A comparative analysis of the influence of refractive error on image acuity using three eye models

To analyse and compare image acuity for different refractive errors generated by either altering axial length or corneal curvature and using three human eye models with two pupil sizes.Three different eye models, Liou-Brennan, Goncharov and Navarro, were used. Simulations were made (using Ansys Zemax OpticStudio 22.3) for real pupil sizes of 3 and 6 mm with refractive errors ranging from -2 to +2 D in 0.25 D increments. Refractive errors were simulated by varying axial length or corneal curvature. Root mean square (RMS) values were used to determine image acuity.For the 3-mm pupil, all models gave similar results, with the Navarro model having slightly higher RMS values for the emmetropic eye. For the 6-mm pupil, the Liou-Brennan and Goncharov eye models gave similar results, with RMS values lower than for the Navarro eye model. The highest RMS value was visible in the axial length-induced refractive errors. Refractive errors generated by altering corneal curvature give smaller RMS values than those generated by altering axial length. The axial length and corneal radius simulations indicate a wide spread of results for myopic, hyperopic and emmetropic eyes. There are multiple outcomes that give the same refractive error, even within a single-eye model. The axial length/corneal curvature ratio showed a higher ratio for myopes than hyperopes for every model.The influence of refractive error on image acuity varied depending on the simulation method of refractive error and the model used. The origins of refractive error and the influence it has on image acuity need further investigation. As models become more sophisticated, personalised and biologically relevant, they will better represent the image acuity of the eye for varying refractive errors, ethnicities, ages and pupil sizes.