JP2024510104A - System for measuring binocular alignment with adjustable display and eye tracker - Google Patents

Abstract

The system for determining binocular alignment includes: a first display displaying an image to the first eye and operable along a longitudinal direction according to a simulated distance and optical power of the first eye; a first eye tracker assembly that tracks the direction of gaze of the first eye and is horizontally and laterally adjustable to adjust the pupillary distance of the first eye; a second display displaying an image on the second eye and operable along the longitudinal direction according to the simulated distance and optical power of the second eye; a second eye tracker assembly horizontally and laterally adjustable to adjust pupillary distance of the eye; and a computer for determining binocular alignment based on gaze direction. [Selection diagram] Figure 17

Description

(Cross reference to related applications)
This application is filed on September 5, 2017, and is incorporated herein by reference in its entirety. Krall and Aric Plumley, a continuation of U.S. patent application Ser. Jeffrey P., filed in Krall and Aric Plumley, entitled "Method and System for Measuring Binocular Alignment," a continuation-in-part of U.S. Pat. It is something that is claimed.

(Technical field)
FIELD OF THE INVENTION The present invention relates generally to methods and systems for measuring visual acuity, and specifically to measuring binocular alignment.

With normal vision, an individual can focus on objects located at different distances. Ideally, an individual would be able to focus on distant objects, called distance vision, and near objects, called near vision. The eye's optical system uses numerous muscles to change focus between these distances. These muscles adjust various aspects of the eye as it transitions between distance and near vision. Muscular adjustments include subtly changing the shape of the crystalline lens to adjust the focus of the lens, rotating the eyeball to rotate the eye's optical axis, and changing the size of the pupil.

Presbyopia is a natural loss of near vision caused by a loss of flexibility in the eye's crystalline lens as we age. Presbyopia can be partially compensated for by wearing "reading" glasses that correct the refractive error of near vision, so the eye does not have to focus as hard when looking at nearby objects. People with presbyopia require different vision corrections for near vision and distance vision. However, using two glasses and changing them frequently is cumbersome. To avoid having to constantly change glasses, bifocal glasses can be used that provide different vision corrections for near and far vision. The transition between these two visual areas can be abrupt or gradual. Gradual transition glasses are called progressive multifocal lenses (PAL). While abrupt change bifocals have a visible line separating two visual areas, PALs do not have a visible line or edge between areas with different refractive powers.

Despite all of this progress, some types of visual discomfort still exist. One of these discomforts is associated with changing habits in modern digital lifestyles. A large and growing number of professional occupations require workers to spend a large and growing portion of their work time focused on close-range digital interfaces, including computer screens and mobile devices. The same is true in many people's personal lives, especially when they spend time on their cell phones playing video games, sending and receiving text messages, and checking for updates. All of these shifts in work and behavior have sharply increased the amount of time people spend looking at digital screens, devices, displays, and monitors at much closer distances than before. The more time your eyes are trained on near vision images, the more you put undue stress on the muscles associated with near vision, pushing them beyond their comfort zone and often causing muscle strain. This can lead to fatigue, discomfort, pain, or even digitally induced migraines. To date, there is no widespread acceptance of a clear causal mechanism for visual discomfort, pain and migraine associated with these digital devices, even though millions of patients experience these pains every day. There is no consensus. Accordingly, there is a need for eyeglasses or other visual solutions that can provide relief for digital eye discomfort.

U.S. Patent Application No. 15/696,161 U.S. Patent No. 16/579,826

1-4 illustrate the basic problem of binocular misalignment. FIG. 1A shows that vision adjusts in two ways when viewing nearby objects, such as the illustrated cross. First, the optical refractive powers of eyes 1-1 and 1-2 are adjusted to image an object near a distance L onto the retina of each eye. This is often referred to as regulatory response A. Second, rotate the eyes 1-1 and 1-2 inwardly by an angle α, so that the visual axes 2-1 and 2-2 of the eyes are directed toward the same nearby object. This response is often referred to as accommodative vergence AC. For obvious geometrical reasons, the angle α of the accommodative convergence AC with respect to the linear reference axis is directly related to the distance L of the accommodative response A, ie α=α(L). In healthy, well-aligned eyes, the ratio of accommodative convergence AC to accommodative response A, AC/A, is a geometrically well-defined function that varies depending on the object distance L and the pupillary distance PD of the two eyes. It is.

FIGS. 1B-C show that eyes frequently exhibit various forms of accommodative misalignment. In FIG. 1B, each of the two eyes is turned inward, but to a lesser degree than the geometry requires. This means that the accommodative convergence angle α is smaller than what is geometrically required by the misalignment angle β. In particular, the visual axes of eyes 2-1 and 2-2 must be oriented in the direction indicated by the accommodative alignment necessary for proper viewing of nearby objects; rotated inward and instead oriented in what is shown as a relaxed or natural accommodative alignment.

Figure 1C shows the case where this small rotation is asymmetric. In the illustrated case, the visual axis 2-1 of the first eye 1-1 is properly oriented in the direction of the required accommodative alignment, and the visual axis 2-2 of the second eye 1-2 is properly oriented in the direction of the required accommodative alignment. It is rotated inwardly only in the direction of a relaxed or natural accommodative alignment that is misaligned by a misalignment angle β.

Figures 2A-D illustrate several types of accommodative misalignment. The definitions of misalignment used by different schools of optometry and by monographs exhibit some differences, and the techniques for characterizing these misalignments also vary. Accordingly, the definitions illustrated herein are intended to be illustrative only, with analogies and equivalents falling within the scope of the illustrated items.

To place the discussed misalignment in its proper context, we first introduce the concept of fused images. When our two eyes view the same object, each eye generates its own unique visual perception. These perceptions are transmitted from the eyes to the visual cortex, where the brain fuses the two images to generate a three-dimensional (3D) perception of the viewed object. This image fusion can be tested by an optometric diagnostic system. For example, two separate objects of the same shape can be projected separately to the two eyes by means of deflectors, prisms, and mirrors that make it appear as two projections coming from a single object. These visual perceptions will be fused into a single image that is perceived by the brain. Objects projected in this way are called fusible objects and present fusible images.

If in an experiment the distance between the two objects increases, or the deflection angle increases, or the shape of the objects is modified, the projections to the two eyes begin to differ. At a certain distance or difference between objects, the difference between the visual perceptions of the two eyes exceeds a threshold and the brain stops merging the two images into a single perception. Objects with such differences in distance, angle, or shape are called non-fusible objects and present a non-fusible image.

With this preparation, Figures 2A-D illustrate the concept of fixation shift as measured by a test box, often referred to as a mallet box. The mallet box displays two vertically aligned bars and an "XOX" horizontal "anchor". In some implementations, the two bars can be shifted sideways. In other cases, an adjustable mirror or prism is placed in front of the patient's eyes to achieve the same horizontal shift. With suitable selective optics, the anchor and only one of the two bars is shown to the first eye 1-1 as a centrally placed bar 5-1-c, and in addition to the same anchor. The other bar is shown to the second eye 1-2 as a centered bar 5-2-c. The anchors and centrally located bars 5-1-c and 5-2-c are clearly fused. Therefore, a patient's brain without accommodative misalignment problems will fuse these images properly.

FIG. 2B shows that patients with accommodative misalignment do not fuse images properly. A common observation is that the bar is perceived as shifting while the anchor images seen by both eyes are not properly fused into a single image. The first eye 1-1 perceives the shifted bar 5-1-s, and the second eye 1-2 perceives the shifted bar 5-2-s. The angle γ between the line to the center of the image and the visual axes 2-1 and 202 is called the fixation shift.

Figures 2C-D illustrate how to measure the angle required to offset or compensate for fixation misalignment. In the system of Figure 2C, the two bars are countershifted. A countershift bar 5-1-x is shown for the first eye 1-1 and a countershift bar 5-2x is shown for the second eye 1-2. The bars are countershifted until the patient perceives the two bars to be aligned. The angle γ ^* corresponding to these countershifts between the visual axis and the line to the countershifted bar is measured and is more commonly referred to as the concomitant plagiotropy. In the system of Figure 2D, the bars are not countershifted. Instead, an adjustable or replaceable prism 7 is inserted in front of the patient's eye. These prisms are adjusted or replaced until the two bars are perceived as aligned by the patient. The prism angle, or angle of refraction of the refracted visual axis, is then reported as the concomitant tropism γ ^* .

FIG. 3 shows how fixation deviations can be partially compensated for by partially strengthening the partial concomitant tropism. Strictly speaking, the (full) concomitant plagioplasty that completely compensates for the fixation shift is given by the intersection of this curve with the partial concomitant plagioplasty axis. If human vision were a purely optical process, the partially concomitant plagiarism would simply be equal to the negative of the partially compensated fixation shift. Therefore, the curve is a straight line that runs from the top left corner to the bottom right corner and passes through the starting point tilted at -45 degrees. However, FIG. 3 shows that human vision is more complex, and cognition and image processing play an important role in human vision. FIG. 3 shows four types of relationships between partially compensated fixation deviation and partially concomitant tropism. As you can see, none of these lines are straight, none of these lines pass through the origin, and two of them do not intersect the horizontal axis. These Type II and III relationships mean that the amount of partially concomitant tropia cannot fully compensate for fixation deviations. Therefore, many questions remain to determine a concomitant tropism that fully compensates for the patient's fixation deviation. As mentioned in the conclusion by convention, fixation deviation is called "exo" when the eyes do not turn inward as much as necessary, and when the eyes turn too far inward, it is called an "exo". In the case, it is called ``eso (inside)''.

Figures 4A-C illustrate an associated visual misalignment called dissociative plagioplasty. To characterize dissociative dysphoria, an experiment similar to that in Figures 2A-D can be performed, the difference being that instead of showing fusionable images 5-1 and 5-2, the optometrist Non-fusible images 6-1-s and 6-2-s are shown for the eye 1-1 and the second eye 1-2. In FIG. 4A, these non-fusible images are crosses and bars. As FIG. 4B shows, when the eye is unable to fuse images, one or both of the visual axes are often rotated outward. In the illustrated asymmetric case, the visual axis 2-2 of the second eye 1-2 has been rotated outward by an accommodative misalignment angle δ. The angle δ of this outward rotation is measured and is referred to as dissociative plagioplasty. In various applications, the dissociative plagioplasty is equally distributed over the two eyes, so for each eye the dissociative plagiosia is equal to δ/2. In some cases, as shown in FIG. 1C, the dissociative plagioplasty δ can grow itself unequal and must be distributed between the eyes accordingly.

FIG. 4C shows a particularly obvious case, where the field of view of the second eye 1-2 is occluded simply when no image is shown to the second eye 1-2. This is an extreme case of non-fusible images. With respect to FIG. 4B, in response to the block, the visual axis 2-2 of the second eye 1-2 rotates outward by a measurable dissociative oblique angle δ.

The misalignment-impact AC/A ratio is used by some practitioners as a quantitative characterization of accommodative misalignment, including fixation deviation and dissociative tropism. AC/A is the accommodative convergence angle α-δ/2 subtracted by the fixation shift divided by the accommodative distance L, expressed in diopters D, (expressed by the tangent in prism diopters, Δ). A common definition of AC is AC=100 tan (α-δ/2) in prism diopters. For average visual performance, an AC/A ratio of 6-6.5 Δ/D is required, and significantly for large population segments, the average value of the misalignment-impact AC/C ratio is approximately 3. It was measured to be 5Δ/D. Clearly, various forms of accommodative misalignment affect a large percentage of the population, and any progress toward mitigation would be extremely valuable.

A surprising fact in the corresponding field of optometry is that the concomitant and dissociative tropism angles determined by experienced practitioners exhibit a surprisingly wide variation. Experiments performed on the same patient by different optometrists, and sometimes by the same optometrist at different times, report oblique angles Δ expressed in prism diopters, and the distribution has a standard deviation as well as 3Δ. (A prism diopter of 1 Δ corresponds to a 1 cm prism refraction at a distance of 1 meter.) The large variability of these methods precludes effective determination and compensation of accommodative misalignment.

