Astigmatic Refractive

Correction: Jackson Cross

Basic Optics, Chapter 13

 2

Astigmatic Eye Error

er
Er
ror

d
ylin
cy
lin

rc
de
r
o
Err

(Misleading figure! Once the

conoid is collapsed, the focal
lines collapse to a focal point)

In Chapter 11, we saw that astigmatic refractive error results from two cylindrical
error lenses, and therefore requires a spherocylindrical lens for its correction.
 3

Astigmatic Correction

 There are two commonly-used clinical

techniques for refracting the astigmatic
patient:
 Retinoscopic
 Jackson Cross
 4

Astigmatic Correction

 In Chapter 12 we saw how retinoscopic astigmatic

refraction works. Now we will turn our attention to the
Jackson Cross approach.

Retinoscopic Jackson Cross

Step 1 Use sphere to place one focal

line on the retina ?
Step 2 Use cylinder to place the other
focal line on the retina ?
Conoid collapsed to a point Conoid collapsed to a point
Result on the retina on the retina
 5

Astigmatic Correction: Jackson Cross

 In the Jackson Cross approach, the focal

lines are attacked simultaneously
 First, sphere is used to place the Circle of Least
Confusion on the retina
 6

Astigmatic Correction: Jackson Cross

 In the Jackson Cross approach, the focal

lines are attacked simultaneously
 First, sphere is used to place the Circle of Least
Confusion on the retina
 Then, the Jackson cross cylinder is used to…
1) identify the axis of astigmatism, and
2) determine the power of astigmatism
 And this information is used to collapse the
conoid onto the retina!
 7

Astigmatic Correction: Jackson Cross

 But first: What is a Jackson cross lens?

 8

Astigmatic Correction: Jackson Cross

 But first: What is a Jackson cross lens?

 It is a spherocylindrical lens containing plus and
minus cylinders of equal-but-opposite powers
oriented 90o apart
 9

Astigmatic Correction: Jackson Cross

 But first: What is a Jackson cross lens?

 It is a spherocylindrical lens containing plus and
minus cylinders of equal-but-opposite powers
oriented 90o apart
 Key property: A Jackson cross lens has no net
spherical power (i.e., its spherical equivalent power is
zero)
 10

Astigmatic Correction: Jackson Cross

 But first: What is a Jackson cross lens?

 It is a spherocylindrical lens containing plus and
minus cylinders of equal-but-opposite powers
oriented 90o apart
 Key property: A Jackson cross lens has no net
spherical power (i.e., its spherical equivalent power is
zero)
 Because it has no sphere power, a Jackson cross lens will
not move the Circle of Least Confusion when placed before
an astigmatic eye
 11

Astigmatic Correction: Jackson Cross

 Jackson cross lens: Spherocylindrical-

notation examples
 +1.0 -2.0 x 090
 -2.0 +4.0 x 180 Note that for each of these, S.E. = 0

 +0.25 – 0.50 x 135

 12

Astigmatic Correction: Jackson Cross

 Jackson cross lens: Spherocylindrical-

notation examples
 +1.0 -2.0 x 090
 -2.0 +4.0 x 180 Note that for each of these, S.E. = 0

 +0.25 – 0.50 x 135

+1 x 180
-1 x 090 Here are the same Jackson cross lenses written in
power-cross notation.
-2 x 090
+2 x 180
+.25 x 045
-.25 x 135
 13

Astigmatic Correction: Jackson Cross

 Jackson cross lens: Spherocylindrical-

notation examples
 +1.0 -2.0 x 090
 -2.0 +4.0 x 180 Note that for each of these, S.E. = 0

 +0.25 – 0.50 x 135

+1 x 180
-1 x 090 Here are the same Jackson cross lenses written in
power-cross notation. In this format, it is easier to
-2 x 090 appreciate that each consists simply of plus and
+2 x 180 minus cylinders of identical but opposite powers,
oriented 90o apart. (We’ll talk more about power
+.25 x 045 crosses later in this chapter.)
-.25 x 135

OKAP pearl: You must be able to recognize/identify a Jackson cross!

 14

Astigmatic Correction: Jackson Cross

Simple Hyperopic Simple Myopic

(if using a plus-cyl phoropter) (if using a minus-cyl phoropter)

When using the Jackson cross, the starting point is not

the same as it was for the retinoscopic approach

This is key: The circle

of least confusion must
be on the retina
Mixed
 15

Astigmatic Correction: Jackson Cross

Simple Hyperopic Simple Myopic

(if using a plus-cyl phoropter) (if using a minus-cyl phoropter)

Instead, to use the Jackson

cross, the Circle of Least
Confusion must be on the retina
Mixed
 16

Astigmatic Correction: Jackson Cross

Compound Myopic
Simple Myopic

Mixed
(With CoLC on
the retina)

When performing Jackson

cross refraction, all roads
Simple Hyperopic must lead to mixed astigmatism Compound Hyperopic
(with the Circle of Least
Confusion on the retina) before
cylinder is introduced
 17

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

Conoid of Sturm
+1D 2D 2D

Eye Error

+5D

Circle of Least Confusion

Consider this astigmatic eye. How can we use the

Jackson cross lens to neutralize its refractive error?
 18

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090 Note the conoid is four
diopters wide, with the
CoLC in the middle (recall
Conoid of Sturm that the CoLC is always
located at the dioptric half-
+1D 2D 2D way point of its conoid).
It is 4D wide because that
is the difference in power
Eye Error between the two eye-error
focal lines [(+5)-(+1)=4].

