MXPA96003455A - Apparatus and method of determination and marking to be used in optometry and ophthalmolo - Google Patents

Abstract

The present invention relates to a device capable of being used by a patient having an eye and a visual axis associated with the eye and in connection with glasses having a lens through which the visual axis can pass, comprising :to. a movable object configured to minimize obstruction of the patient's vision and comprising a light source; means, positionable adjacent to the lens opposite the lens of the eye, to align the moving object with the visual axis, and c. means, connected to the alignment means, for holding the alignment means to a selected portion of the glasses without preventing movement of the movable object in relation to the visual axis.

Description

DEVICE AND METHOD OF DETERMINATION AND MARKING FOR USE IN OPTOMETRY AND OPHTHALMOLOGY FIELD OF THE INVENTION The invention relates to the apparatus and techniques for determining subjectively (and in some cases at least partially objectively) the relationships between the pupils of patients and the locations in the corresponding multi-focal gauging lenses. BACKGROUND OF THE INVENTION Multifocal lenses, frequently used to remedy presbyopia, contain two or more regions of different corrective potency. A previous attempt in the construction of multi-focal lenses involved the joining of pieces of two separate lenses, one placed on top of the other, within the frames of the frame of each of the gauge structures, left and right of the patient. These lenses, called "Franklin Bifocals", included different horizontal lines that demarcate the boundary between the pieces of lenses joined in each structure. However, the sharp division lines were cosmetically unattractive and the lenses themselves were mechanically weak. The most modern bifocal designs provide correction to the far and near vision for each eye using a single fixed lens in the frame of the frame of the corresponding gaging structure. Typically designed to correct distant vision of the patient, the individual lens includes a cavity or countersunk field on either its front or back surface. A separate segment button is fused to the countersink to provide the appropriate additive power for close vision correction. Alternatively, the distance prescription may be based on a surface of an individual lens and the power of the addition field over the other. Each of these designs provides mechanically stronger lenses than the bifocal Franklin; however, the designs do not eliminate the unattractive visible boundary between the two prescriptive surfaces. The use of these conventional bifocals also causes patients to experience blurring in areas corresponding to demarcation lines as patients move their eyes vertically. Progressive power lenses, also known as "invisible" bi-or tri-focal lenses, eliminate visible discontinuities in other multi-focal designs and which result in vertical blurring by continuously varying the corrective power through particular regions of the individual lenses. Such progressive power lenses effectively disguise their mui-focal nature by fusing adjacent prescriptive curves through pre-polishing and buffing techniques. However, adjacent fusion curves introduce other optical distortions, creating, for some patients, unwanted astigmatism or vertical prism imbalance. Typically, progressive power lenses also contain narrow optical corridors that connect the near and distant viewing areas, reducing peripheral clarity, and resulting in a comfort level of many users. An important consideration in accommodating invisible bifocal lenses to the eyes of patients is that the orientation of the visual axes of the eyes is involved in the optical thresholds where the progressive powers are initiated. In other words, as the left and right eyes move together vertically in the progressive trajectories, they must find parts of the invisible bifocal lenses of the same progressive power. This result depends in part on the choice of the gauging structures and on whether the respective dimensions of the structure allow the exact focusing of the lenses with respect to the patient's pupils. The proper alignment also depends on the technique used to determine the centers of the patient's pupils. There are a variety of devices to assist a practitioner in objectively determining the centers of a patient's pupils in relation to predetermined locations while the patient's head is in its basic position. One such device, the "Multi-Purpose Measuring Device" provided by the Varilux Corporation, is an aligned clear layer having a dotted bottom surface which is designed to temporarily adhere to a patient's gauge structures. While facing the sitting or standing patient using the glasses, the practitioner places the pointed end of the measuring device at the deepest point of one of the left or right structures. Subsequently, the practitioner attempts to align his line of sight with the patient's eye corresponding to the structure containing the measuring device and marks the center of the pupil in the measuring device using a washable felt tip pen. The practitioner can then read the vertical distance from that center of the pupil to the lower surface of the structure from the marks on the measuring device. The vertical distance from the center of the other pupil of the patient in relation to the lower surface can be determined in a similar manner. To measure the horizontal distance from the center of the patient's pupil to a particular location, typically the bridge of the patient's nose, the practitioner orients a measuring device that looks like a conventional rule approximately parallel to the floor and places it slightly above the bridge of the patient. The practitioner then looks along an imaginary vertical line that intersects the center of a pupil and, using the measuring ruler, determines the horizontal distance from the center of the pupil to the bridge of the nose. Similarly, the horizontal distance between the center of the pupil of the other eye and the bridge of the nose can be determined by looking along an imaginary vertical line that intersects the other pupil. These measurement techniques lack the precision necessary to place invisible bifocals adequately for many patients. At least a portion of the patient's pupils is obstructed by the aligned layer, decreasing both the ability of the patient to focus appropriately and the ability of the practitioner to locate the center of the pupil. Parallax presents another problem since the practitioner often can not accurately align his line of sight with that of the patient. Because there is no concrete structure against which the practitioner can verify that the visual axis measurements are accurate, the errors made in determining the centers of the pupil can not be corrected before the prescriptive glasses are made. US Pat. No. 4,206,549 to Gould, the patent of which is hereby incorporated in its entirety by this reference, sets forth another objective device for determining the center of a patient's pupils. The Goukd device overcomes some of the disadvantages of other techniques by using a transparent plate with a small objective mark that can be magnetically attached to the lenses. Initially, a pair of gauge structures are placed on a patient, many of which are provided to the practitioner with simulated flat lenses in place. If such glasses lack these "demonstrator" lenses, simulated flat lenses can be formed by cutting a sheet of plastic or a similar material and securing them in the gauging structures. Subsequently, the transparent plate is attached to either the left or right structure (and later to the other structure if necessary) using sets of magnets located on the opposite surfaces of the lenses, and the practitioner aligns the objective mark with the Center the patient's pupil by sliding the transparent plate through the lenses until he or she believes that the objective mark aligns with the patient's visual axis. Although not exposed in Gould, presumably the structures are removed and a small spot of fluorescent paint is placed on the counter-ocular surface of the simulated lenses coinciding with the registration mark. The practitioner then aligns with the patient and looks at the luminous spot to determine if the registration marks align with the center of the pupil. Alternatively, the light can be projected onto the luminous spot from a position at an angle to the visual axis of the simulated lenses. While the patient stares at infinity he looks at the colored spot and can inform the practitioner if the mark is properly aligned with the visual axis. Because the practitioner makes the initial determination of the center of the pupil in each case, parallax and other misalignment problems remain - both when viewing along the patient's visual axis and when marking the location of the objective mark on the patient. surface of the lenses - when using the Gould device. Any predisposition present in the trends of the practitioner's view also affects the resulting measurement, as does any similar predisposition associated with the marking capabilities of the practitioner's lenses. The friction caused by sliding the plate held magnetically through the surface of the lens can cause a slight movement of the gauge structures from their normal position, further decreasing the accuracy of the determination of the relationship between the center of the pupil and the corresponding lenses. For patients who have long eyelashes or whose gaferia lenses are normally used near their eyes, magnets on the inner surface of the lenses can also contact their eyelashes and cause difficulty in focusing patients during examination. Finally, although the patient can confirm the practitioner's work by observing whether the fluorescent spots align, the misalignment does not necessarily provide the practitioner with additional information to increase the likelihood of an appropriate alignment during the next repetition of the examination. The Gould patent also discloses a subjective mode in which an opaque plate having a very small aperture can be magnetically attached to the lenses. The patient can then look towards a source or object of remote light placed appropriately while adjusting the plate until the source or object of light is seen through the very small aperture. Subsequently, each very small opening location, presumably on the inner surface of the lenses, is marked by the practitioner after the removal of the structures from the patient's head. Although this mode minimizes the effects of parallax when aligning the very small aperture and the center of the pupil, it does not diminish the parallax problems associated with marking the location of the very small aperture on the lenses, nor does it reduce the other obstacles related to the use of the objective modality of the Gould device. In addition, because the opaque plate of the subjective modality blocks peripheral vision of the patient, binocular fusion can not occur and phoria may be introduced. SUMMARY OF THE INVENTION The present invention provides simple and easy to use devices, and associated methods to determine subjectively (and in some cases at least partially objectively) the appropriate position of the progressive power or other lenses. The various modalities of the devices, some of which are primarily designed to be supported by the patient, include a small light source and one or more marking bars activated by the patient. While the patient wears the pre-fixed structures and fixes them on a remote lens (which can illuminate itself for patients with extremely poor vision), place the light source against or immediately adjacent to the outer surface of the lens demonstrates inside any of the structures and places the light so that it focuses on its line of sight. Once the light is centered, the patient activates the marking bars, which contact the outer surface of the lenses in two (or more) points equidistant from the center of the light source. By bisecting an imaginary or real line drawn to connect the two points in the simulated lenses, the practitioner or lens manufacturer (or even the patient) can accurately determine the location where the power changes from the progressive power or where other lenses should begin. The present invention avoids the problems associated with objective devices by allowing the patient to participate in both the alignment of the device and the marking of the lenses. In addition, because the light source and marking bars of some modalities are designed to obstruct the patient's vision very little, their peripheral vision remains intact and allows binocular fusion to occur. The absence of magnets or any other foreign object on the inner surface of the lenses allows the patient to wear the glasses in their normal position without taking into account whether the objects will contact their eyelashes. Similarly, by not using magnetic or other holding means within the field of view, the various embodiments of the present invention can be repositioned by the patient without causing the movement of the gaging structures themselves. Because the invention relieves the practitioner of the tedium of measuring and marking the visual axes of the patient, the practitioner's response to using progressive power lenses should be more favorable. As noted in Borish, Hitzeman, and Brookman, Double Masked Study of Progressive Addition Lenses. in the Journal of the American Optometric Association, vol. 51, no. 10, pp. 933-43 (October 1980), the potential acceptance of progressive power lenses by the patient is colored by the enthusiasm of the practitioner who suggests its use. In addition, because the patient participates in the examination and determination of the location of the lenses, he or she has a greater incentive to adapt the lenses of progressive power. The combination of increased enthusiasm of both patients and practitioners should result in greater acceptance of progressive power lenses in general. Another device according to the invention is designed to be sustained and activated by the practitioner, although it also allows the patient's participation in the alignment process. A deviated support for the head associated with the modalities of this device additionally helps the patient to keep the positioning of his head relatively constant, reducing his movement during the procedure. Other characteristics of these modalities help the practitioner to level the device and place it adjacent to the lenses by marking. Accordingly, it is an object of the present invention to provide means for subjectively determining the proper position of a progressive power or other lens within a gaging structure. A further object of the present invention is to provide means for subjectively aligning an objective with a visual axis of the patient and marking a lens according to the foregoing. Another object of the present invention is to provide means for subjectively determining the proper placement of a progressive power or other lens without introducing foria caused by blocking the peripheral vision of the patient. Still another object of the present invention is to provide simple, easy-to-use means for accurately determining the center of a patient's pupil in relation to lenses within gauge structures.

