KR102645226B1 - Methods of Calculation for A Presbyopia Addition - Google Patents

Abstract

The method for calculating presbyopia addition of the present invention includes the steps of having a subject gaze at a distant point with a monocular eye and causing the striae light emitted and diverged from the near point to enter the pupil; placing lenses with different refractive powers one by one in front of the cornea while observing the retinal reflection; determining the far reaction point Hf according to the first diopter value, which is the refractive power of the lens at which the retinal reflection changes from anterograde to retrograde; having the subject gaze at the near point with a monocular eye and causing the linear light emitted and diverged from the near point to enter the pupil; placing lenses with different refractive powers one by one in front of the cornea while observing the retinal reflection; determining the near reaction point Hn according to the second diopter value, which is the refractive power of the lens at which the retinal reflection changes from accelerating to retrograde; determining the regulatory response range RA from the far reaction point Hf to the near reaction point Hn; It is characterized in that it consists of the step of determining the degree of subscription according to the control reaction range RA and the remote reaction point Hf.

Description

{Methods of Calculation for A Presbyopia Addition}

The present invention relates to a method for calculating the presbyopic signal, and more specifically, to a method for calculating the presbyopic signal, which allows the calculation of the presbyopic signal more accurately and systematically when producing near-field work glasses in relation to the aging phenomenon of the eyes.

Lenses inserted into glasses must be designed to suit the wearer's vision. The wearer's vision is measured using various testing methods, and various values for glasses and lenses are determined based on this, which is called an eyeglasses prescription test.

Unlike the distance glasses prescription test, which examines the refractive function and binocular vision function in a static refractive state, the near vision glasses prescription test is a complex examination of not only the refractive function of the eye, but also the control function involved in the dynamic refractive state of the eye and the related binocular vision function. Since it is more complex, a more in-depth inspection must be performed than a remote inspection.

However, in the optometry room of an actual optician, there are many cases where a subject who wears glasses chooses a ready-made reading glasses, tries them on, and sells them if they decide they are good. Or, when using multi-focal lenses such as progressive lenses at the same time, vision is corrected through a distance glasses prescription test. A subjective refraction test is performed, which is determined by the examinee's doctor by using a close-distance target, such as a back newspaper, to select the spherical refractive power of near glasses as the best view.

As a more professional optometry, in the case of near glasses prescription tests, most subjective refraction tests are performed according to the opinion of the examinee, such as the cross cylinder method, which tests based on the sharpness of the horizontal and vertical lines of the crosshair, and the red-green test, which tests by difference in sharpness among the red-green arrows. become dependent. Therefore, in the case of existing prescription tests for near vision glasses, there are no systematic standards, and most use a subjective test method in which the reading accuracy is adjusted based on the opinions of the test subject, the glasses wearer. For that reason, even if it is not accurate, it is decided based on the subjective judgment of the examinee, and excessive prescriptions of plus power more than necessary are made, raising the risk of damage due to heat within the retina.

Seong Pung-ju (2018), latest edition of Angle Optics, Seoul: Hyunmusa William J. Benjamin (2007), Clinical refraction, Seoul: Korean American Medicine Publishing

In the present invention, in the presbyopia addition test, the accommodative range before and after is measured based on the retina of the gaze line by using the range from the stimulation point for far vision in which accommodative force is not involved in the monocular to the stimulation point for working near vision in which accommodative force is involved. The purpose is to provide an objective refraction prescription through an objective test method that does not involve the subjective judgment of the examinee in calculating the presbyopia addition for near work as the age increases by defining the critical point.

The method for calculating the presbyopia degree of the present invention is
Having the subject gaze at a distant point of 3 m or more with a single eye and injecting the emitted striated light from a near point within the range of 0.33 to 0.50 m into the pupil;
placing lenses with different refractive powers one by one in front of the cornea while observing the retinal reflection;
determining the far reaction point Hf according to the first diopter value, which is the refractive power of the lens at which the retinal reflection changes from anterograde to retrograde;
having the subject gaze at the near point with a monocular eye and causing the striated light emitted from the same near point to enter the pupil;
placing lenses with different refractive powers one by one in front of the cornea while observing the retinal reflection;
A step of determining the near reaction point Hn according to the second diopter value, which is the refractive power of the lens at which the retinal reflection changes from accelerating to retrograde, is preceded;
The above steps are performed using an autorefractometer, or a refractometer and a plate lens.
determining the regulatory response range RA from the far reaction point Hf to the near reaction point Hn;

It is characterized in that the step of determining the degree of subscription according to the control reaction range RA and the remote reaction point Hf is followed.