+5D

Circle of Least Confusion

Consider this astigmatic eye. How can we use the

Jackson cross lens to neutralize its refractive error?
 19

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

Conoid of Sturm
+1D 2D 2D

Eye Error

+5D

Circle of Least Confusion

Consider this astigmatic eye. How can we use the

Jackson cross lens to neutralize its refractive error?
 20

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

1. Use sphere to place the

Circle of Least Confusion Conoid of Sturm
on the retina. 2D 2D
Note: The spherical lens would actually
shrink the conoid a little, but let’s ignore
this small effect for simplicity’s sake!
 21

Astigmatic Correction: Jackson Cross

How much sphere?
Eye Error: Since the eye error SE = +3…
+1 x 180 a spherical -3D lens will place
+5 x 090 the CoLC on the retina (if we
set aside the vertex distance
issue).
1. Use sphere to place the
? Circle of Least Confusion Conoid of Sturm
on the retina. 2D 2D
 22

Astigmatic Correction: Jackson Cross

How much sphere?
Eye Error: Since the eye error SE = +3…
+1 x 180 Eye Error S.E.: +3 a spherical -3D lens will place
+5 x 090 Corrective S.E.: -3 the CoLC on the retina (if we
set aside the vertex distance
issue).
1. Use sphere to place the
? Circle of Least Confusion Conoid of Sturm
on the retina. 2D 2D
 23

Astigmatic Correction: Jackson Cross

How much sphere?
Eye Error: Since the eye error SE = +3…
+1 x 180 Eye Error S.E.: +3 a spherical -3D lens will place
+5 x 090 Corrective S.E.: -3 the CoLC on the retina (if we
(Ignoring vertex distance) set aside the vertex distance
issue).
1. Use sphere to place the
-3 Sph Circle of Least Confusion Conoid of Sturm
on the retina. 2D 2D
 24

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180 Eye Error S.E.: +3
+5 x 090 Corrective S.E.: -3
(Ignoring vertex distance) The -3 sphere pushes the
CoLC onto the retina
1. Use sphere to place the
-3 Sph Circle of Least Confusion Conoid of Sturm
on the retina. 2D 2D
 25

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

1. Use sphere to place the

-3 Sph Circle of Least Confusion Conoid of Sturm
on the retina. 2D 2D

2. Align the axis of the

Jackson Cross with the
(already determined)
astigmatic axis of the eye.

NOTE: We are discussing

determination of cylinder
power first—it’s easier to
understand. But in practice,
axis determination must
be done first. (We’ll get to
it shortly.)
 26

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

-3 Sph Conoid of Sturm

2D 2D

???
2. Align the axis of the
Jackson Cross with the
(already determined)
astigmatic axis of the eye.

What effect does the Jackson cross lens

have on the Conoid of Sturm when it is
+1x090 oriented like this??
-1x180
Jackson
Cross
 27

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
farther apart.
-3 Sph 3D 3D

+1x090
-1x180
Jackson
Cross
 28

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
farther apart.
-3 Sph 3D 3D

(Here’s why)

+1x090 +5 x 090 +6 x 090

+ =
-1x180 +1 x 180 plano x 180
Jackson Eye error Total error
Cross cylinders power
 29

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
farther apart.
-3 Sph 3D 3D

(Here’s why)

Note the conoid is now six diopters wide

+1x090 +5 x 090 +6 x 090
+ = [(+6) – (plano) = 6], 2D greater than its
-1x180 +1 x 180 plano x 180 original 4D width.

Jackson Eye error Total error

Cross cylinders power
 30

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
farther apart.
-3 Sph 3D 3D
Since the S.E. of the J-C
lens = 0, the CoLC does
not move from the retina

+1x090
-1x180
Jackson
Cross
 31

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
farther apart.
-3 Sph 3D 3D
Since the S.E. of the J-C
lens = 0, the CoLC does
not move from the retina

The focal lines become

longer, which makes the
Circle of Least Confusion
larger.

+1x090
-1x180
Jackson
Cross
 32

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
farther apart.
-3 Sph 3D 3D
Since the S.E. of the J-C
lens = 0, the CoLC does
not move from the retina

The focal lines become

longer, which makes the
Circle of Least Confusion
larger.
Because the Circle of Least
+1x090 Confusion is larger, the image
-1x180 seems more blurry to the patient.

Jackson
Cross
 33

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
farther apart.
-3 Sph 3D 3D
Since the S.E. of the J-C
lens = 0, the CoLC does
not move from the retina

The focal lines become

longer, which makes the
Circle of Least Confusion
larger.
Because the Circle of Least
+1x090 Confusion is larger, the image
-1x180 seems more blurry to the patient.

Jackson
Flip the Jackson cross.
Cross
 34

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

-3 Sph

???
What happens to the Conoid when the
Jackson cross is flipped?
-1x090
+1x180

Note the change!

 35

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
closer together.
-3 Sph 1D 1D

Since the S.E. of

the J-C lens = 0,
-1x090 the CoLC does
+1x180 not move from
the retina
Jackson
Cross
 36

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
closer together.
-3 Sph 1D 1D

(Here’s why)

-1x090 +5 x 090 +4 x 090

+
+1x180 +1 x 180 = +2 x 180
Jackson Eye error Total error
Cross cylinders power
 37

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
closer together.
-3 Sph 1D 1D

(Here’s why)

Note the conoid is now two diopters wide

-1x090 +5 x 090 +4 x 090
+
+1x180 +1 x 180 =
[(+4) – (+2) = 2], 4D less than it was before
+2 x 180 this latest change.