This exceptionally large standard deviation is probably due to several factors. These include: (1) The decision method uses the patient's subjective reactions as key inputs. (2) Some methods use central images, others use peripheral images to determine concomitant plagioplasty. The relative accuracy and relevance of these methods has not yet been conclusively evaluated. (3) Many practitioners use a single measurement, or single method, and therefore do not benefit from the important medical information that could be gleaned from performing multiple tests. (4) In a previous preliminary project, Applicant discovered that the eye's prismatic response was quite different from moving the test image. However, understanding the relationship between optimal prism correction based on static and moving test images is at an early stage. (5) There are several ways to define prism misalignment, and these also generate different prism predictions and diagnostics, ultimately requiring a single prism to be formed into the eyeglass. There is far from obvious way to convert and combine various diagnostically determined prism corrections into a single prism prescription. Applicants are not aware of any significant research evaluating how the effectiveness and variability of prism prescriptions depend on the possible combinations of prism corrections determined.

For all of the above reasons, there remains a pressing medical need to determine the prism power that optimally compensates for accommodative misalignment.

To address the medical needs described above, some embodiments display an image to a first eye and operate longitudinally according to a simulated distance and optical power of the first eye. and a first eye tracker assembly that is adjustable in a horizontal lateral direction to track the direction of gaze of the first eye and adjust the pupillary distance of the first eye. a second display for displaying an image on a second eye and operable along a longitudinal direction according to a simulated distance and optical power of the second eye; a second eye tracker assembly that is horizontally and laterally adjustable to track the gaze direction of the eye and adjust the pupillary distance of the second eye; and a computer for determining alignment.

FIG. 3 illustrates various accommodative misalignments. FIG. 3 illustrates various accommodative misalignments. FIG. 3 illustrates various accommodative misalignments. FIG. 3 illustrates a method for determining the type of accommodative misalignment. FIG. 3 illustrates a method for determining the type of accommodative misalignment. FIG. 3 illustrates a method for determining the type of accommodative misalignment. FIG. 3 illustrates a method for determining the type of accommodative misalignment. FIG. 4 illustrates four types of relationships between fixation deviation and partial concomitant tropia. FIG. 3 illustrates a method for determining dissociative plagioplasty. FIG. 3 illustrates a method for determining dissociative plagioplasty. FIG. 3 illustrates a method for determining dissociative plagioplasty. FIG. 1 illustrates a system for determining binocular misalignment. FIG. 1 illustrates one embodiment of a system for determining binocular misalignment. FIG. 1 illustrates one embodiment of a system for determining binocular misalignment. It is a figure showing an IR image by an eye tracker. FIG. 1 illustrates one embodiment of a system for determining binocular misalignment. FIG. 1 illustrates one embodiment of a system for determining binocular misalignment. FIG. 1 illustrates one embodiment of a system for determining binocular misalignment. FIG. 3 is a diagram showing an embodiment of an adjustment optical system. FIG. 3 is a diagram showing an embodiment of an adjustment optical system. FIG. 3 is a diagram illustrating a method for determining binocular misalignment. FIG. 3 shows exemplary details of a measuring step. It is a figure which shows the step of performing a measurement step. It is a figure which shows the step of performing a measurement step. It is a figure which shows the step of performing a measurement step. It is a figure which shows the step of performing a measurement step. FIG. 6 illustrates example details of a determining step; FIG. 4 is a diagram illustrating steps for performing a determining step. FIG. 4 is a diagram illustrating steps for performing a determining step. FIG. 4 is a diagram illustrating steps for performing a determining step. FIG. 3 illustrates a subequatorial embodiment of a method for determining binocular misalignment. FIG. 1 illustrates a system for determining binocular alignment. FIG. 3 is a diagram showing an embodiment of a first optical unit. FIG. 3 is a diagram showing an embodiment of a first optical unit. FIG. 1 illustrates a system for determining binocular alignment. FIG. 3 is a perspective view showing the first optical unit. FIG. 1 is a front view of a system for determining binocular alignment. FIG. 1 illustrates an embodiment of a system for determining binocular alignment with a graphical user interface and a patient communication interface. FIG. 3 shows an embodiment with an autorefractor. FIG. 1 illustrates an embodiment of a system for determining binocular alignment. FIG. 3 is a diagram showing an embodiment of a first optical unit.

The system described in this patent document addresses at least the above-mentioned related medical needs in the following aspects. (1) The systems and methods described determine prism correction solely through objective measurements, without subjective input from the patient. This aspect alone greatly reduces patient-to-patient and practitioner-to-practitioner variability in results. In fact, studies of large samples of patients using Applicant's systems and methods have determined that prisma correction with standard deviation has been reduced from the 3Δ described above to at best less than 1Δ. This significant reduction in the standard deviation of the results alone establishes the method described herein as a quantitative predictive diagnostic method. (2) The system and method uses both central and peripheral test images for a newly gained understanding of how peripheral and central prism corrections are connected. Accordingly, the described system and method is a promising platform for determining optimal compromise prism formulations that negotiate the best compromise for compensating for both central and peripheral accommodative misalignment. (3) The method described has two stages, thus determining the final prism correction in the second stage by building on the critical misalignment information obtained in the first stage. This method therefore integrates the knowledge determined by various methods and the benefits from information determined by all of these. (4) One of the stages of the method involves moving the test image. Therefore, the final determined prism correction similarly captures and integrates the eye's dynamic prism response. (5) The reliable repeatability and small variability of the extensive studies described above demonstrate that Applicant's method is an objective and valid method for producing a single optimized objective prism correction. A convincing argument was presented for combining the outputs of different methods. The five aspects described herein provide advantages individually and in combination.

5-10 illustrate a system 10 for determining binocular alignment, and FIGS. 11-16 illustrate a corresponding method 100 for determining binocular alignment.

FIG. 5 shows, in some embodiments, a stereo display 20 for the system 10 for determining binocular alignment to project visible images to the first eye 1-1 and the second eye 1-2; Accommodation optical system 30 that corrects the projected visible image according to the apparent distance, eye tracker 40 that tracks the orientation of the first eye 1-1 and second eye 1-2, stereo display 20, accommodation optical system 30 and eye tracker 40, which can include a computer 50 for managing binocular alignment determinations. In the following, the eyes will be labeled as a first eye 1-1 and a second eye 1-2. This labeling can correspond to left and right eyes, or vice versa.

FIG. 6A shows a detailed view of some embodiments of system 10. In some embodiments, the eye tracker 40 includes an infrared emitting device positioned proximate the front of the system 10 to project an infrared eye tracking beam onto the first eye 1-1 and the second eye 1-2. diodes, or IR LEDs, 42-1 and 42-2, as well as infrared light sources 44-1 and 44-2 for illuminating the first eye 1-1 and the second eye 1-2 with infrared imaging light. be able to. Both the infrared eye tracking beam and the infrared imaging light are reflected from eyes 1-1 and 1-2. The eye tracker 40 further includes infrared (IR) telescopes 46-1 and 46-2 with infrared (IR) cameras 48-1 and 48-2, which are connected to the first eye 1-1 and the second eye 1. The infrared eye tracking beam and infrared imaging light reflected from -2 can be detected.

Many of the elements of system 10 are included in pairs, such as infrared telescopes 46-1 and 46-2. For simplicity of illustration, pairs of such elements are indicated only by their initial identifiers to avoid confusion, and are referred to as "IR telescopes 46-1 and 46-2", omitting "IR telescopes 46-1 and 46-2". 46".

FIG. 7 shows the resulting IR image 49 detected or sensed by the IR camera 48. In this embodiment, four IR LEDs 42-1, . ．． ．． 42-4 exists separately. To avoid confusion, the "-1" or "-2" designating a particular eye has been omitted from the description of FIG. "-1" here. ．． ．． The "-4" note indicates four IR LEDs, all projecting an IR eye tracking beam to the same eye. Four IR LEDs 42-1, . ．． ．． 42-4 projects four eye-tracking beams onto the eye, which are reflected from the cornea and form so-called Purkinje spots P1-1, . ．． ．． P1-4 is generated as an IR image 49. The "P1" annotation refers to reflection from the proximal surface of the cornea. High index Purkinje spot P2, . ．． ．． refers to reflections from deep lying surfaces inside the eye, such as reflections from the proximal and distal surfaces of the capsule. Embodiments described herein utilize P1 Purkinje spots; other embodiments may utilize high index Purkinje spots.

The reflected IR imaging light of IR light source 44 is similarly detected by IR camera 48. Four Purkinje spots P1-1, . ．． ．． Together, P1-4 form an IR image 49 as shown.

In some embodiments, eye tracker 40 includes an image recognition system 52 and includes Purkinje spots P1-1, . ．． ．． The detected infrared eye tracking beam forming P1-4 and the detected infrared imaging light forming together the IR image 49 are used to determine the orientation of the first eye 1-1 and the second eye 1-2. can be determined. The image recognition system 52 can extract an image of the outline of the pupil 3 using, for example, an edge recognition method. The orientation of the eye 1 from the center of the pupil 3 can then be determined. Separately, Purkinje spots P1-1, . ．． ．． The direction of the eyes can be determined from P1-4. Finally, using various known image recognition and analysis techniques, a "best result" orientation can be determined by combining the two determined orientations using a weighted algorithm. Image recognition system 52 may be a separate processor, a separate application specific integrated circuit, or may be implemented as software located on system management computer 50.

6A-B show that system 10 redirects visible images 26-1 and 26-2 projected from a stereo display to first eye 1-1 and second eye 2-2, and and one infrared-transmissive visible mirror 24-1 and 24-2 for each eye for transmitting both the infrared eye-tracking beam and the infrared imaging light reflected from the second eye, 45-1 and 45-2. can be included. In these embodiments, stereo display screens 22-1 and 22-2 of stereo display 20 can be positioned around the main optical path of system 10, and infrared telescopes 46-1 and 46-2 of eye tracker 40 can be positioned in the main optical path of system 10. For reference, the accommodative lens 34-mirror 24-IR telescope 46 axis for each eye is generally referred to as the main optical path in this embodiment. Also, in figures where optical paths and beams are illustrated, some labels have been simplified for clarity.

FIG. 6B shows that in this embodiment, peripheral stereo display screens 22-1 and 22-2 can project visible images 26-1 and 26-2 toward the main optical path of system 10, with visible images 26-1 and 26-2 are redirected toward eyes 1-1 and 1-2 by infrared-transmitting visible mirrors 24-1 and 24-2. At the same time, both the reflected IR eye tracking beam and the reflected IR imaging light, 45-1 and 45-2, are reflected from the eyes 1-1 and 1-2 and the same infrared-transmissive visible mirrors 24-1 and 24- 2 along the main optical path of system 10 toward IR telescopes 46-1 and 46-2.

FIG. 8A shows another embodiment in which the positions of stereo display screen 22 and IR telescope 46 are swapped. FIG. 8B shows that this embodiment redirects both the reflected infrared eye tracking beam and the reflected infrared imaging light, 45-1 and 45-2, with visible transmissive infrared (IR) mirrors 24'-1 and 24'. -2, indicating that 45-1 and 45-2 are reflected from the first eye 1-1 and the second eye 1-2 to the IR telescopes 46-1 and 46-2. ing. At the same time, the visible-transmissive infrared mirrors 24'-1 and 24'-2 transfer the projected visible images 26-1 and 26-2 from the stereo display screens 22-1 and 22-2 of the stereo display 20 to the first one. It can be transmitted to the eye 1-1 and the second eye 1-2. In these embodiments of system 10, stereo display 20 can be positioned in the main optical path of system 10, and infrared telescope 46 of eye tracker 40 can be positioned around the main optical path of system 10. For reference, the accommodative lens 34-mirror 24-stereo display screen 22 axis for each eye in this embodiment is generally referred to as the main optical path in this embodiment.

FIG. 9 shows a variation of the system 10 of FIGS. 8A-B in which the stereo display 20 can include a single stereo display screen 22 and synchronized glasses 28. Synchronization glasses 28 can be shutter glasses or deflection glasses. In this embodiment, both the projected visible images 26-1 and 26-2 of the left and right stereo display screens 22-1 and 22-2 of FIGS. 8A-B are projected onto the single stereo display screen 22 in a rapidly alternating sequence. displayed by. The synchronized glasses 28 can be precisely adjusted by this alternating sequence and project the visible images 26-1 and 26-2 onto the first eye 1-1 and the second eye 1-2 in a rapidly alternating manner. allowing separate image impressions to be projected to the two eyes. The synchronization glasses 28 can be similar to 3D glasses used for 3D movie projection and can rely on a liquid crystal LCD layer that can quickly change the circular deflection of the two lenses of the synchronization glasses 28. Such a system 10 can achieve a small footprint of the system 10, which can be advantageous. For optimal operation, a sufficiently wide field of view of the stereo display screen 22 is useful.