A further object of the present invention is to provide means for increasing the level of acceptance of progressive power lenses by allowing the patient to participate in determining the location of the lenses in relation to the center of the pupils and reducing the effort required of the practitioner Another object of the present invention is to provide devices that are sustained and activated by the practitioner, although they also allow the participation of the patient in the alignment process. Other objects, features, and advantages of the present invention will become more apparent with reference to the remainder of the written portion and drawings of this application. BRIEF DESCRIPTION OF THE DRAWINGS Figure 1 is a perspective view of one embodiment of the apparatus of the present invention shown placed by a patient adjacent to the outer surface of a pair of gauge lenses. Figure 2 is a side elevational view of the apparatus of Figure 1. Figure 3 is a perspective view of a first alternative embodiment of the apparatus of the present invention. Figure 4 is a perspective view of a second alternative embodiment of the apparatus of the present invention. Figure 5 is a perspective view of a third alternative embodiment of the apparatus of the present invention. Figure 6 is a perspective view of a fourth alternate embodiment of the apparatus of the present invention having a clamped handle. Figure 7 is a perspective view of a fifth alternate embodiment of the apparatus of the present invention. Figure 8 is an electromechanical schematic view of the apparatus of Figure 7. Figure 9 is a perspective view of a sixth alternate embodiment of the apparatus of the present invention. Fig. 10 is an enlarged perspective view of the apparatus of Fig. 9. Fig. 11 is a partially sectioned view, in side elevation of the apparatus of Fig. 9. Fig. 12 is a perspective view of one embodiment of the apparatus of Figs. present invention, designed to be activated primarily by the practitioner. Figure 13 is another perspective view of the apparatus of Figure 12 shown partially broken away. Figure 14 is a plan view (from top to bottom) of the apparatus of Figure 12 shown broken away. Fig. 15 is a schematic representation of a portion of the apparatus of Fig. 12. Fig. 16 is a perspective view of one embodiment of the apparatus of the present invention designed to allow the practitioner to mark the gaferia lenses after removing the glasses of the patient. Figure 17 is a perspective view of the apparatus of Figure 16 shown positioned adjacent a gauge lens for marking the lenses. Figure 18 is another perspective view of the apparatus of Figure 16. Figure 19 is a partially sectioned view, in side elevation of the apparatus of Figure 16. Figure 20 is a perspective view of an alternate embodiment of the present invention. designed to allow the practitioner to mark the gaferia lenses after removal of the patient's glasses. Figure 21 is a cross-sectional view of the apparatus of Figure 20 taken along line 21-21. Figure 22 is a cross-sectional view of the apparatus of Figure 20 taken along line 22-22 of Figure 21. Figure 23 is a perspective view of a portion of the apparatus of Figure 20. Figure 24 is an illustration of a patient wearing the apparatus of figure 20 and looking at a remote objective. DETAILED DESCRIPTION OF THE INVENTION Figures 1-2 detail one embodiment of the apparatus 10 of the present invention designed to allow subjective determination of the proper placement of progressive power or other corrective power lenses. As shown in Figures 1-2, the apparatus 10 can be positioned by the patient 14 against or immediately adjacent to the outer surface 18 of lenses 22 contained within the spectacles 26. The new spectacles 26 often include flat simulators that they can serve as lenses 22, although the apparatus 10 can be used in connection with the existing spectacles 26 of the patient if prescriptive or other lenses are in place. Alternatively, as set forth in the Patent No. 4,206,549 to Gould, the lenses 22 can be cut or stamped from a sheet of plastic and secured to or otherwise secured to the spectacles 26. The apparatus 10 includes a light source 30, a marking bar 34, and two marking elements 38 and 42 associated with the marking bar 34 and positioned so that their respective tips 46 and 50 are equidistant from the light source 30. The ability of the patient to mark the lenses 22 at two points equidistant from each other. the light source 30 forms a significant feature of the invention, since the bisection of an imaginary or real line drawn between the two points provides the reference from which progressive power or other lenses can be accurately positioned or fixed. corrective Also included as part of the apparatus 10 are the structure 54, the compartment 58, the thumb rest 62, the rod 66, the foot 70, the digital rests 74 and 78, the rod 82, and the actuator arm 86. As illustrated in Figures 1 and 2, the structure 54 may be molded or otherwise constructed substantially in a "U" shape and made from any suitable material such as plastic or metal. The structure 54 may also be designed so that the distance between the tips corresponds approximately to or is slightly less than the average amplitude of the lenses 22 in order not to obstruct the view of the patient 14 significantly. The compartment 58 forms the lower surface of the structure 54 and can be used to house a battery or other power source for the light source 30. The compartment 58 can also include a depression or other thumb rest 62 as its lower surface with purpose of allowing the patient 14 to stabilize the apparatus 10 when it is placed in its field of vision. A thin rod 66 extends upwardly from the compartment 58 and houses a light source 30. The light source 30, which typically can be a small fiber optic channel or a light emitting diode (LED), is used as a light source. object for the patient 14. Accordingly, as best shown in Figure 2, the rod 66 extends beyond the plane defined by the tips of the U-shaped structure 54 so that the light source 30 can be positioned against or almost next to the outer surface 18 of the lenses 22. The rod 66 also serves to cover the electrical connections (which can be made through a switch 68) between the light source 30 and the power source in the compartment 58 and, like the structure 54, is designed to obstruct a little the patient's vision. As illustrated in FIGS. 1-2, the foot 70 can be used to assist in the stabilization of the apparatus 10 while it is in use. No non-abrasive material such as felt or Teflon having a sufficient coefficient of friction to prevent undesired movement of the apparatus 10 can form the foot surface 70, which can be secured to either or both of the structure 54 and compartment 58 and is oriented for fixing substantially substantially with the outer surface of the lenses 22. The digital rests 74 and 78 associated with the bar 82 are also designed to assist the patient 14 in stabilizing the apparatus 10, whose bar 82 is connected near