Age-related changes in the crystalline lens shape and refractive index gradient produce changes in dioptric power and high-order aberrations that influence the optics of the whole eye and contribute to a decrease in overall visual quality. Despite their key role, the changes in lens shape and refractive index gradient with age and accommodation and their effects on high-order aberrations are still not well understood. The goal of this project was to develop a combined laser ray tracing (LRT) and optical coherence tomography (OCT) system to measure high-order aberrations, shape and refractive index gradient in non-human primate and human lenses. A miniature motorized lens stretching system was built to enable imaging and aberrometry of the lens during simulated accommodation. A positioning system was also built to enable on- and off-axis OCT imaging and aberrometry for characterization of the peripheral defocus of the lens. We demonstrated the capability of the LRT-OCT system to produce OCT images and aberration measurements of crystalline lens with age and accommodation in vitro. In future work, the information acquired with the LRT-OCT system will be used to develop an accurate age-dependent lens model to predict the role of the lens in the development of refractive error and aberrations of the whole eye.
Hand-held wide-field contact color fundus photography is currently the standard method to acquire diagnostic images of children during examination under anesthesia and in the neonatal intensive care unit. The recent development of portable non-contact hand-held OCT retinal imaging systems has proved that OCT is of tremendous help to complement fundus photography in the management of pediatric patients. Currently, there is no commercial or research system that combines color wide-field digital fundus and OCT imaging in a contact-fashion. The contact of the probe with the cornea has the advantages of reducing motion experienced by the photographer during the imaging and providing fundus and OCT images with wider field of view that includes the periphery of the retina. In this study we produce proof of concept for a contact-type hand-held unit for simultaneous color fundus and OCT live view of the retina of pediatric patients. The front piece of the hand-held unit consists of a contact ophthalmoscopy lens integrating a circular light guide that was recovered from a digital fundus camera for pediatric imaging. The custom-made rear piece consists of the optics to: 1) fold the visible aerial image of the fundus generated by the ophthalmoscopy lens on a miniaturized level board digital color camera; 2) conjugate the eye pupil to the galvanometric scanning mirrors of an OCT delivery system. Wide-field color fundus and OCT images were simultaneously obtained in an eye model and sequentially obtained on the eye of a conscious 25 year-old human subject with healthy retina.