Potential vision tester using adaptive optics, Maxwellian view, and small pupil

We demonstrate a free-space, trolley-mounted potential vision tester (PVT), designed to study and improve the accuracy of visual acuity (VA) measurements in the aging eye. Key features include a high-resolution visual display presented in Maxwellian view, a 3 mm pupil to limit wavefront (WF) aberrations, and a moderate cost deformable mirror to induce or correct higher order optical aberrations. The visual display supported accurate measurement of visual acuities down to 20/5. The moderate cost, piezo deformable mirror induced seven nominal aberrations, calibrated as 0, -0.32, -0.23, + 0.27, and +0.39 microns spherical aberration; + 0.49 microns Y coma; and -0.51 microns X coma. A custom Hartmann Shack (HS) calibration (HSc) system demonstrated that induced aberrations were repeatable and stable. A Badal optometer provided the coarse focus. WF aberrations were measured for five normal subjects with a commercially available HS device (HSP) (OCULUS Pentacam AXL Wave), providing estimates of WF errors for 3 mm and other pupil sizes. VA was measured using four alternative forced-choice for a single black on white E stimulus in each trial. Using the method of constant stimuli yielded robust standard deviation measurements. The 50% fit for VA plotted against induced aberration resulted in linear functions for each subject for the range of our positive and negative spherical aberration data. Subjects differed, but higher order terms were unnecessary to describe data across spherical aberrations.