Jackson Eye error Total error

Cross cylinders power
 38

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
closer together.
-3 Sph 1D 1D
The focal lines become
shorter, which makes the
Circle of Least Confusion
smaller.

-1x090
+1x180
Jackson
Cross
 39

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
closer together.
-3 Sph 1D 1D
The focal lines become
shorter, which makes the
Circle of Least Confusion
smaller.

Because the Circle of Least

Confusion is smaller, the image
seems less blurry to the patient.

-1x090
+1x180
Jackson
Cross
 40

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines Conoid of Sturm
+1x180 closer together.
-3 Sph 1D 1D
The focal lines become
shorter, which makes the
Circle of Least Confusion
smaller.

Because the Circle of Least

Confusion is smaller, the image
seems less blurry to the patient.

Because this is less blurry, cylinder of

-1x090 +1 x 180 is added at the phoropter.
+1x180
Jackson
Cross
 41

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

Conoid of Sturm
+1x180
-3 Sph 1D 1D
 42

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

The Circle of Least Confusion Conoid of Sturm

+1x180 has moved—why?
-3 Sph 1D 1D
 43

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

The Circle of Least Confusion Conoid of Sturm

+1x180 has moved—why?
-3 Sph 1D 1D

Because adding +1 x 180

changed the S.E. of the lenses
before the eye from -3 to -2.50.
 44

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

The Circle of Least Confusion Conoid of Sturm

+1x180 has moved—why?
-3 Sph 1D 1D

Because adding +1 x 180

changed the S.E. of the lenses
before the eye from -3 to -2.50.

To keep the Circle on the retina, the

sphere power must be adjusted to
keep the total S.E. at -3.
 45

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Note that the sphere power
has been changed from -3.0 Conoid of Sturm
+1x180 to -3.50, and that the S.E. of
-3.50 Sph 1.5D 1.5D
-3.50 +1.0 equals -3.0.
 46

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Note that the sphere power
has been changed from -3.0 Conoid of Sturm
+1x180 to -3.50, and that the S.E. of
-3.50 Sph 1.5D 1.5D
-3.50 +1.0 equals -3.0. Note
also that this adjustment has
re-placed the CoLC back on
the retina.
 47

Astigmatic Correction: Jackson Cross

Eye Error: Thirdly, note that the conoid
+1 x 180 is starting to collapse!
+5 x 090
Note that the sphere power
has been changed from -3.0 Conoid of Sturm
+1x180 to -3.50, and that the S.E. of
-3.50 Sph 1.5D 1.5D
-3.50 +1.0 equals -3.0. Note
also that this adjustment has
re-placed the CoLC back on
the retina.
 48

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+1x180 focal lines farther apart.
-3.50 Sph Conoid of Sturm
2.5D 2.5D

+1x090
-1x180
Jackson
Cross
 49

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+1x180 focal lines farther apart.
-3.50 Sph Conoid of Sturm
2.5D 2.5D

(Here’s why)

+1x090 +5 x 090 +6 x 090

+
-1x180 +2 x 180 = +1 x 180
Jackson Eye error Total error
Cross cylinders power
+
corrective
cylinder
 50

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+1x180 focal lines farther apart.
-3.50 Sph Conoid of Sturm
2.5D 2.5D

(Here’s why)

Note the conoid is now five diopters wide

+1x090 +5 x 090 +6 x 090
+
-1x180 +2 x 180 =
[(+6) – (+1) = 5], 2D wider than it was
+1 x 180 before this latest change.

Jackson Eye error Total error

Cross cylinders power
+
corrective
cylinder
 51

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+1x180 focal lines farther apart.
-3.50 Sph Conoid of Sturm
2.5D 2.5D
The focal lines become
longer, which makes the
Circle of Least Confusion
larger.

+1x090
-1x180
Jackson
Cross
 52

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+1x180 focal lines farther apart.
-3.50 Sph Conoid of Sturm
2.5D 2.5D
The focal lines become
longer, which makes the
Circle of Least Confusion
larger.

Because the Circle of Least

Confusion is larger, the image
+1x090 seems more blurry to the patient.
-1x180
Jackson
Cross
 53

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+1x180 focal lines farther apart.
-3.50 Sph Conoid of Sturm
2.5D 2.5D
The focal lines become
longer, which makes the
Circle of Least Confusion
larger.

Because the Circle of Least

Confusion is larger, the image
+1x090 seems more blurry to the patient.
-1x180
Jackson
Flip the Jackson cross.
Cross
 54

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+1x180 and moves them closer.
-3.50 Sph .5D .5D

-1x090
+1x180
Jackson
Cross
 55

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+1x180 and moves them closer.
-3.50 Sph .5D .5D

(Here’s why)

-1x090 +5 x 090 +4 x 090

+
+1x180 +2 x 180 = +3 x 180
Jackson Eye error Total error
Cross cylinders power
+
corrective
cylinder
 56

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+1x180 and moves them closer.
-3.50 Sph .5D .5D

(Here’s why)

Note the conoid is now one diopter wide

-1x090 +5 x 090 +4 x 090
+
+1x180 +2 x 180 =
[(+4) – (+3) = 1], 4D less than it was
+3 x 180 before this latest change.

Jackson Eye error Total error

Cross cylinders power
+
corrective
cylinder
 57

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+1x180 and moves them closer.
-3.50 Sph .5D .5D

The shorter/closer focal lines

make the Circle of Least
Confusion smaller.

