EP3403137A1 - Method of manufacturing a pair of spectacle lenses for the improvement of the visual performance in patients with keratoconus, as well as a set of spectacle lenses - Google Patents

Method of manufacturing a pair of spectacle lenses for the improvement of the visual performance in patients with keratoconus, as well as a set of spectacle lenses

Info

Publication number
EP3403137A1
EP3403137A1 EP17717250.9A EP17717250A EP3403137A1 EP 3403137 A1 EP3403137 A1 EP 3403137A1 EP 17717250 A EP17717250 A EP 17717250A EP 3403137 A1 EP3403137 A1 EP 3403137A1
Authority
EP
European Patent Office
Prior art keywords
fitting
eye
glasses
keratoconus
glass
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP17717250.9A
Other languages
German (de)
French (fr)
Inventor
Christiaan Jacobus Hubertus FRAMBACH
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Frambach BV
Original Assignee
Frambach BV
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Frambach BV filed Critical Frambach BV
Publication of EP3403137A1 publication Critical patent/EP3403137A1/en
Pending legal-status Critical Current

Links

Classifications

    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C7/00—Optical parts
    • G02C7/02—Lenses; Lens systems ; Methods of designing lenses
    • G02C7/06—Lenses; Lens systems ; Methods of designing lenses bifocal; multifocal ; progressive