Some embodiments of system 10 need not include mirror 24 or 24'. In these systems, the eye tracker 40 can include a compact implementation of an IR camera 48 positioned close to the front of the system 10 and sufficiently large so that the IR camera 48 does not block the projection by the stereo display screen 22. Can be tilted at a large angle. The image recognition system 52 implementing the eye tracker 40 in this manner recognizes the substantially tilted IR image 49 and the Purkinje spots P1, . ．． ．． A geometric transformation unit may be included to determine the direction of the visual axis of the eye from P4.

In embodiments of system 10, accommodation optics 30 may include phoropter wheels 32-1 and 32-2 with a series of accommodation optics lenses 34-1 and 34-2 that vary optical power. These accommodation optical system lenses 34 are useful for simulating the apparent distance between the first eye 1-1 and the second eye 1-2.

As described below with respect to method 100, system 10 can be utilized to project visible images 26 at different apparent distances to a patient. Doing this can involve at least two technical solutions. First, by inserting an accommodation optics lens 34 with variable optical power into the main optical path, the impression of the projected visible image 26 can be made farther or closer. Second, by projecting visible images 26-1 and 26-2 closer or further away from each other, the appropriate convergence of these images, when viewed as being at an apparent distance to the patient, is achieved. Another important factor can be simulated.

In some embodiments, for the first technical solution, the accommodation optics 30 can be used instead of or in combination with the phoropter wheel 32, such as curved mirrors, trial lenses, flip-in/ It may include a flip-out lens, an adjustable liquid crystal lens, a deformable mirror, a mirror movable in the z-direction, a rotating diffractive optical element, a translating diffractive optical element, a variable focus moiré lens, or a focus lens group.

10A-B show that, as a second technical solution, the adjustment optics 30 includes a pair of rotatable deflectors 36, rotatable prisms 38, or adjustable prisms 38 (only one shown); The projections of images 26-1 and 26-2 can be deflected to the first eye 1-1 and the second eye 1-2 to simulate apparent distance convergence for the first eye and the second eye. It shows.

In some embodiments, convergence shifts the projections of visible images 26-1 and 26-2 projected by stereo display screens 22-1 and 22-2 toward each other as well as by the optical elements described above. In other words, they can also be simulated by projecting them close to each other.

In some systems 10, the conditioning optics 30 and the stereo display 20 can be combined into a single light field display that includes a microlens array, and the stereo display screen 22- combined with the optical properties of the microlens array. Using the projected visible images 26-1 and 26-2 displayed on 1 and 22-2, the apparent distance of the projected visible images 26-1 and 26-2 when viewed by the patient is changed. be able to.

In some systems 10, conditioning optics 30 and stereo display 20 can be combined into a single light field display that includes a MEMS scanner, focus modulator, or light source.

Having described embodiments of system 10 that have been developed to provide advances in the context of prismatic or accommodative misalignment problems and misalignment problems, embodiments of system 10 can now be used to solve binocular misalignment problems. Various methods 100 for determining are described.

11-16 illustrate a method 100 of how to use the above-described embodiment of system 10 to determine binocular alignment of eyes 1-1 and 1-2.

FIG. 11 shows that some embodiments of the method 100 include the step of measuring 120 the apparent distance of the dissociative tropia of the patient's first eye 1-1 and the second eye 1-2, and the measured dissociation. It is shown that the step of determining 140 the accommodative vergence of the first eye 1-1 and the second eye 1-2 of the apparent distance using gender dysphoria can be included. As mentioned above, the method 100 is a two stage method, so the results integrate information and knowledge revealed by two different stages.

As described in more detail below, in some embodiments, the measuring step 120 includes unfused measurements for the first eye 1-1 and the second eye 1-2 using the stereo display 20 of the system 10. Projecting possible visible images 26-1 and 26-2 may be included. For the purpose of more concisely describing method 100, visible images 26-1 and 26-2 of FIGS. 5-10 will simply be referred to below as images 26-1 and 26-2.

Examples of projecting non-fusible images to determine dissociative plagioplasty are described with respect to, eg, FIGS. 2C-D. Here, the two non-fusible images 6-1-s and 6-2-s are of comparable or dominant appearance. Some embodiments of method 100 also involve projecting such comparable dominant non-fusible images.

In other embodiments, the projecting step includes projecting a dominant image to the first eye 1-1 and projecting a non-dominant image to the second eye 1-2. I can do it. As described with respect to FIGS. 2C-D, the eye 1-2 viewing the non-dominant image often begins to wander after the brain's efforts to fuse the two non-fusible images fail. In these embodiments, the measuring step 120 includes tracking eyes 1-1 and 1-2 by eye tracker 40 and determining the time when wandering eye 1-2 finally achieves a relaxed orientation. can include. Achievement of this relaxed state may be inferred by the eye tracker 40 determining, for example, that the movement of the eyes 1-2 has slowed below a threshold, or has changed from directional movement to random jitter, or has stopped. I can do it. By measuring the orientation of at least one of the first eye 1-1 and the second eye 1-2 by the eye tracker 40 with the eye tracker 40 determining that the eye 1-2 has reached a relaxed state. Dissociative plagioplasty can be measured.

FIG. 12 details the implementation of these steps, and FIGS. 13A-D illustrate these steps in particular embodiments. In these embodiments, measuring step 120 may include the following.
projecting 122 a central image to the first eye with apparent distance convergence using a stereo display;
Step 124 of projecting, using a stereo display, images distributed to the second eye by apparent distance convergence, characterized in that the central image and the distributed images are non-fusible. ,
tracking 126 rotation of at least one of the first eye and the second eye using an eye tracker;
identifying 128 a relaxed state from the stability of the tracked rotation;
Measuring 130 dissociative dysphoria by measuring the orientation of at least one of the first eye and the second eye in a relaxed state using an eye tracker and a computer.

The left panel of FIG. 13A shows that projecting the center image 122 may include projecting a center image 201-1, in this case a cross, onto the stereo display screen 22-1 of the stereo display 20 of the system 10. It shows. The projection step 122 may be performed by an apparent distance convergence 206. Reference axis 202-1 is taken for reference as a center normal connecting the center of first eye 1-1 to the center of stereo display screen 22-1. Thereby, the apparent distance convergence 206 can be characterized by the apparent distance convergence angle α=α(L), which is the angle between the two eyes 1-1 and 1-2 at the apparent distance L. This is the angle that the visual axis 204-1 of the first eye makes with the reference axis 202-1 when viewing an object placed halfway between the two eyes. In general, even if the first eye's visual axis 204-1 is not located along this line, the apparent distance convergence 206 will be offset by an angle α(L) relative to the reference axis 202-1. 1 is represented and shown by a line deviating from the center of eye 1-1.

The center image 201-1 is centered in the scene offset from the center of the stereo display screen 22-1 by an apparent distance convergence angle α(L) to simulate apparent distance convergence 206. For brevity, this angle may be simply denoted as vergence angle α. The definition of the visual axis 204-1 of the first eye may incorporate other relevant parts of the lens or accommodation optic 30-1, through which the first eye 1-1 is centered. Observe image 201-1.

The right panel of FIG. 13A shows the projection step 124 of a distributed image to the second eye 1-2, in this case a set of irregularly arranged balls or spheres of random size and position with no clearly visible center. It shows. Center image 201-1 is an example of a dominant image, and distributed image 201-2 is an example of a non-dominant image. Centered dominant image 201-1 and distributed non-dominant image 201-2 are examples of non-fusible images. Alternatively, the stereo display screen 22-2 can simply be darkened as another embodiment of the non-fusible distribution image 201-2 instead of irregularly arranged balls, similar to the block of FIG. 4C. can.

FIG. 13B shows that, as described above, the second eye 1-2 is initially rotated inward by a convergence angle α of approximately the same apparent distance as the first eye 1-1; It is shown that the second eye 1-2 wanders after the fusion of the image 201-1 and the distributed image 201-2 fails. The eye tracker 40 tracks the wandering second eye 1-2 until the optometrist or automated program determines that the wandering second eye 1-2 has reached a state of relaxation from the rotational stability tracked in the identification step 128. A tracking step 126 of 1-2 may be performed. This stability can be defined in various ways from the eye stopping, or the amplitude of the eye's jitter going below a threshold, or the directional rotation of the eye developing into directionless wandering.

At measurement step 130, once a relaxed state is identified at step 128, eye tracker 40 determines the relaxed state by determining the angle δ between the clearly visible convergence 206 and the visual axis 204-2 of the second eye. The direction of the eye 1-2 can be measured. In this measurement step 130, the angular deviation of the relaxed second eye 1-2 from the convergence 206 of the apparent distance, δ, is called the dissociative plagioplasty 208 with its dissociative plagioplasty angle δ. This definition is quite similar to Figures 4B-C. As mentioned above, small differences exist between various practitioner definitions of dissociative plagioplasty.

In some related embodiments, the tracking step 126 may involve tracking the rotation of the first eye 1-1, the second eye 1-2, or both. In these embodiments, dissociative plagioplasty 208 includes step 130 of measuring the first eye's tropia angle δ-1, the second eye's tropia angle δ-2, and the step of measuring δ-1 and δ-2. can be defined from the step of determining the dissociative plagioplasty δ as a type of average value of δ.

Figures 13A-B show that steps 122-130 of the overall measurement step 120 can be performed when the near viewing distance, eg L, is in the range 40 cm-100 cm.

Figures 13C-D show that the same steps 122-130 can also be performed as part of a distance vision test when the apparent distance is L large and the apparent distance convergence angle is α=0. . In related embodiments, L may be in the range 1m-10m. Expressed in diopters, method 100 can be performed at near viewing distances corresponding to 1-3D and at far viewing distances corresponding to 0-0.5D.

In summary, the result of the measuring step 120, the first stage of the method 100, is a dissociative plagioplasty 208, with a dissociative plagioplasty angle of δ. The second stage of method 200, determination step 140, performs additional tests of prismatic misalignment established only for determined dissociative plagioplasty 208. Thus, the overall method 100 is a combination of the first and second stages, and thus the method 100 integrates two separate tests of prism misalignment, and further according to knowledge and knowledge of two different types of binocular alignment. Integrate your data. Doing this promises quantitatively complete treatment and quantitatively better improvement of visual acuity.

FIG. 14 shows that the determining step 140 uses a stereo display to display the first image to the first eye and the second image to the second eye by the apparent distance convergence corrected by the measured dissociative phoria. It is shown that the step of presenting 142 a second image can be included, where the first image and the second image can be fused.

FIG. 15A shows that in some implementations of presentation step 142, a first fusible image 210-1 can be presented on a stereo display screen 22-1 for a first eye 1-1, and a second 210-2 can be presented on the stereo display screen 22-2 for the second eye 1-2. These fusible images 210-1 and 210-2 can be peripheral. For example, peripheral images 210-1 and 210-2 may be two essentially identical circular bands, or rings, of a ball or planet, as shown. The centers of fusible images 210-1 and 210-2 can be shifted towards each other according to the apparent distance convergence 206, where the convergence angle α is equal to the dissociative tropism δ (208) measured in the measurement step 120. Corrected by The measured dissociative tropia δ can be distributed symmetrically as δ/2−δ/2 between the two eyes, as shown. In these common cases, the centers of fusible images 210-1 and 210-2 are centered at α - δ/2, corrected by dissociative tropism, δ, relative to the reference axes 202-1 and 202-2. They can be shifted towards each other according to the vergence angle α. In response, the first eye's visual axis 204-1 and the second eye's visual axis 204-2 are generally aligned with these visual axes 204 pointing toward the center of the fusible image 210. As shown, aligned apparent distance convergence 206 corrected by dissociative plagioplasty 208.

In some cases, when the binocular misalignment of the two eyes is asymmetric, the optometrist may have reason to attribute a dissociative tropia δ measured unevenly between the two eyes. Note also that the previous agreement to make the description inclusive is continued; the description now refers to the "pair of restriction N-1 and restriction N-2" simply as "restriction N", and here shall not cause confusion.

The shift of the fusible image 210 may be influenced by the adjustment optics 30. The settings of the accommodating optics 30 may depend on L, the accommodating distance, or the optical power of the glasses preferred by the patient, which may be further corrected by cylinders or aberrations.