-1x090
+1x180
Jackson
Cross
 58

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+1x180 and moves them closer.
-3.50 Sph .5D .5D

The shorter/closer focal lines

make the Circle of Least
Confusion smaller.

Because the Circle of Least

Confusion is smaller, the image
seems less blurry to the patient.

-1x090
+1x180
Jackson
Cross
 59

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+1x180 and moves them closer.
-3.50 Sph .5D .5D

The shorter/closer focal lines

make the Circle of Least
Confusion smaller.

Because the Circle of Least

Confusion is smaller, the image
seems less blurry to the patient.

Because this is less blurry, +1 x 180

-1x090 is added at the phoropter. (You
+1x180 remember to adjust the sphere.)
Jackson
Cross
 60

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

+2x180 Conoid of Sturm

-4 Sph 1D 1D
 61

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+2x180 focal lines farther apart. Conoid of Sturm
-4 Sph 2D
2D

+1x090
-1x180
Jackson
Cross
 62

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+2x180 focal lines farther apart. Conoid of Sturm
-4 Sph 2D
2D

(Here’s why)

+1x090 +5 x 090 +6 x 090

+
-1x180 +3 x 180 = +2 x 180
Jackson Eye error Total error
Cross cylinders power
+
corrective
cylinder
 63

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+2x180 focal lines farther apart. Conoid of Sturm
-4 Sph 2D
2D

(Here’s why)

Note the conoid is now four diopters wide again

+1x090 +5 x 090 +6 x 090
+
-1x180 +3 x 180 =
[(+4) – (+3) = 1], 3D wider than it was before
+2 x 180 this latest change.

Jackson Eye error Total error

Cross cylinders power
+
corrective
cylinder
 64

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+2x180 focal lines farther apart. Conoid of Sturm
-4 Sph 2D
2D

The focal lines become

longer, which makes the
Circle of Least Confusion
larger.

+1x090
-1x180
Jackson
Cross
 65

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+2x180 focal lines farther apart. Conoid of Sturm
-4 Sph 2D
2D

The focal lines become

longer, which makes the
Circle of Least Confusion
larger.

Because the Circle of Least

Confusion is larger, the image
+1x090 seems more blurry to the patient.
-1x180
Jackson
Cross
 66

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the
+2x180 focal lines farther apart. Conoid of Sturm
-4 Sph 2D
2D

The focal lines become

longer, which makes the
Circle of Least Confusion
larger.

Because the Circle of Least

Confusion is larger, the image
+1x090 seems more blurry to the patient.
-1x180
Jackson
Flip the Jackson cross.
Cross
 67

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines
+2x180 closer together—in this case, (Misleading figure!)
-4 Sph collapsing the Conoid of Sturm.

-1x090
+1x180
Jackson
Cross
 68

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines
+2x180 closer together—in this case, (Misleading figure!)
-4 Sph collapsing the Conoid of Sturm.

(Here’s why)

-1x090 +5 x 090 +4 x 090

+
+1x180 +3 x 180 = +4 x 180
Jackson Eye error Total error
Cross cylinders power
+
corrective
cylinder
 69

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines
+2x180 closer together—in this case, (Misleading figure!)
-4 Sph collapsing the Conoid of Sturm.

(Here’s why)

-1x090 +5 x 090 +4 x 090 Note the conoid is now collapsed!

+
+1x180 +3 x 180 = +4 x 180
[(+4) – (+4) = 0]

Jackson Eye error Total error

Cross cylinders power
+
corrective
cylinder
 70

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens moves the focal lines
+2x180 closer together—in this case,
-4 Sph collapsing the Conoid of Sturm.

Because this is less blurry, +1 x 180

is added at the phoropter. (You
remember to adjust the sphere.)

-1x090
+1x180
Jackson
Cross
 71

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

+3x180 CoS
-4.50 Sph .5D .5D
 72

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the Conoid of Sturm
+3x180
-4.50 Sph focal lines farther apart. 1.5D 1.5D

+1x090
-1x180
Jackson
Cross
 73

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the Conoid of Sturm
+3x180
-4.50 Sph focal lines farther apart. 1.5D 1.5D

(Here’s why)

+1x090 + +5 x 090 +6 x 090

= +3 x 180
-1x180 +4 x 180
Jackson Eye error Total error
Cross cylinders power
+
corrective
cylinder
 74

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the Conoid of Sturm
+3x180
-4.50 Sph focal lines farther apart. 1.5D 1.5D

(Here’s why)

+1x090 + +5 x 090 +6 x 090 Note the conoid is now three diopters wide
= +3 x 180 [(+6) – (+3) = 3], 2D wider than it was before
-1x180 +4 x 180 this latest change.

Jackson Eye error Total error

Cross cylinders power
+
corrective
cylinder
 75

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the Conoid of Sturm
+3x180
-4.50 Sph focal lines farther apart. 1.5D 1.5D

The focal lines become

longer, which makes the
Circle of Least Confusion
larger.

+1x090
-1x180
Jackson
Cross
 76

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the Conoid of Sturm
+3x180
-4.50 Sph focal lines farther apart. 1.5D 1.5D

The focal lines become

longer, which makes the
Circle of Least Confusion
larger.

Because the Circle of Least

Confusion is larger, the image
seems more blurry to the patient.
+1x090
-1x180
Jackson
Cross
 77

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
Reintroduction of the cross
in this orientation moves the Conoid of Sturm
+3x180
-4.50 Sph focal lines farther apart. 1.5D 1.5D

The focal lines become

longer, which makes the
Circle of Least Confusion
larger.

