RU2599041C2 - Method and device for screening assessment of vision nature - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine. Method for screening assessment of vision nature consists in presentation of images of figures to a patient, fixation of patient's answers and their analysis. Assessment is carried out in three levels with representation of pseudorandom sequence of images in conditions of separation. At the first level checking availability of monocular vision is performed, wherein figures are presented 1-4 times. At second level - presence of binocular or simultaneous vision, for that figures are presented at least twice. At third level - presence of alternating suppression or unstable binocular vision, for that figures are presented at least twice, wherein figures for right eye and for left eye are interplaced. At that, at correct response at the first level, fixed result corresponds to the number of figures, intermediate result is fixed - both eyes can see, and at correct response at the second level - final result - binocular vision. At correct response at the first level, fixed result corresponds to the number of figures, intermediate result is fixed - both eyes can see, and at correct response at the second level coinciding with the number of figures increased by the number of figures visible by both eyes - final result - simultaneous vision. At correct response at the first level only for one eye an intermediate result is fixed - monocular vision of one eye, which is specified at the third level, and at the correct response for the same eye - final result - monocular vision of said eye. At correct response at the first level firstly for one, then for the other eye an intermediate result is fixed - monocular vision with alternating suppression, which is specified at the third level, and at the visibility firstly for the left, then for the right eye the final result is fixed - alternating suppression. At correct response at the first level firstly for one, then for the other eye, an intermediate result is fixed for both eyes - unstable binocular vision, which is specified at the third level, and at the visibility firstly for the left, then for the right eye, then simultaneously for both eyes the final result is fixed - unstable binocular vision.

EFFECT: invention enables to increase accuracy and validity of assessment results of vision nature owing to excluding the possibility of memorizing test tasks, assessment of the obtained result based on several functionally related measurements.

1 cl, 4 dwg

Description

The invention relates to medical equipment and can be used for screening assessment of the nature of vision in various population groups, including schoolchildren, draftees, drivers, children and people with developmental delays. The essence of the method and device for its implementation is to provide specialized modes for presenting test patterns to assess the nature of vision, which can significantly improve the quality and reliability of the results by eliminating the possibility of memorizing test tasks and evaluating the result based on several functionally related measurements.

The most commonly used method of researching eye cooperation (the nature of vision) is as follows: the subject is presented at a fixed distance (usually 5.0 and / or 0.33 meters) with a four-point test, or the Worth test, implemented on the basis of the device type "Color Test". The device has four openings with light filters (a circle) illuminated from within by a standard light source. Three types of filters are used: the first - providing the visibility of the light source to one eye, the second - to the other, the third - to two eyes. As a rule, these are blue, red and neutral filters that provide these conditions when using the studied red-blue filter glasses. In a typical device of this type, you can see three circles with one eye, two with the other, and 2, 3, 4, or 5 with two eyes. A person with normal binocular vision can see four circles. With monocular vision, either two circles or three will be visible. With simultaneous vision, the illusion of the appearance of five circles arises. With the help of additional questions, it is possible to determine the presence of alternating suppression or unstable binocular vision.

Known methods for studying binocular vision, in particular the nature of vision, and devices for their implementation, based on haploscopy (separation of the visual fields of the left and right eyes), for example, described in Russian patent RU 2133103 C1 "Method for the study and restoration of binocular vision."

For example, Russian patents RU 2084197 C1 “A method for studying binocular vision” and RU 2084198 C1 “A flower test for examining binocular vision” are known, which describe a similar method and device, which introduced the additional ability to change the size of “circles” and the distances between their centers for the possibility of maintaining their angular dimensions when changing the test distance.

The disadvantage of the described methods and devices is their static nature, predictability and, as a result, the ability to easily remember the correct answer. People who want to show the presence of the correct binocular vision easily remember the correct answer - four luminous "circles". This primarily applies to children, especially often such effects are observed during periods of mass medical examination, when there is a quick exchange of information between people undergoing examination. In this regard, the number of incorrect assessments of the nature of vision increases: on the one hand, by remembering the correct answer (four) and verbalizing it during examination in patients with binocular vision impairment (improved estimates), and on the other hand, due to incorrect answers ( naming the number of circles other than four) individuals who, for one reason or another, wish to show the absence of binocular vision, despite its presence.