In some embodiments, the first fusible image 210-1 and the second fusible image 210-2 can be dynamic. In FIG. 15A, the directional dashed arcs indicate that the planet's rings can rotate about their centers. Experiments have shown that rotating the peripheral fusible image 210 reliably and reproducibly captures the peripheral prism effect. In the presentation step 142, the radius of rotation, spatial distribution, color, dynamics, and speed of these fusible images 210 can all be adjusted to provide optimal weighting to alignment information.

In some embodiments, first image 210-1 and second image 210-2 can be static. In some embodiments, the first image 210-1 and the second image 210-2 can be centered. These embodiments may present unique medical benefits.

FIG. 14 explains and FIG. 15B illustrates that the presentation step 142 can be followed by a projection step 144. The projection step 144 may include projecting the first additional central image 212-1 onto the first eye 1-1 and the second additional central image 212-2 onto the second eye 1-2. can. These center images 212 can be projected onto the center of the fusible image 210. In an embodiment of a fusible image 210 that is a touring planet, an additional central image 212 may be projected at the center of this touring, for example as a cross as shown.

The projection step 144 of these two additional central images 212-1 and 212-2 can be performed in an alternating manner using the stereo display 20. To represent the alternating scheme of the projection step 144, only one of the additional center images is shown with a cross 212-1 in solid lines, and the other additional center image, 212-2, is shown in dashed lines in FIG. 15B. . The alternating time can be selected according to several different conditions and can be less than 1 second, in the range 1-100 seconds, and possibly in the range 5-10 seconds.

Assuming that the angle δ of dissected plagioplasty 208 measured in step 120 fully captures the binocular alignment of eye 1, then eye 1, corrected by the dissective platitude angle δ/2, is additionally centered by the convergence angle α. No adjustment is necessary to the projection step 144 of the image 212. This manifests itself in the visual axis 204 of the eye remaining aligned to the convergence angle α corrected by the dissociative oblique angle δ/2 after the projection step 144.

However, Applicant's research revealed that the patient moved and adjusted his eye 1 in response to the projection 144 of the additional central image 212 with a corrected convergence angle α-δ/2. This led the applicant to recognize that additional measurements were needed to determine the residual prism alignment of the rest of the eye. These additional measurements are described in steps 146-154 below.
An eye tracker is used to track accommodation of the first eye in response to the projection of the first additional central image and further to track accommodation of the second eye in response to the projection of the second additional central image. step 146,
projecting in an alternating manner using a stereo display and a computer a first additional center image shifted with a first iterative concomitant tropism to reduce accommodation of the first eye; projecting 148 a second additional central image shifted by a second iterative concomitant oblique to reduce
An eye tracker is used to track the accommodation of the first eye in response to the projection of the shifted first additional central image and to track the accommodation of the first eye in response to the projection of the shifted second additional central image. tracking 150 ocular accommodation;
determining whether the effective accommodation of the first and second eyes is less than an accommodation threshold; and further determining whether the effective accommodation of the first and second eyes is greater than the accommodation threshold; Step 152 of returning to the step of projecting;
identifying 154 a stabilized concomitant hypoplasia from a final first recurrent concomitant hypoplasia and a final second recurrent concomitant hypoplasia if the effective accommodation of the first and second eyes is less than an accommodation threshold;
Identifying 156 the sum of the dissociative plagioplasty and the stabilized concomitant plagioplasty as a correction for the accommodative vergence corresponding to the apparent distance. These steps are described in detail next.

To determine the residual prism misalignment, following the projection step 140, the eye tracker 40 is used to track the accommodation of the first eye 1-1 in response to the projection of the first additional central image 212-1. FIG. 14 describes and FIG. 15 illustrates that the step 146 may be followed by tracking the accommodation of the second eye 1-2 in response to the projection of the second additional central image 212-2. FIG. 15B shows that the first eye 1-1 is adjusted to the projection step 144 by rotating the first eye's visual axis 204-1 by the first eye's accommodation angle 214-1, indicated by ε-1. , the second eye 1-2 is shown accommodating by rotating the visual axis 204-2 of the second eye by the second eye accommodation angle 214-2 indicated by ε-2. From here on, for the sake of brevity, the angle will refer to the apparent distance convergence corrected by the dissociative plagioplasty with the angle α-δ/2 instead of the reference axis 202. The fact that adjustment angles ε-1 and ε-2 were found to be non-zero necessitated the next step of decision step 140.

FIG. 15C shows that step 140 of determining accommodative vergence is then performed on the first eye shifted by a first iterative concomitant tropia φ(n)-1 to reduce accommodation of the first eye 1-1. a second additional central image shifted by a second iterative adjoint oblique φ(n)-2 to project an additional central image 212-1 of the second eye 1-2 and further reduce accommodation of the second eye 1-2. 212-2. Here, accommodation of the eye can be measured by the change in accommodation angle ε(n)-1, as detailed below.

For clarity and brevity, only the first eye 1-1 is explicitly illustrated in this FIG. 15C. The shifted additional central image 212 is connected by a line to the eye 1 and is further characterized by a shifted image axis 216. FIG. 15C shows a first shifted image axis 216-1 connecting the shifted first additional central image 212-1 to the first eye 1-1.

It was noted with respect to FIGS. 2-3 that the fixation shift λ and the concomitant tropism γ ^* required to compensate for it are simply not equal and opposite to each other. Consistent with this realization, the concomitant tropism φ(n)-1 is simply unequal and opposite to the first eye's accommodation angle, ε(n)-1. Accordingly, embodiments of method 100 perform these quantifications in steps 1, 2, . ．． ．． Determine by repeating n. The step exponents are shown in the above definition as φ(n)-1 and ε(n)-1ε, and the first iterative adjoint platitude is denoted by φ(1)-1 and the first The second iterative concomitant obliquity of is denoted by φ(1)-2, and so on. Naturally, the "-1" and "-2" indices continue to label the angles of the first eye 1-1 and the second eye 1-2, respectively, "(1)", "(2 )",. ．． ．． The "(n)" index labels the first, second, and nth steps of the iterative process.

Like the projection step 144, the projection step 148 of these shifted additional center images 212-1 and 212-2 can be performed in an alternating manner using the stereo display 20 and the computer 50.

FIG. 15C further shows that, following the projection step 148, the eye tracker 40 is used to track the accommodation of the first eye 1-1 in response to the projection of the shifted first additional central image 212-1; It is shown that step 150 of tracking the accommodation of the second eye 1-2 in response to the projection of the shifted second additional central image 212-2 may continue. Upon instructing presentation to only the first eye 1-1, the tracking step 150 responds to the projection step 148 of the first additional centered image 212-1 shifted by the first iterative concomitant oblique φ(n)-1. This includes tracking of the accommodation angle ε(n+1)-1 of the first eye 1-1.

This tracking step 150 is similar to tracking step 146. This is distinguished by an iterative step index with growth from (n) to (n+1). In simplified terms, embodiments of the method include shifting the additional central image 212 by the iterative adjoint tropia φ(n), tracking the reactive accommodation angle ε(n+1) of eye 1, and changing the accommodation angle. determining the accommodation of eye 1 from ε(n+1)−ε(n), and then changing the accommodation angle to a new iteration selected in magnitude and sign to reduce ε(n+1)−ε(n). It involves repeating the shifting of the additional center image 212 by the adjoint oblique φ(n+1).

In some embodiments, the magnitude of φ(n+1)-φ(n) is ε(n+1)-ε(n): |φ(n+1)-φ(n)|=|ε(n+1)-ε (n) |. It can be chosen to be equal to λ|ε(n+1)−ε(n)|. In some cases, these embodiments may exhibit slow congestion. Therefore, in some embodiments, |φ(n+1)−φ(n)| is λ|ε(n+1)−ε(n)|:|φ(n+1)−φ(n)|=λ|ε (n+1)−ε(n)|, where λ<1. These embodiments often exhibit optimal congestion. Other non-linear, polynomial, non-analytical or analytic relationships may also be utilized in various embodiments.

After repeatedly performing these steps 148 and 150, a decision step 152 may be performed to determine whether the effective accommodation of the first and second eyes is below an accommodation threshold. Using the above framework, decision step 152 can evaluate whether the change in adjustment angle |ε(n+1)−ε(n)| is less than a threshold value. Effective accommodation can be defined in various ways. The effective accommodation is the change in the angle of accommodation of only one eye with respect to eye 1-1 |ε(n+1)−ε(n)|, or the sum of the changes in the angle of accommodation of both eyes 1-1 and 1-2, or It may include some weighted average value or non-linear relationship.

If the change in adjustment angle |ε(n+1)−ε(n)| is greater than the threshold, the method may return to projecting step 148 of the shifted first additional center image 212, as shown in FIG. 15C. .

On the other hand, if in step (n) the eye accommodation, characterized for example by the change in accommodation angle |ε(n)−ε(n−1)|, is found to be less than a threshold, stop the iteration. The method further includes the step of identifying 154 the stabilized concomitant plagioplasty φ from the final first iterative concomitant plagioplasty φ(n)-1 and the final second iterative concomitant plagioplasty φ(n)-2. I can continue. Also, a different formula may be employed to define the stabilizing adjoint tropism φ in this step 154, for example φ=(φ(n)-1)+(φ(n)-2).

In previous embodiments, dissociative plagioplasty δ and stabilized concomitant plagioplasty φ are generally defined for both eyes. The value per eye is therefore half the angle defined here in the symmetrical case.

The identification step 154 is followed by an identification step 156 of the sum (δ+φ) of the dissociative tropism δ and the stabilizing concomitant tropism φ as a correction of the accommodative convergence AC by the accommodative convergence angle α, which corresponds to the apparent distance. I can continue. This converts the full or fully corrected accommodative vergence determined by method 100 in units of prism diopters Δ to the corresponding full or fully corrected accommodative vergence angle: [α−(δ+φ )/2]. As mentioned above, the common definition of accommodative vergence is AC=100 tan [α−(δ+φ)/2] in prism diopter Δ. This equation shows one way in which the result of an embodiment of method 100 is a separate step forward compared to the previous method, where only dissociative plagioplasty δ corrects α AC=100tan[α-δ/2]. Another difference compared to the previous method is the particular system 10 and method 100 in which δ was determined.

By determining the fully corrected AC by method 100, binocular alignment can be recharacterized by the AC/A ratio, the ratio of accommodative vergence AC to accommodative response A. This AC/A ratio can be determined for a single distance or can be formed from AC and A values for multiple distances. For brevity, in the following we will simply refer to fully corrected accommodative vergence AC as accommodative vergence AC.

In some embodiments, the method 100 includes the steps of determining the distance accommodative convergence AC(L _d ) as the accommodative convergence resulting from performing the method 100 at the distance apparent distance L _d and the near distance apparent distance L d . determining the near accommodative convergence AC(L _n ) as the accommodative convergence resulting from performing the method at a distance L _n .

With this in mind, some embodiments determine the binocular alignment of the first eye and the second eye in diopters of distance accommodative response A (L _d ) and near accommodative response A (L _n ) by first determining the distance accommodative convergence AC divided by the distance accommodative response A (L _d ) - the near accommodative response A (L _n ) - the near accommodative convergence AC ₍ The binocular alignment of the first eye and the second eye can be characterized by calculating the ratio of L _d ).
Binocular alignment = [AC(L _d ) - AC(L _n )]/[A(L _d ) - A(L _n )] (1)

In some embodiments, apparent distance measuring step 120 and apparent distance determining step 140 can be performed using accommodation optics 30.

When the shortcomings of existing methods are described above, the subjectivity of patient feedback has been identified as one source of clutter in the data and the reason for limited reproducibility. In this context, it is stated that embodiments of method 100 can be performed without requiring a subjective response from the patient to determine one of the key quantities or angles. (Of course, non-subjective responses regarding comfort, for example, can be part of method 100). This is one of the questions why method 100 provides measurements with high reproducibility.

FIG. 16 shows that, in some embodiments, when the method 100 is performed at an apparent distance corresponding to near vision, the dissociative plagioplasty and concomitant vergence corresponding to near vision are centered below the equatorial direction 9. It is shown that by displaying the placed image 201, the viewing angle can be determined at a viewing angle below the equator direction 9.

Applicants' extensive experiments have shown that when prism glasses are manufactured based on the accommodative vergence determined by method 100, patients wearing the glasses experience visual discomfort, pain, and discomfort associated with digital devices. demonstrated that they reported a very promising reduction in migraine.

