Visual Axis and Stiles–Crawford Effect Peak Show a Positional Correlation in Normal Eyes: A Cohort Study

PURPOSE: The purpose of this study was to locate the visual axis and evaluate its correlation with the Stiles–Crawford effect (SCE) peak. METHODS: Ten young, healthy individuals (20 eyes) were enrolled. An optical system was developed to locate the visual axis and measure SCE. To locate the visual axis, 2 small laser spots at 450 nm and 680 nm were co-aligned and delivered to the retina. The participants were asked to move a translatable pinhole until these spots were perceived to overlap each other. The same system assessed SCE at 680 nm using a bipartite, 2-channel (reference and test) Maxwellian-view optical system. The peak positions were estimated using a two-dimensional Gaussian fitting function and correlated with the visual axis positions. RESULTS: Both the visual axis (x = 0.24 ± 0.35 mm, y = −0.16 ± 0.34 mm) and the SCE peak (x = 0.27 ± 0.35 mm, y = −0.15 ± 0.31 mm) showed intersubject variability among the cohort. The SCE peak positions were highly correlated in both the horizontal and vertical meridians to the visual axes (R(2) = 0.98 and 0.96 for the x and y coordinates, respectively). Nine of the 10 participants demonstrated mirror symmetry for the coordinates of the visual axis and the SCE peak between the eyes (R(2) = 0.71 for the visual axis and 0.76 for the SCE peak). CONCLUSIONS: The visual axis and SCE peak locations varied among the participants; however, they were highly correlated with each other for each individual. These findings suggest a potential mechanism underlying the foveal cone photoreceptor alignment.