Because the Circle of Least

Confusion is larger, the image
seems more blurry to the patient.
+1x090
-1x180
Flip the Jackson cross.
Jackson
Cross
 78

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+3x180 and moves them closer.
-4.50 Sph .5D .5D

-1x090
+1x180

Jackson
Cross
 79

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+3x180 and moves them closer.
-4.50 Sph .5D .5D

(Here’s why)

-1x090 + +5 x 090 +4 x 090

=
+1x180 +4 x 180 +5 x 180

Jackson Eye error Total error

Cross cylinders power
+
corrective
cylinder
 80

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+3x180 and moves them closer.
-4.50 Sph .5D .5D

(Here’s why)

-1x090 + +5 x 090 +4 x 090 Note the conoid is now one diopter wide
= [(+5) – (+4) = 1], 2D less than it was before
+1x180 +4 x 180 +5 x 180 this latest change.

Jackson Eye error Total error

Cross cylinders power
+
corrective
cylinder
 81

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+3x180 and moves them closer.
-4.50 Sph .5D .5D
Note also that the focal lines
have changed positions (i.e., the
horizontal line is now anterior,
and the vertical line is posterior)

+1x090
-1x180

Jackson
Cross
 82

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+3x180 and moves them closer.
-4.50 Sph .5D .5D
Note also that the focal lines
have changed positions (i.e., the
horizontal line is now anterior,
and the vertical line is posterior)

This is indicated by the fact that the

axis 180 cylindrical power is now
(and for the first time) greater than
that of the axis 090 cylinder.

+1x090 +4 x 090
-1x180 +5 x 180

Jackson
Cross
 83

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+3x180 and moves them closer.
-4.50 Sph .5D .5D
Note also that the focal lines
have changed positions (i.e., the
horizontal line is now anterior,
and the vertical line is posterior)

The focal lines become shorter,

which makes the Circle of Least
Confusion smaller.

+1x090
-1x180

Jackson
Cross
 84

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
This alignment of the cross
lens shortens the focal lines CoS
+3x180 and moves them closer.
-4.50 Sph .5D .5D
Note also that the focal lines
have changed positions (i.e., the
horizontal line is now anterior,
and the vertical line is posterior)

The focal lines become shorter,

which makes the Circle of Least
Confusion smaller.

Because this is less blurry, +1 x 180

+1x090 is added at the phoropter. (You
-1x180 remember to adjust the sphere.)

Jackson
Cross
 85

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
The refractive error has been
eliminated.
+4x180
-5 Sph

(Misleading figure!)
 86

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
The refractive error has been
eliminated.
+4x180
-5 Sph

(Here’s why)

Note the conoid is collapsed

No without the Jackson cross.
Jackson +5 x 090 +5 x 090
+ = (Remember, the -5D sphere
cross
lens
+5 x 180 +5 x 180 lens is pushing the collapsed
conoid back onto the retina.)

Eye error Total error

cylinders power
+
corrective
cylinder
 87

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
The refractive error has been
eliminated.
+4x180
-5 Sph

(Here’s why)

To understand why, recall that

Note the conoid is collapsed we can think of any spherical
No without the Jackson cross.
Jackson +5 x 090 +5 x 090 lens as being composed of two
+ = (Remember, the -5D sphere cylindrical lenses oriented 90 o
cross
lens
+5 x 180 +5 x 180 lens is pushing the collapsed apart. So, in this case, think of
conoid back onto the retina.) the -5D sphere lens as being
composed of two -5D cylinders,
Eye error Total error
cylinders power one of which is at axis 090 and
+ the other at axis 180.
corrective
cylinder
 88

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
The refractive error has been
eliminated. However, we don’t know
+4x180 this yet, and thus we reintroduce the
-5 Sph Jackson cross lens.
 89

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
The refractive error has been
eliminated. However, we don’t know Conoid of Sturm
+4x180 this yet, and thus we reintroduce the
-5 Sph Jackson cross lens. 1D 1D

In this orientation, the Jackson cross

pulls the vertical focal line forward
by 1D and pushes the horizontal
focal line back 1D.

+1x090
-1x180

Jackson
Cross
 90

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090
The refractive error has been
eliminated. However, we don’t know Conoid of Sturm
+4x180 this yet, and thus we reintroduce the
-5 Sph Jackson cross lens. 1D 1D

In this orientation, the Jackson cross

pulls the vertical focal line forward
by 1D and pushes the horizontal
focal line back 1D.

Flip the Jackson cross.

+1x090
-1x180

Jackson
Cross
 91

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

In this orientation, the Jackson cross Conoid of Sturm

+4x180 pushes the vertical focal line back
-5 Sph by 1D and pulls the horizontal 1D 1D
focal line forward 1D.

-1x090
+1x180

Jackson
Cross
 92

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

In this orientation, the Jackson cross Conoid of Sturm

+4x180 pushes the vertical focal line back
-5 Sph by 1D and pulls the horizontal 1D 1D
focal line forward 1D.

Flipping the Jackson cross between

these two positions does not change
the size of the Circle of Least Confusion;
therefore, the patient perceives the
images as equally blurry.

-1x090
+1x180

Jackson
Cross
 93

Astigmatic Correction: Jackson Cross

Eye Error:
+1 x 180
+5 x 090

In this orientation, the Jackson cross Conoid of Sturm

+4x180 pushes the vertical focal line back
-5 Sph by 1D and pulls the horizontal 1D 1D
focal line forward 1D.

