Ultrafast adaptive optics for imaging the living human eye

Adaptive optics (AO) is a powerful method for correcting dynamic aberrations in numerous applications. When applied to the eye, it enables cellular-resolution retinal imaging and enhanced visual performance and stimulation. Most ophthalmic AO systems correct dynamic aberrations up to 1-2 Hz, the commonly-known cutoff frequency for correcting ocular aberrations. However, this frequency may be grossly underestimated for more clinically relevant scenarios where the medical impact of AO will be greatest. Unfortunately, little is known about the aberration dynamics in these scenarios. A major bottleneck has been the lack of sufficiently fast AO systems to measure and correct them. We develop an ultrafast ophthalmic AO system that increases AO bandwidth by ~30× and improves aberration power rejection magnitude by 500×. We demonstrate that this much faster ophthalmic AO is possible without sacrificing other system performances. We find that the discontinuous-exposure AO-control scheme runs 32% slower yet achieves 53% larger AO bandwidth than the commonly used continuous-exposure scheme. Using the ultrafast system, we characterize ocular aberration dynamics in six clinically-relevant scenarios and find their power spectra to be 10-100× larger than normal. We show that ultrafast AO substantially improves aberration correction and retinal imaging performance in these scenarios compared with conventional AO.