Polarization Modulation Using Wave Plates to Enhance Foveal Fixation Detection in Retinal Birefringence Scanning for Strabismus Screening Purposes

Abstract

To enhance foveal fixation detection while bypassing the deleterious effects of corneal birefringence in binocular retinal birefringence scanning (RBS) for pediatric vision screening purposes, a new RBS design was developed incorporating a double-pass spinning half wave plate (HWP) combined with a fixed double-pass retarder into the optical system. The spinning HWP enables essential differential polarization detection with only one detector, easing constraints on optical alignment and electronic balancing, and together with a fixed wave plate, this differential RBS signal can be detected essentially independent of various corneal retardances and azimuths. Utilizing the measured corneal birefringence from a dataset of 300 human eyes, an algorithm was developed in MATLAB for optimizing the properties of both wave plates to statistically maximize the RBS signal, while having the greatest independence from left and right eye corneal birefringence. Foveal fixation detection was optimized with the HWP spun 9/16 as fast as the circular scan, with the fixed retarder having a retardance of 45 degrees and fast axis at 90 degrees. Combined with bull's-eye focus detection, this computeroptimized RBS design promises to provide an effective screening instrument for automatic identification of infants at risk for amblyopia, the leading cause of vision loss in childhood.