Flipping the Jackson cross between

these two positions does not change
the size of the Circle of Least Confusion;
therefore, the patient perceives the
images as equally blurry.

Because the images are equally blurry,

-1x090 we know the refractive error has been
+1x180 eliminated!

Jackson
Cross
 94

Astigmatic Correction: Jackson Cross

Take a deep breath…

 95

Astigmatic Correction: Jackson Cross

Take a deep breath…

Now we’re ready to discuss the more difficult concepts

involved in using the Jackson cross to determine cylinder axis.
 96

Astigmatic Correction: Jackson Cross

Take a deep breath…

Now we’re ready to discuss the more difficult concepts

involved in using the Jackson cross to determine cylinder axis.

But first, let’s talk more about combining cylinders…

 97

Astigmatic Correction: Jackson Cross

Combining PLUS Cylinders

+2
x90 + +2
x90 = ?
What will be the resulting lens when two identical plus cylinders of identical orientation are combined?
 98

Astigmatic Correction: Jackson Cross

Combining PLUS Cylinders

No sphere
+2
x90 + +2
x90 = +4
x90
All cylinder

What will be the resulting lens when two identical plus cylinders of identical orientation are combined?
A cylindrical lens with axis identical to that of the parent cylinders and power equal to the sum of their powers.
Note that the resultant lens has no spherical power.
 99

Astigmatic Correction: Jackson Cross

Combining PLUS Cylinders

No sphere
+2
x90 + +2
x90 = +4
x90
All cylinder

+2
x90
+ +2
x180 = ?
What will be the resulting lens when two identical plus cylinders oriented 90o apart are combined?
 100

Astigmatic Correction: Jackson Cross

Combining PLUS Cylinders

No sphere
+2
x90 + +2
x90 = +4
x90
All cylinder

+2
+2 + x180 = All sphere
No cylinder
x90

+2 sphere
What will be the resulting lens when two identical plus cylinders oriented 90o apart are combined?
A spherical lens with no cylinder; its power is the same as (not the sum of) that of the parent lenses.
 101

Astigmatic Correction: Jackson Cross

Combining MINUS Cylinders

-1 -1

+ = ?
90 90

What will be the resulting lens when two identical minus cylinders of identical orientation are combined?
 102

Astigmatic Correction: Jackson Cross

Combining MINUS Cylinders

-1 -1 -2

No sphere
+ = All cylinder

90 90 90

What will be the resulting lens when two identical minus cylinders of identical orientation are combined?
The same as in the plus-cylinder situation: A cylindrical lens with axis identical to that of the parent cylinders,
power equal to the sum of their powers, and no spherical power.
 103

Astigmatic Correction: Jackson Cross

Combining MINUS Cylinders

-1 -1 -2

No sphere
+ = All cylinder

90 90 90

-1

+ -1 180
= ?
90

What will be the resulting lens when two identical minus cylinders oriented 90o apart are combined?
 104

Astigmatic Correction: Jackson Cross

Combining MINUS Cylinders

-1 -1 -2

No sphere
+ = All cylinder

90 90 90

-1

+ -1 180
= All sphere
No cylinder

90

-1 sphere
What will be the resulting lens when two identical minus cylinders oriented 90o apart are combined?
Same as with the plus: A spherical lens with no cylinder, and power the same as that of the parent lenses.
 105

Astigmatic Correction: Jackson Cross

Combining MIXED Cylinders

-1

+2
x90 + = ?
90

But what if the lens is of mixed parentage, with a plus and a minus lens of identical axis but different powers?
 106

Astigmatic Correction: Jackson Cross

Combining MIXED Cylinders

-1

No sphere
+2
x90 + = +1
x90
All cylinder

90

But what if the lens is of mixed parentage, with a plus and a minus lens of identical axis but different powers?
As with the ‘purebred’ cases, the resultant will be a cylindrical lens with axis identical to that of the parent
cylinders and power equal to the sum of their powers, with no spherical power.
 107

Astigmatic Correction: Jackson Cross

Combining MIXED Cylinders

-1

No sphere
+2
x90 + = +1
x90
All cylinder

90

+1
x90
+ -1 180
= ?
What if the plus and minus parents are of identical powers but oriented 90o apart?
 108

Astigmatic Correction: Jackson Cross

Combining MIXED Cylinders

-1

No sphere
+2
x90 + = +1
x90
All cylinder

90

+1 Sphere=0
+1 + -1 180
= -1 180 Plus and
minus cyl
x90 x90

Jackson Cross
What if the plus and minus parents are of identical powers but oriented 90o apart?
This is the definition of a Jackson cross lens. (You recognized that immediately, though.)
 109

Astigmatic Correction: Jackson Cross

BUT, in each of these situations, the orientation of the cylinder combination

has been regular: either on-axis or 90o apart.