This significant improvement is believed to have been achieved because the method 100 has developed and integrated solutions regarding points (1)-(5) identified above as follows.
(1) Method 100 does not use the patient's subjective response as a primary input.
(2) Method 100 uses both peripheral images, e.g., images 124 and 210, and central images, e.g., images 201 and 212.
(3) Method 100 uses a two-stage method of measuring step 120 and determining step 140 to collect and utilize information regarding both central and peripheral vision.
(4) Method 100 uses a moving test image, e.g. image 210.
(5) The method 100 may, for example, develop a particular definition of accommodative vergence and a protocol for this determination in steps 142-156, and further use this definition to ensure that the prescribed eyeglasses reduce eye strain-related discomfort. It has been proven through extensive testing that it is especially effective at reducing deterioration.

For all of these reasons, the system 10 and method 100 described above provide a promising new method for reducing the discomfort, pain, and migraines associated with ocular strain.

17-25 illustrate additional embodiments of a system 310 for determining binocular alignment that are shown to be similar to the embodiments of system 10 for determining binocular alignment in FIGS. 8A-B. Similar parts are therefore essentially labeled with the same label of 300. By way of example, system 310 for determining binocular alignment can be considered one embodiment of system 10 for determining binocular alignment, and thus the various elements and techniques described with respect to system 10 may be implemented as 310 and vice versa. For brevity, system 310 for determining binocular alignment may also be referred to simply as system 310.

FIG. 17 shows a first display 322-1 operable along the longitudinal direction according to the simulated distance and optical power of the first eye 1-1 and displaying an image on the first eye 1-1. and a first eye tracker assembly 340-1 for tracking the direction of gaze of the first eye 1-1, which is adjustable in a horizontal lateral direction to correspond to a first pupillary distance 4-1 of the first eye. a first optical unit 315-1 including a first optical unit 315-1, which is operable along the longitudinal direction according to the simulated distance and optical power of the second eye 1-2 and transmits an image to the second eye 1-2; A second display 322-2 to display and track the viewing direction of the second eye 1-2, which is horizontally adjustable to correspond to the pupillary distance 4-2 of the second eye 1-2. a second optical unit 315-2 including a second eye tracker assembly 340-2; A system 310 for determining binocular alignment is shown including a computer 350 coupled to one optical unit 315-1 and a second optical unit 315-2. Figure 17 also shows an xyz coordinate system on the side for an alternative way to characterize orientation. Using this xyz coordinate system, the "horizontal lateral direction" is aligned with the x-axis, the "vertical lateral direction" is aligned with the y-axis, and the "longitudinal direction" is aligned with the z-axis. This alignment can be exact, or in some embodiments this alignment can be within an acceptable range, such as plus or minus 10 degrees.

Different patients have different prescriptions, such as several diopters of myopia or hyperopia. Some previously described embodiments of the system 10 for determining binocular alignment use phoropter wheels 32-1 and 32-2 with lenses of different diopters to simulate these prescriptions, whereas fixed stereo Displaying images to the patient by display screens 22-1 and 22-2 - see, eg, FIGS. 8A-B. These embodiments measure binocular alignment at two different nominal distances. These distances are further re-simulated by rotating the phoropter wheels 32-1 and 32-2 and fitting a diopter lens representing the simulated distances in addition to the patient's prescription.

An embodiment of a system 310 for determining binocular alignment includes phoropter wheels 32-1 and 32-2. Initially, an embodiment determines the simulated distance and optical power of eyes 1-1 and 1-2. Both of the above functions are performed by activating displays 322-1 and 322-2 along the longitudinal direction according to the display. Removing the phoropter wheels 32-1 and 32-2 reduces the physical size of the system 310 for determining binocular alignment using the system 10 for determining binocular alignment using the phoropter wheels 32-1 and 32-2. be significantly smaller than This is an advantage in crowded optometrists' offices where physical space is required. Further, the use of phoropter wheels 32-1 and 32-2 allows the system 10 for determining binocular alignment to only simulate a patient's prescription in discrete steps, such as one diopter step. As a further advantage, the system 310 for determining binocular alignment can operate the first and second displays 322-1 and 322-2 essentially sequentially along the longitudinal direction, thus , the patient's prescription can be continuously simulated with high accuracy, preferably within 0.1 diopter or better.

Another problem with system 10 using the phoropter wheel 32-1 design is that when the phoropter wheel 32-1 is rotated to fit a new lens to simulate a new distance or new prescription, the first Because eye tracker assembly 340-1 views eye 1-1 through the lens of phoropter wheel 32-1, the magnification changes with rotation of phoropter wheel 32-1. This change in magnification requires recalibration of the image analysis performed by computer 350. This recalibration can result in time lag and thus coding problems. In contrast, embodiments of system 310 that determine binocular alignment using actuatable first and second displays 322-1 and 322-2 avoid the need for this recalibration and allow system 310 to Facilitates operation.

In some embodiments, the first display 322-1 and the second display 322-2 have a longitudinal extent in the range of 50-200 mm, and in some embodiments in the range of 75-125 mm. Can be moved. The closest longitudinal distance between the first and second displays 322-1 and 322-2 and the first and second eye tracker assemblies 340-1-340-2 may be in the range of 5-40 mm. In other cases, it may be in the 10-30 mm range. Accordingly, in some embodiments, the system 310 for determining binocular alignment is configured to perform binocular alignment in a range of -20D to +20D, or less, in others, in a range of -10D to +10D, or less, and in still other embodiments. , -10D to +20D, or less prescription optical power can be simulated.

In embodiments, the closer the first and second displays 322-1 and 322-2 are positioned to the eyes 1-1 and 1-2, the larger the field of view perceived by the patient. This field of view can extend from at least -30 degrees to +30 degrees, and in others from at least -35 degrees to +35 degrees to even greater values. Accordingly, some embodiments of the system 310 for determining binocular alignment may also be used for visual field testing that has multiple uses, such as identifying local blind spots, or scotomas, as well as problems with peripheral vision. These symptoms may be indicative of various diseases such as glaucoma or brain disorders.

There are advantages to making at least a portion of the first and second optical units 315-1 and 315-2 laterally adjustable, and embodiments for achieving this adjustability. . As described above, adjusting different pupillary distances for different patients allows the first and second eye tracker assemblies 340-1 and 340-2 to be adjusted in the horizontal lateral, "x" direction. This can be achieved by Furthermore, in systems where the first and second optical units 315-315-2 are fixed, when the patient is asked to look at a simulated near object, the eyes are off-centered from the nasal offset. View through the system's front lens (see first lens assembly 360-1 in FIG. 18) through the region. Although these anterior lenses provide the designed optical power , these off-center regions introduce unintended prisms into the refraction of light that confound proper determination of the patient's binocular alignment. Embodiments of the system 310 for determining binocular alignment operate by enabling first and second eye tracker assemblies 340-1 and 340-2 with their corresponding anterior lenses in a horizontal lateral direction. , to minimize or eliminate such problems. In such a system 310, when a nearby object is simulated by displaying an image on the first and second eyes 1-1 and 1-2 shifted closer to the center of the system 310, the first The first and second eye tracker assemblies 340-1 and 340-2, along with their front lenses, are positioned on the horizontal side so that the patient continues to view nearby objects through the center of the front lenses of the system 310 to determine binocular alignment. can be actuated in both directions, thereby avoiding unintended prismatic effects.

The above motivation for introducing horizontal lateral adjustability can only be achieved by making the first and second eye tracker assemblies 340-1 and 340-2 adjustable or actuatable along a horizontal lateral direction. cannot be achieved. First, the first and second eye tracker assemblies 340-1 and 340-2 may thus be adjustable along with their corresponding front lenses. Further, in some embodiments of the system 310 for determining binocular alignment, the first display 322-1 may also be structurally adjustable or actuatable in conjunction with the first eye tracker assembly 340-1. Additionally, the second display 322-2, along with the second eye tracker assembly 340-2, can also be structurally adjustable or actuatable. When taking into account the adjustability of the front lens as well, in these embodiments the entire first optical unit 315-1 and second optical unit 315-2 are placed horizontally as shown in FIG. It can be adjustable or actuatable.

Further adjustability may be useful as well. Notably, there is a significant spread among people regarding the vertical position of the left and right eyes, with the two eyes often being vertically misaligned by a few millimeters. Such patients may experience problems with eye alignment by the first and second optical units 315-1 and 315-2. An embodiment of the system 310 for determining binocular alignment allows a first eye tracker assembly 340-1 with an anterior lens to be adjustable in a vertical lateral direction and a second eye tracker assembly 340-2 with an anterior lens. This problem can be managed by making it vertically and laterally adjustable. Through the language of predefined coordinate systems, this translates into adjustability along the y-axis.

FIG. 18A shows that in some embodiments of the system 310 for determining binocular alignment, a first eye tracker assembly 340-1 within a first optical unit 315-1 is connected to one or more first An infrared light emitting diode (IR LED) 342-1 is included, indicating that an infrared (IR) eye tracking beam 342b-1 can be projected onto the first eye 1-1. Additionally, the first eye tracker assembly 340-1 also includes a first infrared (IR) light source 344-1 for illuminating the first eye 1-1 with infrared (IR) imaging light 344b-1. You can also do it. Finally, the first eye tracker assembly 340-1 includes a first infrared (IR) camera 348-1 and transmits a reflected IR beam and a IR eye tracking beam 342b-1 after reflection from first eye 1-1, collectively labeled IR light 345b-1, and IR imaging light 344b- after reflection from first eye 1-1. 1 can be detected. Of course, in the system 310 for determining binocular alignment, within the second optical unit 315-2, a second eye tracker assembly 340-2 provides an infrared (IR) eye tracking beam to the second eye 1-2. one or more second infrared (IR) light emitting diodes 342-2 projecting 342b-2; a second infrared (IR) light source 344 illuminating the second eye 1-2 with infrared imaging light 344b-2; -2, and a reflected IR eye tracking beam 342b-2 from eye 1-2, collectively labeled reflected IR beam and IR light 345-2, through second IR optics 346-2. and a second infrared (IR) camera 348-2 that detects the IR imaging light 344b-2 after reflection from the eye 1-2. Since the second eye tracker assembly 340-2 is similar to the first eye tracker assembly 340-1, there is no need to explicitly show the second eye tracker assembly 340-2. For instructional purposes, the xyz coordinate system of FIG. 17 is illustrated from a rotated perspective with respect to FIG.

In embodiments, the number of first and second IR LEDs 342-1 and 342-2 can range from 1-10, and in some embodiments from 2-4. In embodiments, the first infrared light source 344-1 includes a set of individual infrared light emitting diodes spatially distributed to illuminate the first eye 1-1 with dispersed infrared imaging light 344b-1. The second infrared light source 344-2 can further include a set of spatially distributed individual infrared light emitting diodes for illuminating the second eye 1-2 with the dispersed infrared imaging light 344b-2. can be included. The individual infrared diodes of first and second infrared light sources 344-1 and 344-2 can be positioned in many different patterns, such as circles, arcs, rectangles, and rectangular arrays, among others. These numbers can range from 1-50, and in some embodiments from 5-20. Infrared imaging light 344b-1 and 344b-2 can be dispersed or homogenized in a variety of ways, including by a diffuser, or by a scattering mirror, or by a scattering surface.

FIGS. 18A-B illustrate that one or more first infrared (IR) light emitting diodes 342-1 can be placed at various locations on the first eye tracker assembly 340-1. In FIG. 18A, a first infrared (IR) light emitting diode 342-1 is positioned in the front area of the first eye tracker assembly 340-1 near the first eye 1-1. In these designs, the IR eye tracking beam 342b-1 may make a large angle with the principal optical axis of the first optical unit 315-1, potentially complicating the centering of the reflected IR light. There is. In FIG. 18B, one or more first infrared (IR) light emitting diodes 342-1 are connected to a first infrared (IR) camera 348-1, often close to the central first IR optics 346-1. located high upstream along the optical path in close proximity to. These designs allow the IR eye tracking beam 342b-1 to be closely aligned with the main optical axis of the first optical unit 315-1.