Definitions

  • the invention relates to a method for the manufacture of a pair of spectacle glasses for improving visual acuity in patients with keratoconus not corrected with contact lenses or corrected with hard or soft contact lenses.
  • Keratoconus is an eye condition in which a part of the cornea which is partly in front of the pupil slowly becomes thinner and a cone-shaped deformation (conus) forms at the site of this thinner part.
  • the eye condition starts in puberty and can be progressive until the age of 40. Keratoconus occurs in both eyes but is asymmetrical in gradation. Keratoconus is estimated to occur in one out of 1,500 persons.
  • a keratoconus patient's first symptom is blurred and/or double vision with one eye. With normal refraction with spherical and cylindrical lenses, it is often not possible to correct the blur and the shadowy double images.
  • the best way to correct the visual deficit in keratoconus is with hard contact lenses. Hard contact lenses generally give better correction in keratoconus than a pair of glasses.
  • Hard contact lenses can be corneal, scleral or hybrid contact lenses.
  • One of the symptoms of uncorrected optics with keratoconus is that when looking at optotypes on a letter chart, a typical orientation-specific shadow formation occurs at the inferior part. After correction with glasses or soft contact lenses, this shadow formation at the inferior part of the optotypes remains unchanged. After correction with a hard contact lens, the keratoconus patient has better vision; a smaller typical orientation-specific shadow formation now occurs at the top of the letters.
  • the typical orientation-specific shadow formation on optotypes in the uncorrected keratoconus patient is caused by the fact that the wavefront is deflected more strongly at the location of the conus (see Figure 1).
  • the shadow that occurs after correction with a hard contact lens at the superior part of the letters is caused by the light at the location of the conus travelling a shorter path in comparison with the path of the light in the rest of the pupil (see Figure 2).
  • the path of a wavefront that passes the optical elements of the eye is measured with aberrometry.
  • Zernike polynomials are mathematical representations that describe the errors of the wavefront.
  • Tilt, coma, secondary astigmatism, trefoil and tetrafoil are polynomials that characteristically occur in patients with keratoconus.
  • kits with higher order aberration contact lenses and methods of use is known from US8894208A.
  • This kit of contact lenses comprises two or more contact lenses with a known higher order aberration for each given lens power.
  • the higher order aberration may comprise spherical aberration, a coma aberration or a trefoil aberration.
  • a specialist selects a fitting lens from the kit and applies the fitting lens to the eye of the patient and measures a residual higher order aberration of the lens- eye system. If the residual higher order aberration exceeds a predetermined magnitude, the specialist selects a second fitting lens from the kit, applies the second fitting lens to the eye of the patient and measures the residual higher order aberration of the lens-eye system. This is repeated until the fitting lens is found that yields the best results.
  • a wavefront corrected lens is known that is obtained from measurements with an aberrometer.
  • Zernike polynomials By making use of the Zernike polynomials, it is possible to apply the unique patient-related wavefront to the anterior of the lens using lathe-cut technology.
  • a specialist selects a fitting lens from the fitting set or measures over the already fitted lens, with which the wavefront of the patient is established.
  • the uncorrected higher order aberrations are added as optical correction to the already present basic power.
  • the disadvantage of this system is that the patient has no control over the visual end result; it ignores the adaptation of the patient and the capacity for binocular summation.
  • An objective of the invention is to provide a method for obtaining a pair of spectacle glasses for the improvement of visual acuity in patients with keratoconus not corrected with contact lenses or corrected with hard or soft contact lenses, whereby it is not necessary to use an aberrometer or adaptive optics.
  • the method according to the invention is characterized in that it comprises the following steps:
  • each fitting glass has a positive strength in increasing segment strength and the remaining part has a strength equal to zero and in patients in which keratoconus is not corrected or corrected with soft lenses of each fitting glass one segment has a negative strength In incremental segment strength and the remaining part has a strength equal to zero, which segment is located on the underside of the fitting glass,
  • the most effective fitting glass from the set of fitting glasses for the eye with the least amount of keratoconus by applying different fitting glasses of the set of fitting glasses according to the normal rules of the subjective refraction one by one to that eye, while the patient looks with both eyes to a reference object, whereby the most effective fitting glass is the fitting glass for that eye regarding which the patient says that they can see best with it,
  • the most effective fitting glass from the set of fitting glasses for the eye with the highest degree of keratoconus by applying different fitting glasses of the set of fitting lenses according to the normal rules of the subjective refraction one by one to that eye, while the patient looks with both eyes at the optotypes, and the most effective fitting lens determined earlier is applied in front of the eye with the least amount of keratoconus, whereby the most effective fitting lens is the fitting lens for the eye with the highest degree of keratoconus regarding which the patient states that they can see best with it,