But what if the alignment is oblique, i.e., neither on-axis nor 90o apart?
 110

Astigmatic Correction: Jackson Cross

Combining Oblique Cylinders: SAME Sign
 111

Astigmatic Correction: Jackson Cross

Combining Oblique Cylinders: SAME Sign

+2
x12
0 + +2
x75 = ?
What will be the resulting lens when two identical plus cylinders with oblique orientation are combined?
 112

Astigmatic Correction: Jackson Cross

Combining Oblique Cylinders: SAME Sign

+2 Some sphere
+2
x12
0 + x75 = Some cylinder
Axis between

What will be the resulting lens when two identical plus cylinders with oblique orientation are combined?
A spherocylindrical lens with the axis of plus power oriented between the axes of the parent cylinders.
(An equivalent result would occur if two identical minus cylinders were similarly combined.)
 113

Astigmatic Correction: Jackson Cross

Combining Oblique Cylinders: SAME Sign

+2 Some sphere
+2
x12
0 + x75 = Some cylinder
Axis between

Combining Oblique Cylinders: DIFFERENT Sign

-1

+2
x12
0
+
75
= ?
What if the obliquely-oriented parent cylinders are of different signs?
As in the same-sign situation, a spherocylindrical lens will result. However, the axis of cylinder
power will not be oriented between the axes of the parent cylinders! Let’s look at this in more detail…
 114

Astigmatic Correction: Jackson Cross

Combining Oblique Cylinders: SAME Sign

+2 Some sphere
+2
x12
0 + x75 = Some cylinder
Axis between

Combining Oblique Cylinders: DIFFERENT Sign

-1

Some sphere
+2
0
+ = Some cylinder
Axis between
x12
75

What if the obliquely-oriented parent cylinders are of different signs?

As in the same-sign situation, a spherocylindrical lens will result. However, the axis of cylinder
power will not be oriented between the axes of the parent cylinders! Let’s look at this in more detail…
 115

Astigmatic Correction: Jackson Cross

Combining Oblique Cylinders:

DIFFERENT Sign

When cylinders of opposite sign and oblique orientation are

combined, the resultant lens is… a Jackson cross!
Understanding the specific orientation of the axes of the
resultant Jackson cross requires a new concept…
The bisector angle: The axis halfway between that of the parent cylinders (assuming
they are of equal but opposite powers). The axes of the resultant Jackson cross are
to be found 45o to each side of the bisector angle.
 116

Astigmatic Correction: Jackson Cross

Combining Oblique Cylinders:

DIFFERENT Sign

Jackson
Cross !
When cylinders of opposite sign and oblique orientation are
combined, the resultant lens is…a Jackson cross!
Understanding the specific orientation of the axes of the
resultant Jackson cross requires a new concept…
The bisector angle: The axis halfway between that of the parent cylinders (assuming
they are of equal but opposite powers). The axes of the resultant Jackson cross are
to be found 45o to each side of the bisector angle.
 117

Astigmatic Correction: Jackson Cross

Combining Oblique Cylinders:

DIFFERENT Sign

Jackson
Cross ! Power?
Axes?

When cylinders of opposite sign and oblique orientation are

combined, the resultant lens is…a Jackson cross!
Understanding the specific orientation of the axes of the
resultant Jackson cross requires a new concept…
The bisector angle: The axis halfway between that of the parent cylinders (assuming
they are of equal but opposite powers). The axes of the resultant Jackson cross are
to be found 45o to each side of the bisector angle.
 118

Astigmatic Correction: Jackson Cross

‘Bisector Angle’
½ between cylinder axes
Combining Oblique Cylinders: (if powers are equal)
DIFFERENT Sign

Jackson
Cross

When cylinders of opposite sign and oblique orientation are

combined, the resultant lens is…a Jackson cross!
Understanding the specific orientation of the axes of the
resultant Jackson cross requires a new concept…
The bisector angle: The axis halfway between those of the parent cylinders
(assuming they are of equal but opposite powers). The axes of the resultant
Jackson cross are to be found 45o to each side of the bisector angle.
 119

Astigmatic Correction: Jackson Cross

‘Bisector Angle’
½ between cylinder axes
Combining Oblique Cylinders: (if powers are equal)
DIFFERENT Sign
Jackson cross 45o 45o Jackson cross
Plus axis Minus axis

Jackson
Cross

When cylinders of opposite sign and oblique orientation are

combined, the resultant lens is…a Jackson cross!
Understanding the specific orientation of the axes of the
resultant Jackson cross requires a new concept…
The bisector angle: The axis halfway between those of the parent cylinders
(assuming they are of equal but opposite powers). The axes of the resultant
Jackson cross are to be found 45o to each side of the bisector angle.
 120

Astigmatic Correction: Jackson Cross

‘Bisector Angle’
½ between cylinder axes
Combining Oblique Cylinders: (if powers are equal)
DIFFERENT Sign
Jackson cross 45o 45o Jackson cross
Plus axis Minus axis

Jackson
Cross

90o

When cylinders of opposite sign and oblique orientation are

combined, the resultant lens is…a Jackson cross!
Understanding the specific orientation of the axes of the
resultant Jackson cross requires a new concept…
The bisector angle: The axis halfway between those of the parent cylinders
(assuming they are of equal but opposite powers). The axes of the resultant
Jackson cross are to be found 45o to each side of the bisector angle.
(Note that this ‘double 45o requirement’ puts the axes 90o apart, as is required
in a Jackson cross.)
 121

Astigmatic Correction: Jackson Cross

For Example…

-2 x 085 +2 x 095
 122

Astigmatic Correction: Jackson Cross

For Example… Bisector Angle = 090

45o 45o
Plus axis = 135 Minus axis = 45

-2 x 085 +2 x 095
 123

Astigmatic Correction: Jackson Cross

For Example… Bisector Angle = 090

45o 45o
Plus axis = 135 Minus axis = 45

-2 x 085 +2 x 095

Resultant:
-.35 +.70 x 135
(Note that this is in fact a Jackson cross)
 124

Astigmatic Correction: Jackson Cross

For Example… Bisector Angle = 090

45o 45o
Plus axis = 135 Minus axis = 45

-2 x 085 +2 x 095

Why should we care

Resultant:
about all of this -.35 +.70 x 135
cylinder mumbo-jumbo?
(Note that this is in fact a Jackson cross)
 125

