U.S. patent application number 14/856849 was filed with the patent office on 2016-11-03 for computerized refraction and astigmatism determination.
The applicant listed for this patent is Aaron Dallek, Steven P. Lee. Invention is credited to Aaron Dallek, Steven P. Lee.
Application Number | 20160317025 14/856849 |
Document ID | / |
Family ID | 57203846 |
Filed Date | 2016-11-03 |
United States Patent
Application |
20160317025 |
Kind Code |
A1 |
Lee; Steven P. ; et
al. |
November 3, 2016 |
COMPUTERIZED REFRACTION AND ASTIGMATISM DETERMINATION
Abstract
The present disclosure relates generally to a system and method
for determining the refractive error of a patient, more
particularly determining the patient's refractive error by using a
computerized screen, and providing the patient with a prescription
for the patient's preferred type of corrective lenses. The system
and method do not require the trip or expense of a doctor visit,
and are optimized for convenience and cost effectiveness. In a
general embodiment, the present disclosure provides a method for
determining a corrective lenses prescription of a patient. The
method includes, separately, for each eye of the patient,
determining an astigmatism prescription for the patient via a
computerized screen and without the use of a refractor lens
assembly, including testing for a cylinder component and an axis
component at the same time by presenting at least one diagram to
the patient via the computerized screen and enabling the patient to
select at least one input per diagram corresponding to a cylinder
measurement and an axis measurement for the corrective lenses
prescription for the patient.
Inventors: |
Lee; Steven P.; (Chicago,
IL) ; Dallek; Aaron; (Chicago, IL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Lee; Steven P.
Dallek; Aaron |
Chicago
Chicago |
IL
IL |
US
US |
|
|
Family ID: |
57203846 |
Appl. No.: |
14/856849 |
Filed: |
September 17, 2015 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62155080 |
Apr 30, 2015 |
|
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 3/0041 20130101;
A61B 3/036 20130101; A61B 2560/0493 20130101; A61B 3/18 20130101;
A61B 3/111 20130101; A61B 3/16 20130101; G16H 40/67 20180101; A61B
3/032 20130101; A61B 5/0022 20130101; A61B 3/0025 20130101; A61B
3/0083 20130101; A61B 2560/0223 20130101 |
International
Class: |
A61B 3/032 20060101
A61B003/032; A61B 3/036 20060101 A61B003/036; A61B 3/11 20060101
A61B003/11; A61B 3/00 20060101 A61B003/00; A61B 5/00 20060101
A61B005/00 |
Claims
1. A method for determining a corrective lenses prescription for a
patient comprising, separately, for each eye of the patient:
determining an astigmatism prescription for the patient via a
computerized screen and without the use of a refractor lens
assembly, wherein determining the astigmatism prescription for the
patient comprises testing for a cylinder component and an axis
component at the same time by presenting at least one diagram to
the patient via the computerized screen and enabling the patient to
select at least one input per diagram, wherein the at least one
input per diagram corresponds to a cylinder measurement and an axis
measurement used to determine the cylinder component and the axis
component of the corrective lenses prescription for the
patient.
2. The method according to claim 1, wherein the method is provided
via an internet.
3. The method according to claim 1, wherein presenting the at least
one diagram comprises sequentially presenting at least two diagrams
comprising at least two portions, and the at least two diagrams
differ from each other by at least the spacing between the at least
two portions.
4. The method according to claim 3, wherein the at least two
diagrams are a same diagram.
5. The method according to claim 1, further comprising: acquiring
an image of the patient; and determining a pupillary distance
measurement for the patient based on a known canthal distance based
on an age and a gender of the patient and at least one calibration
data point that is related to the acquired image of the
patient.
6. The method according to claim 1, wherein the method further
comprises sending the determined cylinder component and the
determined axis component to at least one doctor for review and
approval.
7. The method according to claim 1, wherein the cylinder component
is based, at least in part, on the cylinder measurements from the
at least one input per diagram.
8. The method according to claim 1, wherein the axis component is
based, at least in part, on the axis measurements from the at least
one input per diagram.
9. The method according to claim 1, further comprising determining
a sphere component of the corrective lenses prescription for the
patient via the computerized screen by: (i) presenting a first
figure to a patient via the computerized screen, wherein the first
figure is too small to be clearly seen by the patient, and (ii)
enabling the patient to make at least one input to increase the
size of the first figure until it can be just barely be made out by
the patient, wherein the at least one input corresponds to a first
sphere measurement.
10. The method according to claim 9, wherein determining the sphere
component of the corrective lenses prescription for the patient via
the computerized screen comprises: (iii) presenting a second figure
to a patient via the computerized screen, wherein the second figure
is large enough to be clearly seen by the patient, and (iv)
enabling the patient to make at least one input to decrease the
size of the second figure just until it can no longer be made out
by the patient, wherein the at least one input corresponds to a
second sphere measurement.
11. The method according to claim 10, wherein the sphere component
is based, at least in part, on the first sphere measurement and the
second sphere measurement.
12. The method according to claim 11, wherein at least one of steps
(i) and (ii), or steps (iii) and (iv) are repeated at least
once.
13. The method according to claim 1, wherein the computerized
screen is located a distance from the patient, in a kiosk.
14. The method according to claim 13, wherein the method further
comprising instructing the patient to take a determined number of
heel-to-toe steps from the computerized screen to reach the
distance.
15. The method according to claim 14, wherein the determination of
the number of heel-to-toe steps is based on at least a shoe size of
the patient.
16. The method according to claim 1, wherein determining the
corrective lenses prescription for the patient is based, in part,
on a previous corrective lenses prescription for the patient.
17. A non-transitory computer readable medium including a plurality
of instructions, which when executed by at least one processor,
cause the at least one processor to operate with at least one
display device and at least one input device to determine a
corrective lenses prescription for a patient comprising, for each
eye of a patient: (a) determining, without the use of a refractor
lens assembly, an astigmatism prescription for the patient by, (i)
presenting at least one diagram to the patient via the computerized
screen, and (ii) enabling the patient to select at least one input
per diagram, wherein the at least one input per diagram corresponds
to a cylinder measurement and an axis measurement used to determine
the corrective lenses prescription for the patient; (b)
determining, without the use of a refractor lens assembly, a power
prescription for the patient by, (i) presenting a first figure to a
patient via the computerized screen, wherein the first figure is
too small to be clearly seen by the patient, (ii) enabling the
patient to make at least one input to increase the size of the
first figure until it can just barely be made out by the patient,
wherein the at least one input corresponds to a first sphere
measurement, (iii) presenting a second figure to a patient via the
computerized screen, wherein the second figure is large enough to
be clearly seen by the patient, and (iv) enabling the patient to
make at least one input to decrease the size of the second figure
just until it can no longer be made out by the patient, wherein the
at least one input corresponds to a second sphere measurement;
wherein a final sphere measurement is based, at least in part, on
the first sphere measurement and the second sphere measurement.
18. The non-transitory computer readable medium of claim 17,
wherein presenting the at least one diagram comprises sequentially
presenting at least two diagrams wherein the at least two diagrams
each comprise at least two portions, and the at least two diagrams
differ from each other by at least the spacing between the at least
two portions.
19. The non-transitory computer readable medium of claim 17,
wherein determining the corrective lenses prescription for the
patient further comprises: acquiring an image of the patient; and
determining a pupillary distance measurement for the patient based
on a known canthal distance based on an age and a gender of the
patient and at least one calibration data point that is related to
the acquired image of the patient.
20. The non-transitory computer readable medium of claim 17,
further comprising sending the determined corrective lenses
prescription to at least one doctor for review and approval.
Description
PRIORITY CLAIM
[0001] This non-provisional patent application claims priority to
and the benefit of U.S. Provisional Patent Application Ser. No.
62/185,080, titled "COMPUTERIZED REFRACTION AND ASTIGMATISM
DETERMINATION," filed on Apr. 30, 2015; the entire contents of
which is expressly incorporated herein by reference.
BACKGROUND
[0002] The present disclosure is generally related to determining a
glasses and/or a contacts prescription for a patient with a
refractive error in need of correction. Many people have refractive
errors of the eye which cause them to be either myopic (commonly
known as nearsightedness) or hypermetropic (commonly known as
farsightedness). One of ordinary skill in the art will understand
that myopia refers to a refractive defect of the optical properties
of an eye that causes images to focus forward of the retina (i.e. a
refractive error). Those optical defects are typically caused by,
among other things, defects of the cornea, elongation of the eye
structure, other conditions, or a combination of those conditions.
Hyperopia, on the other hand, refers a refractive error of the
optical properties of an eye that causes images to focus behind the
retina. Those optical defects are the result when the optics of the
eye are not strong enough for the front to back length of the eye.
Myopia and hyperopia have one component, a sphere measurement,
which indicates the strength or power necessary to correct for the
optical defects.
[0003] Astigmatism refers to a refractive error that causes light
entering the eye to focus on two points rather than one. It is
caused by an uneven power of the cornea. An astigmatism has two
components, an axis measurement, which indicates the angle along
which any image viewed by the patient is distorted, and a cylinder
measurement, which indicates the strength or power of the
distortion. Myopia, hyperopia, and astigmatism are the principle
refractive errors that cause patients to seek treatment to correct
their vision problems.
[0004] A manifest refraction analysis is a diagnostic tool used by
ophthalmologists and optometrists whereby a patient's refractive
error is tested to indicate whether the patient would benefit from
correction with glasses or contact lenses. As part of that
technique, a patient looks through a phoropter while the
ophthalmologist or optometrist evaluates each of the patient's
eyes. A retinal reflex diagnosis technique is often used to assess
the magnitude of the refractive error present in the patient's
eyes. Subjective feedback from the patient is used to refine the
manifest refraction, which involves the patient making choices
between image quality as different lenses having different powers
are slid into place in the phoropter. These refractive errors can
be corrected with lenses, typically spectacle lenses, known as
glasses, or contact lenses, which are applied directly to the eye.
They can also be corrected with various types of surgery. At the
end of the manifest refraction analysis, the ophthalmologist or
optometrist may produce a prescription for glasses, contact lenses,
and/or refractive surgery.
[0005] Other methods for determining the refractive error of a
patient include known diagnostic devices such wavefront sensors,
refractometers, and others that are well known in the art. Some of
these diagnostic devices use computers to assist in determining the
refractive error of the patient. For example, one implementation of
a wavefront-type refractor that is well known in the art uses a
"Hartmann-Shack" sensor to measure the wavefront of a light beam
generated from an illumination spot projected on the retina and
passed through the eye's optics. In such a wavefront type
refractor, a probe beam from a laser or a super-luminescent diode
is projected onto the retina through the eye's optics. Light
scattered by the retina passes through the eye's optics, and
emerges through the eye's pupil. The wavefront of the emerging beam
carries refractive information relating to the eye's optics. For
example, if the eye is emmetropic (i.e., the eye's optics are
without refractive error), the wavefront of the emerging beam
should be flat. Relay optics relay the wavefront emerging from
eye's pupil onto the Hartmann-Shack sensor. The Hartmann-Shack
sensor measures the distortion of the wavefront and provides that
information to a computer to compute the refractive errors of the
eye due to aberrations of the eye's optics.
[0006] Each of the above-described techniques for determining a
patient's refractive error requires the patient to travel to a
place where such machines or doctors are present and available to
perform the determination. And, having traveled to a doctor's
office, a patient then has to pay for the time and services of the
doctor, which may or may not be covered by their health insurance.
This can be both expensive and inconvenient for a patient.
[0007] For a patient who desires contacts, a second charge
generally applies for a "fitting." This charge is frequently
unnecessary because most contacts manufacturers only offer one or a
few base curve and diameter combinations, meaning there is only one
or a few possible "fits" for that contact. When a patient has worn
contacts before and is comfortable in their previous brand, there
is no need to perform a "fitting." Despite this, it is commonly
required by doctor's offices that a "fitting" be performed, and the
accompanying fee charged. Health insurance seldom covers this fee.
In some cases, the doctor may require that the patient make
another, separate office visit to have their "fitting." Therefore,
determining a contacts prescription can be even more expensive and
inconvenient for a patient.
[0008] In addition, the cost of the above described machinery
(phoropter, wavefront refractor, etc.) is prohibitive to ownership
by an individual not engaged in a medical practice, so patients do
not have the option of determining their own glasses or contacts
prescription outside of a medical practice setting.
[0009] Furthermore, in-office subjective astigmatism tests
generally only determine a patient's axis prescription within
10.degree. of accuracy.
[0010] Thus, there exists a need for a more convenient, less
costly, more accurate way for patients to determine and receive
glasses and contacts prescriptions.
SUMMARY
[0011] The present disclosure relates generally to a system and
method for determining the refractive error of a patient, more
particularly determining the patient's refractive error by using a
computerized screen or other suitable visual tool, and without the
use of a refractor lens assembly, and providing the patient with a
corrective lenses prescription for the patient's preferred type of
corrective lenses. The system and method do not require the trip or
expense of a doctor visit, and are optimized for convenience and
cost effectiveness.
[0012] In a general embodiment, the present disclosure provides a
method for determining a corrective lenses prescription of a
patient. The method includes, separately, for each eye of the
patient, determining the astigmatism prescription of the patient
via a computerized screen without the use of a refractor lens
assembly.
[0013] In an embodiment, determining the astigmatism prescription
of the patient via the computerized screen and without the use of a
refractor lens assembly includes testing for a cylinder component
and an axis component at the same time by presenting at least one
diagram to the patient via the computerized screen and enabling the
patient to select at least one input per diagram. The at least one
input per diagram corresponds to a cylinder measurement and an axis
measurement used to determine the cylinder component and the axis
component of the corrective lenses prescription for the
patient.
[0014] In a further embodiment, the cylinder component is based, at
least in part, on the cylinder measurements from the at least one
input per diagram. In another further embodiment, the axis
component is based, at least in part, on the axis measurements from
the at least one input per diagram.
[0015] In a further embodiment, presenting the at least one diagram
includes sequentially presenting at least two diagrams having at
least two portions. In another further embodiment, the at least two
diagrams differ from each other by at least the spacing between the
at least two portions. In a still further embodiment, the at least
two diagrams are the same diagram.
[0016] In a further embodiment, the method includes determining a
pupillary distance measurement for the patient based on a known
canthal distance (based on an age and a gender of the patient) and
at least one calibration data point.
[0017] In an embodiment, the method is provided via an
internet.
[0018] In an embodiment, the method includes sending the determined
cylinder component and the determined axis component of the
corrective lenses prescription for the patient to at least one
doctor for review and approval.
[0019] In another further embodiment, the method includes
determining a sphere component of the corrective lenses
prescription for the patient via the computerized screen. The
method includes (i) presenting a first figure to a patient via the
computerized screen. The first figure is too small to be clearly
seen by the patient. The method further includes (ii) enabling the
patient to make at least one input to increase the size of the
first figure until it can just barely be made out by the patient.
The at least one input corresponds to a first sphere
measurement.
[0020] In a still further embodiment, the method includes (iii)
presenting a second figure to a patient via the computerized
screen. The second figure is large enough to be clearly seen by the
patient. The method (iv) enables the patient to make at least one
input to decrease the size of the second figure just until it can
no longer be made out by the patient. The at least one input
corresponds to a second sphere measurement.
[0021] In another further embodiment, the method includes
determining a final sphere measurement based, at least in part, on
the first sphere measurement and the second sphere measurement. In
yet another further embodiment, the method includes repeating at
least one of steps (i) and (ii), or steps (iii) and (iv) at least
once.
[0022] In a further embodiment, the method includes that the
computerized screen is located a distance from the patient, in a
kiosk. In another further embodiment, the method includes
instructing the patient to take a determined number of heel-to-toe
steps from the computerized screen to reach the distance. In a
still further embodiment, the determination of the number of
heel-to-toe steps is based on at least a shoe size of the
patient.
[0023] In another further embodiment, determining the corrective
lenses prescription for the patient is based, in part, on a
previous corrective lenses prescription for the patient.
[0024] In another embodiment, the present disclosure provides a
non-transitory computer readable medium. The non-transitory
computer readable medium includes a plurality of instructions,
which when executed by at least one processor, cause the at least
one processor to operate with at least one display device, at least
one memory device, and at least one input device to determine a
corrective lenses prescription of the patient without the use of a
refractor lens assembly. The corrective lenses prescription
comprises an astigmatism prescription and a power. The
non-transitory computer readable medium determines the corrective
lenses prescription of the patient by, for each eye of the patient,
determining the astigmatism prescription of the patient. The
non-transitory computer readable medium determines the astigmatism
prescription of the patient by presenting at least one diagram to
the patient via a computerized screen (without the use of a
refractor lens assembly) and enabling the patient to select at
least one input per diagram. The patient-selected input corresponds
to a cylinder measurement and an axis measurement used to determine
the corrective lenses prescription for the patient. The
non-transitory computer readable medium further determines the
corrective lenses prescription of the patient by, for each eye of
the patient, determining the power of the corrective lenses
prescription of the patient. The non-transitory computer readable
medium determines the power of the prescription by presenting a
first figure to a patient via the computerized screen. The first
figure is too small to be clearly seen by the patient. The
non-transitory computer readable medium further determines the
power of the prescription by enabling the patient to make at least
one input to increase the size of the first figure until it can
just barely be made out by the patient. The at least one input
corresponds to a first sphere measurement. The non-transitory
computer readable medium further determines the power of the
prescription by presenting a second figure to a patient via the
computerized screen. The second figure is large enough to be
clearly seen by the patient. The non-transitory computer readable
medium further determines the power of the prescription by enabling
the patient to make at least one input to decrease the size of the
second figure just until it can no longer be made out by the
patient. The at least one input corresponds to a second sphere
measurement. The non-transitory computer readable medium determines
a final sphere measurement based, at least in part, on the first
sphere measurement and the second sphere measurement.
[0025] In a further embodiment, the non-transitory computer
readable medium presenting at least one diagram to the patient
further includes presenting at least two diagrams. The at least two
diagrams each include at least two portions. The at least two
diagrams differ from each other by at least the spacing between the
at least two portions.
[0026] In another further embodiment, the non-transitory computer
readable medium further determines a pupillary distance measurement
for the patient based on a known canthal distance based on an age
and a gender of the patient and at least one calibration data
point.
[0027] In a further embodiment, the non-transitory computer
readable medium further includes sending the determined corrective
lenses prescription to at least one doctor for review and
approval.
[0028] An advantage of the present disclosure is to provide a
patient more convenience in determining and receiving a glasses
and/or contacts prescription.
[0029] An advantage of the present disclosure is to reduce the cost
and expense to the patient of determining and receiving a glasses
and/or contacts prescription.