In addition, in order to evaluate the configuration of the circles that the patient sees, the doctor needs to ask a whole complex of clarifying questions (which in practice depend on the doctor’s conscientiousness and depth of understanding of the features of binocular vision) and receive answers to them that are not always clear, according to which he should classify the nature of vision. An example of a standard test device for determining the nature of the type of color test is shown in FIG. one.

The aim of the present invention is to increase the accuracy and reliability of assessing the nature of vision due to the original method and device for assessing the nature of vision, which exclude the possibility of knowingly untrue answers of the studied, and the final result is formed on the basis of several related cross-checked assessments.

As the closest analogue, the patent RU 2084198 C1 “Color test for the study of binocular vision” was selected. The patent describes a technical solution for creating a device for presenting a standard pattern described above, which is formed when testing the nature of vision. The device contains the following elements:

- separators of the visual fields of the left and right eyes;

- a display for forming a pattern in the form of a standard Vors test with four luminous elements, two of which are visible to one eye, one to the other, one to two eyes;

- a block for scaling the angular dimensions of the test formed on the display;

- a control unit coordinating the operation of these elements.

The algorithm for checking the nature of vision is standard and looks like this in the described patent: the display initiates the appearance of a test pattern in the form of four bright figures, while the pattern has the ability to scale. The patient observes the display through the dividers of the visual fields and verbally reports on how many bright figures he sees. Then, based on the subject’s response, the doctor makes his judgment about the nature of his vision. If the patient sees four figures, they believe that he has normal binocular vision, if three have monocular vision with one eye (as a rule, the device is designed so that it is the left eye), two with monocular vision with the other eye, five with simultaneous vision. If the patient sees then 3, then 2 objects - his vision is alternating, and if it is 3, then 4 or 2, then 4 - unstable binocular.

The described patent proposes a technical solution for assessing the nature of vision, however, as well as in other studied technical solutions, there are no elements necessary for a qualitative assessment of this function of vision, which implies:

- providing a testing mode that excludes the possibility of remembering the correct answers;

- providing the possibility of rechecking the results;

- providing the ability to maintain an automated database of results, including for tracking the dynamics of changes;

- ensuring the presentation of various situationally necessary specialized patterns, including for adults, schoolchildren and preschoolers, people with developmental delays, etc., excluding the possibility of remembering them;

- providing the ability to verify the understanding and feasibility of the task.

The present invention is directed to solving the following technical problem:

- improving the accuracy and reliability of the results of determining the nature of vision by eliminating the possibility of remembering the correct answers and evaluating the result based on several functionally related measurements;

- ensuring the situationally necessary completeness of the obtained test material due to the possibilities of forming test tasks and the conditions for their implementation;

- expanding the circle of people capable of adequately conducting research on the nature of vision, including at the expense of children, people with developmental delays, foreigners, etc. due to the introduction of a regime to check the understanding and feasibility of a task;

- expanding the possibilities of organizing individualized tests due to the formation with the help of one device of a multitude of different types of test tasks;

- Creation of an automated database of the results.

The solution of the problem is as follows: a device for assessing the nature of vision, including:

- Power Supply,

- block separation of the visual fields of the left and right eyes,

- a display unit for presenting four bright figures in the form of a standard Vors test or its modifications, two of which are visible to one eye, one to the other, one to two eyes,

- a block for scaling the angular dimensions of the test formed on the monitor,

- a control unit connected by two-bit multi-wire tires with all other blocks, characterized in that the device for screening assessment of the nature of vision further comprises:

- block indicating the results,

- test setup block,

- block of testing algorithms,

- block of operating modes (trial, explanation, test),

- block visual content,

- data block of test results,

- block interactive recording of patient responses,

- data input unit,

- verbal accompaniment unit.