each end of the device. the tips of the "U" -shaped structure 54 and form the upper section of the apparatus 10. Typically, the patient 14 places an index on one of the digital rests 74 and 78 to counteract the upward force generated by the presence of his thumb in the thumb rest 62. The movement of the marking rod 34 and the elements 38 and 42 is carried out using an arm or driving lever 86. In a modal With the invention consistent with FIGS. 1-2, a torsion spring associated with the drive arm 86 is included within the bar 82. Referring primarily to FIG. 2, in its non-actuated position., the arm 86 lies slightly above the horizontal plane that includes the center of the bar 82, while the tips 46 and 50 of the marking elements 38 and 42 rest a short distance from the outer surface 18 of the lenses 22. However, when a patient 14 presses on the arm 86, typically with the middle finger of the hand holding the apparatus 10, the torsion spring is tensioned and the marking rod 34 moves in a curved path sufficient to allow the tips 46 and 50 (which may be inked felt, petrolatum pencil, or other suitable devices) contact and mark the outer surface 18 of the lenses 22. Once the pressure on the arm 86 is released, the torsion spring is relaxes and returns tips 46 and 50 and arm 86 to their resting positions. Although figure 2 shows the marking rod 34 as rigidly attached to the actuator arm 86 at an angle of approximately 90 °, there may be any suitable angle between these components. However, optimal results will probably be obtained if the displacement requirements of the marking rod 34 are minimized. Similarly, those of ordinary skill in the art will recognize that drive means that include elements other than a torsion spring may be used. , to assist in the forward and backward movement of the marking rod 34. For example, the arm 86 can be designed merely to rotate around the bar 82, sufficient friction exists between the arm 86 and the bar 82 to require that it be provided. some force by the patient 14 in order to cause the marking rod 34 to contact the outer surface 18 of the lenses 22. However, the accuracy of the marking will probably increase if the amount of force required to be delivered by the patient 14 is small . The operation of the apparatus 10, exposed mainly in relation to the left eye 90 of the patient 14 and its corresponding visual axis or basic line of sight 94, can be described as follows. Initially, the spectacles 26 should be fixed to the patient 14. Although the apparatus 10 can be used whether the spectacles 26 are pre-set or not, adjusting the spectacles 26 after one or both lenses 22 are marked may result improper placement of progressive power lenses or other corrective lenses. Once the glasses 26 are placed comfortably, the patient 14 can grasp the apparatus 10 with the index finger of his left hand placed on the digital rest 74 and the thumb placed on the thumb rest 62. The patient 14 is fixed then, preferably while standing or sitting and with its head in its basic position, (using both left and right eyes 90 and 98, respectively) on a remote object RT such as a map, an image or other suitable object located at along the basic line of sight 94. While being fixed on the remote object, the patient 14 places the apparatus 10 so that the light source 30 is located immediately adjacent the outer surface 18 of the lenses 22 and is focused along the basic line of sight 94. Once the light source 30 is centered, the patient 14 operates the arm 86, typically with his left middle finger, and causes the marking rod 34 to contact the lenses 22 e n two points along its outer surface 18. The lenses 22 can then be used as a model to create the progressive power or other corrective lens by being fixed in the corresponding section of the eyeglasses 26. A similar procedure can be followed in connection with the right eye 98 of the patient 14, the patient 14 typically grasping the apparatus 10 in his right hand with his index finger placed in the digital rest 78. In addition, those of ordinary skill in the art will recognize that the apparatus 10 can be modified to allow the simultaneous or concurrent marking of the lenses 22 associated with both left and right eyes 90 and 98. Similarly, the apparatus 10 may be modified so that it is biased on or otherwise secured to the outer portion of the glasses 26 if is desired Additional marking elements and tips can be added to, for example, allow the triangulation of the reference point for the final corrective lenses. Alternatively, the apparatus 10 may be modified so that a single marking tip (very thin) aligns with the center of the light source 30 and is thereby able to make a single mark corresponding to the exact location of the point Reference of corrective lenses. Similarly, the light source 30 can be modified so that, for example, it attaches to the nasal bridge of the spectacles 26 and extends away from the patient 14, in which case the patient 14 can see the light source 30 in a distant mirror. Nevertheless, in each case, the apparatus 10 is designed so that there is a known or determinable relationship between the locations marked on the lenses 22 and the point on the lenses 22 through which the patient 14 aligns the light source 30. Since the apparatus 10 is designed to obstruct a little of the patient's vision, 14 its peripheral vision remains intact and allows binocular fusion to occur, thereby preventing the introduction of phoria to reduce accuracy. By stabilizing the apparatus 10, decreasing the amount of force required to move the driving arm 86, and limiting the travel distance of the marking rod 34, the accuracy of the resulting measurements is improved by minimizing the movement of the spectacles 26 in relation to of the apparatus 10 while in use. If the vision of the patient 14 is extremely poor when using non-optimal or simulative prescriptive lenses such as lenses 22, the remote object on which the patient 14 is fixed can illuminate itself or be otherwise represented to be seen more easily. . By minimizing the errors associated with traditional objective positioning devices, the apparatus 10 allows the precise location where a power change or other appropriate component of the corrective lens must exist or begin to be obtained merely by bisecting an imaginary or real line drawn for connecting the two marks on the lenses 22 or otherwise determining the relationship between the mark or marks and the point on the lenses 22 through which the patient 14 aligns the light source 30. Figures 3-8 detail alternative embodiments of the present invention. Each of the apparatuses 310, 410, 510 and 610 includes a light source and associated marking means and functions similarly to the apparatus 10. The apparatus 310 of Figure 3, for example, comprises a light source 330, a structure 354, a compartment 358, a thumb (or finger (middle)) rest 362, a rod 366, an electrical switch 368, a foot 370, a (thumb) finger rest (middle) 374, an actuator arm 386, and a tensioned torsion spring when the