[0030] Another advantage of the present disclosure is to determine
a glasses and/or contacts prescription without the need for
expensive equipment only feasible for use in a doctor office.
[0031] Another advantage of the present disclosure is to determine
a glasses and/or contacts prescription without placing lenses or a
lens assembly before the eyes of the patient.
[0032] Still another advantage of the present disclosure is to more
quickly determine a glasses and/or contacts prescription.
[0033] A further advantage of the present disclosure is to more
accurately determine the axis and cylinder astigmatism
prescriptions of a patient.
[0034] Additional features and advantages are described herein, and
will be apparent from the following Detailed Description and the
figures.
BRIEF DESCRIPTION OF THE FIGURES
[0035] FIGS. 1A and 1B are a flowchart illustrating an example
method of operating an embodiment of the system of the present
disclosure.
[0036] FIG. 2A illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays requests for information regarding a prior
prescription of the patient, a fillable form for the patient to
enter data regarding their prior prescription, and requests for
information regarding what refractive errors the patient may
have.
[0037] FIG. 2B illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays a request for information regarding a prior
prescription of the patient and a request for information regarding
what refractive errors the patient may have.
[0038] FIG. 3 illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays a diagram and enables a patient to make an input,
wherein the input corresponds to an axis measurement of the
patient.
[0039] FIG. 4A illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein a
diagram is shown as it would look to a corrected eye with
astigmatism, or to an eye without astigmatism.
[0040] FIGS. 4B, 4C, 4D, and 4E illustrate screen shots of examples
of embodiments of the system of the present disclosure, wherein
each diagram is shown as it would look to an uncorrected eye with
astigmatism along a given axis.
[0041] FIG. 5 illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
diagram is shown as it would look to a corrected eye with
astigmatism after the patient has made at least one input, wherein
the input corresponds to a cylinder measurement of the patient.
[0042] FIG. 6 illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system calibrates the amount of distance between a camera mounted
to the computerized screen and the patient.
[0043] FIGS. 7A and 7B illustrate screen shots of examples of an
embodiment of the system of the present disclosure, wherein the
system displays a figure and enables a patient to make at least one
input to change the size of the figure, wherein the at least on
input corresponds to a sphere measurement of the patient.
[0044] FIGS. 8A, 8B, 8C, and 8D illustrate screen shots of examples
of an embodiment of the system of the present disclosure, wherein
the system displays a colorblocked diagram and enables a patient to
make at least one input to select a more defined-appearing part of
the diagram, wherein the input corresponds to a determination that
the patient is near or far sighted (if not wearing corrective
lenses), over or under corrected (if wearing corrective lenses), or
otherwise.
[0045] FIG. 9A illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays a figure and enables a patient to make at least one
input to affect the rotation of the figure, wherein the at least
one input corresponds to an axis measurement.
[0046] FIG. 9B illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays a figure and enables a patient to make at least one
input to affect the spacing or size of various parts of the figure,
wherein the at least one input corresponds to an cylinder
measurement.
[0047] FIG. 10A illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays wherein the system displays a line diagram and
enables a patient to make at least one input, wherein the at least
one input corresponds to a cylinder measurement.
[0048] FIG. 10B illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
figure of 10A is rotatable to align with the determined axis of a
patient's astigmatism.
[0049] FIG. 11A illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays fine spoke diagram, which is a smaller angular
portion of spoke diagram of FIG. 12B, and enables a patient to make
at least one input, wherein the at least one input corresponds to a
fine axis measurement.
[0050] FIG. 11B illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays a concentric semi-circle diagram 1105 and enables a
patient to make at least one input, wherein the at least one input
corresponds to an axis and/or a cylinder measurement.
[0051] FIG. 12A illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays line diagram, and enables a patient to make at
least two inputs, wherein the at least two inputs correspond to a
cylinder measurement.
[0052] FIG. 12B illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays a spoke diagram 1205 and enables a patient to make
at least one input, wherein the at least one input corresponds to a
gross axis measurement.
[0053] FIG. 13 illustrates a screen shot of an example of an
embodiment of the system of the present disclosure, wherein the
system displays line diagram 1304, and enables a patient to make at
least one input, wherein the at least one input corresponds to a
cylinder measurement.
[0054] FIGS. 14A-D are screen shots of example embodiments of the
system of the present disclosure which demonstrate that the
alternating parts may be of different sizes or spacing, but still
test for the same determination in the astigmatism severity
determination.
[0055] FIG. 15 is a screen shot of an example of an embodiment of
the system of the present disclosure, which demonstrates that the
alternating parts may be of different sizes or spacing, but still
test for the same astigmatism axis determination.
[0056] FIG. 16 is a screen shot of an example of an embodiment of
the system of the present disclosure, which demonstrates that an
astigmatism axis gross determination figure may be modified in size
and shape, and stretched in minor fashion, and still be usable by
the system for determining an axis of astigmatism for a
patient.
[0057] FIG. 17 is a screen shot of an example of an embodiment of
the system of the present disclosure, which demonstrates a possible
configuration for a macular degeneration test.
DETAILED DESCRIPTION
[0058] FIGS. 1A and 1B illustrate a flowchart of an example of a
process or method 100 pursuant to an embodiment of the system of
the present disclosure. In various embodiments, one or more
processors execute a set of instructions to implement the process
100. Although process 100 is described with reference to the
flowchart shown in FIGS. 1A and 1B, the system may employ many
other processes of performing the acts associated with this
illustrated process. For example, the system may change the order
of certain of the illustrated blocks. The system can also make
certain of the illustrated blocks optional, the system may repeat
certain of the illustrated blocks, and/or the system may not employ
certain of the illustrated blocks.
[0059] As indicated by block 102, the system displays on a
computerized screen a fillable form for a patient to make at least
one input of a prior glasses or contacts prescription, contacts
brand name, and/or contacts manufacturer.
[0060] A computerized screen in accordance with an embodiment of
the present disclosure includes, without limitation: a monitor, a
television display, a plasma display, a liquid crystal display
(LCD), a display based on light emitting diodes (LEDs), a display
based on a plurality of organic light-emitting diodes (OLEDs), a
display based on polymer light-emitting diodes (PLEDs), a display
based on a plurality of surface-conduction electron-emitters
(SEDs), or any other suitable electronic device or display
mechanism. In certain embodiments, as described above, the
computerized screen includes a touch-screen. It should be
appreciated that the computerized screen may be of any suitable
size, shape, and configuration.
[0061] The computerized screen displays a fillable form, fillable
fields, or other vehicle for the patient to input data, if the
patient has such data, including a prior glasses prescription, a
prior contacts prescription, a prior contacts brand name, and/or a
prior contacts manufacturer. The data related to the prior contacts
prescription can be information from a box of the patient's
contacts, which they may still have in their possession. In one
embodiment, the computerized screen is part of a patient terminal,
which the patient may use to access the system and process.
[0062] In another example embodiment, the fillable form may query
the patient regarding their satisfaction with their current glasses
or contact lenses, as well as how often they wear the glasses or
contact lenses.
[0063] As indicated by block 104, the system receives at least one
input of a prior glasses prescription, a prior contacts
prescription, a prior contacts brand name, and/or a prior contacts
manufacturer. It should be appreciated that the system may
automatically fill in or populate the form, fields, or other
vehicle based on other data input by the patient. As one
non-limiting example, the patient may input a prior contacts brand
name. The system may then use a look-up table or other method to
retrieve from memory the corresponding base curve and/or diameter
aspects of the prior prescription. This is especially possible with
respect to contacts brand names or manufacturers who provide only
one or a few possible base curve and/or diameter sizes.
[0064] In one possible alternative to block 104, the system may
receive an input that the patient either does not have or does not
wish to enter the requested prior prescription information, as
indicated by block 106. In one possible embodiment, block 106 is
not a part of the process 100, and the patient must enter prior
prescription information before continuing to the next block. In
another possible embodiment, block 106 is part of process 100 and
the patient is not required to enter any prior prescription
information before continuing to the next block.
[0065] The system displays on the computerized screen a query to
the patient regarding whether they are nearsighted or farsighted,
as indicated by block 108, and receives at least one input from the
patient in response to the query regarding whether they are
nearsighted or farsighted, as indicated by block 110.
[0066] At block 112, the system displays a first diagram to the
patient on the computerized screen intended for a first eye (either
right or left) of the patient. It should be appreciated that the
patient should view the first diagram with their uncorrected first
eye, i.e. if they wear glass or contacts, they should remove them
and view the diagram without the correction of their glasses or
contacts.
[0067] The system receives an input from the patient regarding how
they view the first diagram with their first eye, wherein the input
from the patient corresponds to an axis measurement for an
astigmatism, as indicated by block 114. It should be appreciated
that the axis measurement can be used as at least one part of a
skew function which the system may apply to other diagrams and
figures displayed for the first eye. In one embodiment, the system
receives an input from a patient, wherein the input indicates that
they do not have an astigmatism in the eye being tested, as
indicated by block 120. In this embodiment, the patient may either
move on to blocks 122 through 130 with their first eye, or they may
repeat block 112 with their second eye.
[0068] If the patient makes an input which indicates an axis
measurement in accordance with block 114, the system displays a
second diagram on the computerized screen, as indicated by block
116. In one embodiment, the first diagram and second diagram are
the same diagram. In another embodiment, the first diagram and the
second diagram are different diagrams. In one embodiment, the
second diagram is distorted based on the partial skew from the axis
measurement determined from the patient's input at block 114. For
example, the second diagram may be stretched or elongated by some
unit along the patient-identified axis. In another embodiment, the
second diagram is not initially distorted.
[0069] The system receives at least one input from the patient,
wherein the at least one input corresponds to a cylinder
measurement of the first eye, as indicated by block 118. It should
be appreciated that the cylinder measurement can be used as at
least one part of a skew function which the system may apply to
other diagrams and figures displayed for the first eye. The skew
function is intended to correct for any astigmatism that the
patient may have in the eye being tested. As such, the skew
function will make any diagram or figure it is applied appear
distorted to a corrected eye, while appearing clear to a corrected
eye.
[0070] It should be appreciated that blocks 112 through 120 should
be repeated, separately, for the second eye of the patient. After
repeating blocks 112 through 120 for the second eye, it should
further be appreciated that the axis measurement and cylinder
measurement for the second eye can be used as parts of a skew
function which the system may apply to other diagrams and figures
displayed for the second eye in the same way those measurements
were described as being used for the first eye. It should further
be appreciated that, in one embodiment, immediately after
completing blocks 112 through 120 for a first eye, the patient may
switch to their second eye and again work through blocks 112
through 120. In an alternative embodiment, the patient may go on to
other blocks, for example, blocks 122 through 130, with their first
eye, before returning to blocks 112 through 120 for their second
eye.
[0071] At block 122, the system displays a first figure to the
patient on the computerized screen intended for a first eye (either
right or left) of the patient. The first figure is displayed such
that it is too small to be clearly seen by the patient. It should
be appreciated that the patient should view the first figure with
their uncorrected first eye, i.e. if they wear glass or contacts,
they should remove them and view the figure without the correction
of their glasses or contacts. In one example embodiment, the first
figure is distorted by the skew function determined with the
patient inputs of blocks 114 and 118 for the patient's first eye.
In another example embodiment, the first figure is not distorted by
the skew function.
[0072] The system receives an input from the patient regarding how
they view the first figure with their first eye, wherein the input
from the patient corresponds to a first sphere measurement, as
indicated by block 124.
[0073] As indicated by block 126, the system displays a second
figure on the computerized screen, wherein the second figure is
displayed such that it is large enough to be clearly seen by the
patient. In one embodiment, the first figure and second figure are
the same figure. In another embodiment, the first figure and the
second figure are different figures. In one embodiment, the second
figure is distorted It should be appreciated that the patient
should view the second figure with their uncorrected first eye,
i.e. if they wear glass or contacts, they should remove them and
view the figure without the correction of their glasses or
contacts. In one example embodiment, the second figure is distorted
by the skew function determined with the patient inputs of blocks
114 and 118 for the patient's first eye. In another example
embodiment, the second figure is not distorted by the skew
function.
[0074] The system receives an input from the patient regarding how
they view the second figure with their first eye, wherein the input
from the patient corresponds to a second sphere measurement, as
indicated by block 126. The system averages the first and second
sphere measurements to determine a final sphere measurement, as
indicated by block 130. It should be appreciated by one of skill in
the art that the system can determine a final measurement in any
suitable manner, and it final measurement need not be the product
of an straight average. For example, the system may use only the
last-input result, only the first-input result, some weighted
average based on statistical variance from other inputs, or the
system may completely ignore inputs it considers to be of such a
great statistical variance from other inputs that it is likely to
be in error.
[0075] It should be appreciated that blocks 122 through 130 should
be repeated, separately, for the second eye of the patient. It
should further be appreciated that, in one embodiment, immediately
after completing blocks 122 through 130 for their first eye, the
patient may switch to their second eye and again work through
blocks 112 through 130 for their second eye. In an alternative
embodiment, the patient may have already completed blocks 112
through 120 with their second eye.
[0076] It should further be appreciated that the system may repeat
sets of blocks 122 and 124 any number of times, in any order, and
may alternate sets of blocks 122 and 124 with sets of blocks 126
and 128 any number of times. In one example embodiment, the system
works through blocks 122 through 128 for an eye of the patient,
then repeats blocks 122 and 124 again for the same eye before
moving on to block 130. In this example embodiment, the three
resultant sphere measurements are averaged to determine the final
sphere measurement at block 130. In another example embodiment, the
system works through blocks 122 and 124, then repeats blocks 122
and 124, then also works through blocks 126 and 128 two times. In
this example embodiment, the four resultant sphere measurements are
averaged to determine the final sphere measurement at block
130.
[0077] As indicated by block 132, the system displays on the
computerized screen a query to the patient regarding whether they
would like a glasses prescription, a contacts prescription, or
both. At block 134, the system receives an input from the patient
regarding their desired prescription or prescriptions.
[0078] The system displays pricing information to the patient, and
conventionally enables the patient to select a method of payment
and to provide payment information, as indicated by block 136.
Enabling the patient to select their method of payment and to
provide payment information may be accomplished via a fillable
form, fillable fields, or some other way, as is well-known in the
art. The system receives at least one input from the patient
regarding their desired method of payment and their payment
information, as indicated by block 138, and provides the patient
their requested and paid-for prescription or prescriptions, as
indicated by block 140.
[0079] In one embodiment, before the patient receives their
prescription, it is sent to one or more doctors to sign off on the
various determined refractive error measurements. For example, the
system may send the axis measurement to be signed off upon by one
doctor, the cylinder measurement to be signed off upon by another
doctor, and the sphere measurement to be signed off upon by a third
doctor. In an alternative example, the system may send all three
measurements to the same doctor for sign off. It should be
appreciated that any combination of doctors signing off on any part
of the prescription may be employed for any combination of cost and
time effectiveness considerations.
[0080] It should be appreciated that the system may enable the
patient to make an input regarding how or where to send their
selected prescription after they have received it. In one
embodiment, the system may send the prescription data to an
optometrist's or opthalmologist's offices, a central glasses and/or
contacts fulfillment company, a glasses and/or contacts retail
location (physical or virtual), or the like. In a further
embodiment, the patient may select where to send the prescription
by choosing from a list, a map, entering a name, or some other
method.
[0081] In another embodiment, the system may enable a patient to
browse eyeglass frames. In such an embodiment, the system may
display an image of the patient with mock eyeglass frames displayed
over the top of the patient's face, and may enable the patient to
modify the appearance of the frames, for example, by changing the
size, shape, color, material, texture, etc. of the mock frames. In
another further embodiment, the system may determine a location for
the mock lenses on the face of the patient in any suitable manner,
such as via known facial or pupil recognition systems, or via a
system-recognizable physical frame provided to and worn by a user.
In another further embodiment, the system may display instructions
for a patient to purchase their desired frames online, at a
physical storefront location, or to have them shipped to a desired
location.
[0082] It should be appreciated by one of skill in the art that the
applicant has surprisingly discovered, and disclosed herein, a
novel inversion of the conventional method of determining the
refractive error for a patient. In the conventional technique, the
patient is located far from a figure or diagram, and lenses of
various strengths and configurations are placed before the
patient's eyes. The patient provides subjective feedback on which
of the lenses provides better vision quality. The doctor or
technician refines the prescription by changing the lenses placed
in front of the patient's eyes, until the subjective feedback from
the patient indicates that the best vision quality has been
accomplished by one of the provided lenses. In contrast, the
embodiments of the present disclosure do not require any lenses or
any lens assembly. It should be appreciated that the diagrams and
figures themselves are adjusted by the inputs of the patient, and
thus the necessary prescription may be determined, in whole or in
part, from factors such as: the distance between the patient and
the computerized screen, the original size of the diagram or figure
on the computerized screen, the patient-adjusted size of the
diagram or figure on the computerized screen, the number of inputs
received from the patient, the amount of incremental effect of each
input, and other relevant factors.
[0083] It should further be appreciated that, in some embodiments
of the present disclosure, the patient may indicate to a second
person which input should be made. In those embodiments, the second
person would perform the input to the computerized screen, based on
the instructions of the patient. The second person may be any
suitable person, including a friend of the patient, family member
of the patient, doctor, office assistant, office technician, or any
other person.
[0084] It also be appreciated that the present disclosure is not
limited to a single computerized screen. In some embodiments, the
patient may use more than one computerized screen, on one or more
patient terminals, to interact with the system. In another
embodiment, the patient and the second person may interact with the
system on the same patient terminal and/or computerized screen. In
still another embodiment, the patient and the second person may
interact with the system on different patient terminals and/or
computerized screens.
[0085] In another embodiment the system may allow a patient to
begin the process and method in one location, such as a brick and
mortar location, and continue or complete the process and method in
at least one other location, such as in their home. It should be
appreciated that in such an embodiment some kind of unique patient
identification would be used to authenticate that the same patient
is interacting with the system in the first location and the
additional location(s). Such authentication systems are known in
the art and described below.
[0086] In another embodiment, a patient may use one computerized
screen to control another computerized screen. For example, the
system may enable a patient with a smartphone to use the smartphone
as a remote to control another patient terminal with a computerized
screen, such as a kiosk, personal computer, or tablet computer in
order to interact with the system. In one example of such an
embodiment, the system would send a patient a link to their remote
device, such as via email or SMS text message. The patient is
enabled to access the link to launch an interface, such as via a
browser, which can then be used to interact with the system in a
unique hand held manner. In another example embodiment, the remote
device interacts with the system through an application stored on
the remote device, commonly known as an "app." The remote device
may be any suitable device, such as a cell phone, smart phone,
tablet, notebook, or other remote device, that is capable of
interacting nearly-instantaneously with the system to receive
instructions and enable the patient to make at least one input to
the system over at least one communication interface, such as the
internet, text messaging, email, voice, or data, to control the
computerized screen from a distance. It should be appreciated by
one of skill in the art that such a system is unique in that it
allows a patient to take a medical examination with their own
smartphone or other remote device, and fully be able to control the
examination.