  • the axis of the segment can be determined
  • spectacle glasses manufactured in a manner as described above achieve a greater improvement of vision than if the spectacle glasses have only spherical and cylindrical strengths.
  • Corrections resulting from unilateral measurements with the aid of an aberrometer or adaptive optics take no consideration of adaptation and binocular summation with which the visual acuity is improved by combining information originating from the left and right eyes.
  • determining the right spectacle glasses is not based on aberrometry, but on subjective refraction, bearing in mind adaptation and binocular summation.
  • the amount of correction of higher order aberrations is subjectively determined and is not based on measurements made with an aberrometer, but on characteristic wavefront patterns in patients with keratoconus.
  • the invention also relates to a pair of spectacle glasses manufactured by the method according to the invention.
  • the invention relates to a set of fitting glasses for the improvement of visual acuity in patients with keratoconus corrected with corneal, hybrid or scleral contact lenses.
  • the set of fitting glasses is characterized in that the set of fitting glasses comprises more than two fitting glasses whose segment has a negative strength and the remaining part has a value of zero, which segment is at the bottom of the fitting glass, with the strength of the segment of the pass glasses differing from one another. It has been found that the visual acuity of a keratoconus patient can be improved with a fitting glass with a suitable sector-specific power.
  • a suitable fitting glass can be found for every patient or at least almost every patient. It is noted that a sector with a rounded point has to be understood as belonging to the sector shape referred to above, or a sector that is centred or inclined in order to compensate for the centring or inclination of the contact lens on the eye.
  • a further embodiment of the set of fitting glasses according to the invention is characterized in that the sector extends over an angle between 10 and 180 degrees. Preferably, the sector extends over an angle between 60 and 120 degrees and it is even more preferable that the sector be a quadrant.
  • Figure 1 shows a typical wavefront of the uncorrected vision of a patient with keratoconus
  • Figure 2 shows a typical wavefront of a patient with keratoconus corrected with a hard contact lens
  • Figure 3 shows an embodiment of a fitting glass of the set of fitting glasses according to the invention.
  • Figure 1 shows a typical wavefront of the uncorrected optics of a patient with keratoconus.
  • a part 5 of the cornea 1 of the eye that is located partly in front of the pupil 3 is thinner and forms a cone-shaped projection.
  • the shaded part 7 in the inferior part of the pupil 3 of the keratoconus patient represents a more negative power.
  • Figure 2 shows a typical wavefront of a patient with keratoconus corrected with a hard contact lens 9.
  • the shaded part 10 in the inferior part of the pupil 3 of the keratoconus patient represents a more positive power.
  • Figure 3 shows an embodiment of a fitting lens of the set of fitting lenses according to the invention.
  • the fitting glass 1 1 has a quadrant 13 with a positive power and the remaining part 15 of the front optics is piano (ie strength equal to zero). This quadrant is located at the underside of the fitting glass.
  • a number of such fitting glasses of which the powers of the quadrants differ from each other through increasing power form a set that is used to correct of aberrations resulting from correction with hard contact lenses in patients with keratoconus.
  • the power of the quadrants of the fitting glasses of the set preferably form a series with a fixed ascending degree of difference.
  • the set of fitting glasses is made of fitting glasses with a positive strength segment on the underside and a strength of zero for the rest of the front.
  • the strength of the segment of the fitting glasses increases 0.25 diopters from 0.25 diopters to 6.00 diopters.
  • the procedure is as follows. First, it is determined which of the patient's eyes has the lowest degree of keratoconus. Then, for that eye, according to the normal rules of subjective refraction, first, the spherical value is determined with which the patient can see best, then the most effective fitting glass - the one with which the patient can see best - is determined from the set of fitting glasses by applying different fitting glasses of that set of fitting glasses one by one to that eye while the patient looks with both eyes at optotypes. Thereafter, this is repeated for the other eye of the patient.
  • a spectacle glass is manufactured for each eye with a strength equal to that of the spherical fitting glass which is best seen with that eye and which has a segment with a strength equal to the sum of the strength of the segment of the selected most effective fitting glass for that eye and the strength of the spherical fitting glass that is best seen with that eye.
  • the invention may, for example, also relate to a method for the manufacture of a pair of spectacle glasses for improving visual acuity in patients with keratoconus corrected with soft contact lenses instead of hard contact lenses. In that case, the sectors of the fitting glasses must have a more negative power.

