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Related Experiment Video

Updated: Mar 27, 2026

Author Spotlight: Advancements in Refractive Surgical Correction for Presbyopia and Exploring Postoperative Visual Acuity
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Do small-aperture presbyopic corrections influence the visual field?

David A Atchison1, Stella Blazaki2, Marwan Suheimat1

  • 1Institute of Health & Biomedical Innovation, School of Optometry & Vision Science, Queensland University of Technology, Brisbane, Australia.

Ophthalmic & Physiological Optics : the Journal of the British College of Ophthalmic Opticians (Optometrists)
|January 16, 2016
PubMed
Summary

Small-aperture optics, like the KAMRA inlay, minimally impact visual field measurements. Annular designs preserve visual field sensitivity better than circular apertures, offering a promising solution for presbyopia correction.

Keywords:
KAMRA inlaydepth-of-focuspresbyopiasmall-aperture opticsvisual field

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Area of Science:

  • Ophthalmology
  • Optics
  • Visual Science

Background:

  • Presbyopia, an age-related condition, reduces the eye's ability to focus on near objects.
  • Small-aperture optics are designed to increase the depth-of-focus, aiding presbyopic individuals.
  • Understanding the impact of these optics on visual field measurements is crucial for clinical application.

Purpose of the Study:

  • To investigate the effect of small-aperture optics on visual field measurements.
  • To compare the impact of circular versus annular small-aperture designs on visual fields.

Main Methods:

  • Theoretical and ray-tracing models were employed to predict light transmission through different small-aperture designs.
  • Three afocal opaque soft contact lenses with varying apertures (1.5mm, 3.0mm circular; 1.5-4.0mm annular) were tested on five healthy volunteers.
  • Static automated perimetry was used to evaluate visual fields along the horizontal meridian up to 50° eccentricity.

Main Results:

  • Ray-tracing predicted reduced pupil transmittance at specific angles for circular apertures, while annular designs affected central field transmittance based on pupil size.
  • Experimental results showed minor sensitivity losses (around 2 dB) within 10° radius for circular apertures, increasing to 7 dB at 50°.
  • Annular stops demonstrated minimal sensitivity loss (≤3 dB) across the tested visual field.

Conclusions:

  • Small-aperture optics, particularly KAMRA-type annular designs, have minor effects on visual field measurements.
  • Annular apertures are superior to circular artificial pupils in preserving visual field integrity.
  • These findings support the clinical utility of annular small-aperture devices for presbyopia correction.