[0087] In another embodiment, the system utilizes a handheld
patient terminal with a digital screen remote from a second patient
terminal with a digital screen as a remote control for testing done
via the internet by effectively turning the handheld patient
terminal into a remote control via a any suitable client or server
application (such as a web browser). For example, the handheld
patient terminal may be any suitable device, such as a cell phone,
smart phone, tablet, notebook, or other remote device, that is
capable of interacting nearly-instantaneously with the system to
receive instructions and enable the patient to make at least one
input to the system over at least one communication interface, such
as the internet, text messaging, email, voice, or data, to control
the computerized screen from a distance. The remote patient
terminal may similarly be any suitable device with a computerized
screen large enough to be viewed from a distance, such as a kiosk,
personal computer, or tablet computer in order to interact with the
system.
[0088] In one example embodiment of such a system, the patient is
enabled to log into an online portal on either terminal, and make
at least one input to request a message be sent to the handheld
terminal. The message may be any suitable message, such as a text
message, an email message, or a voice message. For example, the
system may send the patient a text message to their smart phone
after the patient requests the message by entering their cell phone
number. The patient is enabled to click on or enter a link within
the message, which will cause the system to open a web browsing
session on the handheld terminal, transforming the handheld
terminal into a remote control for the remote terminal, which is
also logged into a browsing session. The system may connect the
handheld terminal and the remote terminal sessions via any suitable
protocol. In a further embodiment, the system connects the handheld
terminal and the remote terminal sessions via a WebSocket protocol.
A WebSocket protocal provides full-duplex communications channels
over a single TCP connection, and allows the server to send content
to a browser without being queried by the client, and maintains the
same connection while messages are sent back and forth. Such a
direct line of duplex communication increases the real-time speed
of a remote control, making the remote more convenient for a
patient, and providing a better user experience. Applicants have
surprisingly found that the use of a remote control and, more
specifically, the use of a WebSocket-based remote control of a
smartphone, tablet, or other portable handheld device to control a
web accessible computer based system, such a PC, MAC, or any tablet
with a digital screen in unique and advantageous in the
telemedicine space. The use of such a device, results in the
ability to have real time transmission, and real time feedback to a
patient when running a telemedicine based solution, which is more
convenient for the patient.
[0089] In another embodiment, the system uses a voice recognition
system to enable a patient to make at least one input. In a further
embodiment, the system includes a voice recognition system for
conducting an eye examination, or a sub-examination of an eye
examination. In a such an embodiment, the system would enable a
user to make an input by speaking to the system, equipped with a
microphone and conventional voice recognition software. As is known
in the art, microphones and voice recognition software are readily
commercially available and use standard voice recognition formulas
which embed a conventional automatic learning system, so that the
system would be able to adapt to more difficult languages over
time. The system would receive voice inputs from the patient to
record and analyze them using the conventional voice recognition
software. It should be appreciated by one of skill in the art that
enabling a patient to provide inputs via their voice would provide
several benefits. First, the patient that is taking constituent
tests of an examination, such as an eye examination, would not need
to see the details of the screen perfectly clearly, and could
utilize their hearing (communicated through spoken instructions)
and speaking (to provide inputs back to the system) instead, which
is more user-friendly since it is easier to use and provides
additional options for inputting responses. This is especially
relevant for portions of the system in which the patient is using
an uncorrected eye, is somewhat distant from the computerized
screen, or both. Another benefit of such a system is that it
enables a patient to use their hands for purposes other than
providing inputs to the system. For example, the patient may then
be free to hold up test object, or to cover their eyes. Further,
the use of a system which speaks to the patient and allows the
patient to respond by speaking back simulates a more typical
doctor's office-based subjective eye examination, and may help
patient's assimilate to the system of the present disclosure.
[0090] Referring now to FIGS. 2A and 2B, an embodiment of the
present disclosure is illustrated. The example system of FIG. 2A
includes a display 200 which the system shows on the
above-described computerized screen. The display 200 includes
progress bar 202, 204, 206, and 208. It should be appreciated that
the progress bar may be any suitable progress meter. In the
embodiment of FIG. 2A, the progress bar 202, 204, 206 and 208 is a
sectioned progress bar where the section currently being worked on
202 is indicated by being a darker color than the other sections.
It should be appreciated that for a sectioned-type progress bar, or
other types of progress meters, the indication of the section being
worked on can be any variation in color, size, font, text, or
otherwise. In another embodiment, the sections of the progress bar
are selectable by the patient, such that the patient can move
through the process 100 by selecting the section of the process to
which they wish to go. In a different embodiment, the sections are
not selectable by the patient to move the patient through the
various sections.
[0091] In the embodiment illustrated by FIGS. 2A and 2B, the system
provides instructions for the patient regarding how to work through
the section 202, and further provides verbal instructions which the
patient can control, turn off, turn on, and/or adjust by
articulating the verbal direction control elements 210.
[0092] As illustrated by the embodiment shown in FIGS. 2A and 2B,
the system queries the patient regarding whether they have their
prior glasses or contacts prescription 212. The patient is enabled
to respond to the query by selecting one of the radio buttons 214
or 216. It should be appreciated that any other method for
accepting a response to a query from the patient may be employed by
the system, such as a drop down list, a fillable field, and/or a
check box.
[0093] In the embodiment of FIG. 2A, when the patient selects the
radio button corresponding to "YES" 214, the system provides the
fillable form 218 through 264. The system enables the patient to
upload a picture of a prior glasses prescription 218 and/or a prior
contacts prescription 236. The system also enables the patient to
enter their prior prescription data into the conventional fillable
fields 220 through 234 and 238 through 264. Specifically, the
fillable form has fields for the glasses prescription of the
patient's right eye, or "OD" 220, 222, 224, and 226. "OD" is the
common acronym for the latin "oculus dextrus," which means "right
eye." The fillable form also has fields for the glasses
prescription of the patient's left eye, or "OS" 228, 230, 232, and
234. "OS" is the common acronym for the latin "oculus sinister,"
which means "left eye." More specifically, fillable fields 220 and
228 are for the sphere, or "SPH," or power measurement of the
patient's right and left eyes, respectively. The sphere measurement
represents the degree of nearsightedness or farsightedness of the
patient. The unit of the sphere measurement is the diopter. A plus
sign "+" in front of the sphere measurement indicates the amount of
farsighedness of the patient, while a negative sign "-" in front of
the sphere measurement indicates the amount of nearsightedness of
the patient. The more positive (for farsighted people) or negative
(for nearsighted people) the sphere measurement is, the more severe
the refractive error, and thus, the more powerful the corrective
lenses must be to correct for the error.
[0094] The cylinder, or "CYL" fields 222 and 230 for the right and
left eye, respectively, and the axis fields 224 and 232, for their
right and left eye, respectively, indicate that the patient has an
astigmatism in the corresponding eye. If no astigmatism is present,
the cylinder and axis fields are conventionally left blank. The
cylinder measurement indicates the severity, in diopters, of the
astigmatism in the patient's eye. The bigger the cylinder
measurement, the more severe the astigmatism of the patient. The
axis measurement is a number between 0.degree. and 180.degree.. The
unit of the axis measurement is degrees. The axis measurement
indicates the axis along which the patient's vision is distorted
due to the imperfections in the curvature of the cornea.
[0095] The combination of sphere, cylinder and axis measurements
make up the distance vision portion of the conventional eyeglasses
or contacts prescription. The remainder of the glasses prescription
is directed to the near vision portion of the prescription, and is
generally for reading glasses or the reading portion of bifocal
corrective lenses. The ADD fields 226 and 234, respectively for the
right and left eyes of the patient, represent the additional
refractive power, in diopters, to be added to the spherical power
in order to allow the patient to read up-close if they are
presbyopic. If the patient needs no correction for distance vision,
the ADD power alone would be the patient's prescription for
conventional reading glasses, available at most drugstores and/or
convenience stores.
[0096] In an example embodiment, the system enables a patient to
determine the ADD power for those patients who require it. Those
patients are referred to as presbyopic emmetropes (those that do
not require spectacle correction for distance), and their
presbyopia is generally a result of aging, typically occurring
around approximately 40 years old. This is the age period when a
patient generally begins to need reading glasses. However, in the
past, in order to determine a correct reading glasses ADD number,
or to create a proper no-lined progressive bifocal spectacle or
contact lens, patients needed to go to an eye doctor's office to
obtain the proper measurement. Applicants have surprisingly found,
however, a system for determining the power for both top and bottom
portions of bifocal lenses which avoids the need to visit a
doctor's office or endure a full and lengthy examination at the
office. The system queries the patient regarding their age, the
size of figures they are able to see with their uncorrected eyes
(via any of the methods or processes disclosed herein), and the
distance they desired to be corrected for (i.e. a patient may
desire a single pair of glasses to see both books at 16 inches and
to see other objects at 21 inches (or any other combination of top
segment and bottom segment)). It should be appreciated that the
desired distances can be determined by any suitable method, such as
via a computerized screen as disclosed herein (such as a
smartphone), a simple printable paper measurement aid, via
estimation with a length of paper. The system may also enable a
patient to estimate the distance range they most desire to be
corrected for, such as the distance range they use most often, in
easily estimable terms, such as arms length, further than arms
length, or closer than arms length. The system utilizes such inputs
from the patient to determine a custom prescription for no-line
bifocals or single reading glasses without guessing or requiring a
trip to a doctor's office and its associated expenses.
[0097] As shown in FIG. 2A, the contacts prescription includes many
of the same measurement fields as the glasses prescription.
Specifically, the sphere measurement fields, 238 and 252; the
cylinder measurement fields, 240 and 254; the axis measurement
fields, 242 and 256; and the add measurement fields, 244 and 258,
for the right and left eyes, respectively, are also present in the
contacts prescription. Although the fields have the same names and
abbreviations, contacts prescriptions and glasses prescriptions can
be different, partly because the lenses of glasses are further from
the surface of the eye than contacts.
[0098] In addition, the system provides the additional measurement
fields for the base curve, or "BC," 246 and 260, the diameter, or
"DIAM," 248 and 262, and the name of the contacts brand and/or
manufacturer, 250 and 264. During the time when only hard, gas
permeable contact lenses were available, the base curve and
diameter measurements were necessary to ensure the comfort of the
rigid lenses. With the rise of soft, flexible contact lenses, many
contact lens manufacturers only provide one, two, or a few
different base curve or diameter options for their lenses. If the
base curve and diameter measurements are known from a prior
prescription, and the patient was comfortable in those lenses, then
other lenses with those same measurements are highly likely to also
be comfortable for the patient, even if the manufacturer is
different. If the manufacturer is the same, it is even more likely
that the patient will be comfortable in lenses with the same
measurement. In this way, it should be appreciated that a contacts
"fitting" is generally unnecessary for those who have previously
worn contacts, so long as the patient was comfortable in their
prior lenses. In one embodiment, for patient-identified prior
contacts manufacturers or brand names, the base curve and diameter
measurements can be looked up by the system in a lookup table or
other memory database. In another embodiment, the system can
automatically fill in, or populate, any possible fields 246, 248,
260, and/or 262 with the looked-up base curve and diameter
measurements.
[0099] In an embodiment, the system can use the prior prescription
information as a check on the determined current prescription. In a
further embodiment, the system can require more tests from a
patient to confirm the current prescription if there is a
statistically significant difference between a value of the prior
prescription and the corresponding value of the determined
prescription.
[0100] In one embodiment, the system is capable of reading the
uploaded picture or scan of the prior glasses prescription 218
and/or the prior contacts prescription 236. In a further
embodiment, the system may automatically fill in, or populate, any
possible fillable fields with information read from the uploaded
prior glasses prescription 218 and/or the prior contacts
prescription 236. In another embodiment, the patient may upload a
photograph or scan of a prior contacts box or container and the
system may automatically fill in, or populate, any possible
fillable fields with information read from the uploaded photograph
or scan of the prior contacts box or container. In another
embodiment, the system is capable of recognizing conventionally
encoded information, such as information from a barcode, QR code,
matrix code, Aztec code, or other known types of encoded
information. In a further embodiment, the system is capable of
scanning the encoded information from a prior glasses or contacts
prescription, and/or a prior glasses or contacts box or container.
In a still further embodiment, the system may automatically fill
in, or populate, any possible fillable fields with information read
from the scanned prior glasses or contacts prescription, and/or a
prior glasses or contacts box or container.
[0101] After the patient fills in whatever data the patient has
available from prior prescriptions, the system queries the patient
regarding what appears more blurry or out of focus for them when
they are not using corrective lenses 268. Again, in the example
embodiment of FIG. 2A, the system provides radio buttons 270, 272,
and 274 for the patient to select an answer, but any suitable
method for enabling an input to the query would be acceptable. If
the patient selects distance 270 as being more blurry, this may
suggest that they are nearsighted, and they may have some
astigmatism. If the patient selects near 272 as being more blurry,
this may suggest that they are farsighted, and they may have some
astigmatism. If the patient selects both as being equally blurry
274, they may be nearsighted or farsighted, and they likely have an
astigmatism.
[0102] As illustrated in the embodiment of FIG. 2B, when the
patient responds to the query regarding whether they have a prior
prescription with "NO," the system does not display the fillable
form and fields 218 through 264, as in FIG. 2A. Instead, in the
embodiment of FIG. 2B, the system moves directly to a presentation
of query 268 and enables the patient to respond via radio buttons
270, 272 and 274, just as in FIG. 2A.
[0103] Referring now to FIG. 3, another embodiment of the present
disclosure is illustrated. At this stage of the process, the system
presents display 200, and the progress bar indicates that the
patient is currently in the Astigmatism Angle section 204. The eye
tracker 302, 304 indicates which eye is being tested. It should be
appreciated that the eye tracker may be any suitable progress
meter. In the embodiment of FIG. 3, the eye tracker 302, 304 is a
sectioned eye tracker where the section corresponding to the eye
being tested 302 is indicated by being a darker color than the
other section corresponding to the other eye. It should be
appreciated that for a sectioned-type eye tracker, or other types
of progress meters, the indication of the eye being tested can be
any variation in color, size, font, text, or otherwise. In another
example embodiment, the sections of the eye tracker 302, 304 are
selectable by the patient, such that the patient can change the eye
being tested by selecting the section corresponding to the other
eye. In a different embodiment, the sections are not selectable by
the patient to change the eye being tested.
[0104] As can be seen by reference to FIG. 3, the eye tracker 302,
304 indicates that the eye being tested is the left eye, indicated
by the darker shading of the left eye section 302. Written
instructions 306 are provided to the patient, along with verbal
instructions, which the patient can control with verbal direction
control elements 210. In the example embodiment shown in FIG. 3,
the written directions read "Cover your right eye. Select the line
that is darker, thicker or more prominent. If three lines are
darker, thicker or more prominent then select the middle. If two
lines are darker, thicker or more prominent then select the middle
button between those lines." The directions 306 refer the patient
to the diagram 310. Diagram 310 is a known diagram for diagnosing
the axis of an astigmatism. Patients with an astigmatism will see
the lines around the axis of their astigmatism as more bold, or in
better focus, then the other lines of the diagram. The lines
correspond to angle measurements. In this example embodiment, the
lines are evenly spaced at intervals of 15.degree.. It should be
appreciated that any suitable angular interval may be employed by
the diagram 310. The system enables the patient to make an input of
a line, or the centermost part of a group of lines, which are more
prominent when the patient views the diagram. It should be
appreciated that the patient is viewing the diagram with their
uncorrected eye.
[0105] In the embodiment shown in FIG. 3, the letters A through S
308, as well as the smaller letter combination buttons 310 are
selectable to indicate the axis angle of the patient. It should be
appreciated that the axis line selectable icons 308, 310 need not
be letters, but could be numbers, the angle measurement, pictures,
symbols, or any other suitable icon. As shown in FIG. 3, the letter
"A" 308a corresponds to an axis of 0.degree., the letter "G" 308b
corresponds to an axis of 75.degree., the letter "J" 308c
corresponds to an axis of 90.degree., the letter "O" 308d
corresponds to an axis of 165.degree., and the letter S 308e
corresponds to an axis of 180.degree.. In another example
embodiment, the system provides a button for the patient to
indicate that none of the lines in the diagram appears as darker,
thicker or more prominent, indicating that the patient does not
have an astigmatism in that eye. In a further example embodiment,
when the patient makes at least one input which indicates that they
do not have an astigmatism in the eye being tested, the system
moves on to test the other eye for an astigmatism. In another
embodiment, when the patient makes at least one input which
indicates that they do not have an astigmatism in the eye being
tested, the system moves on to the eye test for that same eye,
skipping the section testing the astigmatism severity for that eye.
In an alternative embodiment, when the patient makes at least one
input which indicates that they do not have an astigmatism in the
eye being tested, the system still tests the severity of any
astigmatism in that eye as a double-check that the patient does not
have an astigmatism in that eye.
[0106] It should be appreciated that, after selecting the line or
lines of the patient's axis measurement for the patient's left eye,
as shown in FIG. 3, the system may repeat the same test with
diagram 310 for the right eye by moving the eye tracker 302, 304 to
indicate that the right eye 304 is being tested, and by adjusting
the written instructions 306 to reflect that the right eye is now
being tested. In another embodiment, the patient continues to work
through the sections of the progress bar with the left eye, and,
after completing the astigmatism severity test 206 for the left
eye, will repeat the two astigmatism sections 204 and 206 for the
right eye before moving on to the eye test 208 for either eye. In
another embodiment, the patient works through all sections 204,
206, and 208 with one eye, the left eye, for example, before going
back to work through each section 204, 206, and 208 with the other
eye, in this example, the right eye. It should further be
appreciated that any order of testing, with any order of eyes being
tested is suitable. It should further be appreciated that by
providing patient-selectable progress bar sections 204, 206 and
208, and eye tracker sections 302 and 304, the patient may select
whichever order they prefer.
