For Wired News by one of my favorite journalists, Kristen Philipkoski:
Getting a Closer Look at the Eye

Eye diseases such as glaucoma and macular degeneration often aren’t discovered until a patient is well on his way to blindness. But a new imaging technology promises to deliver diagnoses at critically early stages.
The technology, called adaptive optics, was originally developed for peering into outer space. It made headlines most recently for giving astronomers rare views of Saturn’s largest moon, Titan…
In 1953, an astronomer named Horace Babcock first proposed using adaptive optics for looking at stars and planets without atmospheric distortion, but the technology was not developed until the late ’60s and early ’70s by the military and aerospace industry, mainly in conjunction with developing high-powered lasers to destroy satellites. The technology remained classified until 1991.
It wasn’t applied to medical research until about five years ago when David Williams of the University of Rochester noticed that eliminating distortions in the earth’s atmosphere was probably a similar endeavor to eliminating distortions caused by the human eye when trying to use a microscope to see inside it.
Researchers at the University of Heidelberg in Germany had made the same observation, but never succeeded in proving that adaptive optics could work in the eye.
Now, at the Indiana University School of Optometry in Bloomington, Indiana, researchers are utilizing adaptive optics with another technique called optical coherence tomography, which allows doctors to capture images deep inside tissue.
By combining these two powerful technologies, an ophthalmologist might be able to not only find damaged cells in the retina, but also to precisely map the aberrations inside the eye that make eyesight less than perfect.
The new technology would replace the archaic phoropter (the part of the exam when the eye doctor says does it look better here, or here, and you usually can’t tell) and give a theoretically precise diagnosis.
With an exact map of the eye, they could precisely plan laser correction surgery, or create customized contact lenses, Olivier said.
Several combinations of adaptive optics with other imaging technologies are in the works, but the technology is still too expensive and the mirrors too large to enable widespread use.

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Getting a Closer Look at the Eye
By Kristen Philipkoski | Also by this reporter Page 1 of 1
02:00 AM Jan. 23, 2003 PT
Eye diseases such as glaucoma and macular degeneration often aren’t discovered until a patient is well on his way to blindness. But a new imaging technology promises to deliver diagnoses at critically early stages.
The technology, called adaptive optics, was originally developed for peering into outer space. It made headlines most recently for giving astronomers rare views of Saturn’s largest moon, Titan.
However, researchers studying the human eye are discovering the technology has applications in their field as well.
Adaptive optics uses mirrors to eliminate the visual distortion caused by the earth’s atmosphere. Ophthalmologists, it turns out, encounter a similar distortion when looking inside the human eye, which prevents them from seeing the minute details of the retina.
Those details can indicate when someone is developing glaucoma or macular degeneration, which are often diagnosed when it’s no longer possible to do something about it.
Centers for adaptive optics around the world are developing ways to use the technology to see individual cells in the retina, which would help diagnose potential eye diseases early enough to prevent them.
“Adaptive optics showed that you could image the individual cells in the eye, particularly the cone photo receptors, which are responsible for color vision and high-resolution vision in humans,” said Scot Olivier, adaptive optics group leader at the Lawrence Livermore National Laboratory. “These are cells that are mostly invisible in the retinal diseases that cause blindness in this country.”
In 1953, an astronomer named Horace Babcock first proposed using adaptive optics for looking at stars and planets without atmospheric distortion, but the technology was not developed until the late ’60s and early ’70s by the military and aerospace industry, mainly in conjunction with developing high-powered lasers to destroy satellites. The technology remained classified until 1991.
It wasn’t applied to medical research until about five years ago when David Williams of the University of Rochester noticed that eliminating distortions in the earth’s atmosphere was probably a similar endeavor to eliminating distortions caused by the human eye when trying to use a microscope to see inside it.
Researchers at the University of Heidelberg in Germany had made the same observation, but never succeeded in proving that adaptive optics could work in the eye.
Now, at the Indiana University School of Optometry in Bloomington, Indiana, researchers are utilizing adaptive optics with another technique called optical coherence tomography, which allows doctors to capture images deep inside tissue.
By combining these two powerful technologies, an ophthalmologist might be able to not only find damaged cells in the retina, but also to precisely map the aberrations inside the eye that make eyesight less than perfect.
The new technology would replace the archaic phoropter (the part of the exam when the eye doctor says does it look better here, or here, and you usually can’t tell) and give a theoretically precise diagnosis.
With an exact map of the eye, they could precisely plan laser correction surgery, or create customized contact lenses, Olivier said.
Several combinations of adaptive optics with other imaging technologies are in the works, but the technology is still too expensive and the mirrors too large to enable widespread use.
“It looks like there will be a large explosion of this in the next few years,” said Donald Miller, a professor in the Visual Sciences Group at the Indiana University School of Optometry. “Right now, there are about five operational systems in the world in laboratories, including here at IU.”
Olivier’s lab is working on a MicroElectricalMechanical system, or MEM, a device to build tiny and less expensive mirrors using the same technique that’s employed for building integrated circuits.
“We are now applying these to the adaptive optics for human vision, which will allow us to build a much more compact and inexpensive system,” Olivier said.