Astigmatic Correction: Jackson Cross

Consider the process involved

in determining cylinder axis
with the Jackson cross…
 126

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 Consider the process involved
Note: Not aligned! in determining cylinder axis
with the Jackson cross…
+2 x 090

Cylindrical
error lens
Corrective
cylinder in
phoropter
 127

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 Consider the process involved
Note: Not aligned! in determining cylinder axis
with the Jackson cross…
+2 x 090

Cylindrical error lens

Corrective cylinder
in phoropter

Cylindrical -2 x 080 +2 x 090

error lens
Corrective
cylinder in Note: Not aligned!
phoropter
 128

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 Consider the process involved
Note: Not aligned! in determining cylinder axis
with the Jackson cross…
+2 x 090

Cylindrical error lens

Corrective cylinder
in phoropter

Cylindrical -2 x 080 +2 x 090

error lens
Corrective
cylinder in Note: Not aligned!
phoropter

This is why we care—axis determination

with the Jackson cross involves combining
off-axis cylinders of opposite signs!
 129

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080
Note: Not aligned!

+2 x 090

Cylindrical error lens

Corrective cylinder
in phoropter

Cylindrical -2 x 080 +2 x 090

error lens
Corrective
cylinder in Note: Not aligned!
phoropter

Resultant?
 130

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 The combination of the
Note: Not aligned!
eye error and the misaligned
corrective lens produces the
+2 x 090 resultant cross cylinder:
+.35 x 130
-.35 x 040 Conoid of Sturm

.35D .35D

Cylindrical
error lens
Corrective
cylinder in
phoropter

Resultant?
 131

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 The combination of the
Note: Not aligned!
eye error and the misaligned
corrective lens produces the
+2 x 090 resultant cross cylinder:
+.35 x 130
-.35 x 040 Conoid of Sturm

.35D .35D

The Jackson cross lens is

introduced in the axis-
Cylindrical determination position.
error lens
Corrective
cylinder in
phoropter
 132

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 With this orientation of the
cross, the focal lines become Resultant:
longer, which makes the Circle +.35 x 130
+2 x 090 of Least Confusion larger. -.35 x 040

Conoid of Sturm
.60D .60D

+.25 x 130
-.25 x 040

Jackson
Cross
 133

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 With this orientation of the
cross, the focal lines become Resultant:
longer, which makes the Circle +.35 x 130
+2 x 090 of Least Confusion larger. -.35 x 040

Conoid of Sturm
.60D .60D
The image thus becomes
more blurry to the patient.

+.25 x 130
-.25 x 040

Jackson
Cross
 134

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 With this orientation of the
cross, the focal lines become Resultant:
longer, which makes the Circle +.35 x 130
+2 x 090 of Least Confusion larger. -.35 x 040

Conoid of Sturm
.60D .60D
The image thus becomes
more blurry to the patient.

Flip the Jackson cross.

+.25 x 130
-.25 x 040

Jackson
Cross
 135

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 In this orientation, the focal
lines become shorter, which Resultant:
makes the Circle of Least +.35 x 130
+2 x 090 Confusion smaller. -.35 x 040

Conoid of Sturm

.1D .1D

-.25 x 130
+.25 x 040

Jackson
Cross
 136

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 In this orientation, the focal
lines become shorter, which Resultant:
makes the Circle of Least +.35 x 130
+2 x 090 Confusion smaller. -.35 x 040

Conoid of Sturm

Because this is less blurry,

.1D .1D
the cylinder axis is rotated 10o
toward the plus.

-.25 x 130
+.25 x 040

Jackson
Cross
 137

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 In this orientation, the focal
lines become shorter, which Resultant:
makes the Circle of Least +.35 x 130
+2 x 080 Confusion smaller. -.35 x 040

Conoid of Sturm

Because this is less blurry,

.1D .1D
the cylinder axis is rotated 10o
toward the plus.

The Jackson cross is reintroduced.

-.25 x 130
+.25 x 040

Jackson
Cross
 138

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 Now the only error present
is due to the Jackson cross
cylinder itself.
+2 x 080

Conoid of Sturm

.25D .25D

+.25 x 130
-.25 x 040

Jackson
Cross
 139

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 Now the only error present
is due to the Jackson cross
cylinder itself.
+2 x 080

Conoid of Sturm
As the Jackson cross is flipped, .25D .25D
the positions of the focal lines
reverse, but the Circle of Least
Confusion does not change in
size.

-.25 x 130
+.25 x 040

Jackson
Cross
 140

Astigmatic Correction: Jackson Cross

Eye Error:
-2 x 080 Now the only error present
is due to the Jackson cross
cylinder itself.
+2 x 080

Conoid of Sturm
As the Jackson cross is flipped, .25D .25D
the positions of the focal lines
reverse, but the Circle of Least
Confusion does not change in
size.

Because the Circle does not change

in size, the patient perceives the
+.25 x 130 two positions as equally blurry,
-.25 x 040 and we know the correct axis
has been found.
Jackson
Cross
 141

Astigmatic Correction: Jackson Cross

 So that’s how Jackson Cross refraction works!

Retinoscopic Jackson Cross

Use sphere to place one focal Use sphere to place the CoLC
Step 1 line on the retina on the retina

Use cylinder to place the other Use cross to simultaneously

Step 2 focal line on the retina collapse both focal lines

Conoid collapsed to a point Conoid collapsed to a point

Result on the retina on the retina