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  • Health & Medical Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Physics & Mathematics (AREA)
  • General Health & Medical Sciences (AREA)
  • General Physics & Mathematics (AREA)
  • Optics & Photonics (AREA)
  • Eyeglasses (AREA)

Abstract

In a method for the manufacture of a pair of spectacle glasses for the improvement of visual acuity in patients with keratoconus corrected with hard or soft contact lenses, use is made of a set of fitting glasses of which a sector at the underside of the fitting glass has a more positive or negative power. First, it is determined which of the patient's eyes has the lowest degree of keratoconus. Then, according to the normal rules of the subjective refraction, first, the best spherical glass is determined and then, from the set of fitting glasses, the most effective fitting lens is determined by applying different fitting lenses of that set of fitting lenses according to the method one by one to that eye while the patient looks with both eyes at optotypes. During the refraction the other eye can be branded. Then, a spectacle glass is manufactured for each eye with a power equal to that of the fitting glass chosen that has a sector with a power equal to the sum of the power of the sector of the selected fitting glass and the power of the spherical fitting glass.

Description

Method of manufacturing a pair of spectacle lenses for the improvement of the visual performance in patients with keratoconus, as well as a set of spectacle lenses
BACKGROUND OF THE INVENTION: Field of the invention
The invention relates to a method for the manufacture of a pair of spectacle glasses for improving visual acuity in patients with keratoconus not corrected with contact lenses or corrected with hard or soft contact lenses.
Keratoconus is an eye condition in which a part of the cornea which is partly in front of the pupil slowly becomes thinner and a cone-shaped deformation (conus) forms at the site of this thinner part. The eye condition starts in puberty and can be progressive until the age of 40. Keratoconus occurs in both eyes but is asymmetrical in gradation. Keratoconus is estimated to occur in one out of 1,500 persons. A keratoconus patient's first symptom is blurred and/or double vision with one eye. With normal refraction with spherical and cylindrical lenses, it is often not possible to correct the blur and the shadowy double images. Generally, the best way to correct the visual deficit in keratoconus is with hard contact lenses. Hard contact lenses generally give better correction in keratoconus than a pair of glasses.
Contact lenses fitted in patients with keratoconus have a special geometry that spares the superior part of the conus as much as possible. Hard contact lenses can be corneal, scleral or hybrid contact lenses.
One of the symptoms of uncorrected optics with keratoconus is that when looking at optotypes on a letter chart, a typical orientation-specific shadow formation occurs at the inferior part. After correction with glasses or soft contact lenses, this shadow formation at the inferior part of the optotypes remains unchanged. After correction with a hard contact lens, the keratoconus patient has better vision; a smaller typical orientation-specific shadow formation now occurs at the top of the letters.
The typical orientation-specific shadow formation on optotypes in the uncorrected keratoconus patient is caused by the fact that the wavefront is deflected more strongly at the location of the conus (see Figure 1). The shadow that occurs after correction with a hard contact lens at the superior part of the letters is caused by the light at the location of the conus travelling a shorter path in comparison with the path of the light in the rest of the pupil (see Figure 2).
The path of a wavefront that passes the optical elements of the eye is measured with aberrometry. Zernike polynomials are mathematical representations that describe the errors of the wavefront. Tilt, coma, secondary astigmatism, trefoil and tetrafoil are polynomials that characteristically occur in patients with keratoconus.
The reduction of visual acuity in young keratoconus patients starts unilaterally. This reduction, at the beginning of the disease, occurs gradually, with adaptation partially compensating for the decrease in unilateral visual acuity. Keratoconus patients confirm the monocular visual simulation by aberrometers. However, the binocular perception does not match. Binocular summation compensates (partially) for the asymmetrical blurring, resulting in better visual acuity. In persons with large quantities of uncorrected higher order aberrations, the binocular summation ratio can improve the contrast sensitivity values by a factor of 1.4. In practical terms, this means that patients with keratoconus binocularly experience less shadowy double images. This also means, however, that full correction of the aberrations, achieved by unilateral measurements with the help of the aberrometer or adaptive optics of a patient with keratoconus does possibly not yield the best correction. This correction can also overlook the adaptation that a patient with keratoconus has already undergone for the specific blurring. Patients with normal eyes looking through the simulated perspective of a keratoconus patient have poorer visual acuity than the keratoconus patient with the same optical characteristics. With complete correction executed with measurements through aberrometry or adaptive optics, it is possible that the desired correction may not be achieved because binocular summation that is controlled from the visual cortex is overlooked. Through adaptation to the specific blurring of keratoconus and the presence of improvement of visual acuity through binocular summation, subjective refraction may be a better method for achieving a correction of the most bothersome wavefront errors.