[0107] Referring now to the embodiment illustrated in FIG. 4A,
another example embodiment of the present disclosure is
illustrated. At this stage of the process, the system presents
display 200, and the progress bar indicates that the patient is
currently in the Astigmatism Severity section 206. The eye tracker
302, 304 indicates that the left eye 302 is being tested. The
written directions 406 read: "Cover your right eye. 1. Keep Right
Eye covered. 2. Click the (+) until the grid is all perfect
squares." The written instructions refer to diagram 408a, which
shows a large square divided into several smaller squares. The
system provides patient-selectable icons 410 and 412 to adjust the
diagram until the patient views all of the grid of diagram 408a as
perfectly square. When the patient views all of the grid of diagram
408a as perfectly square, the patient selects the
patient-selectable icon 414. If the system is malfunctioning in
some way, the system provides a button 418 to request assistance
with the malfunction. It should be appreciated that button 418 is
optional, but useful in the case that the animation of the diagram
changing is not visible to the patient. It should further be
appreciated that diagram 408a in FIG. 4A is illustrated as it would
appear to a patient without an astigmatism, or to a patient with an
astigmatism who is wearing their corrective lens on the eye being
tested. In other words, the boxes of diagram 408a are square in
FIG. 4A, but would appear distorted to an uncorrected eye with an
astigmatism.
[0108] The applicant has surprisingly found that use of the grid
shown as diagram 408a can be used to determine the cylinder
prescription of a patient by measuring the amount of distortion is
necessary, along the patient's axis of astigmatism, in order for
the patient to view the figure as square to their uncorrected
eye.
[0109] Referring now to the embodiments illustrated in FIGS. 4B,
4C, 4D and 4E, other embodiments of the present disclosure are
illustrated. In the embodiments of these figures, the patient has
selected icons 308a, 308b, 308c, 308d, and 308e of FIG. 3,
respectively. Thus, the corresponding diagrams of those FIGS. 408b,
408c, 408d, and 408e, respectively, are illustrated as being
stretched along the patient-selected axis for that figure.
Specifically, FIG. 4B shows the diagram 408b distorted along the
75.degree. axis, FIG. 4C shows the diagram 408c distorted along the
90.degree. axis, FIG. 4D shows the diagram 408d distorted along the
165.degree. axis, and FIG. 4E shows diagram 408e distorted along
the 180.degree. axis. If the patient selects the "+" 412, the
diagram elongates along the axis. If the patient selects the "-"
410, the diagram contracts along the axis. In this way, the patient
can manipulate the diagram until the boxes appear square to their
uncorrected eye. As the patient manipulates the diagram, scale 416
provides a visual representation to the patient of how much they
have changed the diagram 408b, 408c, 408d, or 408e.
[0110] It should be appreciated that the system may distort the
diagram in any suitable way, at any suitable speed, and at any
suitable increment. In one embodiment, the system automatically
distorts the diagram prior to enabling the patient to make an
input. In another embodiment, the system automatically begins
distorting the diagram, and continues to distort the diagram until
the patient makes an input to stop the distortion. In a further
embodiment, the patient may further adjust the distortion of the
diagram by making at least one input. In another further
embodiment, the patient may not further adjust the distortion of
the diagram by making any inputs. In another embodiment, the system
does not distort the diagram prior to receiving at least one input
from the patient.
[0111] Referring now to the embodiment illustrated in FIG. 5,
another embodiment of the present disclosure is illustrated. As
shown in FIG. 5, the patient has manipulated diagram 408f such
that, to the patient's uncorrected eye, the boxes appear square.
Scale 416 demonstrates that the diagram 408f has been manipulated.
At this point, the patient can press the icon 414 indicating that
they view the boxes of the diagram 408f as square. The system
determines, from the amount of manipulation of diagram 408f, a
cylinder measurement for that eye of the patient.
[0112] It should be appreciated that the combination of the axis
measurement and the cylinder measurement for a given eye of the
patient can be used by the system to determine a skew function to
apply to further diagrams and figures intended for the given eye.
In this way, the astigmatism will not affect the results of the eye
test, for example, because the figures used in the eye test will
have been modified to counter the effect of the astigmatism.
[0113] Referring now to the embodiment illustrated in FIG. 6,
another example embodiment of the present disclosure is
illustrated. At this stage of the process, the system presents
display 200, and the progress bar indicates that the patient is
currently in the Eye Test section 206. Specifically, the display
200 in FIG. 6 is directed to calibrating a camera which may be
attached to the computerized screen to determine the distance of
the patient from the computerized screen. The system must know the
distance of the patient in order to accurately calculate the sphere
measurements from the eye tests. If the patient's computerized
screen does not have a camera, the system will provide the patient
a specified distance to remain away from the screen. This distance
may be the same or different for each instance of the
"small-to-large" eye test (described at blocks 122 and 124 of FIG.
1A) and/or each instance of the "large-to-small" eye test
(described at blocks 126 and 128 of FIG. 1A).
[0114] The written instructions 606 of the example embodiment
illustrated by FIG. 6 read: "1. Hold a credit card with the
magnetic strip facing the camera. 2. Place the card 11'' from the
camera. 3. Use a piece of paper to measure 11''. Roll the paper the
long way. Place one end touching the screen near the camera and the
other touching the credit card. Remove the paper and keep the card
in place. Click the Calibrate button. 4. Click on the magnetic
strip in the picture. 5. When magnetic strip is highlighted click
the Done button." Camera viewer 610 shows the patient what the
camera is viewing. The patient can follow the instructions to click
the Calibrate button 612 and the Done button 614 in accordance with
the written instructions. It should be appreciated that any other
suitable or conventional method of calibrating the distance between
the patient and the computerized screen may be employed.
[0115] It should be appreciated that any suitable distance between
the patient and the screen may be used. In one embodiment, the
distance between the patient and the screen is determined based on
whether the patient is nearsighted or farsighted. In a further
embodiment, the system determines that the distance between the
patient and the screen is the same for a nearsighted patient and a
farsighted patient. In another embodiment, the system determines
that the distances between the patient and the screen are different
for a nearsighted patient and a farsighted patient. In one
embodiment, the system may determine the distance between the
patient and the screen depending on the kind, type, dimensions, or
other characteristics of the screen. In another embodiment, the
patient may be enabled to make an input regarding whether the
determined input is difficult for the patient to use. In a further
embodiment, the system may determine a new distance between the
patient and the screen after the patient makes an input regarding
whether the determined input is difficult for the patient to
use.
[0116] In another example embodiment, they system or patient
terminal may utilize mirrors to simulate the a greater or lesser
distance between the patient and the computerized screen, such as
is conventional in projection technology, or in, for example, a
optometrist's office. In a further example embodiment, the mirrors
are adjustable based on the location of the patient, such that the
patient may move and the mirrors may adjust to account for the
movement to maintain the same simulated distance.
[0117] In another example embodiment, the system determines a focal
distance for patient, which may then be used for various tests,
such as astigmatism cylinder determination tests. As discussed in
the Background section, astigmatism is a refractive error of the
eye that causes light entering the eye to focus on two points in or
around the retina of a patient, rather than one. Patients with
astigmatism may have any of the following combinations of focal
points for one or both eyes: in front of the retina and behind the
retina; in front of the retina and on the retina; on the retina and
behind the retina; two points in front of the retina separated by a
finite distance; or two points behind the retina separated by a
finite distance. These focal points in and around the patient's
retina correlate to distances in real space. Therefore, a patient
with astigmatism can relocate themselves nearer to or further from
an object until their view of that object is approximately in
focus, despite the astigmatism. That location (where the viewed
object is approximately in focus) is the real space location
corresponding to one of the patient's two focal distances.
[0118] Applicants have surprisingly found that, when patients that
view digital screens containing images oriented at the patient's
axis of astigmatism where the patient is located remote from the
digital screen at one of their focal distances, this enables the
system to isolate the refractive errors related to astigmatism from
the refractive errors related to sphere, providing a more accurate
cylinder determination than when at a known, but non-focal
distance, location from the digital screen.
[0119] In one such example embodiment, the system instructs the
patient to move away from the digital screen until they cannot see
the details of the object, image, or figure displayed on the
digital screen. The displayed object, image, or figure may be
displayed at any suitable orientation, such as at the patient's
astigmatism axis as was previously determined by the system or as
was gleaned from a previous prescription of a patient. The system
enables the patient to make an input indicating that they cannot
see the displayed object, image, or figure, then instructs the
patient to move towards the screen in small increments until they
can just make out the details of the displayed object, image, or
figure. By way of example only, if the displayed image is a capital
letter "E," the system may instruct the patient to move towards the
screen in small increments until they can make out the direction in
which the tines of the "E" are pointing (left, right, up, down,
etc.). The system enables a user to make at least one input
indicating that they can just make out the details of the displayed
object, image, or figure. The distance of the patient from the
screen when they can just make out the details of the object,
image, or figure is one of the patient's focal distances. In this
example embodiment, the system conducts the remainder of the
cylinder determination with the patient at this determined focal
distance locations.
[0120] In another embodiment, the system instructs the patient to
move a known, fixed distance from the digital screen displaying the
testing images for the duration of certain of the tests described
herein, such as the astigmatism cylinder tests, the astigmatism
axis tests, or any other suitable test. The known, fixed distance
may be any suitable distance, so long as the distance is known,
input by the patient, or calculable at some time before, during, or
after the patient undergoes the cylinder determination tests. In
one example embodiment, the known, fixed distance is 10 feet. In
another example embodiment, the known, fixed distance is 6 feet. In
an example embodiment wherein the patient is located a known, fixed
distance from the digital screen displaying testing images, the
specific testing being conducted would proceed under the direction
of the system as described in detail elsewhere in this
disclosure.
[0121] In an additional example embodiment, the system may query
the patient for their shoe size and gender and, using that
information, have the patient estimate their distance from the
computerized screen via heel-to-toe measurement and enter that
distance into the system. In an alternative example embodiment, the
system may instruct the patient to take a determined number of
heel-to-toe steps from the computerized screen, placing the patient
at a fairly accurate distance from the computerized screen.
[0122] In another example embodiment, the system utilizes an input
from an external source that can triangulate and measure the
distance of an individual in real time from that of a monitor, as
is known in the art. Example systems include X-Box Kinect.RTM.,
which has a distance monitoring function utilizing a depth sensor
combining an infrared laser projector and a monochrome CMOS sensor,
which captures video data in 3D under any ambient light conditions.
This external source input is then utilized, either in whole or in
part, to measure the distance between the patient and the
computerized screen, to perform a validation check of the distance
a patient believes he or she is at (input by the patient or based
on system instructions to the patient to move to a certain
distance), or to verify measurements in kiosk-based structures or
systems (as described further herein).
[0123] Referring now to the embodiment illustrated in FIG. 7A,
another embodiment of the present disclosure is illustrated. At
this stage of the process, the system presents display 200, and the
progress bar indicates that the patient is currently in the Eye
Test section 206. The eye tracker 302, 304 indicates that the left
eye 302 is being tested. For systems with cameras, the system
provides a calibration box 708 with an estimate of the distance of
the patient from the camera/computerized screen. In one embodiment,
the system uses the camera-measured distance of the patient from
the screen to determine a font size or an icon size to display to
the patient as part of FIG. 710.
[0124] The written instructions 706 read: "Cover your right eye.
Move your face 28 inches from the screen. Click "I can see" when
you can just barely recognize the letters from that distance. DON'T
WAIT UNTIL IT IS CLEAR! Use the + and - to make sure the letters
are just barely recognizable." The written instructions refer to
FIG. 710, which in this embodiment is a series of letters. It
should be appreciated that any suitable kind or number of visual
cues, symbols, shapes, or icons can make up the FIG. 710, such as
letters, numbers, pictures, or the like. As shown in FIG. 7A, the
system provides patient-selectable icons 712 and 716 to adjust the
figure until the patient views the figure as just barely being able
to make out the letters of the figure. When the patient views the
figure and can just barely make out the letters, the patient
selects the patient-selectable icon 414. In one embodiment, the
FIG. 710 starts small enough that the figures cannot be clearly
seen by the patient, and the patient must make at least one input
to increase the size of the figure until it can just barely be made
out. In another embodiment, shown in FIG. 7B, the figure starts
large enough to be clearly seen by the patient, and the patient
must make at least one input to decrease the size of the figure
just until the figure can no longer be made out.
[0125] The system determines a sphere measurement from at least one
input from a "small-to-large" eye test. The system determines
another sphere measurement from at least one input of a
"large-to-small" eye test. As discussed previously, the
"small-to-large" eye test and the "large-to-small" eye test may be
performed any number of times, in any order, for each eye, with
each eye test resulting in a sphere measurement determined from the
at least one input of the patient. In one embodiment, the system
may perform only the "small-to large" eye test, and not the
"large-to small" eye test. In another embodiment, the system may
perform only the "large-to small" eye test, and not the "small-to
large" eye test. Either or both eye tests may be performed one or
more times per eye of the patient. When the system has provided all
instances of the eye test to both eyes, the system averages the
sphere measurements from the eye test instances to determine a
final sphere measurement. It should be appreciated that the system
may determine not to use a given sphere measurement in the final
sphere measurement if it is a statistically significant unit of
measurement away from the average of the remaining resultant sphere
measurements. In one embodiment, the system takes the mean of the
resultant sphere measurements as the final sphere measurement.
[0126] It should be appreciated that the system may adjust the size
of the figure in any suitable way, at any suitable speed, and at
any suitable increment. In one embodiment, the system automatically
increases (for the "small-to-large" test) or decreases (for the
"large-to-small" test) the figure prior to enabling the patient to
make an input. In another embodiment, the system automatically
begins increasing or decreasing the figure, and continues to
increase or decrease the figure until the patient makes an input to
stop the increasing or decreasing. In a further embodiment, the
patient may further adjust the size of the figure by making at
least one input. In another further embodiment, the patient may not
further adjust the size of the figure by making any inputs. In
another embodiment, the system does not increase or decrease the
figure prior to receiving at least one input from the patient.
[0127] It should be appreciated that the above-described
embodiments of the present disclosure may be implemented in
accordance with or in conjunction with one or more of a variety of
different types of systems, such as, but not limited to, those
described below.
[0128] Referring now to FIGS. 8A, 8B, 8C and 8D, another embodiment
of the present disclosure is illustrated, wherein the system
displays at least one colorblocked diagram 800 and enables a
patient to make at least one input to select a more
defined-appearing part of the diagram, wherein the input
corresponds to a determination that the patient is near or far
sighted (if not wearing corrective lenses), over or under corrected
(if wearing corrective lenses), or otherwise. The colorblocked
diagram 800 may be presented once, twice, or more in a series, for
each eye. The colorblocked diagram 800 may be the same or slightly
different for each presentation to the patient. In the examples
shown in FIGS. 8A, 8B, 8C, and 8D, the colorblocked diagrams 800
are slightly different.
[0129] The colorblocked diagram 800 has at least two parts, shown
as part 802 and part 804. In the embodiment shown in FIGS. 8A-D,
parts 802 and 804 are semicircles having a background color. In the
examples shown in FIGS. 8A-D, part 802 has a brighter background
color, while part 804 has a duller background color. It should be
appreciated by one of skill in the art that any suitable brighter
and duller colors, may be used as the background color of parts 802
and 804, respectively. In one embodiment, part 802 has a background
from the green family of colors (including the various colors of
green from dark to light, bright to dark, and mixed with other
colors, i.e. yellow-green or blue-green), while part 804 has a
background from the red family of colors (including the various
colors of red from dark to light, bright to dark, and mixed with
other colors, i.e. purple-red or red-orange). In another
embodiment, part 802 has a background from the yellow family, while
part 804 has a background from the purple family.
[0130] Parts 802 and 804 further include a plurality of lines of
various lengths 806 that, when placed closed together and viewed
from a short distance, appear as an arrowhead shape. In each of
FIGS. 8A-D, the arrow directions face away from each other, and are
comprised of horizontal or vertical lines 806. It should be
appreciated by one of skill in the art that any suitable number of
lines (straight or curved, in any suitable density), arranged into
any suitable direction, making up any suitable aggregate shape may
be used. In another further embodiment, the lengths 806 may be
replaced by solid or semi-solid shapes, such as circles, squares,
triangles, letters, numbers etc. It should further be appreciated
that parts 802 and 804 may be shapes other than semicircles, such
as half squares, half triangles, etc.
[0131] As discussed above, the colorblocked diagram 800, in one or
more of its configurations, may be used to determine whether a
patient is near or far sighted if not wearing corrective lenses.
The system may instruct the patient to remove any corrective
lenses, such as glasses or contacts, before using the system. The
system presents a colorblocked diagram to one eye of the patient,
and enables the patient to make an input regarding which of the
arrow parts appears more distinct to their uncorrected eye. In one
embodiment, the patient may select that part 802 with the brighter
background looks more distinct (i.e. sharper or more defined), that
part 804 with the duller background looks more distinct, or that
the arrows on parts 802 and 804 are about equally distinct. In
general, a selection that part 802 with the brighter background is
more distinct than part 804 with the duller background suggests
that the patient is farsighted. In general, a selection that part
804 with the duller background is more distinct than part 802 with
the brighter background suggests that the patient is nearsighted.
It should be appreciated by one of skill in the art that performing
two or more tests per eye with colorblocked diagrams having arrows
pointing in different directions will assist in mitigating any
subjective error from the patient. In an embodiment, the patient is
presented with FIGS. 8A to 8D in any order, for their first eye,
than 8A to 8D, in any order, for their second eye. The system uses
the results of the one, two, three, four, or more colorblocked
diagram tests to determine the near or far sightedness of the
patient.
[0132] It should be appreciated that the tests shown by example in
FIGS. 8A to 8D may also be used to determine if a patient is over
or under corrected if performed while wearing corrective lenses. In
one example embodiment, the patient performs the same steps
described immediately above, individually for each eye, while using
their corrective lenses. In this example embodiment, a selection
that part 802 with the brighter background is more distinct than
part 804 with the duller background suggests that the patient is
overcorrected with their present corrective lenses, while a
selection that part 804 with the duller background is more distinct
than part 802 with the brighter background suggests that the
patient is under corrected by their present corrective lenses.
[0133] Referring now to FIG. 9A, another embodiment of the present
disclosure is illustrated. FIG. 9A is a screen shot of an example
of an embodiment of the system of the present disclosure, wherein
the system displays a line diagram 900 and enables a patient to
make at least one input to affect the rotation of the line diagram,
wherein the at least one input corresponds to an axis measurement.
In the example embodiment shown in FIG. 9A, the line diagram 900 is
a line, or a long thin rectangle on a solid background. The
rectangle/line is made up of alternating parts 902 and 904.
