Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
  • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
  • A61B3/103—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for determining refraction, e.g. refractometers, skiascopes
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
  • A61B3/02—Subjective types, i.e. testing apparatus requiring the active assistance of the patient
  • A61B3/06—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing light sensitivity, e.g. adaptation; for testing colour vision

Definitions

• Method and eye test device for determining the need for a visual aid in the dark and / or at dusk, and a set of vision aids
• the invention relates to a method and a vision test device for eliminating the need for a vision aid in the dark and / or dusk, and a set of vision aids comprising spectacle lenses and / or contact lenses.
• Defective eyesight is generally corrected with spectacle lenses or contact lenses in order to improve visual performance, i.e. the goodness of seeing - to increase.
• the optimum refractive values such as sphere, cylinder and axis of the spectacle lens or the contact lens, are determined in a subjective or objective measurement process.
• Refractive measuring methods are known, e.g. Wavefront detection from US Pat. No. 6,511,180 B1, which not only allow the values of the sphere, cylinder and axis already mentioned above to be determined, but also higher-order imaging errors.
• the effects of higher order aberrations depend on the opening of the eye pupil.
• the size of the pupil opening is, among other things, influenced by the brightness of the environment, medication, the age and diseases of the examined persons.
• the pupil opening in daylight fluctuates between 2.5 and 3.5 mm in healthy adults. It decreases with age.
• the pupil opening increases with decreasing luminance and the effects of higher-order errors increase.
• a vision test system is known in which optotypes are generated by means of a light emitting screen. This arrangement is able to influence the light coming from the screen in such a way that optotypes or parts thereof can only be seen by one eye or by both eyes. Variations in the luminance and contrast of the screen should make it possible to determine the sensitivity to contrast and the adaptation behavior. However, a method for specifically determining the need for night glasses is not disclosed. From EP 0 830 838 A2, a vision test device for subjectively tweaking the twilight vision is known, which has a number of optotypes to be switched into the beam path and a glare light source in a closed housing.
• the daytime visual acuity or graded visual acuity can also be determined as a variant under twilight conditions.
• a connection between the determined daytime visual acuity and twilight visual acuity is not drawn here.
• the respective test person and also the optician are left alone in their assessment of the determined values. There is no determination of higher-order errors, the effects of which increase, particularly in the dark.
• the task is solved by measuring the ametropia at least at a value of high luminance> 10cd / m 2 and at night at least one value of low luminance ⁇ 10cd / m 2 is measured.
• the difference between daytime and nighttime ametropia is then determined and, if a defined value is exceeded, the recommendation to use a visual aid in the dark and / or dusk is issued.
• the specified method can also be used to determine the ametropia and to subsequently inform the test person of the determined values.
• the test person can also be recommended glasses for the day.
• the test person can be fitted with day and night glasses or only day glasses or only night glasses.
• the ametropia is preferably measured at a value of high luminance> 10 cd / m, in particular in the range from 10 3 cdm 2 to 10 5 cd / m 2 .
• the specified range corresponds to the brightness that a person in Central Europe is normally exposed to during the day. This covers both sunny and cloudy days.
• luminances can be selected that are adapted to the respective external circumstances.
• the ametropia is determined.
• the respective ametropia can be determined with several luminances and then the ametropia can be determined by suitable averaging.
• the sphere can be averaged purely arithmetically and the cylinder can be averaged ve torially.
• Night vision is preferably measured at a value of low luminance ⁇ 10 " cd / m 2 , in particular in the range from 10 " 2 cd / m 2 to IQ "5 cd / m 2.
• the range can be selected so that it is on
• the average range of luminance levels to which, for example, a driver is exposed at night, possibly even at dusk, can be determined for this purpose, so that strong dusk, illuminated streets in the dark and deep black night can be detected.
• the night vision deficiency is determined for at least one value in this area of the luminous intensity.
• the respective ametropia can also be averaged for several luminance levels and the night vision deficiency can then be determined by suitable averaging.
• the ametropia during the day and at night can each be carried out with an objective measurement, e.g. a wavefront measurement can be determined.
• a subjective measurement is conceivable, e.g. using optotypes.
• optotypes to create a better contrast ratio with inverse optotypes, i.e. bright optotypes on a dark background, in particular optometers made of LED. Good refraction values can only be achieved with high contrast.
• the daytime and / or the nighttime ametropia can preferably be determined by means of waveform analyzes. It is also conceivable that the ametropia is determined using the auto-refractory method. For example, the daytime ametropia can be measured both by the wavefront analysis and by the autoref actuator method. If different daily ametropia are determined for a test person, they can select the subjectively best result. It can be provided according to the invention to determine the spherical values for the day and night ametropia. The cylinder and the axes can also be determined. Furthermore, higher-order errors, in particular spherical aberration, coma and / or three-leaf errors, can be determined.
• the daytime ametropia is measured first and then the nighttime ametropia. Of course, this process is also reversible. With every measurement it should be ensured that the pupils have adapted to the respective luminance.
• the pupil sizes can be measured in particular as a function of the luminance used.
• the recommendation for using a visual aid in the dark includes a suggestion and / or an offer for suitable spectacle lenses and / or contact lenses.
• the recommendation of a visual aid for correcting the night vision deficiency is issued if at least one of the following difference values is exceeded when determining the difference between day and night vision deficiency: a. for spherical values> l A dpt, b. for the cylinder values> l A dpt, c. for axis change> 7 °, d. for the middle sphere> X A dpt,
• the axis change depends on the cylinder change.
• the middle sphere is defined as "sphere + Vz cylinder".
• "> l A dpt" provided for a, b, and / or d "> Vi dpt” can also be provided, for example.