Wherein:

- a control unit connected to other units is designed to ensure synchronous operation of all elements of the system;

- the results display unit is designed to be able to view the results obtained during testing;

- the test setup block allows you to select the desired mode of operation, as well as the testing algorithm, using the data found respectively in the block of test modes and the block of algorithms for presenting test patterns;

- the block of operating modes contains information about all possible modes of the device (for example, situationally necessary screening, full verification, explanation, trial testing, understanding, test children’s, universal test, etc.);

- the block of testing algorithms contains all the necessary algorithms necessary for the implementation of the selected operating modes,

- the visual content block is designed to store the shape of the elements of the four-point test, as well as its modifications and other visual images. These may include scalable circles, combinations of geometric patterns, images for children, including dynamic, multimedia explanations of the assignment, etc .;

- a block of data and test results is intended to store various information about the study, including the main functional indicator, as well as additional information, such as the patient’s reaction time, protocols of his answers indicating correct and incorrect, etc .;

- the unit for interactive recording of patient responses is intended, respectively, for recording responses that can be generated both by the patient and the medical professional;

- the data input unit is designed to enter patient data and other qualifying information, for example, full name or a comment on the patient’s card, etc .;

- the verbal accompaniment unit is designed to automatically formulate target questions and formulate options for the patient’s actions, which serve, as a result, to simplify and standardize the testing procedure.

In the present invention, as well as in the selected prototypes, it is necessary to use the technology of separating the visual fields of the left and right eyes, however, unlike the prototype, any type of separation of test images can be used: anaglyphic, polaroid, shutter (temporary), raster, etc. d.

The technical result of the present invention is to create a specialized device that provides the ability to assess the nature of vision, devoid of the ability to remember the correct answers, and the formation of estimates based on several cross-checked tests, the formation of a number of additional service modes, as well as the automatic generation of a database of results.

The invention is illustrated by an example of a specific implementation of the device and the following drawings:

FIG. 1 - a standard device type "Color Test" to assess the nature of vision.

FIG. 2 - functional diagram of the device.

FIG. 3 is a variant of a specialized pattern for simplifying the assessment of the nature of vision (areas with the number 1 are visible to one eye, areas with the number 2 are visible to the other, and with the number 3 to two eyes).

Variants of algorithms for assessing the nature of vision. Abbreviations and designations: PG, LH, DG, respectively - presented figures visible by the right eye, left eye and two eyes. 1.1-2.3 - patient response options at level 1; 2.1-2.3 - patient response options at level 2; A, B, C, D - patient response options at level 3 (see the description of the test algorithm option).

FIG. 4a - the algorithm of the first level of testing and its relationship with the second and third levels (option),

FIG. 4b - algorithm of the second level of testing (option),

FIG. 4c - algorithm of the third level of testing (option).

The device according to the invention (Fig. 2) contains several coordinated functional blocks interconnected by bidirectional multi-bit tires:

- power supply (1),

- block separation of the visual fields of the left and right eyes (2),

- a test display unit for presenting a standard Vors test (a test for determining the nature of vision) or its modifications (3),

- a block for scaling the angular dimensions of the test formed on the test display (4),

- a control unit connected to all other units (5),

- block indicating the results (6),

- test settings block (7),

- block of testing algorithms (8),

- block of operating modes (9),

- block visual content (10),

- data block of test results (11).

- block interactive recording of patient responses (12),

- data input unit (13),

- verbal accompaniment unit (14).

All units of the device are connected to the corresponding terminals of the power supply (1).

All blocks of a patented device can be implemented on the basis of modern electronic components, the main of which are given below:

- the unit for separating the fields of the left and right eyes (2) can be implemented on the basis of modern technologies of 3D images - anaglyphic, polaroid, shutter, etc .;

- test display unit (3) can be implemented on the basis of a standard computer monitor;

- the block for scaling the angular dimensions of the test (4) can be implemented on the basis of the processor and standard software algorithms;

- a control unit (5) connected to other units can be implemented on the basis of a standard system computer unit;

- a block indicating the results (6) can be implemented on the basis of a standard computer monitor;

- test settings block (7) can be implemented on the basis of a computer monitor;

- a block of testing algorithms (8) can be implemented on the basis of standard processor and data storage facilities;

- the block of operating modes (9) can be implemented on the basis of standard processor and data storage facilities;

- a block of visual content (10) can be implemented on the basis of standard processor and data storage facilities;

- the test results data block (11) can be implemented on the basis of standard processor and data storage facilities;

- the unit for interactive recording of patient responses (12) can be implemented on the basis of a standard or specialized computer keyboard;

- the data input unit (13) can be implemented on the basis of a standard or specialized computer keyboard;

- verbal accompaniment block (14) can be implemented based on standard technologies for recording and reproducing speech.