Alternating parts 902 and 904 are different colors. In the
embodiment of FIG. 9A, part 902 has a brighter background color,
while part 904 has a duller background color. It should be
appreciated by one of skill in the art that any suitable brighter
and duller colors, may be used as the background color of parts 902
and 904, respectively. In one embodiment, part 902 has a background
from the green family of colors (including the various colors of
green from dark to light, bright to dark, and mixed with other
colors, i.e. yellow-green or blue-green), while part 904 has a
background from the red family of colors (including the various
colors of red from dark to light, bright to dark, and mixed with
other colors, i.e. purple-red or red-orange). In another
embodiment, part 902 has a background from the yellow family, while
part 904 has a background from the purple family.
[0134] The alternating parts 902 and 904 may be any suitable shape
or size. For example, in FIG. 9A, the alternating parts 902 and 904
are squares which make up the rectangle/line of line diagram 900,
without any space between the parts. It should be appreciated by
one of skill in the art that two or more alternating parts may be
used.
[0135] The system presents the line diagram 900 to the patient. In
one embodiment, the system begins rotating the diagram 900 about
its center. In another embodiment, the patient makes an input to
begin rotation of the diagram 900 about its center. The rotation is
slow enough that the patient can identify changes. In one
embodiment, the patient may make an input to speed up or slow down
the rotation of the diagram 900. In another embodiment, the diagram
900 does not rotate automatically, and the patient must make an
input corresponding to each rotation of the diagram 900.
[0136] The applicant has surprisingly found that use of a line
diagram, such as line diagram 900, can be used to determine the
axis prescription of a patient to within 1.degree. of accuracy.
Because the effect of an astigmatism is to distort, or stretch, a
patient's vision along an axis, when the line diagram 900 is near
or at the patient's axis of astigmatism, the alternating parts 902
and 904 will blur together and appear as a different color than
either of the parts individually. In one example embodiment where
part 902 is green and part 904 is red, the line appears yellow at
or near the axis of the patient's astigmatism. It should be
appreciated by one of skill in the art that if the patient does not
have an astigmatism, the line will not appear to change color.
[0137] The rotational axis of the line diagram 900 is composed of
angles ranging from 0 degrees to 360 degrees. However, in an
optical prescription, angles are written in 0 degrees to 180
degrees. Thus, one of skill in the art will appreciated that angles
0.degree. and 180.degree. are the same, 170.degree. and 350.degree.
are the same, 100.degree. and 280.degree. are the same and so on
and so forth. The axis line extends below the 180.degree. point,
and that is why angles above 180.degree. also have a corresponding
equivalence below 180.degree..
[0138] In an embodiment of they system of the present disclosure,
the system presents the patient with the line diagram 900, which
may rotate by system or patient direction, as described above. The
patient viewing the diagram with one corrected eye at a time, is
enabled to make an input corresponding to when they see the line
appear to change color. In one embodiment, the patient is prevented
from making an input that the line did not change color until at
least one or more full rotations of the line have been completed.
In another embodiment, once a patient makes an input indicating
that the line appeared to change color, the patient is enabled to
make further fine-tuning inputs causing small rotations to the line
until the patient makes another input corresponding to the angle at
which the changed color appears most distinctly (i.e. strongest,
darkest, or most clear). In one embodiment, the fine-tuning inputs
cause a rotation of 1.degree.. It should be appreciated by one of
skill in the art that other fine-tuning increments can be used,
such as 2.degree., 5.degree., or 10.degree.. Since conventional
subjective axis determination techniques use increments of
10.degree., and since an astigmatism can be along any axis (at any
degree), any increment less than 10.degree. should yield a more
accurate determination than the phoropter system used by eye care
professionals in-office. The angle selected by the input
corresponding to the angle at which the changed color appears most
distinctly is the axis prescription of the patient. The system then
repeats the process for the other uncorrected eye of the
patient.
[0139] In an embodiment, the system enables the patient to make an
input reflecting that the line did not appear to change color. It
should be appreciated by one of skill in the art that such an input
would suggest that the patient does not have an astigmatism in that
eye. In a further embodiment, the system gives the patient an
additional axis test for that eye, such as that described in FIG.
3. In a different further embodiment, the system permits the
patient to skip the cylinder test, and go right to an axis test for
the other eye, or another kind of test, such as the power test.
[0140] Referring now to FIG. 9B, another embodiment of the present
disclosure is illustrated. FIG. 9B is a screen shot of an example
of an embodiment of the system of the present disclosure, wherein
the system displays a line diagram 906 and enables a patient to
make at least one input to affect the spacing or size of various
parts of the line diagram 906, wherein the at least one input
corresponds to an cylinder measurement.
[0141] The applicant has surprisingly found that use of a line
diagram, such as line diagram 906, can be used to accurately
determine the cylinder prescription of a patient. Because the
effect of an astigmatism is to distort, or stretch, a patient's
vision along an axis, when the alternating parts are stretched to
correspond to the severity of the patient's astigmatism, the
patient's eye will once again be able to resolve the alternating
parts in their actual colors. It should be appreciated by one of
skill in the art that if the patient does not have an astigmatism,
the line will only appear with the alternating parts in their
actual colors.
[0142] The line diagram 906 shown in the example embodiment of FIG.
9B is different from FIG. 9A in that it is used to determine the
severity of astigmatism for a patient. If it was previously
determined that the patient has an axis of astigmatism, this is the
next test to determine how much astigmatism that individual has.
Line diagram 906 is first shown in the angle of astigmatism that
was determined in the axis determination test described with
reference to FIG. 9A, and has alternating parts 902 and 904,
similar to those described above with reference to FIG. 9A. As
confirmed previously during the test described with reference to
FIG. 9A, the line diagram 906 should appear as a different color
than the alternating parts 902 and 904. In the example where
alternating parts 902 and 904 are green and red, respectively, the
line diagram 906 at the axis of astigmatism for the patient being
tested should appear yellow to the patient.
[0143] The system presents the line diagram 906 to one uncorrected
eye of a patient at a time. In one embodiment, the system
automatically increases the size (i.e. length and/or width) of the
alternating parts 902 and 904 until the patient makes an input
indicating that they can see the colors of the alternating parts
again. The patient is enabled to make fine-tuning inputs to change
the size of the alternating parts until the size where they can
first see the alternating colors. In an embodiment where line
diagram 906 first appears yellow to a patient even though parts 902
and 904 are green and red, respectively, the patient would make an
input when they begin to see the green and red parts 902 and 904
again. In another embodiment, the system does not automatically
change the size of the alternating parts, and enables the patient
to make inputs corresponding to all size changes.
[0144] In another embodiment, the system begins by inserting space
between the alternating parts 902 and 904 until the patient makes
an input indicating that they can see the colors of the alternating
parts again. The patient is enabled to make fine-tuning inputs to
change the spacing of the alternating parts until the size where
they can first see the alternating colors. In another embodiment,
the system does not automatically change the spacing of the
alternating parts, and enables the patient to make inputs
corresponding to all spacing changes.
[0145] It should be appreciated by one of skill in the art that the
size and spacing changes can be made in the same test, at the same
time, or sequentially in any order. In one example embodiment, the
size of the alternating parts 902 and 904 changes until the patient
make an input, at which point the system enables the patient to
make fine-tuning inputs affecting the size, spacing, or both of the
alternating parts. In another example embodiment, the spacing of
the alternating parts 902 and 904 changes until the patient make an
input, at which point the system enables the patient to make
fine-tuning inputs affecting the spacing, size, or both of the
alternating parts. The system determines the astigmatism severity,
or cylinder prescription of the patient from the final size and/or
spacing of the alternating parts. The system then repeats the
process for the other uncorrected eye of the patient.
[0146] Referring now to FIGS. 10A and 10B, another embodiment of
the present disclosure is illustrated. FIG. 10A is a screen shot of
an example of an embodiment of the system of the present
disclosure, wherein the system displays a line diagram 1101 and
enables a patient to make at least one input, wherein the at least
one input corresponds to a cylinder measurement. FIG. 10B is a
screen shot of an example of an embodiment of the system of the
present disclosure wherein the figure of 10A is rotatable to align
with the determined axis of a patient's astigmatism.
[0147] In the example embodiment shown in FIGS. 10A and 10B, the
line diagram 1001/1004 is a series of lines, or long thin
rectangles on a solid background. The series of lines includes
lines of different sizes. In the example embodiment shown in FIG.
10A, the lines increase in size as they are view from the top of
diagram 1001 to the bottom of diagram 1001. The rectangles/lines
are made up of alternating parts 1002 and 1003. Alternating parts
1002 and 1003 are different colors, one brighter and the other
duller, similar to the alternating parts 902 and 904 discussed
above. In the embodiment of FIG. 10A, part 1003 has a brighter
background color, while part 1002 has a duller background
color.
[0148] It should be appreciated by one of skill in the art that the
size of the lines or alternating parts, and the spacing between the
lines or the alternating parts may be any suitable amount. For
example, FIGS. 10A and 10B show the lines separated by space, but
the alternating parts of each line are immediately adjacent. In
another example embodiment, the alternating parts may have space
between them and the lines may be immediately adjacent.
[0149] The system presents the line diagram 1001 or 1104 to one
uncorrected eye of a patient at a time. The patient is enabled to
make at least one input to select one or more lines that appear
different in color from the remaining lines. In one example
embodiment where part 1003 is green and part 1002 is red, a line of
alternating parts appears yellow below the cylinder, or astigmatism
severity of the patient's astigmatism. The selection may be
accomplished in any suitable manner, such as by selecting and
clicking a line, or a button representing a line, such as buttons
1000.
[0150] The applicant has surprisingly found that use of a line
diagram, such as line diagrams 1001 and 1004, can be used to
accurately determine the cylinder prescription of a patient.
Because the effect of an astigmatism is to distort, or stretch, a
patient's vision along an axis, when the alternating parts are
stretched to correspond to the severity of the patient's
astigmatism, the patient's eye will once again be able to resolve
the alternating parts in their actual colors. It should be
appreciated by one of skill in the art that if the patient does not
have an astigmatism, the lines will only appear with the
alternating parts in their actual colors.
[0151] Referring now to FIG. 11B, another embodiment of the present
disclosure is illustrated. FIG. 11B is a screen shot of an example
of an embodiment of the system of the present disclosure, wherein
the system displays a concentric semi-circle diagram 1105 and
enables a patient to make at least one input, wherein the at least
one input corresponds to an axis and/or a cylinder measurement.
[0152] In the example embodiment shown in FIG. 11B, the semi-circle
diagram 1105 is a half-circle on a solid background. The
half-circle is made up of alternating parts 1107 and 1108, arranged
into concentric half-circles. Alternating parts 1107 and 1108 are
different colors, one brighter and the other duller, similar to the
alternating parts 902 and 904 discussed above. In the embodiment of
FIG. 11B, part 1108 has a brighter background color, while part
1107 has a duller background color.
[0153] The alternating parts 1107 and 1108 may be any suitable
shape or size, with any suitable spacing between them. For example,
in FIG. 11B, the alternating parts 1107 and 1108 are concentric
curved rectangular slices which make up the semi-circle of diagram
1105, without any space between the parts. It should be appreciated
by one of skill in the art that two or more alternating parts may
be used. In the example embodiment of FIG. 11B, the semi-circle
diagram 1105 is divided into wedges by radii lines 1009. It should
be appreciated that radii lines can be placed at any suitable
angular distance from each other, such as at 1, 2, 5, 10, or 30
degrees, or at other degree increments. It is preferable that the
angular distance be evenly divisible into 180 degrees. As shown in
FIG. 11B, the radii lines 1009 are placed 20 degrees apart.
[0154] The system presents the semi-circle diagram 1105 to one
uncorrected eye of a patient at a time. The patient is enabled to
make at least one input to select one or more wedges that looks
different in color from the remaining wedges. The selection may be
accomplished in any suitable manner, such as by selecting and
clicking a wedge, or a button representing a wedge, such as buttons
1106.
[0155] The applicant has surprisingly found that use of a
semi-circle diagram, such as semi-circle diagram 1105, can be used
to determine the axis prescription of a patient. Because the effect
of an astigmatism is to distort, or stretch, a patient's vision
along an axis, at the portion of the semi-circle diagram nearby to
the patient's axis of astigmatism, the alternating parts 1107 and
1108 will blur together and appear as a different color than either
of the parts individually. In one example embodiment where part
1108 is green and part 1107 is red, a portion of a wedge appears
yellow at or near the axis of the patient's astigmatism. It should
be appreciated by one of skill I the art that a greater blurring of
the colors away from the center of the circle diagram, indicates a
more severe astigmatism cylinder measurement. It should be
appreciated by one of skill in the art that if the patient does not
have an astigmatism, none of the portions of the wedges will appear
to change color.
[0156] Referring now to FIG. 12B, another embodiment of the present
disclosure is illustrated. FIG. 12B is a screen shot of an example
of an embodiment of the system of the present disclosure, wherein
the system displays a spoke diagram 1205 and enables a patient to
make at least one input, wherein the at least one input corresponds
to a gross axis measurement.
[0157] In the example embodiment shown in FIG. 12B, the spoke
diagram 1205 is a series of lines, or long thin rectangles on a
solid background, arranged as radii lines on a half-circle dark
background 1209. In the example embodiment shown in FIG. 12B, the
lines are approximately the same size. The rectangles/lines are
made up of alternating parts 1207 and 1208. Alternating parts 1207
and 1208 are different colors, one brighter and the other duller,
similar to the alternating parts 902 and 904 discussed above. In
the embodiment of FIG. 12B, part 1207 has a brighter background
color, while part 1208 has a duller background color.
[0158] The system presents the spoke diagram 1205 to one
uncorrected eye of a patient at a time. The patient is enabled to
make at least one input to select one or more lines that appear
different in color from the remaining lines. In one example
embodiment where part 1207 is green and part 1208 is red, a line of
alternating parts appears yellow at or near the axis of the
patient's astigmatism. The selection may be accomplished in any
suitable manner, such as by selecting and clicking a line, or a
button representing a line, such as buttons 1206.
[0159] Referring now to FIG. 11A, another embodiment of the present
disclosure is illustrated. FIG. 11A is a screen shot of an example
of an embodiment of the system of the present disclosure, wherein
the system displays fine spoke diagram 1002, which is a smaller
angular portion of spoke diagram 1205, and enables a patient to
make at least one input, wherein the at least one input corresponds
to a fine axis measurement.
[0160] In the example embodiment shown in FIG. 11A, the spoke
diagram 1102 is a series of lines, or long thin rectangles on a
solid background, arranged as radii lines on a portion of a
half-circle dark background. In the example embodiment shown in
FIG. 11A, the lines are approximately the same size. The
rectangles/lines are made up of alternating parts 1103 and 1104.
Alternating parts 1103 and 1104 are different colors, one brighter
and the other duller, similar to the alternating parts 902 and 904
discussed above. In the embodiment of FIG. 11A, part 1104 has a
brighter background color, while part 1103 has a duller background
color.
[0161] The system presents the spoke diagram 1102 to one
uncorrected eye of a patient at a time. The patient is enabled to
make at least one input to select one or more lines that appear
different in color from the remaining lines. In one example
embodiment where part 1104 is green and part 1103 is red, a line of
alternating parts appears yellow at or near the axis of the
patient's astigmatism. The selection may be accomplished in any
suitable manner, such as by selecting and clicking a line, or a
button representing a line, such as buttons 1101. It should be
appreciated by one of skill in the art that the fine spoke diagram
1102 represents the portion of the gross spoke diagram 1205 which
the patient previously selected as appearing different in color
from the other portions of the diagram. It should further be
appreciated that fine spoke diagram 1102 uses smaller angular
increments between the radii lines to provide a more accurate
angular axis determination. In another example embodiment, the
patient may first select a wedge from the semi-circle diagram 1105,
then use the fine axis diagram 1102 to fine tune the axis
determination. In such example, the angular portion used in diagram
1102 would correspond to the wedge section or sections selected by
the patient as appearing different from the remainder of the wedges
in 1105.
[0162] The applicant has surprisingly found that use of a spoke
diagram, such as spoke diagrams 1102 and 1205, can be used to
accurately determine the axis prescription of a patient. Because
the effect of an astigmatism is to distort, or stretch, a patient's
vision along an axis, at the portion of the spoke diagram nearby to
the patient's axis of astigmatism, the alternating parts 1103 and
1104 of diagram 1102, and parts 1207 and 1208 of diagram 1205 will
blur together and appear as a different color than either of the
parts individually. It should be appreciated by one of skill in the
art that if the patient does not have an astigmatism, none of the
lines will appear to change color. It will further be appreciated
that any suitable sizing, spacing or shape of alternating parts may
be used so long as they are along the various axes.
[0163] Referring now to FIG. 12A, another embodiment of the present
disclosure is illustrated. FIG. 12A is a screen shot of an example
of an embodiment of the system of the present disclosure, wherein
the system displays line diagram 1201, and enables a patient to
make at least two inputs, wherein the at least two inputs
correspond to a cylinder measurement.
[0164] In the example embodiment shown in FIG. 12A, the line
diagram 1201 is a line, or a long thin rectangle on a solid dark
background. The rectangle/line is made up of alternating parts 1202
and 1203. Alternating parts 1202 and 1203 are different colors, one
brighter and the other duller, similar to the alternating parts 902
and 904 discussed above. In the embodiment of FIG. 12A, part 1202
has a brighter background color, while part 1203 has a duller
background color.
[0165] The applicant has surprisingly found that when a patient
with astigmatism views a diagram like 1201, they will see a
doubled-line, or two lines, instead of the single line presented in
the diagram. The applicant has further surprisingly found that the
amount of distance between the two appearing lines corresponds to
the cylinder measurement of the patient. It should be appreciated
that a patient without an astigmatism will only see the single
line.
[0166] The system displays the line diagram 1201 to one uncorrected
eye of a patient at a time. The patient is enabled to make at least
two inputs to select the edge of a first appearing line and to
select the edge of the second appearing line, as shown by arrows
1200 and 1204 in FIG. 12A. In this way, the patient is identifying
the distance between the two appearing lines. The patient is also
enabled to select that they only see one line, indicating that they
do not have an astigmatism, or that the size of the alternating
parts is above their cylinder axis. In such an example, the system
may re-present the diagram 1201 with smaller alternating parts. The
selection of beginning and ending points of the two-appearing lines
may be accomplished in any suitable manner.
[0167] Referring now to FIG. 13, another embodiment of the present
disclosure is illustrated. FIG. 13 is a screen shot of an example
of an embodiment of the system of the present disclosure, wherein
the system displays line diagram 1304, and enables a patient to
make at least one input, wherein the at least one input corresponds
to a cylinder measurement.