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It is desirable to determine the control reaction range RA using the formula RA = 3-(Hf-Hn).

When the accommodative response range RA is determined and long-distance correction is necessary,

A) 2.75D ≤ RA ≤ It is 3.00D,

1) If Hf ≤ 1.75D

Far-corrected refraction = Hf-2

2) If Hf ≥ 3.25D

Far-corrected refraction = Hf-3

3) If 2.00D ≤ Hf ≤ 3.00D

Distance corrected refraction = 0

B) RA ≤ 2.50D,

1) If Hf ≤ 1.75D

Far-corrected refraction = (Hf-2) + (RA-3)

2) If Hf ≥ 3.25D

Far-corrected refraction = Hf-3

3) If 2.00D ≤ Hf ≤ 3.00D

Far-corrected refraction = RA-3

C) RA ≥ 3.25D,

1) If Hf ≤ 1.75D

Far-corrected refraction = (Hf-2) + (RA-3)

2) If Hf ≥ 3.25D

Far-corrected refraction = (Hf-3) + (RA-3)

3) If 2.00D ≤ Hf ≤ 3.00D

Far-corrected refraction = RA-3

It is desirable to decide by .

The step of determining the degree of subscription according to the control reaction range RA and the remote reaction point Hf is

A) 2.75D ≤ RA ≤ It is 3.00D,

1) If Hf ≤ 1.75D

Lag = ((-1+(3-RA)) + (subject age × 0.012)

2) If Hf ≥ 3.25D

Lag = 0

3) If 2.00D ≤ Hf ≤ 3.00D

Lag = Hf-3

B) RA ≤ 2.50D,

1) If Hf ≤ 1.75D

Lag = -1+(3-RA)

2) If Hf ≥ 3.25D

Lag = 0

3) If 2.00D ≤ Hf ≤ 3.00D

Lag = (Hf-3) + (3-RA)

C) RA ≥ 3.25D,

1) If Hf ≤ 1.75D

Lag =((-1+(3-RA)) + (subject age × 0.012)

2) If Hf ≥ 3.25D

Lag = 3- RA

3) If 2.00D ≤ Hf ≤ 3.00D

Lag = (Hf-3) + (3-RA) + (subject age × 0.012)

determining the adjustment rack Lag by;

Heo Seong's relative control force nRA is nRA = RA - |Lag| Steps for calculating according to the equation;

calculating the critical point CP using the equation CP = 1 - Lag;

It is desirable to calculate the membership Add using the formula Add = nRA - CP.

According to the present invention, the test method uses the accommodative response range of the intraocular response point to the accommodative stimulus from the distance outside the eye to the near working distance, and has the effect of providing an objective and more accurate test method than the subject's subjective subjective refraction test method.

1 is a diagram illustrating a far-distance reaction point and a near-distance reaction point.

Hereinafter, the present invention will be described in more detail with reference to the drawings according to embodiments thereof.

First, each of the subject's monocular eyes is tested. In order to cover the unexamined monocular and prevent the intervention of accommodative force for one monocular, the subject is asked to gaze at a distant point of more than 3 m, and a linear light is emitted into the pupil to enter the pupil. I order it.

Lenses with different refractive powers are placed one by one in front of the cornea while observing the retinal reflection of the striated light incident into the monocular pupil. At this time, it is possible to select a lens that changes the retinal reflex from anterograde to retrograde. The refractive power of this lens is called the first diopter value, and the first diopter value is referred to as the far reaction point Hf.

Next, each of the subject's monocular eyes is tested. In order to cover the untested monocular and prevent the intervention of accommodative force in one monocular, the subject is asked to gaze at a near point of 0.33 m, and a striae light is emitted into the pupil. Enter the company. The near point is set to the working distance of the test subject and can be set to one within the range of 0.33 to 0.50 m.

