correction from external lenses are not likely to solve the problem. That would only mean that the wavefront correction will introduce optical distortion near the view angle for which the correction is designed. That is, the correction is useful only when you are looking through a lens in the design direction. For other directions, the wavefront is merely another aberration. On the other hand, if the correction swivels with the direction of viewing, as might be the case when wavefront correction is built into the contac lens system, the correction will track with the viewing direction. Bill SignaturePrivate Profit; Public Poop! Avoid collateral windfall! > In article > <dfd155d2-850f-46e3-b9b5-e529b9ab7ed5@n10g2000yqm.googlegroups.com>, [quoted text clipped - 23 lines] > > Bill Sphere and cylinder corrections are also only perfect when looking straight ahead, right? But they seem to hold up okay. The net benefit is still there even when looking pretty far off axis. Do you have reason to believe that this breaks down when we get to 3rd or 4th order correction? -- > Sphere and cylinder corrections are also only perfect when looking > straight ahead, right? But they seem to hold up okay. The net benefit > is still there even when looking pretty far off axis. Do you have > reason to believe that this breaks down when we get to 3rd or 4th order > correction? These "quadratic" corrections are only slightly sensitive to direction. Looked at from the wavefront point of view, the added thickness varies smoothly. That is, there are no sudden bumps in the surface. Wavefront correction will add thickness rather suddenly as the fourth power of the radius. It will be a ring around the design direction that would be of no use unless the pupil is large and you are looking in the design direction. For everything else, this will be a ring of spherical aberration introduced unnecessarily. Bill SignaturePrivate Profit; Public Poop! Avoid collateral windfall! >Sphere and cylinder corrections are also only perfect when looking >straight ahead, right? Adding to what Bill said... Not perfect, but power and astigmatic errors are typically no more than an eighth of a diopter (up to at least 15mm off-axis), *if* the lens has the correct base curve and is positioned properly in front of the eyes. Note that Rxs are given in quarter diopter steps, so that eighth diopter errors are generally imperceptible. > Do you have >reason to believe that this breaks down when we get to 3rd or 4th order >correction? From the link I posted above... "this seems impossible to me without drawbacks, either you keep the high order aberration up to the edge of the pupil intact, so to really get the best supervision or you start smoothing it already before reaching the edges. In the first case you have one POINT of perfect supervision, but at the slightest move away it will get worse, even worse as without higher order correction, as those higher order will combine ("interfere") in the wrong way (especially when you move away by about half the pupil diameter). OR, you do the smoothing, but to avoid the bad interference, it seems to me, that you need pretty strong smoothing, so much of the supervision effect is lost. What you gain in one area, you lose in another place, it´s like that "sandbox rule" about the distribution of aberrations in a traditional PAL." http://www.optiboard.com/forums/showpost.php?p=158764&postcount=6 Robert Martellaro ~~~~~~~~~~~~~~~~~~ Optician/Owner Roberts Optical Wauwatosa Wi. ~~~~~~~~~~~~~~~~~~ "Science is a way of trying not to fool yourself." - Richard Feynman > In article > <dfd155d2-850f-46e3-b9b5-e529b9ab7...@n10g2000yqm.googlegroups.com>, [quoted text clipped - 26 lines] > -- > Private Profit; Public Poop! Avoid collateral windfall! This point has been made several times in this thread. > > Wavefront glasses can't produce dramatic effects, and they can't > > anticipate changes in your wavefront morning-to-evening, nor those [quoted text clipped - 25 lines] > we've been using a 1st order polynomial for hundreds of years and now > we have the option of using a 6th order polynomial. Well, that's what you don't understand about enginnering, though. It's not *US* that have been fitting Polynomials to curves, it's *Mathematicians* that been doing it all these centuries. Which is why for the 21st Century, the non-druid engineers invented *fiber optics*, Optical Computers, Holograms, C++, RISC Processors, HDTV, CD+rw, CD- rom, CD-ram, DVD-rw, DVD-rom, DVD-ram, E-Libraries, E-Books, E-Publishing, On- Line Banking, On-Line Publishing, GPS, XML, USB, Cell Phones, Autonomous Vehicles, and Post Ford Batteries, and Post Chrysler Phonics for the Druids. Maybe 6 is overkill > because of the alignment issues and variation over the day, etc, but > perhaps 2nd or third order will make a noticeable difference to 10% of [quoted text clipped - 5 lines] > > - Show quoted text - >> > It may be better, a little, if you're always looking through the >> > center of the lenses. [quoted text clipped - 17 lines] >I'm not an expert in this field, but why would you expect everyone's >error to be fully corrected with only sphere and cyl corrections? The question is, can "wavefront glasses" reduce higher order aberrations inherent in the eye system. The CW seems to be they can not do so without doing an equal or greater amount of harm than good. It seems likely that any improvement in vision with wavefront glasses is due to the accuracy of the refraction and on-axis lens power, along with reduced amounts of off-axis astigmatic and power error, along with reduced amounts of higher order aberrations in the eyeglass lens. Robert Martellaro ~~~~~~~~~~~~~~~~~~ Optician/Owner Roberts Optical Wauwatosa Wi. ~~~~~~~~~~~~~~~~~~ "Science is a way of trying not to fool yourself." - Richard Feynman |
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