Prior art A kit with higher order aberration contact lenses and methods of use is known from US8894208A. This kit of contact lenses comprises two or more contact lenses with a known higher order aberration for each given lens power. As an example, the higher order aberration may comprise spherical aberration, a coma aberration or a trefoil aberration. A specialist selects a fitting lens from the kit and applies the fitting lens to the eye of the patient and measures a residual higher order aberration of the lens- eye system. If the residual higher order aberration exceeds a predetermined magnitude, the specialist selects a second fitting lens from the kit, applies the second fitting lens to the eye of the patient and measures the residual higher order aberration of the lens-eye system. This is repeated until the fitting lens is found that yields the best results.
The disadvantage of this known method is that it requires an aberrometer that is not present in every ophthalmological practice.
From US2013297015A a wavefront corrected lens is known that is obtained from measurements with an aberrometer. By making use of the Zernike polynomials, it is possible to apply the unique patient-related wavefront to the anterior of the lens using lathe-cut technology. A specialist selects a fitting lens from the fitting set or measures over the already fitted lens, with which the wavefront of the patient is established. The uncorrected higher order aberrations are added as optical correction to the already present basic power. The disadvantage of this system is that the patient has no control over the visual end result; it ignores the adaptation of the patient and the capacity for binocular summation.
Summary of the invention
An objective of the invention is to provide a method for obtaining a pair of spectacle glasses for the improvement of visual acuity in patients with keratoconus not corrected with contact lenses or corrected with hard or soft contact lenses, whereby it is not necessary to use an aberrometer or adaptive optics. To this end, the method according to the invention is characterized in that it comprises the following steps:
providing a set of more than two fitting glasses, whereby for the improvement of visual acuity in patients with keratoconus corrected with hard contact lenses, of each fitting glass one segment has a positive strength in increasing segment strength and the remaining part has a strength equal to zero and in patients in which keratoconus is not corrected or corrected with soft lenses of each fitting glass one segment has a negative strength In incremental segment strength and the remaining part has a strength equal to zero, which segment is located on the underside of the fitting glass,
determining which eye of the patient has the lowest degree of keratoconus and is thus the better eye,
determining the optimal spherical strength according to the normal rules of the subjective refraction, followed by
determining the most effective fitting glass from the set of fitting glasses for the eye with the least amount of keratoconus by applying different fitting glasses of the set of fitting glasses according to the normal rules of the subjective refraction one by one to that eye, while the patient looks with both eyes to a reference object, whereby the most effective fitting glass is the fitting glass for that eye regarding which the patient says that they can see best with it,
determining the axis of the segment for which a kc glass can be used,
patient and refractionist are well aware that one looks through the optical center of the glasses during the refraction,
determining the optimal spherical strength of the other eye,
determining the most effective fitting glass from the set of fitting glasses for the eye with the highest degree of keratoconus by applying different fitting glasses of the set of fitting lenses according to the normal rules of the subjective refraction one by one to that eye, while the patient looks with both eyes at the optotypes, and the most effective fitting lens determined earlier is applied in front of the eye with the least amount of keratoconus, whereby the most effective fitting lens is the fitting lens for the eye with the highest degree of keratoconus regarding which the patient states that they can see best with it,
with a kc-glass the axis of the segment can be determined,
manufacturing a spectacle glass for each eye of the patient with a power equal to that of the fitting glass with which that eye has the greatest acuity, and that has a sector with a power equal to the sum of the power of the sector of the selected most effective fitting glass for that eye and the power of the spherical fitting glass with which that eye has the greatest acuity. It has been found that spectacle glasses manufactured in a manner as described above achieve a greater improvement of vision than if the spectacle glasses have only spherical and cylindrical strengths. Corrections resulting from unilateral measurements with the aid of an aberrometer or adaptive optics take no consideration of adaptation and binocular summation with which the visual acuity is improved by combining information originating from the left and right eyes. In the method according to the invention, determining the right spectacle glasses is not based on aberrometry, but on subjective refraction, bearing in mind adaptation and binocular summation. In the method according to the invention, the amount of correction of higher order aberrations is subjectively determined and is not based on measurements made with an aberrometer, but on characteristic wavefront patterns in patients with keratoconus.