Lenses with different refractive powers are placed one by one in front of the cornea while observing the retinal reflection of the striated light incident into the monocular pupil. At this time, it is possible to select a lens that changes the retinal reflex from anterograde to retrograde. The refractive power of this lens is called the second diopter value, and the second diopter value is referred to as the near reaction point Hn.

The series of steps described above can be performed manually using an existing autorefractometer or using a refractor and plate lens.

In case of astigmatism, it is desirable to measure Hf and Hn based on the approximately meridian.

Figure 1 schematically shows the first and second diopters representing the far reaction point Hf and the near reaction point Hn, as well as the far point Pf and the near point Pn.

Based on the retina within the eye, the absolute coordinates of + on the right and - on the left represent the near reaction point Hn, and the far reaction point Hf differs by 3 diopters based on the absolute coordinates.

Therefore, since it is a natural phenomenon that the monocular far reaction point Hf and the near reaction point Hn are measured differently for each person, the range of the far reaction point Hf to the near reaction point Hn, which is the accommodative response in response to stimulation from the far stimulus to the task near, is the accommodative response. The range is defined as RA, and is defined by the equation RA = 3-(Hf-Hn).

The normal case is shown in Figure 1. When the far reaction point Hf is +2.00D, the near reaction point Hn also has the same value of +2.00D with a difference of 3.00D, so the range of the accommodative response RA in the coordinate system of Figure 1 is 3.00 It is calculated as D.

The present invention is for statistical purposes such as patients with monocular blindness, cataracts and corneal ablation procedures such as LASIK and LASEK, pseudomyopia with severe statistical errors, and normal people but requiring subscription due to latent hyperopia. Excluding those who cause errors, a total of 181 people with refractive error who do not have severe diabetes or high blood pressure, which are vascular diseases, and who have relatively good foveal reflexes are selected and based on the measured values, each variable is measured according to statistical techniques. This was achieved by analyzing the correlation between .

There are a total of 125 people with myopia, 68 men and 57 women. 68% are men and 57% are women, and they range in age from 10 to 60. In addition, there were a total of 56 people with manifest hyperopia, 30 men and 26 women, with men making up 53.6% and women 46.4%.

Frequency analysis of participant demographics(myopia=125, hyperopia=56) Myopia
(31.0 years) Age Frequency Percent(%) Cumulative Percent(%) - 19 22 17.6 17.6 20 - 29 35 28.0 45.6 30 - 39 14 11.2 56.8 40 - 49 24 19.2 76.0 50 - 59 23 18.4 94.4 60 - 7 5.6 100.0 Sub Total 125 100.0 Manifest
Hyperopia
(55.7 years) 40 - 49 4 7.1 7.1 50 - 59 16 28.6 35.7 60 - 36 64.3 100.0 Sub Total 56 100.0 Total 181

As age increases, the negative accommodative lag Lag in both emmetropia and ametropia in myopia models gradually decreases, and after the age of 50, the intraorbital accommodative response range RA decreases due to organic causes of guidance such as latent hyperopia. Change occurs. In order to confirm the suitability of the model according to changes in accommodative power, the accommodative response range RA, which is intraorbital control, was evaluated separately into myopia and overt hyperopia.

Since the intraorbital accommodative response range RA is different for each model, changes in the range of accommodative lag Lag, false relative accommodative power nRA, and addition degree ADD cannot be overlooked. Accommodative response range RA, false relative accommodative force, which are the main variables of the myopia and hyperopia models. There is a need to evaluate the parameters of accommodative force nRA, accommodative lag Lag, and accession ADD to use them effectively in clinical refraction.

Prior to analyzing the paths between variables, frequency analysis was performed using SPSS, a statistical analysis package. Then, the variables were covaried and the parameters were evaluated by showing posterior the average value using Analysis Moment Structure (ver. 18) Bayesian (Bayesian structural equation modeling (SEM)) technique. Table 2 shows the covariance analysis of each variable using AMOS. The correlation between variables was confirmed through .