[0168] In the example embodiment shown in FIG. 13, the line diagram
1304 is a line, or a long thin rectangle on a solid background,
wherein the width and height of the line increases when viewed from
left to right. The rectangle/line is made up of alternating parts
1301 and 1302. Alternating parts 1301 and 1302 are different
colors, one brighter and the other duller, similar to the
alternating parts 902 and 904 discussed above. In the embodiment of
FIG. 13, part 1302 has a brighter background color, while part 1301
has a duller background color. It should be appreciated that any
suitable arrangement of differently sized lines is appropriate. For
example, the width and height of the line may decrease from left to
right, or the line may be oriented vertically (or at any angle
relative to horizontal) as opposed to horizontally. In another
example, there may be space between the differently sized line
segments. In the example embodiment shown in FIG. 13, there is no
space between the differently sized line segments.
[0169] The system displays the line diagram 1304 to one uncorrected
eye of a patient at a time. The patient is enabled to make at least
one input to select one or more line segments that appear different
in color from the remaining lines. In one example embodiment where
part 1302 is green and part 1301 is red, a line segment of
alternating parts appears yellow below the cylinder, or astigmatism
severity of the patient's astigmatism. The selection may be
accomplished in any suitable manner, such as by selecting and
clicking a line segment, or a button representing a line segment,
such as buttons 1303.
[0170] The applicant has surprisingly found that use of a line
diagram, such as line diagram 1304, can be used to accurately
determine the cylinder prescription of a patient. Because the
effect of an astigmatism is to distort, or stretch, a patient's
vision along an axis, when the alternating parts are stretched to
correspond to the severity of the patient's astigmatism, the
patient's eye will once again be able to resolve the alternating
parts in their actual colors. It should be appreciated by one of
skill in the art that if the patient does not have an astigmatism,
the lines will only appear with the alternating parts in their
actual colors.
[0171] Referring now to FIGS. 14A-D, other embodiments of the
present disclosure are illustrated. FIGS. 14A-D are screen shots of
example embodiments of the system of the present disclosure which
demonstrate that the alternating parts may be of different sizes or
spacing, but still test for the same determination in the
astigmatism severity determination. From FIG. 14A to FIG. 14D, the
spacing between the alternating parts increases. However, so long
as the sizing and spacing is known, each of FIGS. 14A to 14D are
usable by the system.
[0172] Referring now to FIG. 15, another embodiment of the present
disclosure is illustrated. FIG. 15 is a screen shot of an example
of an embodiment of the system of the present disclosure, which
demonstrates that the alternating parts may be of different sizes
or spacing, but still test for the same astigmatism axis
determination. Contrast, for example, FIG. 12B with FIG. 15, which
has larger alternating parts. However, so long as the sizing and
spacing is known, each of FIG. 12B and FIG. 15 are usable by the
system.
[0173] Referring now to FIG. 16, another embodiment of the present
disclosure is illustrated. FIG. 16 is a screen shot of an example
of an embodiment of the system of the present disclosure, which
demonstrates that an astigmatism axis gross determination figure
may be modified in size and shape, and stretched in minor fashion,
and still be usable by the system for determining an axis of
astigmatism for a patient. For example, FIG. 16 shows a slight
horizontal stretch as compared to the perfectly semicircular figure
of FIG. 11B. FIG. 16 also shows, in contrast to FIG. 11B, smaller
alternating parts and a greater number of wedges of the figure
which do not meet at a center point of the semicircular figure.
[0174] In another example embodiment, the system may test or
confirm a patient's astigmatism axis by displaying only certain
axes. For example, the system may display a set of shapes (such as
circles) filled with lines of alternating colors (bright and dull),
as described above. In this example embodiment, all of the lines in
a given circle would be of the same axis, and the lines in the
remaining circles could be at other axes. The system would enable
the patient to make at least one input to select a circle that
appears blurry to each of their uncorrected eyes, tested
individually. For instance, in the case where the bright color is
selected from the green family and the dull color is selected from
the red family, the patient may select the circle that appears
yellow. Based on the at least one input from the patient, the
system can determine or confirm the patient's axis prescription.
For example, in a situation where the test is being given to
confirm a prescription, the system will determine if the
prescription is confirmed by comparing the axis of the patient's
selected circle or circles to the axis it previously determined. If
the axis measurements match or are close, then the prescription is
confirmed. It should be appreciated that any suitable number of
shapes, any suitable number of axes, and any suitable number of
iterations of the test may be utilized by the system to initially
test or to confirm an axis prescription for a patient.
[0175] In another embodiment, the system begins the axis tests by
displaying an object(s), image(s), or figure(s) that appears most
clearly (when viewed with each uncorrected eye of a patient at a
time) for those patients with a 90 degree or 180 degree astigmatism
axis. As is known in the art, the most common astigmatism
orientations are at 90 degrees or 180 degrees. This is caused by
the cornea of a patient's eye not being round, like a softball, but
instead more flattened around the edges, like a football shape. The
most common corneal surface shapes are horizontal and vertical,
yielding the 90 degree or 180 degree axis of astigmatism (sometimes
called "regular astigmatism"). Astigmatism errors in other axes
(sometimes called "irregular astigmatism") are less common, thus,
from a time management perspective, it is best to start from the
most common axes, and test the less common axes only when the
patient's input(s) indicate that they do not have an astigmatism
axis of 90 degrees or 180 degrees. Starting from the most likely
axes will speed up the testing process, which is more convenient
for the patient.
[0176] In such an example embodiment, the system displays
object(s), image(s), or figure(s) that will appear sharper for
patient's with a 90 degree astigmatism (when viewed with each
uncorrected eye of a patient at a time), contrasted with object(s),
image(s), or figure(s) that do not appear as sharp for those
patients. In a further example embodiment, the contrasting
object(s), image(s), or figure(s) are displayed at a 180 degree
axis thereby testing for the 90 degree or 180 degree astigmatism
axis together, which may save time and be more convenient for the
patient. In another example embodiment, multiple iterations of
object(s), image(s), or figure(s) may be displayed, where the first
displayed set includes, for example, a 90 degree axis portion and
other axes portions, and a second set may include a 180 degree axis
portion and other axes portions. In a further example embodiment,
if the patient's input(s) indicate that they do not have an
astigmatism axis of 90 degrees or 180 degrees, the system will test
for an axis in the 45 and 135 degree angles in the manner described
above, or herein. If the patient's inputs still do not indicate
that they have an astigmatism axis of 45 or 135 degrees, the system
may continue testing other axis options in the manner described in
this paragraph or elsewhere in this disclosure. In a still further
example embodiment, if the patient's inputs still do not indicate
that they have an astigmatism axis of 45 or 135 degrees the system
will estimate a determination that the patient does not have an
astigmatism and move on to another portion of the examination.
[0177] In another example embodiment, the system may test or
confirm a patient's cylinder prescription by displaying
spaced-apart shapes. Applicant has surprisingly found that
spaced-apart shapes located along the patient's axis of astigmatism
and spaced correspondingly to the cylinder of the patient (or
higher) will appear to touch when viewed with the patient's
uncorrected eye (each eye individually). For example, the system
may display two or more dots in a grid or any other suitable
pattern, where at least two of the dots we spaced along the
patient's axis of astigmatism. The system would enable the patient
to make at least one input to select or otherwise identify the dots
that appear to each of their uncorrected eyes, tested individually,
to be touching. Based on the at least one input from the patient,
the system can determine or confirm the patient's cylinder
prescription, where the actual distance between the dots that
appear to the uncorrected eye of the patient to be touching
corresponds to a cylinder measurement. For example, in a situation
where the test is being given to confirm a prescription, the system
will determine if the prescription is confirmed by comparing the
cylinder of the patient's selected dots to the cylinder it
previously determined. If the cylinder measurements match or are
close, then the prescription is confirmed. It should be appreciated
that any suitable number of shapes, any suitable number of axes,
any suitable colors, and any suitable number of iterations of the
test may be utilized by the system to initially test or to confirm
a cylinder prescription for a patient. It should further be
appreciated that the spaced apart shapes may be spaced at different
intervals, or that more than one display (with varying intervals
between the shapes) may be used in order to fine tune the cylinder
determination.
[0178] In a further example embodiment where the system tests or
confirms a patient's cylinder prescription by displaying
spaced-apart shapes, the system may display a single shape (i.e., a
triangle) split into multiple pieces, or multiple shapes, where the
pieces/shapes are displayed as separated from each other with blank
space along the patient's already-determined or known axis of
astigmatism. In one example, these spaced apart pieces/shapes are
displayed as same color or wavelength. In another example, the
spaced apart pieces/shapes are displayed as different colors. In
such an embodiment, the system displays the spaced apart
pieces/shapes and iterates the size of the separation until the
patient's inputs indicate that the astigmatism blur of the viewed
pieces/shapes are such that the pieces/shapes appear to be just
touching (when viewed with each uncorrected eye of a patient at a
time). As discussed previously, the system may enable the patient
to make one or more inputs to increase or decrease the spacing
between the pieces/shapes, the system may automatically move the
pieces/shapes and enable the patient to make at least one input to
stop the movement, or a combination of both. As discussed in detail
above, the real difference in spacing between the displayed
figures/shapes when they appear, to the uncorrected eye of a
patient with astigmatism, corresponds to the severity of the
astigmatism (i.e., cylinder). Thus, the system determines a
cylinder measurement from the patient's inputs regarding when the
displayed pieces/shapes appear to be touching.
[0179] It should be appreciated that all the astigmatism
determination tests described with reference to FIGS. 9A through 16
can consist of alternating parts in any suitable shapes, including,
but not limited to the squares and rectangles depicted in the
Figures, and any suitable number or combination of alternating
colors in any suitable color families. It should further be
appreciated that whenever a patient cannot see a color change
relative to the other figures displayed, it may be because of one
of the following issues: (1) the patient does not have an
astigmatism; (2) the size of the displayed alternating parts
corresponds to a higher cylinder error than the patient has; and/or
(3) the diagram is not at the patient's axis of astigmatism. To
address situation (1), the system may enable a patient to make an
input indicating that they do no have an astigmatism. To address
situation (2), the system may decrease the size of the alternating
parts, re-display the diagram, and query the patient again
regarding any perceived color change. To address situation (3), the
system may re-determine the axis by presenting the patient with a
same or with a different axis test.
[0180] Referring now to FIG. 17, another embodiment of the present
disclosure is illustrated. FIG. 17 is a screen shot of an example
of an embodiment of the system of the present disclosure, which
demonstrates a possible configuration for a macular degeneration
test. By using such a test, the system enables a patient to conduct
an examination of the locations in which they have lost a partial
amount or full amount of vision. As is well-known in the art, it is
standard practice for optometrists to test this using a simple grid
on a sheet of paper (lines left to right and top to bottom) with a
marked center. The patient is told to stare at the center with one
eye at a time and draw with a pencil any area that appear
distorted, missing, or otherwise different than the rest. The
optometrist notes in the patient's chart which parts of their
retina are damaged. Such a test is useful for macular degeneration,
where patients lose their central vision, as well as other retinal
issues such as diabetic retinopathy, where specific parts of ones
vision become missing or blurry. In contrast to this prior art
system, the system of the present disclosure is more advanced. The
system displays a figure including a set of curved lines. In the
embodiment shown in FIG. 17, the FIG. 1700 has generally
semicircular curved lines 1702 opening to the right, and a center
region 1704. The system instructs the patient to focus on the
center region with a single uncorrected eye at a time, and enables
the patient to select any lines which appear to have blurry or
missing portions. Alternatively, the system enables the patient to
select the portions of the lines which appear to be blurry or
missing. The system then displays a similar set of curved lines,
but this time with the opening facing some other direction, such as
left. In one embodiment, the second figure is displayed as opening
to the opposite side as the first figure. It should be appreciated
that the orientation of the curved lines may differ in shape or
actual apex angle, and may be any suitable shape or apex angle. The
system increases the intensity of the user-selected lines or parts
of lines and enables the patient to make at least one input
regarding whether their vision is improved in those areas based on
the increase in intensity. In should be appreciated by one of skill
in the art that the at least one input corresponds to a
magnification level for that region of a patient's vision, which
corresponds to a particular location on the patient's retina which
has experienced at least some vision loss. The system may then use
the determined magnification level for lens creation to create a
specific customized lens with precise additional magnification
levels in certain locations to aid in the patient's overall ability
to see throughout their full field of vision. In one embodiment,
the system can be used to keep track of macular degeneration (or
other degenerative vision disease) at home, and monitor changes as
vision changes progress. It should be appreciated by one of skill
in the art that such routine testing is important for those with or
at risk for vision issues as a sudden change or threshold level of
change can be detrimental, and may need physician evaluation
immediately.
[0181] In another example embodiment of a vision loss test, the
system uses straight lines instead of the curved lines described
above with reference to FIG. 17. In one such example embodiment,
the displayed first figure includes vertical lines, and the system
enables the patient to make at least one input to select the line
or lines, or portions of lines that appear distorted or to have
parts missing. The system then displays horizontal lines and
enables the patient to make at least one input to select the line
or lines, or portions of lines that appear distorted or to have
parts missing. It should be appreciated by one of skill in the art
that the lines can be any angle or format, any thickness or color,
and can also be employed with a combination of straight and curved
lines, or a combination of semi-straight or modified lines in any
suitable combination so long as the patient is enabled to identify,
and the system is thus able to determine, the coordinates of the
section(s) on the patient's retina that correlate(s) to missing or
impaired vision. It should further be appreciated that if the
patient-identified lines are of a type of circular distortion or
circular vision loss, a system such as that described above can
easily identify that type and can thus isolate any future changes
in vision loss that differ from the original regions. One such
example of vision loss occurs in those with diabetic changes, or
those with advanced macular degeneration. Traditional vision exams
typically only monitor these changes every six months to a year and
do not allow for a steady progression analysis to take place. In
the system described by the present disclosure, the testing and
analysis can easily and conveniently be done with greater frequency
such that any changes can be detected in a more accurate and
time-sensitive manner. Further, it is contemplated that such
testing results may be stored and accumulated in a generic database
so that the system may compare vision loss data of a specific
patient to that of the general population, by analyzing vision loss
between right and left eye data points of an individual to that of
right and left eye intervals of that of the entire population or
data set of patients stored in the database of the system.
[0182] In an embodiment, the system includes determining the skew,
and thus, quality, of a patient's progressive lenses. Progressive
lenses, also called progressive addition lenses (PAL), progressive
power lenses, graduated prescription lenses, and varifocal or
multifocal lenses, are corrective lenses used in eyeglasses to
correct presbyopia and other disorders. Progressive lenses include
at least two different prescriptions in different parts of the
lens, and a gradient between them. Generally, the progressive
lenses begin with the patient's distance prescription near the top
of the lens and graduate to the addition (or reading glasses) power
prescription near the bottom of the lens. The gradient can be as
smooth or long as is necessary for patient comfort. However, the
progression of the prescriptions in these lenses create regions of
aberration away from the optic axis, causing blur or skew, which
varies in relation to the quality of the lens. The higher the
quality of the lens, the lower the blur, while the lower the
quality of the lens, the higher the blur. Thus, it is advantageous
to inform patients of the blur inherent in progressive lenses, its
causes, and options for decreasing blur and increasing clarity. In
one example embodiment, the system displays a figure. In a further
example embodiment, the displayed figure is a grid of lines,
similar to that shown at reference numeral 408a in FIG. 4A, or that
described above with reference to the optometrist-based prior art
macular degeneration test. It should be appreciated that the system
may fill an entire computerized screen with such a grid, or a
portion of the computerized screen. The system instructs the
patient to view the displayed figure with one corrected eye
(wearing a progressive lens) at a time. The system enables the
patient to make at least one input to identify areas of distortion
or blurriness. It should be appreciated that any suitable method of
user-input may be enabled, such as outlining or drawing with a
cursor, simple point-and-click selection, via a touch screen, via a
remote control, by voice control, or by other known input devices
and methods. The system may then describe the amount of distortion
present in the lens by a simple percentage (i.e. if the patient
selects 5 percent of the blocks as distorted or blurry, they would
have 5% distortion) and advise the patient what reduction in level
of distortion a higher quality lens might yield.
[0183] It should further be appreciated that both the vision loss
test and the progressive lens check test described in the preceding
paragraphs can be employed by the system displaying a simple Amsler
grid image with lines running up and down and left to right and
enabling a patient to select the areas that look blurry or missing
via any suitable input and selection means. It should further be
appreciated at any suitable color combination may be used, such as
black lines on a white background (black-on-white), blue-on-yellow,
blue-on-red, white-on-red, or any other suitable combination of
colors.
[0184] In another example embodiment of the present disclosure, the
system includes a visual field test. Typically, a patient tests
their visual field using a specific machine located in-office at a
doctor visit. The conventional visual field testing machine
operates as follows: a patient places their head against or into a
machine and looks through a viewfinder. The machine tests each eye
individually (by for example, blocking the view of the eye not
being tested) and instructs the patient to focus their eye on a
center dot, and click a button (or other input device) with their
hand to select when they can see a dot being projected into their
field of view through the viewfinder. The machine flashes dots
relatively quickly, and if a patient does not make an input that
they saw a dot, the machine marks the spot associated with that dot
as having some vision loss. Often, the machine will re-test those
areas later, lengthening the process for testing the patient. When
performed at a doctor's office, the test is often difficult and
uncomfortable for a patient to take. Many patients find it
difficult to concentrate for such a long period of time, and
elderly patients often end up falling asleep while taking the test.
Nevertheless, a visual field test is an important diagnostic tool
used for the determination and routine follow up patients with
glaucoma, brain tumors, diabetes, and many other conditions. Thus,
it would be advantageous to provide a visual field test which may
be conducted at a location remote from a doctor's office and
convenient for the patient, such as in the patient's home.
Additionally, at a remote location, the patient may take their time
with test, and pause the test if they become distracted or tired,
thus yielding a more accurate result. In an example embodiment of
the present disclosure, the system includes a visual field test
that a patient is enabled to take at a location remote from a
doctor's office. In such a system, the patient may be instructed to
focus on a central dot (or other shape) as is conventional, or may
be instructed to focus on a cursor present on the computerized
screen. As is typical, the system tests one eye of a patient at a
time while focusing on a location. A weak dot (or other suitable
shape or figure) is displayed on the screen, in an area
corresponding to a part of the patient's visual field, and the
patient is enabled to make at least one input to connote that they
saw the dot. Any suitable input method may be employed by the
system, such as enabling the patient to move their mouse over to
that area the dot appeared to click it, touching the area (if using
a touch-screen device), selecting a button, voice control, or other
suitable methods. If the patient is too slow to make the at least
one input, the system will flash another dot on the computerized
screen and flag that area to re-test or as having some vision loss.