• a recommendation can be made not only when the ametropia gets worse at night, but also when it has improved. Because wearing an excessively adjusted visual aid can also lead to irritation when looking.
• test person can immediately experience the difference between day and night glasses. This can significantly increase the willingness to wear different glasses at night and thus reduce the dangers in traffic.
• provision can be made to determine the ametropia with different values of high luminance by averaging.
• Night vision deficiency can also be determined by averaging at different values of low luminance.
• the inventive the test person's eye test device to visualize their possible ametropia in the dark, show an image, e.g. an eye chart, a landscape image, an image of a nighttime freeway.
• This image first shows the sharpness that the test person can achieve in the dark with their "normal day glasses". Therefore, this picture is more or less blurry for many test persons.
• Test subjects who have normal vision in daylight can alternatively see an image that has the sharpness that the test subject can achieve in the dark without glasses. Here too, many test subjects will have to show a blurry picture.
• test subjects are then shown the same image with the better sharpness that they can achieve with night vision glasses. In this way, even distrust test subjects who consider second glasses to be unnecessary can be persuaded to buy such glasses, at least for safety reasons, when driving.
• different metrics can be used to measure the night vision.
• different metrics such as Strehl ratio of the point spread function (PSF), entropy of the PSF, enclosed energy of the PSF, modulation transfer function (MTF), the ametropia are determined.
• PSF point spread function
• MTF modulation transfer function
• the respective ametropia is measured at different attenuation levels. This can be integrated into the recommendation for the use of the visual aid in such a way that test persons are recommended to wear a first pair of glasses during the day, a second pair at dusk and a third pair at night. An even finer gradation may be useful for certain professions.
• the object is achieved in that a wavefront detector is provided for measuring day and night vision deficiency and for
• an evaluation unit is provided, which the values of day and night ametropia are recorded and, if a defined value is exceeded, the recommendation for the use of a visual aid in the dark is given.
• the output can take place, for example, on a display or on a printer.
• the recommendation can consist of a simple "yes” or “no” or specify the exact values for the night glasses and / or day glasses.
• the vision test device can comprise a wavefront detector for objective ametropia determination and / or optotypes for subjective ametropia determination.
• the wavefront detector can not only detect 2nd order visual defects such as spheres, cylinders and axes (SCA), but also higher order visual defects.
• SCA 2nd order visual defects
• elements e.g. Dimmer.
• a device for measuring the pupil size can be provided in the vision test device according to the invention.
• the object is achieved in that a first vision aid is provided to compensate for ametropia in the light and at least a second vision aid to compensate for ametropia in the dark and / or at dusk.
• a set of visual aids can include a first visual aid to compensate for ametropia in the dark, a second visual aid to compensate for an ametropia at dusk and a third visual aid to compensate for an ametropia in the dark.
• the first visual aid can consist of glasses and contact lenses if necessary.
• the second lens can also consist of glasses and contact lenses if required.
• the lenses can be made of glass as well as plastic. It is conceivable to combine the first and second visual aids for optimal vision in the dark. For example, glasses with -2dpt can be provided for the day. At night, however, a test person has -3 dpt. This test person can then put a clip on your glasses. This clip has a lens for removing one or both eyes equal to the remaining ametropia. It is also conceivable to use contact lenses during the day. In the dark, the contact lenses remain on the eye. In addition, glasses are then put on to compensate for the remaining ametropia.
• the respective visual aid can have refractive and / or diffractive structures.
• FIG. 1 schematically shows a preferred method sequence for determining the need for night glasses.
• a vision test device is provided which works by means of the wavefront mode and possibly also by means of the autorefractor mode.
• a test person looks monocularly or binocularly into the vision test device shielded from the ambient light.
• the eye to be examined or both eyes are illuminated. This reduces the pupil to a value of approximately 2-4 mm, for example approximately 3.5 mm.
• the daytime ametropia can be measured.
• the measurement can only take place in the wavefront mode, it can optionally also take place in the autorefractor mode. If necessary, both modes can also be used.
• the values of the daily ametropia for, for example, sphere, cylinder and axis are determined and can be output to the test person, the ophthalmologist, the optician or another person responsible for viewing.
• the night vision is measured. It is also possible to first determine the ametropia and then the daily ametropia. To determine night vision, the test subject's eyes are not or only slightly illuminated. For example, the pupils dilate to 6 mm. A wavefront measurement is used. The values determined for night vision problems can also be output to the test person, the ophthalmologist or another person on site. It is also conceivable not to output the determined values of night vision and or day vision, but to use it only internally to determine the difference from the values for night vision and the values for day vision and if a defined value is exceeded, e.g. for a sphere> 0.5 D to recommend the use of a visual aid in the dark or at dusk.
• a defined value e.g. for a sphere> 0.5 D to recommend the use of a visual aid in the dark or at dusk.

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• Life Sciences & Earth Sciences (AREA)
• Health & Medical Sciences (AREA)
• Medical Informatics (AREA)
• Biophysics (AREA)
• Ophthalmology & Optometry (AREA)
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• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
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• 2004
  • 2004-01-24 DE DE102004003688A patent/DE102004003688A1/de not_active Ceased
  • 2004-12-15 JP JP2006549909A patent/JP2007518500A/ja active Pending
  • 2004-12-15 WO PCT/EP2004/014278 patent/WO2005070285A1/de active Application Filing
  • 2004-12-15 AU AU2004314137A patent/AU2004314137A1/en not_active Abandoned
  • 2004-12-15 CN CNA2004800408903A patent/CN1905834A/zh active Pending
  • 2004-12-15 EP EP04821177A patent/EP1708611A1/de not_active Withdrawn
• 2006
  • 2006-07-12 US US11/484,667 patent/US20070008493A1/en not_active Abandoned

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