Predicting subjective judgment of best focus with objective image quality metrics

Purpose: To determine the impact of higher-order monochromatic aberrations on lower-order subjective sphero-cylindrical refractions. Methods: Computationally-aberrated, monochromatic Sloan letters were presented on a high luminance display that was viewed by an observer through a 2.5mm pupil. Through-focus visual acuity (VA) was determined in the presence of spherical aberration (Z(4)(0)) at three levels (0.10, 0.21 and 0.50D). Analogous through-astigmatism experiments measured visual acuity in the presence of secondary astigmatism (Z(4)(+/-2)) or coma (Z(3)(-1)). Measured visual acuity was correlated with 31 different metrics of image quality to determine which metric best predicts performance for degraded retinal images. The defocus and astigmatism levels that optimized each metric were compared with those that produced best visual acuity to determine which metric best predicts subjective refraction. Results: Spherical aberration, coma and secondary astigmatism all reduced VA and increased depth of focus. The levels of defocus and primary astigmatism that produced the best performance varied with levels of spherical aberration and secondary astigmatism, respectively. The presence of coma, however, did not affect cylindrical refraction. Image plane metrics, especially those that take into account the neural contrast sensitivity threshold (e.g. the visual Strehl ratio, VSOTF), are good predictors of visual acuity in both the through-focus and through-astigmatism experiments (R = -0.822 for VSOTF). Subjective sphero-cylindrical refractions were accurately predicted by some image-quality metrics (e.g., pupil fraction, VSOTF and standard deviation of PSF light distribution). Conclusion: Subjective judgment of best focus does not minimize RMS wavefront error (Zernike defocus = 0), nor create paraxial focus (Seidel clefocus = 0), but makes the retina conjugate to a plane between these two. It is possible to precisely predict subjective sphero-cylindrical refraction for monochromatic light using objective metrics.