In some embodiments of the system 310 for determining binocular alignment, the computer 350 may include or be connected to an image analysis system 352 and may include reflected IR eye tracking beam 342b-1. and 342b-2, and further using the IR images formed by the infrared imaging lights 344b-1 and 344b-2, determining the orientation of the first eye 1-1 and the second eye 1-2. and the reflected beams are both labeled 345b-1 and 345b-2. Image analysis system 352 determines Purkinje reflexes from first eye 1-1 and second eye 1-2 using detected reflected infrared eye tracking beams 342b-1 and 342b-2; The IR images formed by the infrared imaging lights 344b-1 and 344b-2 can be configured to determine the pupil attributes of the first eye 1-1 and the second eye 1-2. The Purkinje reflection can be one of so-called P1, P2, etc. Purkinje reflexes are labeled according to the visual surface of the eye that reflects them. One of the Purkinje reflexes that is often used is P1, which is the reflection from the anterior surface of the cornea. IR beam 342b-1 is often directed by first IR LED 342-1 to reflect off the tip of the cornea to provide a central P1 Purkinje reflex. Determining the gaze direction may also involve determining one of the pupil attributes, such as the position of the pupil center, or the ellipticity that the image of the pupil has. When the optical axis of the eye is aligned with the main optical axis of the first eye tracker assembly 340-1, the pupil of the eye 1-1 appears as a circle in a typical eye. When the line of sight direction of the eye 1-1 deviates from this principal optical axis due to the rotation angle, the same pupil appears as an ellipse. For example, analyzing the ellipticity of this ellipse, given by the ratio of the minor axis to the major axis, and determining the orientation of these axes provides important information regarding the angle of rotation of the viewing direction. Still other pupil attributes may involve imaging the iris and recording the location of particular features of the iris. Determining pupil attributes may include edge recognition software to identify the exact edge of the pupil.

Such operation of the first and second optical units 315-1 and 315-2 and the image analysis system 352 may occur because, for many patients, the patient's pupils are not the same size and the pupils are not completely circular. , or is designed by recalling that it is perfectly aligned. For example, for patients whose eyes are not perfectly aligned, when one of the two eyes is aligned with the optical axis of the corresponding first and second eye tracker assemblies 340-1 or 340-2, the other eye is not aligned with the corresponding eye tracker optical axis. Finally, the Purkinje reflex may not be exactly coming from the tip.

Regardless of all these possible deviations from the ideal situation, in order to determine the viewing direction of the first and second eyes, 1-1 and 1-2, the image analysis system 352: activated by first instructing the patient to look straight ahead and then recording the patient's Purkinje reflex PI and the position of the pupil center by the first and second IR cameras 348-1 and 348-2. There are many things. (For the rest of this document, the second eye tracker assembly 340-2 is similar to the first eye tracker assembly 340-1 and is therefore not shown in separate repetitive figures for brevity.) ) Additionally, ocular ellipticity and other pupil attributes can also be recorded. Connecting the position of the Purkinje reflex P1 to the center of the pupil can be used to define the direction of the line of sight or the direction of the optical axis of the eye. All of these records are used to serve as reference directions for subsequent measurements. This reference-setting step may then be followed by the step of projecting visible images 326-1 and 326-2 by first and second displays 322-1 and 322-2 onto the patient, which The Purkinje reflex of the first eye 1-1 and the second eye 1-2 is achieved by re-measuring the Purkinje reflex, pupil center and other pupillary attributes such as ellipticity in response to images of the Purkinje reflex of the first eye 1-1 and the second eye 1-2; A step follows of comparing the pupil center and pupil attributes with previously determined reference Purkinje reflexes, pupil centers and pupil attributes of the first eye 1-2 and the second eye 1-2. Comparing these measurements to reference values is used to determine viewing direction and changes in viewing direction, as described below.

In embodiments, the image analysis system 352 determines the position of the center of the pupil in the xy plane determined from the IR image formed from the reflected IR beams 344b-1 and 344b-2 and the reflected IR beams 342b-1 and 342b-2. The position of the Purkinje reflection P1 from the corneal tip determined from can be used. If the pupil centers overlap or coincide with the corneal tip in the xy plane, then the eye is looking straight ahead as in the reference IR image. When the pupil center and the corneal tip are offset in the xy plane, from the direction and magnitude of the offset, the image analysis system 352 can determine the rotation angle of each eye's line of sight relative to the reference direction.

As mentioned above, in a small proportion of patients, the pupil center and corneal tip may not coincide even in the reference image, even when the patient is looking straight ahead. However, even in these cases, the image analysis system 352 takes the positions of the pupil center and corneal tip in the rotated image of the eye, then subtracts these reference positions, and from this formed difference determines how the eye is projected. It is possible to determine rotation angles in the viewing direction of the eyes 1-1 and 1-2 corresponding to the visible images 326-1 and 362-2. Other embodiments may determine gaze direction by other methods, such as other pupillary attributes and/or other Purkinje reflexes. Still other embodiments may use multiple pupil attributes without the Purkinje reflex. Yet other embodiments may do the opposite, using multiple Purkinje reflexes without pupillary attributes.

The direction of gaze changes rapidly over time because the eyes perform many rapid saccadic movements per second. Therefore, the Purkinje reflex and pupil center mentioned above, and possibly other pupil attributes, represent a particular direction of gaze when they are measured close to each other in time. Further, if, conversely, they are measured with a significant time difference, such as 0.1 seconds, or 1 second, or more, then the line of sight computer-computed by the image analysis system 352 will be Accuracy may become less and less. To improve the accuracy of this computation, in some embodiments one or more first infrared light emitting diodes 342-1 are provided with a first infrared light source that illuminates with infrared imaging light 344b-1. 344-1 projects an infrared eye tracking beam (IR beam) 342b-1 in an alternating manner, and one or more second infrared light emitting diodes 342-2 project a second infrared eye tracking beam (IR beam) 342b-1 in an alternating manner, and one or more second infrared light emitting diodes 342-2 illuminate a second infrared imaging light 344b-2. An infrared eye tracking beam 342b-2 is projected in an alternating manner by an infrared light source 344-2. The alternating frequency may be in the 1-1,000 Hz range, in some embodiments 10-150 Hz range, and in some embodiments 60-120 Hz range. These alternations allow the first and second IR cameras 348-1 and 348-2 to be within 1-1,000 milliseconds of each other, within 6-100 milliseconds in other embodiments, and even within other embodiments. In embodiments, within 8-16 milliseconds, the Purkinje reflex and pupil center, and possibly other pupil attributes, can be determined. Determining the Purkinje reflex and the pupil center, and possibly other pupil attributes, in close proximity to each other advantageously increases the accuracy of the gaze direction computation by the image analysis system 352. As mentioned above, in some embodiments of the system 310 for determining binocular alignment, only pupillary attributes are determined, and in other embodiments of the system 310, only Purkinje reflexes are determined. Determining any of these by the above-mentioned repetition rate also increases the accuracy of determining the viewing direction.

In some embodiments of the system 310 for determining binocular alignment, the first eye tracker assembly 340-1 also transmits images from the first display 322-1 longitudinally to the first eye 1-1. and transmits a reflected infrared eye tracking beam 342b-1 and infrared imaging light 344-1, both labeled 345b-1, from a first eye 1-1 to a first infrared camera 348-1. The second eye tracker assembly 340-2 includes a first visible-transmitting infrared mirror 324-1 positioned to redirect laterally to the second eye 1-2. transmits the image from the second display 322-2, and further transmits the reflected infrared eye tracking beam and infrared imaging light, both 345b-2, from the second eye 1-2 to the second infrared camera 348-2. It includes a second visible-transmissive infrared mirror 324-2 positioned to laterally redirect. In some embodiments, the first infrared camera 348-1 is positioned relative to the first visibly transparent infrared mirror 324-1 in one of a vertical lateral and a horizontal lateral direction, and the first infrared camera 348-1 Camera 348-2 is positioned relative to second visible infrared mirror 324-2 in one of vertical lateral and horizontal lateral directions. The horizontal lateral direction corresponds to the x-axis of the xyz coordinate system of FIGS. 17-18, and the vertical lateral direction corresponds to the y-axis.

For example, in virtual reality goggles, there are a variety of eye-tracking display systems available, where the IR eye-tracking beam and the projected visible image do not share a common optical path but also utilize visible-transmissive IR mirrors. do not. In these designs, the eye tracker's IR camera is aimed directly at the eye. However, the geometry of the design indicates that these IR cameras are aimed at the eye from a high angle. Therefore, eye tracking IR beams are often subject to occlusions from long eyelashes that confuse image analysis systems and can even lead to tracking deadlocks. Such occlusion problems due to eyelashes cause the reflected IR beam and IR imaging lights 345b-1 and 345b-2 to share the main optical path, leaving the eye in the normal/z/longitudinal direction and then in the first and is avoided in the present system 310 for determining binocular alignment by redirecting by the second visually transparent IR mirrors 324-1 and 324-2.

As already cited above, when measuring binocular alignment, the first display 322-1 is operable to a first longitudinal position according to a simulated distance, the first longitudinal position being , dynamically corrected according to the optical power of the first eye 1-1, the second display 322-2 is operable to a second longitudinal position according to the simulated distance, and the second display 322-2 is actuatable to a second longitudinal position according to the simulated distance. The directional position is dynamically corrected according to the optical power of the second eye 1-2. The first and second displays 322-1 and 322-2 are operable sequentially along the longitudinal/z direction, thereby determining the optical power of the patient's eyes 1-1 and 1-2; or allow accurate correction of simulated distances according to prescription. It is also worth noting that many virtual reality displays achieve economic benefits by using a single display and displaying images to the left and right eyes on corresponding halves of this single display. However, such a system does not have the freedom to move the two halves of the display to different z-coordinates for many people with different eye prescriptions and would therefore require different z-coordinates. Embodiments of the system 310 for determining binocular alignment are, in contrast, suitable for accommodating such different prescriptions when the two displays 322-1 and 322-2 are independently operable. .

Additionally, when simulating images at different distances to determine binocular misalignment at these distances, the horizontal lateral positions of the images are determined by the computer 350 on the first and second displays 322-1 and 322-. 2 can be moved as appropriate.

FIGS. 18A-B also show that the first optical unit 315-1 receives an infrared eye tracking beam and an infrared imaging light both reflected from the first eye and both labeled 345b-1; The second optical unit 315 can include a first lens assembly 360-1 for directing toward the camera 348-1 and further reducing at least one of chromatic aberration, optical aberration, astigmatism, and wavefront distortion. -2 receives and directs an infrared eye tracking beam and an infrared imaging light reflected from the first eye and both labeled 345b-2 toward a first infrared camera 348-2, and further controls the chromatic aberration. , a second lens assembly 360-2 that reduces at least one of optical aberrations, astigmatism, and wavefront distortion. (Elements of the second optical unit 315-2 are similar to the first optical unit 315-1 and are therefore not explicitly shown for brevity.)

In some embodiments of the system 310 for determining binocular alignment, the first infrared camera 318-1 and the first lens assembly 360-1 are both adjustable, and the second infrared camera 348-2 and the first lens assembly 360-1 are adjustable. The two lens assemblies 360-2 are both adjustable. In embodiments where these two elements are not adjustable together, the image height remains unchanged even when the first and second lens assemblies 360-1 and 360-2 are adjusted to off-center misaligned positions. Infrared cameras 348-1 and 348-2 need to be large so that resolution and low distortion can be maintained. Conversely, in embodiments where the first and second lens assemblies 360-1 and 360-2 are adjustable with the first and second infrared cameras 348-1 and 348-2, the first and second lens assemblies 360-1 and 360-2 are adjustable. Because collinearity with assemblies 360-1 and 360-2 is maintained regardless of adjustment, first and second infrared cameras 348-1 and 348-2 can be made smaller. The small size of first and second infrared cameras 348-1 and 348-2 advantageously reduces the overall size of system 310 for determining binocular alignment.

FIG. 19 illustrates an embodiment of a system 310 for determining binocular alignment. FIG. 19 shows the same elements as FIGS. 17-18, and like FIG. 17, from the top, in the y direction, or vertical lateral direction looking down. In particular, the direction of longitudinal/z directional actuation and the horizontal lateral/x direction are shown in detail.

FIG. 20 shows an embodiment of the first optical unit 315-1 of the system 310 for determining binocular alignment from a perspective view. Apart from the aforementioned elements, further elements of the first z-actuator 347-1 can be seen, which are configured to actuate the first display 322-1 along the longitudinal/z-direction. Additionally, a first coupling 354-1 to the computer 350 can be seen, coupling the first display 322-1 to the computer 350 by a set of flexible or deformable communication lines. The first display 322-1 may be configured to display an image on the first eye 1-1 modified according to at least one of the optical power of the first eye 1-1, a cylinder, and a prism. and the second display 322-2 is further configured to display the image to the second eye 1-2 modified according to at least one of the optical power of the second eye 1-2, the cylinder, and the prism. can do.