arm 386 is actuated, which typically uses the index finger of the patient. The apparatus 310 also includes two marking elements 338 and 342 and corresponding marking tips 346 and 350. However, unlike the marking elements 38 and 42 of the apparatus 10, the marking elements 338 and 342 are connected to a pair of dial rods 334a and 334b, which are both operated by arm 386 through a flexible cable or other suitable transmission device. In addition, each of the feet 370 positioned near the top of the tips of the U-shaped structure 354 houses a stump around which the marking rods 334a and 334b pivot while being guided by lanes 388. Although, as illustrated in figure 3, the marking rods 334a and 334b must travel farther than the rod 34 of figure 1-2 to contact the outer surface 18 of the lenses 22, their resting positions thus being at a distance greater than the basic line of vision 94 of the patient 14. Figure 4 details another embodiment of the present invention in which the driving mechanism includes an arm 486, a torsion spring 490, a support gear 492, a pinion gear 494, a flexible cable 496, and trunnions 498. By depressing the actuator arm 486 the torsion spring 490 is tensioned and causes the teeth of the support gear 492 to clutch with the corresponding teeth of the pinion gear 494. E The flexible cable 496 associated with the pinion clutch 494 transmits the movement, thereby causing the dial rods 434a and 434b to pivot about the journals 498 while being guided by rails 488. The apparatus 410 also includes a light source 430, marking elements 438 and 442 having tips 446 and 450 respectively, a structure 454, a compartment 458, a thumb (or middle finger) rest 462, a rod 466, a momentary switch 468 (which also serves as a finger (middle) (or thumb) rest), and a foot 470. FIG. 5 illustrates an alternate embodiment of the present invention having a circular structure 554 and a combined index finger rest and actuator arm 586. The other components of the apparatus 510 shown in FIG. 5 include a light source 530, rods. 534a and 534b, marking elements 538 and 542, marking tips 546 and 550, a compartment 558, a thumb rest 562, a rod 566, a switch 568, a foot 570, rails 588, and a flexible cable 596 Finally, Figure 6 details an apparatus 610 almost identical to the apparatus 310 of Figure 3 to which the compartment 658 has been extended to form a handle. To use the apparatus 610, the patient 14 merely grasps the handle or compartment 658 in the palm of his hand. An embodiment of the present invention is illustrated in FIGS. 7-8 in which the apparatus 710 utilizes a solenoid 714 to drive a push rod 718 connected through an actuator arm 722 and an actuator shaft 726 toward the markers 734a and 734b. . The apparatus 710 further includes a light source 730 (which may include one or more LEDs and, when appropriate, is used in conjunction with filters such as cellophane of different colors or similar strips) and a fiber optic channel 732 to transmit the light emitted from the light source 730 towards a location central (or otherwise appropriate) towards the markers 734a and 734b. Also shown as forming apparatus 710 are the foot 770 and the spring 738, the intermediate solenoid 714 and the push rod 718. An activating module 742 is electrically connected to the apparatus 710 via the cable 738. The module 742 contains a power source 746 for the light source 730 and a normally open momentary switch 768 for forming the electrical connection between the power source 746 and the solenoid 714. The rheostat 750 can also be electrically connected between the power source 746 and the light source 730 if it is desired to adjust the intensity of the light source 730, and a thumb protrusion 754 can be used to provide power to the light source 730 and vary the resistance of the rheostat 750. The apparatus 710 is designed so that its handle 774 can hold by patient 14 in one hand. The module 742 may be held in the other hand of the patient 14 or alternatively by the practitioner, decreasing the possibility of the apparatus being shaken or moved when the switch 768 is depressed and the lenses 22 are marked. When the light emitted through the channel 732 is centered (or otherwise properly positioned) relative to the basic line of sight 94, e 1 switch 768 can be depressed to activate the solenoid 714. The solenoid 714 drives the turn the push rod 718, allowing the arm 722 to rotate the shaft 726 and cause the markers 734a and 734b to contact the outer surface 18 of the lenses 22. The spring 738 accommodates any overtravel of the solenoid 714 immerser and allows the markers 734a and 734b retract immediately after marking the lenses 22. Figures 9-11 show an embodiment of the present invention in which the apparatus 810 is free to pivot about at least two shafts 801 and 802 to facilitate placement and seating on the outer surface 18 of the lenses 22. The apparatus 810 includes an upper portion 802, a body 816 with a reduced diameter portion enclosed by a sleeve 820, and collars 824 They can be formed integrally with the body 816 and partially enclose the leaf spring 828. The spring 828, shown attached to the body 816 with fasteners 832 (such as piping), defines the opening 836 through which the push rod passes. 818. The pivot bolts 848 (one of which is shown) engage the corresponding openings 849 of the collars 824 and the flange 851., allowing the rotation of the upper part 812 about the axis 801, while the spring 828 (inserted in the slot 844 of the upper portion 812) serves to deflect the upper portion 812 toward a particular, "neutral" position. The rotation about the axis 802 is carried out by the movement of the sleeve 820 in relation to the body 816. Among the other components illustrated in Figures 9-11 are the solenoid 814, the push rod 818, the shaft (pivot) 826, the light source 830, the marking rods 834a and 834b, the (overtravel) spring 838, the cable 840, the activator module 842, the rheostat 850, the momentary switch 868, and the foot 880. These components, as will be recognized by those skilled in the art, they correspond to the components described above, allowing operation of the apparatus 810 by, for example, patient 14 (eg, figures 1-2). Figures 9-11 also include slots 882, in which the marking rods 834 travel, and a journal 886, a torsion spring 890, and an arm journal 894 (each subject to or forming part of the shaft 826) which cooperatively allows the movement of the marking rods 834 and deflects the marking rods 834 to a neutral position. The torsion springs 890 allow the continuous travel of one of the marking rods 834a or 834b in relation to the other if necessary, as when required by the asymmetric curvatures of the lenses. As illustrated in FIG. 11, in its neutral position, the marking rods 834 may be inked if necessary or if it is merely desired to invert the apparatus 810 having marking rods 834 contacting an inking material. Because the top 812 is free to rotate about multiple axes, the patient 14 can seat the apparatus 810 on the outer surface 