The invention also relates to a pair of spectacle glasses manufactured by the method according to the invention.
Further, the invention relates to a set of fitting glasses for the improvement of visual acuity in patients with keratoconus corrected with corneal, hybrid or scleral contact lenses. As far as the set of fitting glasses is concerned, the invention is characterized in that the set of fitting glasses comprises more than two fitting glasses whose segment has a negative strength and the remaining part has a value of zero, which segment is at the bottom of the fitting glass, with the strength of the segment of the pass glasses differing from one another. It has been found that the visual acuity of a keratoconus patient can be improved with a fitting glass with a suitable sector-specific power. By having a set of fitting glasses at one's disposal from which the most suitable fitting glass can be chosen, a suitable fitting glass can be found for every patient or at least almost every patient. It is noted that a sector with a rounded point has to be understood as belonging to the sector shape referred to above, or a sector that is centred or inclined in order to compensate for the centring or inclination of the contact lens on the eye.
A further embodiment of the set of fitting glasses according to the invention is characterized in that the sector extends over an angle between 10 and 180 degrees. Preferably, the sector extends over an angle between 60 and 120 degrees and it is even more preferable that the sector be a quadrant. Brief description of the drawings
Below, the invention will be explained in more detail on the basis of drawings in which embodiments of a fitting glass of the set of fitting glasses and the method according to the invention are shown. In these drawings:
Figure 1 shows a typical wavefront of the uncorrected vision of a patient with keratoconus;
Figure 2 shows a typical wavefront of a patient with keratoconus corrected with a hard contact lens; and
Figure 3 shows an embodiment of a fitting glass of the set of fitting glasses according to the invention.
Detailed description of the drawings
Figure 1 shows a typical wavefront of the uncorrected optics of a patient with keratoconus. A part 5 of the cornea 1 of the eye that is located partly in front of the pupil 3 is thinner and forms a cone-shaped projection. The shaded part 7 in the inferior part of the pupil 3 of the keratoconus patient represents a more negative power.
In addition, Figure 2 shows a typical wavefront of a patient with keratoconus corrected with a hard contact lens 9. Here, the shaded part 10 in the inferior part of the pupil 3 of the keratoconus patient represents a more positive power.
Figure 3 shows an embodiment of a fitting lens of the set of fitting lenses according to the invention. The fitting glass 1 1 has a quadrant 13 with a positive power and the remaining part 15 of the front optics is piano (ie strength equal to zero). This quadrant is located at the underside of the fitting glass. A number of such fitting glasses of which the powers of the quadrants differ from each other through increasing power form a set that is used to correct of aberrations resulting from correction with hard contact lenses in patients with keratoconus. The power of the quadrants of the fitting glasses of the set preferably form a series with a fixed ascending degree of difference.
The set of fitting glasses is made of fitting glasses with a positive strength segment on the underside and a strength of zero for the rest of the front. The strength of the segment of the fitting glasses increases 0.25 diopters from 0.25 diopters to 6.00 diopters. With this set of fitting glasses, a pair of spectacle glasses can be made to improve visual performance in patients with keratoconus already corrected with hard contact lenses.
The procedure is as follows. First, it is determined which of the patient's eyes has the lowest degree of keratoconus. Then, for that eye, according to the normal rules of subjective refraction, first, the spherical value is determined with which the patient can see best, then the most effective fitting glass - the one with which the patient can see best - is determined from the set of fitting glasses by applying different fitting glasses of that set of fitting glasses one by one to that eye while the patient looks with both eyes at optotypes. Thereafter, this is repeated for the other eye of the patient.
In patients in whom keratoconus is corrected by hard contact lenses, fitting lenses with quadrant specific more positive power than the remainder of the anterior optics should be used.
After that, a spectacle glass is manufactured for each eye with a strength equal to that of the spherical fitting glass which is best seen with that eye and which has a segment with a strength equal to the sum of the strength of the segment of the selected most effective fitting glass for that eye and the strength of the spherical fitting glass that is best seen with that eye.
Although in the above the invention is explained on the basis of drawings, it should be noted that the invention is in no way limited to the embodiment shown in the drawings. The invention also extends to all embodiments deviating from the embodiment shown in the drawings within the context defined by the claims. The invention may, for example, also relate to a method for the manufacture of a pair of spectacle glasses for improving visual acuity in patients with keratoconus corrected with soft contact lenses instead of hard contact lenses. In that case, the sectors of the fitting glasses must have a more negative power.