Covariances and correlations (myopia & manifest hyperopia) Model Covariances Correlations Myopia Variable Estimate S· C· P Estimate △RA ↔ △nRA .12 .02 7.38 *** .88 △nRA ↔ △Lag -.04 .01 -4.75 *** -.47 △nRA ↔ △ADD .04 .01 4.59 *** .45 △RA ↔ △Lag -.10 .01 -7.00 *** -.81 △RA ↔ △ADD .05 .02 3.72 *** .36 △Lag ↔△ADD .02 .01 2.48 .013 ^* .23 Manifest
Hyperopia △RA ↔ △nRA .15 .03 5.18 *** .98 △nRA ↔ △ADD .15 .03 5.18 *** .98 △RA ↔ △ADD .16 .03 5.17 *** .97

* Difference between groups is significant at p<0.05 ^* , p<0.01 ^** , p<0.001 ^*** .

According to the above statistical analysis, a method to calculate subscription ADD was found as follows.

Approximately 80% of the examinees had an accommodative response range RA in the range of 2.75D to 3.00D, and the smaller range, 2.5D or less, and the larger range, 3.25D or more, were considered abnormal and classified.

Additionally, if the distance reaction point Hf was less than 1.75D, it was considered myopia, if it was greater than 3.25D, it was considered hyperopia, and if it was between 2.00D and 3.00D, it was considered normal vision.

In optometry, the refractive index of a lens is measured at intervals of 0.25D, so in visual acuity evaluation, the values are calculated at intervals of 0.25.

The range of the accommodative response RA, which determines the range from the far reaction point Hf to the near reaction point Hn, is determined by the equation RA = 3-(Hf-Hn).

If distance correction is required, the distance correction refraction is:

A) 2.75D ≤ RA ≤ It is 3.00D,

1) If Hf ≤ 1.75D

Far-corrected refraction = Hf-2

2) If Hf ≥ 3.25D

Far-corrected refraction = Hf-3

3) If 2.00D ≤ Hf ≤ 3.00D

Distance corrected refraction = 0

B) RA ≤ 2.50D,

1) If Hf ≤ 1.75D

Far-corrected refraction = (Hf -2) + (RA -3)

2) If Hf ≥ 3.25D

Far-corrected refraction = Hf-3

3) If 2.00D ≤ Hf ≤ 3.00D

Far-corrected refraction = RA-3

C) RA ≥ 3.25D,

1) If Hf ≤ 1.75D

Far-corrected refraction = (Hf -2) + (RA -3)

2) If Hf ≥ 3.25D

Far-corrected refraction = (Hf -3) + (RA -3)

3) If 2.00D ≤ Hf ≤ 3.00D

Far-corrected refraction = RA-3

It is desirable to decide by .

The step of determining the degree of subscription according to the control reaction range RA and the remote reaction point Hf,

A) 2.75D ≤ RA ≤ It is 3.00D,

1) If Hf ≤ 1.75D

Lag = ((-1+(3-RA)) + (subject age × 0.012)

2) If Hf ≥ 3.25D

Lag = 0

3) If 2.00D ≤ Hf ≤ 3.00D

Lag = Hf-3

B) RA ≤ 2.50D,

1) If Hf ≤ 1.75D

Lag = -1+(3-RA)

2) If Hf ≥ 3.25D

Lag = 0

3) If 2.00D ≤ Hf ≤ 3.00D

Lag = (Hf-3) + (3-RA)

C) RA ≥ 3.25D,

1) If Hf ≤ 1.75D

Lag =((-1+(3-RA)) + (subject age × 0.012)

2) If Hf ≥ 3.25D

Lag = 3- RA

3) If 2.00D ≤ Hf ≤ 3.00D

Lag = (Hf-3) + (3-RA) + (subject age × 0.012)

determining the adjustment rack Lag by;

Heo Seong's relative control force nRA is nRA = RA - |Lag| Steps for calculating according to the equation;

calculating the critical point CP using the equation CP = 1 - Lag;

Add membership is calculated using the formula Add = nRA - CP.

Negative (-) Lag must always be equal to or less than 0, but when calculated as positive, Lag is set to 0.