In some embodiments, the first display 322-1 and the second display 322-2 are liquid crystal displays, light emitting diode (LED) displays, organic LED displays, quantum dot LED displays, microlens arrays, digital mirror devices. , and a scanning projector microelectromechanical system.

FIG. 21 shows a front z-direction view of the system 310 for determining binocular alignment. This is what the patient can see. First and second lens assemblies 360-1 and 360-2 are shown. Beyond this, some embodiments are centered between a first optical unit 315-1 and a second optical unit 315-2 configured to receive and secure a patient's nose. Includes nose bridge 370.

Such embodiments provide an advancement to related diagnostic systems. A significant number of related diagnostic systems attempt to immobilize the patient's head and eyes by a variant of a chinrest on which the patient rests his or her chin. However, the jaw acts as an axis of rotation relative to the patient's head, and thus the eye may rotate around the resting jaw due to the distance between the jaw and the eye as a radius, causing rotational misalignment with the diagnostic equipment. By fixating the patient's head and eyes at the nose instead of the chin, this residual rotational misalignment can be minimized or eliminated. Nose bridge 370 accomplishes this function with its "down V" shape, fixing the patient's head at the top of the nose, in close proximity to the eyes, instead of at the chin. For this reason, the system 310 for determining binocular alignment in such embodiments is fully eye-fixed.

Another advantage is illustrated by FIGS. 17-21. When referring to the center of the system 310 for determining binocular alignment as the center 311, in a small proportion of patients the pupil center of the patient's first eye 1-1 and the pupil center of the patient's second eye 1-2 are Not at equal distances from the center of symmetry of the patient's head. These differences can be 1-2 mm, which is enough to cause significant errors if the measurements are analyzed assuming symmetrical positioning of eyes 1-1 and 1-2. Thus, in embodiments of the system 310 for determining binocular alignment, the overall pupillary distance ("PD") is not only adjustable to account for patient-to-patient variations, but also is defined relative to the center 311. It is advantageous to make the monopupillary distance 4-1 of the first/left eye adjustable independently of the monopupillary distance 4-2 of the second/right eye and to redefine it with respect to the center 311. . In embodiments, this allows the first eye optical unit 315-1 to be horizontally adjustable relative to the nose bridge 370 in the lateral/x direction so that the first eye 1 -1 single pupil distance 4-1, and the second optical unit 315-2 is adjustable in the horizontal side/x direction with respect to the nose bridge 370, so that the second eye 1-2 can be adjusted. This is achieved by making it possible to accommodate a single pupil distance of 4-2. In some cases, this same goal can only be achieved by making the first and second eye tracker assemblies 340-1 and 340-2 adjustable in a horizontal lateral direction relative to the nose bridge 370.

FIG. 22 illustrates further features of an embodiment of a system 310 for determining binocular alignment. Some embodiments may include a graphical user interface 380 configured for a medical operator to interact with the computer 350 to manage binocular alignment decisions. This graphical user interface 380 provides a medical operator, such as an optometrist or technician, with the infrared images captured by the first and second IR cameras 348-1 and 348-2, the first eye 1-1 and 1-2, among others, the available diagnostic steps selected from the diagnostic procedure to be set and the parameters of the diagnostic procedure can be displayed.

Still other embodiments of the system 310 for determining binocular alignment may include a patient communication interface 385, such as a loudspeaker, to instruct the patient to follow the steps of determining binocular alignment. These instructions can originate from a remote operator, or they can be synchronized to computer 350, which projects pre-recorded and specific visible images 326-1 and 326-2. Other embodiments of patient communication interface 385 may include a patient feedback portal for receiving feedback from patients. Examples include push buttons, track wheels, touch pads, microphones, and voice interactive devices. Any of these patient feedback portals allows the patient to select feedback in response to steps in the diagnostic process. In an embodiment, the computer 350 can initiate a longitudinal/z-adjustment of the first display 322-1, and the loudspeaker of the patient communication interface 385 can display a prerecorded instruction, ``Image is clear.'' "Please press the button to indicate the time you want to do." When the patient presses a button on the patient communication interface 385, the computer 350 records the longitudinal/z position of the first display 322-1 that provides information regarding the patient's prescription or optical power of the eye 1-1. be able to. Alternatively, the computer can move the visible images 326-1 and 326-2 projected in the horizontal side/x direction on the first and second displays 322-1 and 322-2, and The patient may be asked to indicate via a push button when images 326-1 and 326-2 are fused, or when the fusion of the two images is broken. The horizontal lateral/x positions of the two images 326-1 and 326-2 provide information regarding the binocular alignment of the patient's eyes 1-1 and 1-2.

FIG. 23 shows that in some embodiments, the first eye tracker assembly 340-1 includes a first autorefractor 400-1 and can determine refractive information about the first eye 1-1; Further shown is a second eye tracker assembly 340-2 including a second autorefractor 400-2 and capable of determining refractive information regarding the second eye 1-2. As mentioned above, the second autorefractor 400-2 can be similar to the first autorefractor 400-1 and thus need not be explicitly indicated. The refractive information may simply be the refractive power of the eye being tested needed to perform the method 100. For example, a patient's prescription may have changed without the patient's knowledge since the optometrist's last exam. Or, the optometrist may desire to track the degree of adjustment in response to moving the first display 322-1 in the longitudinal/z direction. Or the optometrist may request a check for high-order astigmatism or anomalies.

In embodiments, the first autorefractor 400-1 includes a first wavefront (WF) infrared (IR) light source 402-1 that projects WF IR light 402b-1 onto the first eye 1-1. I can do it. This first WF IR light source 402-1 can have many different embodiments including LEDs, LED arrays, superluminescent LEDs called SLEDs, and expanded beam lasers, among others. The WF IR light 402b-1 can be guided through a first collimator 404-1 and a first polarizing beam splitter 406-1, such that the transmit polarization plane of the first polarizing beam splitter is aligned with the first polarizing beam splitter. It is aligned to the polarization plane of the WF IR light source 402-1. The first WF IR light 402b-1 is transmitted to the first eye tracker assembly 340-1 through a first beam splitter 410-1 and optionally through an optional first refractor lens 408-1. 1 optical path. From here, the WF IR light 402b-1 is directed to the first eye tracker assembly 340-1, which includes a first visible transmission IR mirror 324-1 and a first lens assembly 360-1, as shown in FIG. It can be guided to the first eye 1-1 via the main optical path. The WF IR light 402b-1 (generally in the form of a pencil beam) then reflects off the retina of the first eye 1-1 at a wide spatial angle as reflected WF IR light 402r-1. As the reflected WF IR light 402r-1 propagates through the lens and the cornea of the first eye 1-1, this expanded wavefront is modified by refraction through the lens and the cornea, and thus Information regarding the refractive characteristics of the cornea of the eye 1-1 is obtained. The reflected WF IR light 402r-1 returns through the main optical path of the first eye tracker assembly 340-1, is split by the first beam splitter 410-1, and finally passes through the first micro- It is directed by a first polarizing beam splitter 406-1 toward a lens array 412-1. This first microlens array 412-1 is configured to receive and split the WF IR light 402r-1 reflected from the first eye 1-1 into beamlets. The beamlets are then captured by the first wavefront camera 414-1 and analyzed to determine the refractive information they carry about the first eye 1-1.

The above-described embodiment of autorefractor 400-1 broadly follows the design of a Shack-Hartmann wavefront analyzer. Other embodiments may use other wavefront analysis designs such as Talbot-Moiré interferometry, slit lamp techniques, Tzerning aberrometry, lensmeter techniques, etc. Lensmeter devices can actually capture optical properties of the eye beyond spherical/refractive power. These characteristics include cylinder power and axis information, among others.

System 310 for determining binocular alignment with autorefractor 400-1 provides another useful diagnostic modality. One class of binocular alignment problems is called "accommodative lag." This refers to the phenomenon that when a patient is presented with an object at presentation distance d1, the patient's eyes focus at a different distance d2 that is not equal to d1. d2 is often larger than d1, ie d2>d1. System 310 with autorefractor 400-1 can recognize and diagnose such accommodation lag.

At a high conceptual level, the main goals of the system 310 for determining binocular alignment are the two systems that control human vision: the focal point, which focuses the lens on objects at actual distance by engaging the ciliary muscles; The purpose of this study is to diagnose and characterize the coordination and cross-links of the vergence system and the vergence system that rotates the eyes to see objects at real distance by engaging the six extraocular muscles. The embodiments of the systems 310 for determining binocular alignment of FIGS. 17-23 provide high quality diagnostic information in these cross-link systems through several design choices, and embodiments operate in the longitudinal/z direction. The embodiment simulates an object by first and second displays 322-1 and 322-2 that are capable of displaying first and second optical units 315-1 that are operable in a horizontal lateral direction. and 315-2, and further optionally, embodiments include first and second autorefractors 400-1 and 400-2. These design choices allow these systems 310 for determining binocular alignment to diagnose and characterize the coordination and cross-linking of the focus and vergence systems in an integrated "closed loop" manner. Accordingly, embodiments of the system for determining binocular alignment of 310 include a first display 322-1 and a first eye tracker assembly 340-1, and a second display 322-1 configured to determine a vergence response. 2 and a second eye tracker assembly 340-2, the second display 322-2 and the second eye tracker assembly 340-2 are configured to determine a vergence response and an accommodative response in an integrated manner by the second display 322-2 and the second eye tracker assembly 340-2 The first display 322-1 and the first autorefractor 400-1 and the second display 322-2 and the second autorefractor 400-2 are configured to determine the accommodative response. configured to determine.

For more information, reference is ultimately made to the method 100 for determining binocular alignment described above with respect to FIGS. 11-16. Computer 350 may be configured to perform the steps of method 100. Accordingly, in some embodiments, as part of the binocular alignment determination, computer 350 determines the amount of angular misalignment between the central target and the peripheral fusion lock of the moving target around the image with the blank center. The apparatus may be configured to determine fixation deviation of the patient.

In some embodiments, the computer 350 also allows the first display 322-1 and the second display 322-2 to display one of the eyes fixed on the target at a given time as part of the binocular alignment determination. It may also be configured to determine the total tropia as the average amount of angular misalignment between the first eye 1-1 and the second eye 1-2 when displaying disparate images.

24-25 show a first eye displaying an image on the first eye 1-1 which is movable along the lateral working direction according to the simulated distance and optical power of the first eye 1-1. display 322-1 and a first eye tracker assembly for tracking the direction of gaze of the first eye 1-1 that is adjustable in a horizontal lateral direction to adjust the pupillary distance of the first eye 1-1. 340-1 and a second eye 1 operable along a lateral working direction according to the simulated distance and optical power of the second eye 1-2. a second display 322-2 for displaying an image on the second eye 1-2; a second eye tracker assembly 340-2 that tracks a second eye tracker assembly 340-2; 3 shows a related embodiment of a system 310 for determining binocular alignment that includes a first optical unit for determining 315-1 and a computer 350 coupled to the second optical unit. A notable difference from the embodiment of FIGS. 17-23 is that the positioning of the first and second displays 322-1 and 322-2 is from a longitudinal arrangement to a lateral arrangement in the embodiment of FIGS. 24-25. It is about moving. This difference changes the form factor and dimensions of the overall system 310 and can be advantageous in a crowded optometrist's office. The lateral actuation direction can be a horizontal lateral ("x") direction or a vertical lateral ("y") direction. In FIG. 24 the lateral actuation direction is horizontal and in FIG. 25 it is vertical.