Due to the advanced features, the device can operate in various functional modes, as well as in a combination of these modes, the main of which are described below:

- job explanation mode,

- trial test mode,

- standard test mode,

- automated testing mode with data double-checking, including options:

- automated screening mode,

- automated full assessment of the nature of vision,

- interactive self-test mode.

The main modes of operation of the device are described below.

- Job explanation mode. It can be used optionally.

Designed to explain the job in video or verbal form. For example, for a child in an entertaining multimedia form, the display shows the main features of the upcoming work. The mode is initiated as follows: using the test setup block (7) in the block of operating modes (9), the task explanation mode is selected, and multimedia explanatory video content that is launched on the test display block (3) is selected from the visual content block (10).

- The test test mode is initiated as follows: using the test setup block (7), the test test mode is selected in the block of operating modes, a graphic image of the presented pattern is selected from the visual content block, and the corresponding algorithm is launched from the test algorithm block (8), which runs on test display screen. This mode involves the provision of obviously feasible tasks to verify the correct understanding of the testing task. This mode is important for children, people with developmental disabilities, foreigners, etc. It can be carried out without separators of the visual fields of the left and right eyes. Patient responses are recorded using the interactive response response recording unit (12) and can, if necessary, be recorded in the database of test results (11). These results can be viewed on the results display unit (6) for the adequacy of the patient's reactions.

- The main testing mode can be implemented in several ways:

- standard testing mode, similar to the prototype, with the difference that the test result is evaluated by a doctor and entered into the database manually by a medical specialist using the data input unit;

- the automated full testing mode with data double-checking consists of three testing stages (see the version of the testing algorithm) and is initiated as follows: using the test setup block (7), this mode is selected in the operating mode block, the complex content is selected from the visual content block (10) a graphic image of the presented pattern, which is launched on the screen of the test display (3), and the desired algorithm is selected from the block of testing algorithms (8). Patient responses are recorded using the interactive response response unit (12). The essence of this mode is that the patient is presented with a pseudo-random sequence of tests in which the number of significant figures on the display varies, thus remembering the correct answers is excluded;

- the interactive self-testing mode is similar to the previous mode with the difference that the testing is performed automatically by the patient himself using the unit for interactive recording of patient responses (12);

- the automated screening mode is similar to the automated full testing mode with the difference that it is not a full assessment of the nature of vision, but a simplified one, consisting of two stages of checks (see the version of the testing algorithm) and allowing to identify patients at risk.

For the automated testing mode (determining the nature of vision) with data double-checking, various algorithms can be used, one example of which is shown below. The algorithm conceptually consists of three components shown in FIG. 3.

Structurally, the algorithm consists of 3 parts: 1) checking for the presence of monocular vision, 2) assessing the presence of binocular vision, 3) clarifying the nature of vision - the presence of alternating suppression or unstable binocular vision.

At all three levels, simultaneously with testing, an automatic check is made of the patient's responses to adequacy.

Limitations: in the absence of a figure visible with two eyes (DW), figures visible only with the left eye (LG) and figures visible only with the right eye (PG) must not be horizontally level to exclude horizontal fusion (or be further horizontal fusion boundaries), and vertically should not be closer than the vertical fusion boundaries limit.

In order to avoid accidental testing errors, it is advisable to provide for the possibility of programmatically canceling the last action, which can obviously be caused by accidental contact with the sensors of the interactive recording response block of the patient, and inadequate answers can be checked.

A block diagram of one of the possible algorithms is shown in FIG. 4a-s.

1. Level 1

Checking monocular vision and the adequacy of patient responses. The number of test presentations may vary, but 2-4 presentations are practical.

Only LH and PG figures are presented several times (from 1 to 4), without DG. For example, the sequence: LH + PG, 2LG + PG, 3LG + PG).

1.1. If the patient gives all the correct answers (fixes the number corresponding to the number of figures), an intermediate result is fixed: both eyes see. In this case, to clarify the nature of vision go to the second level.

1.2. If the recorded result coincides with the number of GHGs, an intermediate result is recorded: monocular vision of the GHG, or alternating vision, or unstable binocular. In this case, to clarify the nature of vision go to the third level.