According to the above process, myopia, hyperopia, and emmetropia according to the accommodative response range RA, which ranges from the monocular far response point Hf to the near response point Hn, corresponding to the extra-monocular far stimulus point Pf and the near stimulus point Pn along the gaze line, and the far response point Hf. It was possible to classify and prescribe Wonyong glasses. In addition, the negative Lag when no control is involved, the control range of the false relative control force nRA when the control force is involved, and the critical point, which is a point within the false relative control force nRA that can be identified for short-range work, are calculated. By obtaining this, it was possible to calculate an objective and accurate membership level. Glasses manufactured using this testing method prevented excessive refraction prescriptions and gave subjects a very high level of satisfaction.

Of course, each step of the method described above can be performed in whole or in part by an automated device, and devices implementing this method fall within the scope of the present invention.

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Claims (4)

Having the subject gaze at a distant point of 3 m or more with a single eye and injecting the emitted striated light from a near point within the range of 0.33 to 0.50 m into the pupil;
placing lenses with different refractive powers one by one in front of the cornea while observing the retinal reflection;
determining the far reaction point Hf according to the first diopter value, which is the refractive power of the lens at which the retinal reflection changes from anterograde to retrograde;
having the subject gaze at the near point with a monocular eye and causing the striated light emitted from the same near point to enter the pupil;
placing lenses with different refractive powers one by one in front of the cornea while observing the retinal reflection;
A step of determining the near reaction point Hn according to the second diopter value, which is the refractive power of the lens at which the retinal reflection changes from accelerating to retrograde, is preceded;
The above steps are performed using an autorefractometer, or a refractometer and a plate lens.
determining the regulatory response range RA from the far reaction point Hf to the near reaction point Hn;
A method for calculating the presbyopia addition degree, characterized in that the step of determining the addition degree according to the accommodative response range RA and the far reaction point Hf is followed.
According to claim 1,
A presbyopia subscription calculation method characterized in that the accommodative response range RA is determined by the formula RA = 3-(Hf-Hn).
According to claim 1,
When the accommodative response range RA is determined and long-distance correction is necessary,
A) 2.75D ≤ RA ≤ It is 3.00D,
1) If Hf ≤ 1.75D
Far-corrected refraction = Hf-2
2) If Hf ≥ 3.25D
Far-corrected refraction = Hf-3
3) If 2.00D ≤ Hf ≤ 3.00D
Distance corrected refraction = 0
B) RA ≤ 2.50D,
1) If Hf ≤ 1.75D
Far-corrected refraction = (Hf-2) + (RA-3)
2) If Hf ≥ 3.25D
Far-corrected refraction = Hf-3
3) If 2.00D ≤ Hf ≤ 3.00D
Far-corrected refraction = RA-3
C) RA ≥ 3.25D,
1) If Hf ≤ 1.75D
Far-corrected refraction = (Hf-2) + (RA-3)
2) If Hf ≥ 3.25D
Far-corrected refraction = (Hf-3) + (RA-3)
3) If 2.00D ≤ Hf ≤ 3.00D
Far-corrected refraction = RA-3
A method for calculating presbyopia participation, characterized in that it is determined by .
According to claim 1,
The step of determining the degree of subscription according to the control reaction range RA and the remote reaction point Hf is
A) 2.75D ≤ RA ≤ It is 3.00D,
1) If Hf ≤ 1.75D
Lag = ((-1+(3-RA)) + (subject age × 0.012)
2) If Hf ≥ 3.25D
Lag = 0
3) If 2.00D ≤ Hf ≤ 3.00D
Lag = Hf-3
B) RA ≤ 2.50D,
1) If Hf ≤ 1.75D
Lag = -1+(3-RA)
2) If Hf ≥ 3.25D
Lag = 0
3) If 2.00D ≤ Hf ≤ 3.00D
Lag = (Hf-3) + (3-RA)
C) RA ≥ 3.25D,
1) If Hf ≤ 1.75D
Lag =((-1+(3-RA)) + (subject age × 0.012)
2) If Hf ≥ 3.25D
Lag = 3-RA
3) If 2.00D ≤ Hf ≤ 3.00D
Lag = (Hf-3) + (3-RA) + (subject age × 0.012)
determining the adjustment rack Lag by;
Heo Seong's relative control force nRA is nRA = RA - |Lag| Steps for calculating according to the equation;
calculating the critical point CP using the equation CP = 1 - Lag;
The presbyopia addition calculation method is characterized in that the addition is calculated using the formula Add = nRA - CP.