18 of the lenses 22 with minimal effort. The patient 14 does not need, for example, to hold the apparatus 810 with an axis (nominally longitudinal) 802 perpendicular to the floor, since the upper part 812 will rotate to an appropriate position as one or both feet 880 contact the lenses 22. Similarly, the patient 14 can hold the appliance 810 comfortably, since that the sleeve 820 allows rotation of the body 816. Figures 12-15 illustrate an embodiment of the present invention in which the apparatus 910 is designed to be held by the practitioner. Generally, the apparatus 910 includes a housing 912, a head rest assembly 914, and (one or more) lens detectors 916 and 918. The apparatus 910 may also include at least one level sensor 920, shown in Figure 15. as a pair of mercury switches 922 and 924. These components collectively inhibit the movement of the patient 14 relative to the apparatus 910 and assist the practitioner in leveling the housing 912 and placing it adjacent the exterior surface 18 of the at least one lens 22. Figure 12 also shows left and right gauge tubes 926 and 928. The adjacent left gauge tube 926 are left marker assemblies 930 and 932, while the right marker assemblies 934 and 936 are the adjacent right gauge tube 928. projection 938 and shaft 940 allow the left sight tube 926 to be adjusted in two dimensions. A similar projection 942 and dle 944 permit bi-dimensional adjustment of the right sight tube 928. The momentary switches 946 and 948 activate the left and right marker assemblies 930 and 932, respectively, to mark one or both lenses 22. The assembly of head rest 914 includes a rest 950, against which the patient 14 places his forehead, a connecting shaft 952, and a base 954 secured to the housing 912. The connecting shaft 952 is adapted to rotate in the union 956 and, a Once rotated in position, it can be fixed in place using a fixed screw 958. The connecting shaft 952 is also received by tuno 960 (through slot 962) and is capable of sliding inside tube 960. Spring 964 inside of tube 960 can be used to divert rest 950 towards patient 14, typically causing patient 14 to shake his head and upper body muscles and impart a sufficient back pressure towards rest 950 in order to keep his head erect. This action also reduces the unwanted movement of the patient's head relative to the housing 912 during the marking process. The lens detector 916 may be a rod 966 adjacent to the left sight tube 926, connected to both the spring 968 and the switch 970, and used to provide suitable visual and audio indicators 972 indicating that contact with the lenses 22 has happened These indicators 972 also assist the practitioner to know when the housing 912 is close enough to the lens 22 to ensure that it is marked when closing the momentary switch 946 to activate the left marker assemblies 930 and 932. The lens detector 918 it functions in a manner similar to the detector of the lens 916, includes a rod 974 connected to the spring 976 and the switch 978, and can provide appropriate alarm indicators 980. In the embodiment of FIGS. 12-15, the detectors of the lenses 916 and 918 are positioned so that the rods 966 and 974 are parallel to the left and right sight tubes 926 and 928 and to the left and right marker assemblies 930, 932, 934 and 936. The mercury switches 922 and 924 are designed to complete the circuitry associated with the indicators 972 and provide the practitioner with confirmation that the apparatus 910 is level in both horizontal and vertical planes ertical In Figure 15 a second level sensor 982 is shown and can be included as part of the apparatus 910 if desired. The left sight tube 926 (and its associated left marker assemblies 930 and 932 and the left lens detector 916) can be adjusted horizontally and vertically relative to the visual axis 94 of the patient 14. The rotation projection 938, for example, it moves the pinion gear 984 in relation to the support gear 986, allowing the vertical adjustment of the left sight tube 926. Additionally, the guide rods 988 allow the lateral adjustment of the left sight tube 926 when the projection 938 is pushed or pulled in relation to housing 912. Similar operations on ledge 942 allow adjustment of the right sight tube 928 and its associated right marker assemblies 934 and 936 and the right lens detector 918. Figures 12-15 further detail the left and right marking assemblies 930, 932m 934 and 936. The left marking assemblies 930 and 932 each comprise a marking pen or other in. indicator tool 990, are connected to solenoid 992 for simultaneous operation, and may include springs (of overtravel) 994. Right dial assemblies 934 and 936 are constructed in a similar manner and connected to a single solenoid 996. In the figures 12-13 ocular curvatures 998 are also shown opposite the housing 912 of the marking pens 990, which facilitate the use of the apparatus 910 by the practitioner, and a light source 1000 for each of the left and right sight tubes 926 and 928. In the embodiments of the invention consistent with FIGS. 12-15, the light source 1000 projects towards the optical fiber channels 1002 and 1004 terminating within their respective left and right sight tubes 926 or 928. The lenses 1006 and 1008 can also be used to project different colors of light (eg, red and green or blue and yellow) towards channels 1002 and 1004. The nominal operation of apparatus 910 will be described in connection with the marking of the left lens 22 of the patient 14. The marking of the right lens 22 of the patient 14 is carried out in a similar manner, however, an apparatus 910 with minor modifications can be used to mark both lenses 22 simultaneously if desired With selector switch 1010 properly positioned to activate the left marking assemblies 930 and 932, the practitioner seats the forehead of patient 14 on rest 950. Looking through the eye curves 998 and the left sight tube 926, the practitioner can also preliminarily align the left sight tube 926 with the left eye 90 of the 14. As the housing 912 is attracted to the lens (left) 22, the protruding rod 966 contacts the outer surface 18, causing it to push against the spring 968 and close the switch 970. The practitioner also adjusts the protrusion. 