The time interval for displaying the dot on the computerized screen
is generally fast, and may be any suitable amount of time, such as
0.2 seconds. The system enables the patient to make at least one
input to cause the display of the dot to be adjusted (longer or
shorter). Once the system has at least fully tested the locations
in patient's visual field and received any associated inputs from
the patient, it determines the patient's visual field based on
those recorded inputs, and any lack of recorded inputs. The system
may further adjust the light intensity of the displayed shape or
figure, or display the shape or figure in any suitable color or
combination of colors.
[0185] One potential issue with such a system is that a patient may
move during the test (even if instructed not to) which would cause
the location of the dots on the screen to become associated with a
new position on the patient's eye. Thus, the system may include a
method to determine if the patient has moved during the test. One
possible method is to determine and periodically check the location
of the patient's blind spot. As is known in the art, each person
has a physiological blind spot in each eye where the optic nerve
passes through the optic disc of the retina since there are no
light-detecting photoreceptor cells at that location. The blind
spot location may be determined via methods well-known in the art,
such as by displaying two shapes or figures a known distance apart
and instructing the user to cover one eye, look at the shape or
figure opposite that eye, and move their eye closer to or further
from the screen until the shape or figure disappears. The other
side of the blind spot is determined by when the opposite effect
occurs. The system may also periodically display dots in the blind
spot of the patient. If the patient makes at least one input
connoting that they see a dot that should have been in their blind
spot, the system will determine that the test has become inaccurate
and recalibrate based on the new location of the patient. It should
be appreciated that any suitable method of determining whether a
patient has moved may be employed by the system in addition to or
in place of the above-described methods.
[0186] Another potential issue with such a system is that the
patient needs to know how far away from the screen to place their
eye. Thus, the system may include a method to determine how far the
patient needs to be. One possible method is to use the determined
location of the patient's blind spot, as is conventional and
described above. Alternatively, the system may use any suitable
distance calculation method, such as those known in the art or
described herein.
[0187] It should be appreciated by one of skill in the art that a
static question-based system, as opposed to a
dynamically-changing-images-based system, may be utilized by the
system. In an example embodiment of a static question-based system,
the system may display four figures, three identical, and one
different. The system would enable the patient to make at least one
input to identify the different figure. In such a system, the
figures might begin relatively large in size, and as the patient
correctly selects the different figure, the system would steadily
decrease the size of the displayed figures until the patient is no
longer able to correctly select the different figure. It should be
appreciated by one of skill in the art that if the starting size,
the rate of decrease in size, and the number of correct inputs are
known, the system can calculate the appropriate sphere measurement
for the patient's prescription. It should further be appreciated
that any kind of figure may be used, such as letters, numbers or
shapes, that any suitable number of figures greater than one can be
used, such as 2, 3, 4 or more, and that any suitable number of
similar or different figures may be used. For example, the system
may display five figures, three identical and two different. It
should also be appreciated that any suitable input device may be
used, such as clicking via a cursor, mouse, or trackpad, via a
touch screen, via a remote control, by voice control, or by other
known input devices and methods.
[0188] In another embodiment, the system includes the measurement
of the corneal surface of a patient. In such a system, the
patient's eye is illuminated with a series of concentric rings of
any suitable number, such as two, three, four, five, six, or more,
having a known distance between each ring. In one example
embodiment, the rings are each the same known distance apart. In
another example embodiment, at least one ring is a different known
distance apart from its neighboring rings. The illumination of the
patient's eye may occur in any suitable manner, such as via
projection. After the patient's eye has been illuminated, the
system takes a picture of the patient's eye illuminated with the
concentric rings. In an alternative embodiment, the system enables
the patient (or an assistant of the patient) to take the picture
using the system, or using another mode of the patient terminal on
which the system is being used. In another alternative embodiment,
the system instructs the patient (or an assistant of a patient) to
take the picture using a separate camera device, such as may found
in a digital camera, a camera phone, a camera-enabled computer or
tablet, or any other suitable camera device. Applicants have
surprisingly found that the distortion in the spacing between the
concentric rings as they appear illuminated on the eye of a patient
corresponds to the topology of the patient's cornea. In particular,
Applicants have surprisingly found that when the illuminated
concentric rings appear closer together, the corneal structure is
steeper, whereas if the illuminated concentric rings appear further
apart, the corneal structure is flatter. Thus, the system is able
to determine the exact corneal steepness based on the separation
distance between the illuminated corneal rings compared to the
original known separation between the concentric rings. The system
is also able to detect if the patient's cornea has a malformed
surface, such as keratoconus or an injury based on the appearance
of the illuminated concentric rings on the patient's eye.
[0189] In another embodiment the system includes a pupillary
distance measurement module. It should be appreciated by one of
skill in the art that most inner (medial) and outer (lateral)
canthal distances are routinely within a small range around
approximately 3 cm in all cultures, races, and genders, as long as
the individual is of adult age (generally considered to be 18 years
of age or older). Applicants have surprisingly found that, from
this known range, the system can determine the scale of an image,
and thus calculate additional desired distances, such as a
patient's pupillary distance. Once the system has determined the
pupillary distance of the patient from an image of the patient
based, in part upon the scale of the image and the known canthal
ranges, the system may enable the patient to virtually and view
various glasses frames sized to fit the image of their face, and
their determined pupillary distance. In such an embodiment, the
system may display an image of the patient with mock eyeglass
frames displayed over the top of the patient's face, and may enable
the patient to modify the appearance of the frames, for example, by
changing the size, shape, color, material, texture, etc. of the
mock frames. It should be appreciated by one of skill in the art
that other desired facial measurements may be determined by the
system based upon the known canthal distances, and that any other
desired clothing or accessories may be virtually "fit" via the
methods disclosed herein. One of skill in the art should further
appreciate that the methods disclosed herein may be applied outside
of the context of the facial structure to any part of a human or
animal body known to have a standard or approximate standard size,
and thus may be used to virtually browse and "fit" any suitable
type of clothing or accessory, matched to the size of the
underlying image.
[0190] In another example embodiment, the system includes a method
of determining a pupillary distance measurement of a patient
wherein the patient does not need to utilize an outside source of
measurement. Known prior art systems determine distances remotely
by, for example, requesting the patient to take a photograph of
their face, while simultaneously hold up an object of known size
(such as a credit card or other real life object) nearby to their
eyes in order for the system to scale how far apart the patient's
eyes are. However, in the example embodiments of the present
disclosure, the system does not require the use of any real life
object to scale an image of a face because it utilizes average
sizes of an adult eye. In other words, the system utilizes at least
the average canthal distances across all races and genders in order
to determine an average fixed position in real space as described
above. The system then determines the distance between the pupils
of the patient based on an image of the patient (either taken
directly of the individual using a web camera, phone camera, or any
other suitable camera or video device, or taken from a previous
photograph of the patient), scaled according to the canthal regions
of the patient and the determined average canthal distance (at
least in part) to determine the pupillary distance of an patient's
face.
[0191] It should further be appreciated by one of skill in the art
that the above-described pupillary distance module can be used to
calculate other facial characteristics or biometric data which may
be used to uniquely identify an individual. For example, the system
may use the known canthal distance to calculate the face width
and/or height of a patient positioned in any suitable manner, such
as straight-on to the camera, or full or partial profile. It should
be appreciated that biometric data calculated by the system (such
as pupillary distance, or other facial dimensions) may be used by a
camera-enabled device to lock or unlock access to various
applications on the device (or the device itself) based on a
comparison between the biometric data known by the device and the
biometric data of the person sensed by the camera of the device. If
the known biometric data and the sensed biometric data are similar
to a high-enough degree (such as the same, a statistically
insignificant difference apart, or close to the same within a
confidence range) then the device will identify the sensed person
as the known person and allow the sensed person access. It should
be appreciated that such a biometric-based system works because
certain facial proportions and measurements are unique to
individuals. Potential problems with such a system include that a
person unknown to the system may try to trick the system into
authenticating a photograph or video of the known person. The
system would then recognize the biometric data of the photograph or
video and allow access without the known person actually being
present. To avoid these problems, the system may instruct the
person desiring access to blink an eye (or blink either or both
eyes in a random or predetermined combination or pattern). It
should be appreciated by one of skill in the art that any suitable
and system-recognizable facial expression or combination of facial
expressions may be used (e.g. a smile and a wink, sticking a tongue
out, etc.). If the camera-enabled device is also flash enabled, the
system may activate the flash to determine whether there is an
actual person (as opposed to a recording or photograph) present. In
activating the flash, a person would still be visible to the camera
sensor, but the photograph or video would be washed out and
difficult to sense. The system may also sense or detect shadows on
the face (and whether they change) to confirm a real person is
present.
[0192] In a further embodiment, the pupillary distance measurement
system/biometric access system may enable the known person to
access to lock or unlock access to various applications on the
device (or the device itself). In this further embodiment,
different suitable and system-recognizable facial expressions or
combinations of facial expressions may be used to access or quit
out of different applications (or the device itself). For example,
the patient may stick their tongue out to access the device, may
wink the right eye then the left eye to access one application,
such as a mailbox, then may wink the left eye followed by the right
eye to access a second application. It should be appreciated that
these combinations of suitable and system-recognizable facial
expressions may be used as shortcuts to perform actions inside an
application as well as to provide access (or close out of)
applications or the device itself.
[0193] In another embodiment, the system includes an air puff
tonometer test. Such a test may be implemented for a mobile device,
in a stand-alone location, in a kiosk-type setting, or in any
suitable location, such as by utilizing a small and simple
attachable reflexive device that ejects a force of air through a
small tiny opening by methods known in the art. It should be
appreciated by one of skill in the art that the puff of air will be
forced onto the cornea of a human or non-human eye, in order to
measure its intraocular pressure. Such an attachable reflexive
device may include a high powered photographic lens system that
will allow the camera to determine how much the cornea has
flattened in response to the puff of air. In an alternate
embodiment, the system includes a sensor to measure a apushback or
return of air to the sensor after the air has been puffed to the
patient's cornea. It should be appreciated by one of skill in the
art that the sensor is capable of measuring the amount of air
return in both intensity and delay. In such an embodiment, the
system determines the intraocular pressure of the patient based on
the sensor measurements. It should further be appreciated that the
system may utilize more than form of measurement and/or more than
one iteration of measurement to ensure accuracy. In using such a
attachable reflexive device, the patient is enabled to measure
their intraocular pressure in the manner most convenient or
comfortable for the patient.
[0194] In another embodiment the system includes capability to
allow the patient to query a database of eyeglass frames. In one
example embodiment of such a system, the system enables a patient
to photograph eyeglass frames which they like, or which they
already own, and input the image into the system. In a further
embodiment, the system may instruct the patient to take the
photograph of the frames straight on, as well as with one or two
side views of the frames, while the frames are either on or off of
the patient. The system utilize the photograph or photographs to
determine frame characteristics such as size, shape, size, color,
texture, materials, or any other suitable characteristic to query
the database of frames known to the system for matching or similar
frames which the patient may prefer. The system may determine the
characteristics of the photographed frames in any suitable manner,
such as a quick wireframe analysis of the frames on the patient's
face. As disclosed herein, the system is enabled to determine the
necessary dimensions of the patient's face to accurately determine
matching or similar frame selections to display to the patient. In
one example embodiment of such a system, patients may browse frames
at their local optical shops, and take photographs of their
preferred frames, then use the disclosed online, mobile phone
application, or kiosk-based system to purchase a pair of frames
that are close in shape, size, color, or any other characteristic.
In another example embodiment, the system may query the database
based on a picture of someone other than the patient, such as a
picture provided by the patient of someone unknown to the system,
or a picture from a publication, such as a magazine.
[0195] In one example embodiment, the system determines near and/or
far sightedness by observing behavior and using the properties of
nearsighted and farsighted patients. Nearsighted people can see
near things more clearly than they can see things that are farther
away, while farsighted people can see far things more clearly than
they can see nearer things. In an embodiment to test for
nearsightedness and farsightedness, the system can determine which
condition the patient is experiencing by instructing the patient to
view a near image and a far image simultaneously (or near
simultaneously), then enabling the patient to make an input
reflecting which image appears more clearly. In one embodiment, the
near image would be about a foot away from a computerized screen,
such as a computer monitor and the far image would be more distant
than about a foot away, such as an a computerized screen held at
arm's length (such as a smartphone in an extended arm of the
patient). In another embodiment, the near image would be a
computerized screen held at arm's length (such as a smartphone in
an extended arm of the patient) and the far distance can be more
distance that arm's length, such as 6-10 feet away from a
computerized screen, such as a computer monitor, kiosk, or tablet.
Once the patient can view the two images at the different
distances, the system instructs them to make an input regarding
whether they can see some detail of the image. For instance, in an
embodiment where the image is a series of characters, the system
may ask the patient to make an input when they can identify which
character is different from the others, using one uncorrected eye
at a time. The system enables the patient to make at least one
input to reflect the smallest sized image of which they can make
out the system-identified detail by adjusting the sizes of the
images using methods described in detail elsewhere in this
disclosure. The image may be kept the same on both screens
(increased and decreased together) or may be different sizes on
each screen. Based on the patient's inputs regarding the smallest
size image they can see a detail of close and far away, the system
can determine whether the patient is nearsighted or farsighted. In
a further embodiment, the system additionally uses red and green
overlays on the images in order to either increase or decrease
chromatic aberration.
[0196] The near and far distances the system instructs the patient
to use may be based on age. This would be advantageous since
younger people tend to have better near vision than older people,
because as one ages, one loses some of their ability to accommodate
for close reading. Thus, the system takes age into account to yield
a more accurate determination. In one embodiment, the system
determines the positioning of different-aged individuals by using a
visual field. For instance, the system may display a figure with a
portion on the right side of the screen (an "X" for example, when
the patient is testing their uncorrected right eye) and a portion
on the left side of the screen (such as a vertical line). The
patient is instructed to move their eye towards the X, until they
cannot see the vertical line in their peripheral vision. Someone
who is 40 years old will have a vertical line further away from the
X, than say someone who is 20 years old, because the 20 year old
individual must move their head closer to the computer screen
before they can no longer see the X in their peripheral vision.
[0197] In another embodiment, the system includes a sound vibration
ocular pressure sensor to determine the ocular pressure of a
patient. It should be appreciated by one of skill in the art that
such as system is based on the known fact that objects will vibrate
in response to sound waves. Applicants have surprisingly found that
the various types and frequencies of sound waves correlate directly
to the associated vibration that occurs in the cornea based upon
the ocular pressure, and that these vibrations are measurable by a
camera sensor capturing changes in light reflections from a camera
or by a microphone or other suitable sensor that captures the
frequency of the sound reflected back from the pulsated eye. The
system pulsates sound waves in any suitable standard or variable
frequency against the corneal structure of the patient, then
measures the vibration of the cornea to determine the pressure
inside the cornea. Applicants have surprisingly found that changes
in the light reflections from a camera or measured frequency of
reflected sound from a pulsated eye correlate with the vibration in
the cornea based upon the ocular pressure. Applicants have further
surprisingly found that such systems are functional using
ultrasonic sound waves, infrasonic sound waves and/or acoustic
sound waves. In one example embodiment, a combination of infrasonic
and acoustic sound waves are pulsated in various time intervals and
intensities and sound/decibel levels, and the patient's cornea
vibrates in accordance to the various levels and in accordance with
its internal pressure. It should be appreciated by one of skill in
the art that any suitable speaker or device may generate the sound
waves, such as the standard speaker on a cell phone, tablet, or
personal computer.
[0198] In another embodiment, the system includes a high powered
plus lens to isolate hyperopia and hyperopic prescriptions. This
lens may be included or simulated in any suitable application, such
as in a personal computer application, a mobile phone application,
or in a kiosk-based application. It should be appreciated by one of
skill in the art that a high powered plus lens enables the system
to correct for latent hyperopia, as well as isolate the patient
from using their eye muscles' natural accommodative ability to
focus through a slightly incorrect prescription, thus enabling the
system to provide a more accurate prescription.
[0199] In another embodiment, the system includes an additional
method to determine the distance between the patient and the
computerized screen of the patient terminal, or other desired
distances, such as pupillary distance. The system relies upon the
known canthal distance of the adult patient and an additional data
point to calculate the distance between the terminal or camera and
the patient. The additional data point can be any suitable data
point, such as the height of the patient (if the terminal or camera
can see the entire height of the patient), or known camera
specifications of particular device or patient terminal. The system
uses this known information to determine the distance between the
terminal or camera from the patient. In one example embodiment, the
system may know the canthal distance of the patient is
approximately 3 cm, and may determine that on the image of the
patient from a known camera device (such as from a camera of known
manufacture) that canthal distance is represented by a certain
number of pixels, then the system may, from these known points,
identify the scale of the image of the patient, and thus the
distance between terminal or patient. In an alternative embodiment,
the system uses (or instructs the patient to use one or more of)
two camera devices separated vertically or horizontally by a known
distance to measure the desired distance (distance between the
patient and the camera devices, or some other desired distance). It
should be appreciated by one of skill in the art that such a system
may also be used to determine pupillary distance.
[0200] It should be appreciated that each of the disclosures above
may be implemented in a kiosk-type system, either singly,
individually, or in combination with several kiosks, to provide a
complete eye examination to evaluate various parts of the eye and
refractive system. Examples of various types of known systems which
may be incorporated into such a system include: an eye pressure
measurement system, a photographing system for the photographing
the front and/or back of the eye, a refraction system, and a system
to measure all ancillary tests of an eye exam. In one example
embodiment, the system includes a distance range finder to
determine the distance a patient moves their eye away from a
screen, and enables the patient to make a input at the distance
they first notice an image being sharp with each individual eye. It
should be appreciated that in such an embodiment, the test will be
done with each eye independently, and any suitable number of times,
such as one time, two times, three times, or more. The systems
determines a portion of a prescription for the patient based on
these one or more tests, and based in part on the principle that
the focal point of an eye corresponds to the dioptric power error
of an eye, in that the measurement of initial close focus is
1/distance, where distance is in meters. It should be appreciated
that such a system operates without the need to for the patient to
move their footing position away from their current position.