FIG. 25 details this latter vertical embodiment centered on the first eye 1-1. The elements of the system 310 for determining binocular alignment relating to the second eye 1-2 are similar and not explicitly shown. In this system 310 for determining binocular alignment, a first eye tracker assembly 340-1 includes one or more first infrared emitters that project an infrared eye tracking beam 342b-1 onto the first eye 1-1. A first infrared light source 344-1, which may include a number of individual LEDs that illuminate the first eye 1-1 with a diode 342-1, an infrared imaging light 344b-1, both reflected from the first eye. a first infrared camera 348-1 positioned along the longitudinal direction to detect an infrared eye tracking beam and an infrared imaging light, and collectively labeled 345b-1, and a first eye 1-1; transmits an infrared eye tracking beam and infrared imaging light 345b-1 reflected from a first infrared camera 348-1 along the longitudinal direction, and further transmits an image from a lateral working direction of the first display 322-1 to a first infrared camera 348-1. A first infrared-transmissive visible mirror 324'-1 may be included that longitudinally redirects toward the first eye 1-1. The second eye tracker assembly 340-2 includes one or more second infrared light emitting diodes 342 (not shown for clarity) that project an infrared eye tracking beam 342b-2 onto the second eye 1-2. -2, a second infrared light source 344-2 illuminating the second eye 1-2 with infrared imaging light 344b-2, both reflected from the second eye and collectively labeled 345b-2; a second infrared camera 348-2 positioned along the longitudinal direction for detecting an eye-tracking beam and infrared imaging light, and an infrared eye-tracking beam and infrared imaging light 345b- reflected from the second eye 1-2; 1 to a second infrared camera 348-2 along the longitudinal direction, and further redirects the image longitudinally from the lateral working direction of the second display 322-2 to the second eye 1-2. A second infrared-transmitting visible mirror 324'-2 may be included. Generally, beams entering and exiting eyes 1-1 and 1-2 propagate through first and second lens assemblies 360-1 and 360-2. Many variations and modifications of the embodiment of FIGS. 17-23 can have similar implementations in the embodiment of FIGS. 24-25. For example, horizontal adjustability can be implemented only for first and second eye tracker assemblies 340-1 and 340-2, similar to that described for the embodiment of FIGS. 17-23. or for those assemblies having first and second displays 322-1 and 322-2 with each other, with or without first and second lens assemblies 360-1 and 360-2. can do.

Although this specification contains many details, these should not be construed as limitations on the scope of the invention or what may be claimed, but rather as limitations on the scope of the invention or what may be claimed. It should be interpreted as a description of a characteristic. Certain features that are described in this specification in the context of separate embodiments can also be implemented in combination in a single embodiment. Conversely, various features that are described in the context of a single embodiment can also be implemented in multiple embodiments separately or in any suitable subcombination. Furthermore, although the features have been described above as operating in a particular combination, and are also originally claimed as such, one or more of the features from the claimed combination may be Optionally, the combinations can be deleted and the combinations mentioned in the claims can also be directed to subcombinations or variants of subcombinations.

Claims (28)

A system for determining binocular alignment, the system comprising:
a first optical unit,
a first display displaying an image to a first eye and operable along a longitudinal direction according to a simulated distance and optical power of the first eye;
a first eye tracker assembly that is adjustable in a horizontal lateral direction to track a gaze direction of the first eye and adjust a pupillary distance of the first eye;
a first optical unit including;
a second optical unit,
a second display displaying an image to a second eye and operable along the longitudinal direction according to a simulated distance and optical power of the second eye;
a second eye tracker assembly that is adjustable in a horizontal lateral direction to track the direction of gaze of the second eye and adjust the pupillary distance of the second eye;
a second optical unit including;
a computer coupled to the first optical unit and the second optical unit to determine the binocular alignment based on viewing directions of the first eye and the second eye;
A system for determining binocular alignment characterized by: the first display is structurally adjustable with the first eye tracker assembly;
the second display is structurally adjustable with the second eye tracker assembly;
A system for determining binocular alignment according to claim 1. the first eye tracker assembly is adjustable in a vertical lateral direction;
the second eye tracker assembly is adjustable in the vertical lateral direction;
A system for determining binocular alignment according to claim 1. The first eye tracker assembly includes:
one or more first infrared light emitting diodes that project an infrared eye tracking beam onto the first eye;
a first infrared light source illuminating the first eye with infrared imaging light;
a first infrared camera detecting the infrared eye tracking beam and the infrared imaging light both reflected from the first eye;
including;
The second eye tracker assembly includes:
one or more second infrared light emitting diodes that project an infrared eye tracking beam onto the second eye;
a second infrared light source illuminating the second eye with infrared imaging light;
a second infrared camera detecting the infrared eye tracking beam and the infrared imaging light both reflected from the second eye;
A system for determining binocular alignment according to claim 1. the first infrared light source includes a set of spatially distributed infrared light emitting diodes to illuminate the first eye with widely distributed infrared imaging light;
the second infrared light source includes a set of spatially distributed infrared light emitting diodes to illuminate the second eye with widely distributed infrared imaging light;
A system for determining binocular alignment according to claim 4. the one or more first infrared light emitting diodes are positioned in one of the front areas of the first eye tracker assembly and in close proximity to the first infrared camera;
the one or more second infrared light emitting diodes are positioned in one of the front areas of the second eye tracker assembly and in close proximity to the second infrared camera;
A system for determining binocular alignment according to claim 4. The computer uses the detected reflected infrared eye tracking beam and the detected reflected infrared imaging light to determine the orientation of the first eye and the second eye. including analysis systems;
A system for determining binocular alignment according to claim 4. The image analysis system includes:
determining Purkinje reflexes from the first eye and the second eye using the detected reflected infrared eye tracking beam;
determining pupil attributes of the first eye and the second eye using the detected reflected infrared imaging light;
By comparing the Purkinje reflex and pupillary attributes of the first eye and the second eye with reference Purkinje reflexes and pupillary attributes of the first eye and the second eye, configured to determine the line of sight direction of the second eye;
A system for determining binocular alignment according to claim 7. the one or more first infrared light emitting diodes project the infrared eye tracking beam in an alternating manner with the first infrared light source illuminating with the infrared imaging light;
the one or more second infrared light emitting diodes project the infrared eye-tracking beam in an alternating manner with the second infrared light source illuminating with the infrared imaging light;
A system for determining binocular alignment according to claim 4. The first eye tracker assembly includes:
transmitting an image from the first display along the longitudinal direction to the first eye;
laterally redirecting the reflected infrared eye tracking beam and the infrared imaging light from the first eye to the first infrared camera;
a first visible-transmissive infrared mirror positioned to
The second eye tracker assembly includes:
transmitting an image from the second display along the longitudinal direction to the second eye;
redirecting the reflected infrared eye tracking beam and the infrared imaging light from the second eye in the lateral direction to the second infrared camera;
a second visible-transmissive infrared mirror positioned to
A system for determining binocular alignment according to claim 4. the first infrared camera is positioned relative to the first visible infrared mirror in one of a vertical lateral and a horizontal lateral direction;
the second infrared camera is positioned relative to the second visible infrared mirror in one of the vertical lateral and horizontal lateral directions;
The system according to claim 10. The first optical unit is
both receiving and directing the infrared eye tracking beam and the infrared imaging light reflected from the first eye toward the first infrared camera;
reducing at least one of chromatic aberration, optical aberration, astigmatism, and wavefront distortion;
a first lens assembly;
The second optical unit is
both receiving and directing the infrared eye tracking beam and the infrared imaging light reflected from the second eye toward the first infrared camera;
reducing at least one of chromatic aberration, optical aberration, astigmatism, and wavefront distortion;
including a second lens assembly;
A system for determining binocular alignment according to claim 4. the first infrared camera and the first lens assembly are both adjustable;
the second infrared camera and the second lens assembly are both adjustable;
A system for determining binocular alignment according to claim 12. the first eye tracker assembly includes a first autorefractor that determines refractive information regarding the first eye;
the second eye tracker assembly includes a second autorefractor that determines refractive information regarding the second eye;
A system for determining binocular alignment according to claim 4. The first autorefractor includes:
a first infrared light source that projects wavefront IR light onto the first eye;
a first microlens array that receives reflected wavefront IR light from the first eye and splits it into beamlets;
a first wavefront camera that analyzes the beamlets to determine refractive information regarding the first eye;
The second autorefractor is
a second infrared light source that projects wavefront IR light onto the second eye;
a second microlens array that receives reflected wavefront IR light from the second eye and splits it into beamlets;
a second wavefront camera that analyzes the beamlets to determine refractive information regarding the second eye;
A system for determining binocular alignment according to claim 14. the first autorefractor utilizes at least one of Talbot-Moiré interferometry, split lamp technology, Tzerning aberrometry, and lensmeter technology;
A system for determining binocular alignment according to claim 14. The system for determining binocular alignment includes:
the first display and the first eye tracker assembly, and the second display and the second eye tracker assembly configured to determine a vergence response, the first display and the first autorefraction and the second display and the second autorefractor are configured to determine the convergence response and the accommodative response in an integrated manner, wherein the second display and the second autorefractor are configured to determine the accommodative response.
15. A system for determining binocular alignment according to claim 14. a first display is operable to a first longitudinal position according to the simulated distance;
the first longitudinal position is dynamically corrected according to the optical power of the first eye;
a second display is operable to a second longitudinal position according to the simulated distance;
the second longitudinal position is dynamically corrected according to the optical power of the second eye;
A system for determining binocular alignment according to claim 1. a nose bridge positioned centrally between the first optical unit and the second optical unit and configured to receive and secure a patient's nose;
A system for determining binocular alignment according to claim 1. the first eye tracker assembly is adjustable in the horizontal lateral direction relative to the nose bridge to adjust pupillary distance of the first eye;
the second eye tracker assembly is adjustable in the horizontal lateral direction relative to the nose bridge to adjust pupillary distance of the second eye;
20. A system for determining binocular alignment according to claim 19. The first display and the second display are
comprising at least one of a liquid crystal display, a light emitting diode (LED) display, an organic LED display, a quantum dot LED display, a microlens array, a digital mirror device, and a scanning projector microelectromechanical system;
A system for determining binocular alignment according to claim 1. the first display is configured to display to the first eye an image modified according to at least one of an optical power of the first eye, a cylinder, and a prism;
the second display is configured to display to the second eye an image modified according to at least one of an optical power of the second eye, a cylinder, and a prism;
A system for determining binocular alignment according to claim 1. a graphical user interface configured for interaction by a medical operator with the computer to manage the binocular alignment determination;
A system for determining binocular alignment according to claim 1. a loudspeaker configured to instruct a patient to follow the steps of determining binocular alignment;
a patient feedback portal configured to receive feedback from the patient selected from the group consisting of pushbuttons, trackwheels, touchpads, microphones, and voice interactive devices;
a patient communication interface comprising at least one of:
A system for determining binocular alignment according to claim 1. As part of the binocular alignment determination, the computer calculates the patient's fixation shift as the amount of angular misalignment between the central target and the peripheral fusion lock of the moving target around the image with the blank center. configured to determine;
A system for determining binocular alignment according to claim 1. The computer determines when the first display and the second display display different images with one of the eyes fixed on a target at a time as part of the binocular alignment determination. configured to determine total tropia as the average amount of angular misalignment between the first eye and the second eye;
A system for determining binocular alignment according to claim 1. A system for determining binocular alignment, the system comprising:
a first optical unit,
a first display displaying an image to a first eye and operable along a lateral working direction according to a simulated distance and optical power of the first eye;
a first eye tracker assembly that is adjustable in a horizontal lateral direction to track a gaze direction of the first eye and adjust a pupillary distance of the first eye;
a first optical unit including;
a second eye tracker assembly, the second eye tracker assembly comprising:
a second display displaying an image to a second eye and operable along the lateral working direction according to a simulated distance and optical power of the second eye;
a second eye tracker assembly adjustable in the horizontal lateral direction to track the direction of gaze of the second eye and adjust the pupillary distance of the second eye;
a second optical unit including;
a computer coupled to the first optical unit and the second optical unit to determine the binocular alignment based on viewing directions of the first eye and the second eye;
A system for determining binocular alignment. The first eye tracker assembly includes:
one or more first infrared light emitting diodes that project an infrared eye tracking beam onto the first eye;
a first infrared light source illuminating the first eye with infrared imaging light;
a first infrared camera positioned longitudinally to detect the infrared eye tracking beam and the infrared imaging light both reflected from the first eye;
transmitting the reflected infrared eye-tracking beam from the first eye and the infrared imaging light along the longitudinal direction to the first infrared camera to image an image from a lateral working direction of the first display; a first infrared-transmissive visible mirror that redirects the infrared rays toward the first eye in the longitudinal direction;
including;
The second eye tracker assembly includes:
one or more second infrared light emitting diodes that project an infrared eye tracking beam onto the second eye;
one or more second infrared light sources illuminating the second eye with infrared imaging light;
a second infrared camera positioned along the longitudinal direction to detect the infrared eye tracking beam and the infrared imaging light both reflected from the second eye;
transmitting the reflected infrared eye-tracking beam from the second eye and the infrared imaging light along the longitudinal direction to the second infrared camera to image the second display from a lateral working direction; a second infrared-transmissive visible mirror that redirects the infrared rays toward the second eye in the longitudinal direction;
28. A system for determining binocular alignment according to claim 27.

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