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REFRACTION DISORDERS
EKA SUTYAWAN
DEPT OF OPHTHALMOLOGY
UDAYANA UNIVERSITY
INTRODUCTION
• Eye ≈ camera
■ Lens ≈ lens system, pupil ≈ variable aperture system and
retina ≈ film
■ Refractive interfaces:
– air & anterior surface of cornea
– posterior surface of cornea & aquous humor
– aquous humor & anterior surface of the lens
– Posterior surface of the lens & vitreous humor
(Guyton,2000)
Anatomy of the eye
Accomodation
Total : 60 Diopters
Visual acuity
(Vaughan, 2004)
■ WHO classification for vision:
– 6/6 – 6/18 normal
– < 6/18 – 6/60 visual impairment
– < 6/60 – 3/60 severe visual impairment
– < 3/60 – NLP blindness
(WHO,1992)
REFRACTION
Cycloplegic Refraction
Refraction with relaxed accomodation by instillation of
Cycloplegic drugs
Snellen Projector Phoropter
Jackson Cross
Cylinder
Streak Retinoscopy
Jaeger Chart autorefractometer
REFRACTIVE ERRORS
o Myopia
o Hiperopia
o Astigmatism
o Presbyopia
MYOPIA (NEARSIGHTEDNESS)
• Symptom:
– Blurred at distance vision
– Tendency to squint to see distance object
– Like to read / extensive near work activity
(Garcia, 1989)
• Treatment :
– weakest concave spherical ( minus ) lenses that
give maximal correction
• Complication:
– Retinal detachment high myopia
– Strabismus
– Amblyopia
(Garcia, 1989)
HYPEROPIA
(FARSIGHTEDNESS)
When image of distant objects focuses behind the retina in the
unaccomodated eye
Types of hyperopia:
• Axial Hyperopia
• Refractive / curvature hyperopia
• Index of refraction Hyperopia
• Hyperopia caused by alteration of lens position
■ Treatment of astigmatism:
– Cylinders lenses
– Rigid Gas Permeable (RGP) contact lens
– Toric Contact lens
(Vaughan, 2004)
spectacles
CLE
Contact lens
Phakic IOL