[0201] In another example embodiment, the system is embedded into a
kiosk-based structure, enabling the patient to undergo any of the
testing/diagnostics described herein in any location that the kiosk
is located in, which may be any suitable location including
locations in or nearby to an eyeglasses and/or contacts retail
location, an generic retail location, such as a shopping mall or
store front, an optometrist or ophthalmologist's office, another
type of doctor's office, nearby to Department of Motor Vehicles or
Secretary of State facilities, or any other location. It should be
appreciated by one of skill in the art that an advantage to a
kiosk-based system in accordance with the present disclosure would
be that such as system would not need to utilize any lens
assemblies in order to refract the patient. The kiosk could
therefore be completely lens free in order to determine a
refractive prescription for a patient. This would save the kiosk
manufacturer or operator both money and effort in development, as
well as bulkiness and complexity in the overall structure. The
kiosk-based system may include any of the features described
herein, in any suitable combination or number including a lensless
refraction system, eye health testing, biometric testing, a system
to grind lenses, a system to print of frames, etc. One of skill in
the art should appreciate that a greater number of features may
provide increased convenience to the patient, for example, if the
system could refract a patient, generate a corrective lenses
prescription, and provide the patient with the prescribed
corrective lenses in a one-stop location and time period. It should
further be appreciated by one of skill in the art that a
kiosk-based system would be unique from an in-home lensless
experience (as also described herein), for several reasons,
including because of functionality described above which would not
be practicable in an -in-home setting (such as lens grinding or
frame printing) or because it could require smaller distances (and
space requirements) by use of a conventional mirror arrangement as
is well-known in the art. Mirror arrangements of this sort are
routinely used in doctors' offices to simulate 20 feet when, in
fact, most offices only have less than 12 feet of total distance
available due to the high cost of rent or to maximize exam
rooms.
[0202] In another further embodiment, the system is an all-in-one
corrective lenses production device that will determine the
patient's prescription in the manners described herein, and enables
a patient to select a glasses frame and a type, color and coating
for a lens, as is known in the art. The system will then create the
frame while the patient waits via a 3D printer or other known
methods, and create the lens with a gel-type system that creates
the lens and hardens the lens while the patient waits, or by any
other method which is known in the art for the creation of lenses.
An entire system in accordance with this embodiment advantageously
provides convenience for the patient, as it contains the three
necessary components to finalize a pair of spectacles: a
prescription, a frame, and lenses.
[0203] It should be appreciated by one of skill in the art that for
various modules or portions of the present disclosure which do not
require input from a patient, or which are not subjective in
nature, the patient may be any suitable patient. For example, the
patient may be non-human, such as a pet or a wild animal. In
another example, the patient may be of an age or ability level
which makes communication difficult, such as a child or a
developmentally delayed person. It should further be appreciated
that for such patients, the system may instruct an assistant to the
patient on proper positioning and any necessary inputs.
[0204] In another embodiment, the system determines the former
spectacle eyeglasses prescription (myopic, hyperopic, astigmatic,
or any combination thereof) of a patient without requiring a
written prescription copied into a fillable form by the patient.
The system requires only a camera, a computerized screen, and a
pair of spectacle lenses. The patient places the camera lens a
known distance from a computer monitor. In one example embodiment,
an easy way to set or determine the known distance is to use a
standard piece of paper (8.5.times.11 inches) to select the
placement of the camera device and/or the computerized screen. In
one embodiment, the system instructs the patient to place the
camera device 11 inches (or some other distance) from the
computerized screen. In another example embodiment, the patient
selects the distance between the camera device and the computerized
screen and the system enables the patient to input the selected
distance. Once the camera device has been placed a known distance
from the computerized screen, the patient takes a control picture
of the computerized screen, then places one of the spectacle lenses
against the camera lens and takes a second picture of the
computerized screen. The patient then places the other of the
spectacle lenses against the camera lens and takes a third picture
of the computerized screen. The computerized screen may display any
suitable high-contrast figure, such as a grid or spaced dots. The
system receives the control picture, first lens picture, and second
lens picture from the camera device via methods for data transfer
that are well known in the art, such as though a wired connection
(usb, firewire, thunderbolt, etc.), wireless connection (bluetooth,
etc.), or via cellular data or internet connections. It would be
appreciated by one of skill in the art that placing the spectacle
lens over the camera lens will distort, or change, the visual
appearance of figure displayed by the system on the computerized
screen. Applicants have surprisingly found that by measuring the
amount and direction of distortion of the first and second pictures
from the control picture over a known distance, the system is able
to determine the prescription of the first and second spectacle
lenses without a written prescription document.
[0205] In another example embodiment the system utilizes a screen
that is able to focus its light rays in more than one direction,
and at various points in space, such that it is able to
specifically focus light rays within a designated small space to
make for a more optimal viewing location. This display unit will
therefore allow a patient to see an image in focus, regardless of
their vision correction, because the display will aim the rays
towards the patient and can adjust in real time the rays of light
and their position for the user.
[0206] In a further embodiment, the system determines both cylinder
and axis measurements of a patients' refractive error for each eye
at a time by using a single figure on a screen. The patient is
enabled to view the figure (using one uncorrected eye at a time)
and is enabled to input to the system the extent and reach of the
patients' perception of any doubling or overlap effect. It should
be appreciated by one of skill in the art that any suitable way of
measuring or inputting the doubling or overlap effect can be
utilized, such as by expanded or concentric additional figures, or
by enabling the patient to place markers where at the outer bounds
of the perceived doubling or overlap effect. It should further be
appreciated that any suitable figure may be used by the system such
as a simple shape, symbol, icon. Applicants have surprisingly found
that the perceived doubling or overlap effect corresponds to the
axis (by demonstrating the angle the astigmatism causes distortion
along) and cylinder (by demonstrating the extent of the astigmatism
distortion) measurements of the patient.
[0207] In another embodiment, the system can determine either an
astigmatism cylinder or axis by displaying a spinning symbol and
enabling a patient to view the spinning figure with one uncorrected
eye at a time and make an input when the figure appears as a single
figure without any residual doubling or overlap effect. It should
be appreciated that any suitable figure may be used by the system
such as a simple shape, symbol, icon. Applicants have surprisingly
found that the disappearance of the doubling or overlap effect
caused by an astigmatism corresponds to the axis (by demonstrating
the angle the astigmatism causes distortion along) and cylinder (by
demonstrating the extent of the astigmatism distortion)
measurements of the patient.
[0208] In another further embodiment, a system may enable a patient
to undergo an additional number of examinations after their initial
examination. In one example embodiment, at least one of the
additional examinations is performed by the patient using their
corrected eyes based on the prescription determined by the system
in their initial examination. The system may use the additional
number of examinations to refine the correlation of tests performed
by the system to the most accurate measurement of the patient's
prescription.
[0209] In an embodiment, the system includes determining any
particular areas of a patient's vision loss or reduction throughout
their full field of vision. In one example embodiment, the system
displays a figure. In a further example embodiment, the displayed
figure is a grid of lines, similar to that shown at reference
numeral 408a in FIG. 4A. The system instructs the patient to view
the displayed figure with one uncorrected eye at a time, and look
to or at a center point of the figure. The center point of the
figure may be marked or otherwise identified. The system then
enables the patient make at least one input to select areas in the
figure which appear distorted, missing, or otherwise different than
the rest. The system can use this at least one input to further
test the areas of vision loss by either magnifying those certain
spots of vision loss, or altering their shapes or intensities to
determine if the patient can notice vision improvement. The patient
continues to look to or at the center of the figure while the
system adjusts at least one of the shape, intensity, color, or
other suitable characteristic of each identified area of vision
loss. The system enables the patient to make at least one input per
previously-identified area of vision loss to connote one or more of
the following: (i) the adjustment helped to make the area more
clear/less distorted, (ii) the adjustment did not help to make the
area more clear/less distorted, (iii) the adjustment made the area
clear and not distorted, and (iv) the area is still missing,
blurry, or distorted despite the adjustment. The system may then
iteratively adjust at least one of the shape, intensity, color, or
other suitable characteristic of each identified area of vision
loss and again enable the patient to make one or more of the four
above-identified inputs. This iterative process may continue until
each identified area has been adjusted to appear clear and not
distorted to the uncorrected eye of the patient, wherein the
adjustment to size, intensity, or other characteristic of each area
corresponds to a magnification of a particular location of a
spectacle lens. In one example embodiment, the adjustment
correlates to the base curve of the lens at that particular
location. As an example, if the patient was found to have no
distance prescription, but the system identified two areas of
vision loss that needed increased magnification with 2 levels of
increase (diopters), an example base curve modification would be -4
diopters on the back curve of the lens, and +4 diopters on the
front, but +6 curve on the areas that need 2 levels of
magnification. This is because a lens has two curved surfaces
affecting the vision of the wearer: the front surface and the back
surface. The corrective power of a lens is determined by adding the
front curve to the back curve. This is expressed by the equation:
F1+F2=FTotal. Applicants have surprisingly found that adjusting a
figure to correct for vision loss in particular areas correlates to
base curve measurements for the corresponding locations of a
spectacle lens. Possible applications of the above-described system
include aiding those patients with macular degeneration, glaucoma,
diabetic retinopathy, or other retinal diseases which cause loss of
some or all vision in certain locations.
[0210] In a further embodiment, the system includes grinding or
laser-cutting custom lenses based on the results and prescriptions
of the tests described herein. As is well-known in the art,
spectacle lenses may be made of glass or plastic, such as
lightweight polycarbonate plastic, CR-39 plastic, or high index
plastic lenses. Lenses are generally started as "blanks," which are
already cut to an approximate base curve/power and need only to be
fine tuned to the prescription of each patient. These "blank"
lenses are then conventionally processed by grinding and polishing,
or laser cutting, edging, and coating. In one embodiment, the
system grinds lenses for a patient who has an especially narrow or
wide astigmatism angles. In another embodiment, the system grinds
lenses with different base curve (diopter) values in different
locations to correct for vision loss in those particular areas from
diseases such as macular degeneration, glaucoma, diabetic
retinopathy, or other retinal diseases. It should be appreciated
that such a lens would magnify or minify some parts of patient's
sight to adjust for the patient's weakness in parts of their
eyesight. In a further embodiment, the transitions between the base
curve changes are smooth (as they are in no-line bifocal
lenses).
[0211] The present disclosure contemplates a variety of different
systems each having one or more of a plurality of different
features, attributes, or characteristics. It should be appreciated
that a "system" as used herein refers to various configurations of:
(a) one or more central servers, central controllers, or remote
hosts; and/or (b) one or more patient terminals, such as desktop
computers, laptop computers, tablet computers or computing devices,
personal digital assistants (PDAs), mobile telephones such as smart
phones, kiosk devices, and other mobile or stationary computing
devices.
[0212] For brevity and clarity, unless specifically stated
otherwise, "patient terminal" as used herein represents one patient
terminal or a plurality of patient terminals, and "central server,
central controller, or remote host" as used herein represents one
central server, central controller, or remote host or a plurality
of central servers, central controllers, or remote hosts.
[0213] As noted above, in various embodiments, the system includes
a patient terminal in combination with a central server, central
controller, or remote host. In such embodiments, the patient
terminal is configured to communicate with the central server,
central controller, or remote host through a data network or remote
communication link.
[0214] In certain embodiments in which the system includes a
patient terminal in combination with a central server, central
controller, or remote host, the central server, central controller,
or remote host is any suitable computing device (such as a server)
that includes at least one processor and at least one memory device
or storage device. As further described below, the patient terminal
includes at least one processor configured to transmit and receive
data or signals representing events, messages, commands, or any
other suitable information between the patient terminal and the
central server, central controller, or remote host. The at least
one processor of that patient terminal is configured to execute the
events, messages, or commands represented by such data or signals
in conjunction with the operation of the patient terminal.
Moreover, the at least one processor of the central server, central
controller, or remote host is configured to transmit and receive
data or signals representing events, messages, commands, or any
other suitable information between the central server, central
controller, or remote host and the patient terminal. The at least
one processor of the central server, central controller, or remote
host is configured to execute the events, messages, or commands
represented by such data or signals in conjunction with the
operation of the central server, central controller, or remote
host. It should be appreciated that one, more, or each of the
functions of the central server, central controller, or remote host
may be performed by the at least one processor of the patient
terminal. It should be further appreciated that one, more, or each
of the functions of the at least one processor of the patient
terminal may be performed by the at least one processor of the
central server, central controller, or remote host.
[0215] In certain such embodiments, computerized instructions for
controlling any screens, displays, or interfaces displayed by the
patient terminal are executed by the central server, central
controller, or remote host. In such "thin client" embodiments, the
central server, central controller, or remote host remotely
controls screens, displays, or interfaces displayed by the patient
terminal, and the patient terminal is utilized to display such
screens, displays, or interfaces and to receive one or more inputs
or commands. In other such embodiments, computerized instructions
for controlling screens, displays, or interfaces displayed by the
patient terminal are communicated from the central server, central
controller, or remote host to the patient terminal and are stored
in at least one memory device of the patient terminal. In such
"thick client" embodiments, the at least one processor of the
patient terminal executes the computerized instructions to control
screens, displays, or interfaces displayed by the patient
terminal.
[0216] In certain embodiments in which the system includes a
patient terminal configured to communicate with a central server,
central controller, or remote host through a data network, the data
network is a local area network (LAN) in which the patient terminal
is located substantially proximate to the central server, central
controller, or remote host. In one example, the patient terminal
and the central server, central controller, or remote host are
located in an eyeglasses and/or contacts retail location. In
another example, the patient terminal and the central server,
central controller, or remote host are located in an optometrist's
or ophthalmologist's office.
[0217] In other embodiments in which the system includes a patient
terminal configured to communicate with a central server, central
controller, or remote host through a data network, the data network
is a wide area network (WAN) in which the patient terminal is not
necessarily located substantially proximate to the central server,
central controller, or remote host. For example, the customer
terminal is located: (a) in an area of an eyeglasses and/or
contacts retail location different from an area of the eyeglasses
and/or contacts retail location in which the central server,
central controller, or remote host is located; or (b) in a
eyeglasses and/or contacts retail location different from the
eyeglasses and/or contacts retail location in which the central
server, central controller, or remote host is located. In another
example, the central server, central controller, or remote host is
not located within a eyeglasses and/or contacts retail location in
which the patient terminal is located. In still another example,
the customer terminal is located: (a) in an area of an
optometrist's or ophthalmologist's office different from an area of
the optometrist's or ophthalmologist's office in which the central
server, central controller, or remote host is located; or (b) in an
optometrist's or ophthalmologist's office different from the
optometrist's or ophthalmologist's office in which the central
server, central controller, or remote host is located. In another
example, the central server, central controller, or remote host is
not located within an optometrist's or ophthalmologist's office in
which the patient terminal is located. It should be appreciated
that in certain embodiments in which the data network is a WAN, the
system includes a central server, central controller, or remote
host and a customer terminal each located in a different eyeglasses
and/or contacts retail location in a same geographic area, such as
a same city or a same state. It should be appreciated that systems
in which the data network is a WAN are substantially identical to
systems in which the data network is a LAN, though the quantity of
patient terminals in such systems may vary relative to one
another.
[0218] In further embodiments in which the system includes a
patient terminal configured to communicate with a central server,
central controller, or remote host through a data network, the data
network is an internet or an intranet. In certain such embodiments,
an internet browser of the computer terminal is usable to access an
internet page from any location where an internet connection is
available. In one such embodiment, after the internet page is
accessed, the central server, central controller, or remote host
identifies a patient prior to enabling that player to enter any
data or participate in any tests. In one example, the central
server, central controller, or remote host identifies the patient
by requiring a patient account of the patient to be logged into via
an input of a unique username and password combination assigned to
the patient. It should be appreciated, however, that the central
server, central controller, or remote host may identify the patient
in any other suitable manner, such as by validating a patient
tracking identification number associated with the patient; by
validating a unique patient identification number associated with
the patient by the central server, central controller, or remote
host; or by identifying the patient terminal, such as by
identifying the MAC address or the IP address of the internet
facilitator. In various embodiments, once the central server,
central controller, or remote host identifies the patient, the
central server, central controller, or remote host enables the
entry of any patient data and the participation in any tests, and
displays those tests and screens, displays and interfaces via the
internet browser of the patient terminal.
[0219] It should be appreciated the system of the present invention
may be implemented via any suitable method, such as any computer
readable medium. In one embodiment, the computer readable medium is
software embedded in a website. In another embodiment, the computer
readable medium is software on a non-transitory medium, such as a
CD-ROM, storage in local memory at the patient terminal, or the
like. In another embodiment, the system is provided in an
application programming interface ("API") which may be individually
licensed to third parties to include in their websites or other
media.
[0220] It should be appreciated that the central server, central
server, or remote host and the patient terminal are configured to
connect to the data network or remote communications link in any
suitable manner. In various embodiments, such a connection is
accomplished via: a conventional phone line or other data
transmission line, a digital subscriber line (DSL), a T-1 line, a
coaxial cable, a fiber optic cable, a wireless or wired routing
device, a mobile communications network connection (such as a
cellular network or mobile internet network), or any other suitable
medium. It should be appreciated that the expansion in the quantity
of computing devices and the quantity and speed of internet
connections in recent years increases opportunities for patients to
use a variety of patient terminals to participate in eye tests from
an ever-increasing quantity of remote sites. It should also be
appreciated that the enhanced bandwidth of digital wireless
communications may render such technology suitable for some or all
communications, particularly if such communications are encrypted.
Higher data transmission speeds may be useful for enhancing the
sophistication and response of the display and interaction with
players.
[0221] It should be appreciated that any suitable patient terminal
would be acceptable, so long as the features of the terminal are
known by the system. Preferably, the system includes a terminal
with a resolution of 800.times.600 DPI, a second terminal (such as
a smart phone-type device) with an input device (such as touch
sensing capabilities), and with the ability to run a web browser.
Moreover, any suitable space may be used to conduct the testing.
Preferably the testing space would be a room with at least 15 feet
of linear walking space and the ability to darken the room by
dimming lights or closing blinds/curtains. It should be appreciated
that these system recommendations are merely recommendations to
make the system easier to use and more convenient for the patient,
but that any suitable space or device may be used.
[0222] It should be appreciated by one of skill in the art that the
static (i.e. non-dynamic) figures and diagrams described above with
reference to the figures are also capable of being used in the form
of physical media, such as paper, poster, plastic, or other printed
forms. In such embodiments, the physical media may be displayed to
the patient at any suitable location, such as at their home, at an
office, or at a corrective lenses retail establishment. The
physical media may be view by the patient alone, or may be viewed
with the assistance of one or more other persons, such as an
assistant or doctor. Further, in such embodiments, the results may
be entered into a terminal as described above for the determination
of the appropriate prescription measurements.
[0223] It should be understood that various changes and
modifications to the presently preferred embodiments described
herein will be apparent to those skilled in the art. Such changes
and modifications can be made without departing from the spirit and
scope of the present subject matter and without diminishing its
intended advantages. It is therefore intended that such changes and
modifications be covered by the appended claims.
* * * * *