Claims

CLAIMS:
1. Method for the manufacture of a pair of spectacle glasses for improving visual acuity in patients with keratoconus not corrected with contact lenses or corrected with hard or soft contact lenses:
providing a set of more than two fitting glasses, whereby for the improvement of visual acuity in patients with keratoconus corrected with hard contact lenses, of each fitting glass one segment has a positive strength in increasing segment strength and the remaining part has a strength equal to zero and in patients in which keratoconus is not corrected or corrected with soft lenses of each fitting glass one segment has a negative strength In incremental segment strength and the remaining part has a strength equal to zero, which segment is located on the underside of the fitting glass,
determining which eye of the patient has the lowest degree of keratoconus and is thus the better eye,
determining the spherical value for the eye with the least amount of keratoconus by applying different strengths according to the normal method of subjective refraction for this eye while the patient looks at optotypes with both eyes, whereby the most effective spherical glass for the eye is used to prosecute the refraction with the fitting glasses of said set of pass glasses,
determining the most effective fitting glass from the set of fitting glasses (11) for the eye with the least amount of keratoconus by applying different fitting glasses of the set of fitting glasses according to the normal rules of the subjective refraction one by one to that eye, while the patient looks with both eyes to optotypes, whereby the most effective fitting glass is the fitting glass for that eye regarding which the patient says that they can see best with it,
determining the spherical value for the eye with the highest amount of keratoconus by applying different strengths according to the normal method of subjective refraction for this eye while the patient looks at optotypes with both eyes, whereby the most effective spherical glass for the eye is used to prosecute the refraction with the fitting glasses of said set of pass glasses,
determining the most effective fitting glass from the set of fitting glasses for the eye with the highest degree of keratoconus by applying different fitting glasses of the set of fitting lenses according to the normal rules of the subjective refraction one by one to that eye, while the patient looks with both eyes at the optotypes, and the most effective fitting lens determined earlier is applied in front of the eye with the least amount of keratoconus, whereby the most effective fitting lens is the fitting lens for the eye with the highest degree of keratoconus regarding which the patient states that they can see best with it; during the refraction the eye with the smallest degree of keratoconus can be bombarded,
prior to and / or after determining the most effective fitting glass according to the rules of normal subjective refraction, by holding different spherical fitting glasses with different powers for each eye to determine the base power of the spectacle glasses to be manufactured, the best base power being the power of the spherical fitting glass with which the best can be seen with that eye, and
manufacturing a spectacle glass for each eye of the patient with a power equal to that of the fitting glass with which that eye has the greatest acuity, and that has a sector with a power equal to the sum of the power of the sector of the selected most effective fitting glass for that eye and the power of the spherical fitting glass with which that eye has the greatest acuity.
2. A pair of spectacle glasses manufactured by the method according to claim 1.
3. A set of fitting glasses for the improvement of visual acuity in patients with keratoconus corrected with hard contact lenses, characterized in that the set of fitting glasses comprises more than two fitting glasses (11) whose segment (13) has a positive strength and the remaining part (15) has a value of zero, which segment is at the bottom of the fitting glass, with the strength of the segment (13) of the pass glasses differing from one another.
4. A set of fitting glasses for the improvement of visual acuity in patients with keratoconus corrected with soft contact lenses or not corrected with contact lenses, characterized in that the set of fitting glasses comprises more than two fitting glasses (11) whose segment (13) has a negative strength and the remaining part (15) has a value of zero, which segment is at the bottom of the fitting glass, with the strength of the segment (13) of the pass glasses differing from one another.
5. A set of fitting glasses according to claim 3 or 4, characterized in that the sector (13) extends over an angle between 10 and 180 degrees.
6. A set of fitting glasses according to claim 5, characterized in that the sector extends over an angle between 60 and 120 degrees.
7. A set of fitting glasses according to claim 6, characterized in that the sector (13) is a quadrant.
EP17717250.9A 2016-01-15 2017-01-14 Method of manufacturing a pair of spectacle lenses for the improvement of the visual performance in patients with keratoconus, as well as a set of spectacle lenses Pending EP3403137A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL2016105A NL2016105B1 (en) 2016-01-15 2016-01-15 Method for manufacturing a pair of spectacle lenses for improving visual performance in patients with keratoconus, as well as a set of fitting glasses.
PCT/NL2017/050019 WO2017123092A1 (en) 2016-01-15 2017-01-14 Method of manufacturing a pair of spectacle lenses for the improvement of the visual performance in patients with keratoconus, as well as a set of spectacle lenses

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Publication Number Publication Date
EP3403137A1 true EP3403137A1 (en) 2018-11-21

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EP (1) EP3403137A1 (en)
NL (1) NL2016105B1 (en)
WO (1) WO2017123092A1 (en)

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB259501A (en) * 1926-05-28 1926-10-14 American Optical Corp Improvements in and relating to ophthalmic lenses
JP4030814B2 (en) * 2002-07-10 2008-01-09 ペンタックス株式会社 Multifocal spectacle lens and manufacturing method thereof
US7735998B2 (en) * 2006-10-25 2010-06-15 Volk Donald A Multi-layered multifocal lens with blended refractive index
US9298021B2 (en) * 2013-08-15 2016-03-29 eyeBrain Medical, Inc. Methods and lenses for alleviating asthenopia

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NL2016105B1 (en) 2017-08-02
WO2017123092A1 (en) 2017-07-20

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