938 and levels the housing 912 as necessary to close the mercury switches 922 and 924. These actions activate the indicators 972, signaling to the practitioner that the apparatus 910 is properly positioned to mark the left lens 22, and can also activate the 1000 light source if it has not already been fired. As the practitioner finely adjusts the position of the left-hand sight tube 926, it instructs the patient 14 to notify him when the left eye 90 (and the visual axis 94) aligns with the two colored lights projecting toward the tube. Left watch 926 from channels 1002 and 1004. The practitioner then closes momentary switch 946, activating solenoid 992 and causing marking pens 990 of left marking assemblies 930 and 932 to contact and mark the lens (left) 22. Because the distance and angular relationship between the left marking assemblies 930 and 932 are known, the location of the center of the left eye 90 (and its corresponding visual axis 94) of the patient 14 relative to the lens 22 can be easily determined. from the two marks using, for example, a grid. Apparatus 1110 of Figures 16-19 is designed to indicate line of sight 94 of patient 14 wearing spectacles 26 and maintaining its position in relation to lens 22 of spectacles 26 temporarily. The apparatus 1110 thus allows the practitioner to mark the lens 22 after removing the glasses 26 from the patient 14, facilitating the examination and reducing the possibility of marking errors caused by the movement of the patient. The use of two apparatuses 1110 additionally allows the sight lines 94 of the left and right eyes 90 and 98 of the patient 14 to be determined concurrently. In such cases, only if the practitioner is satisfied that both devices 1110 accurately indicate the basic lines of sight 94, the practitioner would remove the glasses 26 and the 22-mark lenses. Because until later, the patient 14 can reposition the apparatus 1110 as desired, he can correct any errors that arise before any of the lenses 22 is marked (unlike Gould's device). As illustrated in Figures 16-19, the apparatus 1110 includes a rod 1114 curved at one end 1118. The end 1118 defines an opening 1122 for receiving the tip 1126 of the fiber optic channel 1130, allowing the fiber optic channel 1130 transmitting light from a light emitting diode or other light source 1134 to the outer surface 18 of the lens 22. The apparatus 1110 additionally includes a battery 1138 (or an alternative power source) to illuminate the light source 1134, shown in Fig. 19 within housing 1142. In Figs. 16 and 18-19 a switch 1146 is also shown which, if present, may be used to connect light source 1134 to battery 1138. The incorporation of a metal strip 1148 to housing 1142 allows it to be attracted to a magnet 1150 of bar 1154 (see figure 18), which in turn can be secured to outer surface 18 of lens 22 using suction cups 1158. Accordingly, unlike the Gould device, the magnet 1150 will contact neither the left eye 90 nor the right eye 98 of the patient 14. In addition, the inclusion of suckers 1158 on the bar 1154 allows it to remain fixed to the outer surface 18 notwithstanding the movement of the device 1110, avoiding the need to slide a plate held magnetically through the (interior) surface of the gaferia structures as described in the Gould patent. To use the apparatus 1110 for the left eye 90 while wearing the glasses 26, the patient 14 (or the practitioner) initially holds the bar 1154 to the outer surface 18 of the lens 22 using suction cups 1158. By holding the apparatus 1110 in the end 1166 of the rod 1114 opposite the end 1118, the patient 14 illuminates the light source 1134 (by, for example, levering the switch 1146) and is fixed to a remote object located along the basic line of sight 94. The patient 14 then places the apparatus 1110 so that the tip 1126 is adjacent to the outer surface 18 of the lenses 22 and the light emitted from the tip 1126 is centered along the basic line of sight 94. The patient 14 then rotates the end 1166 (if necessary) to cause the strip 1148 to contact the magnet 1150, allowing attraction of the magnet between the strip 1148 and the magnet 1150 to hold the device 1110 in place. However, if subsequently the patient 14 becomes dissatisfied with the position of the apparatus 1110 (as when the movement or other action misaligns the light source 34 and the basic line of sight 94), he only needs to grasp the end 1116 of the rod 1114 , exert enough force to overcome the magnetic attraction, and reposition the apparatus 1110 as appropriate. The use of a second apparatus 1110 allows a similar procedure to be carried out concurrently for the right eye 98. In some embodiments the light sources 1134 in the two apparatuses 1110 can provide light of different colors (e.g. one and green of the other). The patient 1114 can be instructed to fix on the remote object and place the apparatus 1110 until both red and green images (for example) of the light sources 1134 overlap the remote object. If the movement of the patient 14 while placing the second apparatus 1110 disturbs the relationship between the first apparatus 1110 and the basic line of sight 94 of the associated eye, for example, the images from the light sources 1134 will not overlap both of the remote object . Patient 14 can then reposition either one or both of the apparatuses 1110. After the procedure is completed for either or both of the left and right eyes 90 and 98, the spectacles 26 can be removed from the patient 14 with the intact apparatuses 1110 and the sources of light 1134 illuminated. By observing the light sources 1134 through the lenses 22, the practitioner (or even the patient 14 if desired) can mark the interior surfaces 1170 of the lenses 22 opposite the light sources 1134 using a conventional marker 1174 (and return the glasses 26 to patient 14 for verification). The apparatus 1110 thus provides a device for subjectively determining the relationship between the pupils of the patient 14 and a singular point 1178 in each lens 22 of the corresponding spectacles 26. In contrast to the subjective modality of the Gould device (which uses an opaque plate), the apparatus 1110 neither blocks the peripheral vision of patient 14 nor prevents binocular fusion from occurring. As shown primarily in Figure 19, the curvature of the end 1118 of the rod 1114 allows the tip 1126 to protrude from the opening 1122 approximately perpendicular and adjacent the outer surface 18 of the lens 22 when the strip 1148 contacts the magnet 1150. The strip 1148 is also sufficiently wide or appropriately configured to prevent it from rotating or rotating when it comes into contact with the magnet 1150. Alternatively, if the rod 1114 is made of metal, the strip 1148 can be omitted and the rod 1114 may be attracted by itself to the magnet 1150. Figures 20-24 illustrate the apparatus 1200, an alternative to the apparatus 1110 of Figures 16-19. The apparatus 1200 includes a bar 1204 that separates the rods (typically metallic) 1208 and 1212, which allow the sight lines 94 of the left and right eyes 90 and 94 to be determined concurrently using a single device. Like others associated with the apparatus 1110, the rods 1208 and 1212 end at curved ends 1216 and 1220, respectively, each defining an opening 1224A or 1224B through which light can be transmitted. The apparatus 1200 may additionally include a housing 1236 and a switch 1240 in relation to each rod 1208 and 1212 for connecting a suitable power source, such as a battery to a light source. As shown in Figures 20-21 and 23, each housing 1236 includes a fastener 1244 for fastening to the frame 1246 of the eyeglasses 26. Fastening the fasteners 1244 to the eyeglasses 26 holds the apparatus 1200 in position relative to the patient 1114 while sight lines 94 are being determined, increasing the accuracy of the resulting marks. Within