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This manual is written to assist the student of optics or the ophthalmology resi dent in reviewing optics. It is particularly suitable as an optics Board review. However, it was not intended to accomplish the far greater task of encompassing the entire field of geometric optics or even of teaching all that the ophthalmologist needs to know of visual optics or refraction. This manual represents the distillation of lecture notes for an optics Board-review course given at the Massachusetts Eye and Ear InfIrmary, Harvard Medical School, for the last seven years. This optics lecture series, which has also been given at Boston University and at the University of Southern California, has traditionally taken place over a week, with three two hour sessions. Obviously, this six-hour lecture series could not possibly cover the entire field of optics for clinicians. This optics Board-review lecture series has customarily involved a few problems at the end of each lecture which then provided a basis for a review that was given at the beginning of the next lecture. These problems have always proven a useful means of self-testing as well as practice for becoming more comfortable and facile with the concepts involved. The problems have not been taken from the American Board of Ophthalmology test materials, either written or oral. However, they incorporate many of the concepts and computational manipulations which are frequently tested on the ophthalmology boards.
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Measurement of visual acuity has been the cornerstone of visual testing since Snellen began quantitating visual acuity using letter optotypes in the 1860s. Bjerrum in the 1880s brought sophistication and quantitation to the assessment of the visual field with tangent screen examination using differently sized and colored targets. Further advances in visual testing did not occur until the Goldmann perimeter and the Farnsworth Munsell 100 Hue test were introduced in the 1940s, permitting further refinement in the detection and quantitation of acquired visual loss. An explosion of interest in sensory visual function testing followed the demonstration by Quigley and his colleagues in 1982 that despite the loss of more than 40% of the axons in the optic nerve, Snellen acuity and kinetic perimetry remained normal. Much of this interest has focused on a search for more sensitive and disease-specific sensory visual tests. Previously, novel tests used to probe visual function remained in the province of the visual physiologist and psychophysicist. These tests are now being introduced by the ophthalmologist into clinical practice. Concomitantly, the mass production of microcomputers and other technical advances have made tests such as automated perimetry and visual evoked response testing affordable for most offices. The clinician is presently being inundated with a plethora of visual function tests that may require a knowledge of visual psychophysics and statistics to understand and interpret. The purpose of this book is to acquaint the clinician with these new tests so that they may be used to maximum benefit.