each housing 1236 a channel 1248 is formed and a magnet 1252 is adhered, towards which the respective rods 1208 and 1212 are attracted and around which they can pivot in use. Because the depth of the channel (generally X-shaped) 1248 is greater than the thickness of the rods 1208 and 1212, the rods 1208 and 1212 can pivot not only from side to side (as indicated by arrows 1256), but also towards and away from lenses 22 (as indicated by arrows 1260). Rods 1208 and 1212 are also repositioned vertically when necessary. However, once the rods 1208 and 1212 are pivoted and repositioned by the patient 1114 (or practitioner), the magnetic force provided by the magnet 1252 retains the rods 1208 and 1212 in place even when the glasses 26 are removed for the marked. Alternatively or additionally, the associated telecommunications or electronic equipment could detect the location of the rods 1208 and 1212 relative to the glasses 26 and store the information or transmit it directly to a lens manufacturing operation to be used. As described in connection with Figures 16-19, the light sources associated with the rods 1208 and 1212 can provide light of different colors, if desired (e.g., red one and green the other). The patient 1114 can then be instructed to attach to a remote object RT and place the rods 1208 and 1212 until both the red and green images overlap the remote object RT. The foregoing is provided for the purposes of illustration, explanation and description of the embodiments of the present invention. Various modifications and adaptations of the modalities, including those previously exposed, will become apparent to those of ordinary experience in the matter and can be made without departing from the spirit or scope of the invention. In addition, verification procedures may be included as part of the present invention. For example, once a lens is marked, an opaque cellophane tape that has a small diameter hole on the lens could be placed, with the omen centered between the double marks, determining either the patient or the practitioner if the hole aligns with the visual axis of the patient. Finally, although the apparatus of the present invention shown in Figures 1-11 and 16-24 are designed to be held or manipulated by the patient 14, and allow for the precise positioning of the corrective lenses when the subjective techniques described above are used, the apparatus may be held by the practitioner (such as the apparatus of Figures 12-15) or be attached to a static object if necessary, such as when the patient 14 lacks the full function of the hand or arm.

Claims (11)

1. NOVELTY OF THE INVENTION Having described the present invention, it is considered as a novelty and therefore the content of the following claims is claimed as property: 1. A device capable of being used by a patient having an eye and a visual axis associated with the eye and in connection with glasses that have a lens through which the visual axis can pass, comprising: a. a movable object configured to minimize obstruction of the patient's vision and comprising a light source; b. means, positionable adjacent to the lens opposite the lens of the eye, to align the movable object with the visual axis; and c. means, connected to the alignment means, for holding the alignment means to a selected portion of the glasses without preventing movement of the movable object in relation to the visual axis.
2. 2. A device according to claim 1, characterized in that the alignment means comprises: a. a housing that defines a channel; b. a rod placed at least partially in the channel; and c. means to allow movement of the rod within the channel.
3. A device according to claim 2, characterized in that the means allowing the movement comprises a magnet connected to the housing, magnetically attracted towards the rod, and around which the rod pivots.
4. A device according to claim 3, characterized in that the rod has a thickness and an amplitude and the channel has a depth and a maximum amplitude, whose depth is greater than the thickness of the rod and whose maximum amplitude is greater than the amplitude of the dipstick.
5. A device according to claim 4, characterized in that the fastening means comprises a fastener connected to the housing.
6. 6. A device according to claim 5, characterized in that the movable object is movable in three dimensions in relation to the visual axis.
7. A device according to claim 6, characterized in that (1) the movable object further comprises means, having first and second ends, for transmitting the light emitted by the light source from the first end to the second extreme (2). ) the rod defines an opening for receiving the second end of the transmission means.
8. A device according to claim 2, characterized in that the clamping means comprises a suction cup connected to the housing.
9. 9. A device capable of being used by a patient having a left eye with an associated left visual axis and a right eye with an associated right visual axis, and in connection with the glasses having left and right lenses through which they can pass the respective left and right visual axes, which comprises: a. movable objects, first and second, each of which is movable in three dimensions in relation to the visual axis; b. a first means, positionable adjacent to the left lens opposite the left lens of the left eye, to align the first movable object with the left visual axis; c. means, connected to the first alignment means, for holding the first alignment means to the left lens without preventing movement of the first moving object in relation to the left visual axis; d. a second means, positionable adjacent to the right lens opposite the right lens of the right eye, to align the second movable object with the right visual axis; and. means, connected to the second alignment means, for holding the second alignment means to the right lens without preventing movement of the second moving object in relation to the right visual axis, - and f. a bar connected to the first and second alignment means.
10. A device according to claim 9, characterized in that each of the first and second alignment means comprises: a. a housing that defines a channel; b. a rod placed at least partially in the channel; and c. means to allow movement of the rod within the channel.
11. 11. A method, for a patient having an eye and a visual axis associated with the eye, for marking a lens (1) within the structure of gambols used by the patient, (2) having inner and outer surfaces, and (3) through which the visual axis of the patient can pass, comprising the steps of: a. fastening to the goggles, using a fastening means, a device comprising a removable moveable object adjacent to the outer surface of the lens; b. moving the movable object in order to align it with the visual axis without moving the clamping means; c. direct light through the movable object; d. remove the patient's glasses without moving the movable object; and e. mark the inner surface of the lens in the opposite place to the movable object.