1.3. If the recorded result coincides with the number of LH, an intermediate result is fixed: monocular vision of LH, or alternating vision, or unstable binocular. In this case, to clarify the nature of vision also go to the third level.

1.4. If the recorded result sometimes coincides with the number of GHG figures, sometimes with the number of LH figures, an intermediate result is fixed: monocular vision with alternating suppression or inadequate response. In this case, to clarify the nature of vision also go to the third level.

1.5. If the recorded result sometimes coincides with the number of figures presented, sometimes coincides with the number of PG and / or LH, an intermediate result is recorded: unstable binocular vision or inadequate response. In this case, to clarify the nature of vision also go to the third level.

1.6. In the case of other answer options, the result is recorded: inadequate response of the patient (the patient gives obviously wrong answers).

2. Level 2

Conducted after answer 1.1.

Verification of binocular vision and adequacy of responses

The number of presentations may vary, but it is practical to use 2-4 presentations.

Presented several times PG, LH and DG figures (from 1 to 4). For example, the sequence: 0PG + 2LG + 0DG, 0PG + 1LG + 1DG, 1PG + 2LG + 0DG, 1PG + 1LG + 2DG.

2.1. If the patient gives only the correct answers (each presentation presents a number corresponding to the number of figures), the final result is fixed: binocular vision.

2.2. If the patient fixes a natural difference, and the number recorded by the patient is not equal to the number of presented figures, but is increased exactly by the number of DH, the final result is fixed: simultaneous vision.

2.3. In the event that the patient fixes other response options, the final result is recorded: inadequate patient response.

In principle, for the purposes of screening (screening out a risk group), the first two levels are sufficient. In this case, patients who have shown results 1.1-1.5 and 2.2 can be assigned to a risk group (simultaneous vision and other problems).

If clarification of the nature of vision is required, a third level is required.

3. Level 3

Assessment of the nature of vision and the adequacy of patient responses

The operation of the device in this mode is more complicated than in the previous steps. It can be organized in various ways. For example, all tasks can be generated in an automated verbal form, and at the same time, the task for the patient can be extremely simplified up to pressing or not pressing a single button, the traditional type of verification can be used according to the standard pattern, or an automated verification algorithm can be implemented, one of which options are given below.

To facilitate understanding of the test, a slightly modified pattern shown in FIG. 3, where vertical elements are visible with one eye (LG, marked with the number 1), horizontal elements with the other (PG, marked with the number 2), and the area of their intersection with two (DW, marked with the number 3).

The pattern is presented several times, while the figures of PG and LG change places in random order. In this example, if the patient sees vertical or horizontal elements, he presses the corresponding button “up” or “right” on the block of interactive fixation of the patient’s answers, and if he sees both horizontal and vertical elements, he presses both buttons.

After testing in this group, the following options are possible.

- Option A. The patient constantly signals that he sees the missing vertical and horizontal elements, the result is fixed: inadequate answer.

- Option B. The patient sees only the GHG figures, the result is fixed, depending on the answers at the previous level. If the option was previously fixed

1.2 - the result: monocular vision of the GHG;

1.3-1.5 - result: inadequate response.

- Option C. The patient then sees the PG of the figure, then the LH. If the option was previously fixed

1.2, 1.3, 1.5 - result: inadequate response;

1.4 - result: alternating suppression.

- Option D. The patient then sees the figures of PG, then LH and PG at the same time, or either the figures of LH, then LH and PG simultaneously. If the option was previously fixed

1.2-1.4 - result: inadequate response;

1.5 - result: unstable binocular vision.

Claims (2)

1. The method of screening assessment of the nature of vision, consisting in presenting images of the figures to the patient, fixing the patient's responses and their analysis,
characterized in that
the assessment is carried out at three levels with the presentation of a pseudo-random sequence of images in the conditions of separation:
at the first level, they check for the presence of monocular vision, in which figures are presented 1-4 times;
at the second level - the presence of binocular or simultaneous vision, for which they present at least two times the figure;
at the third level, the presence of alternating suppression or unstable binocular vision, for which they present at least two times the figures, and the figures for the right eye and left eye are interchanged, while
with the correct answer at the first level, the recorded result corresponds to the number of figures, fix the intermediate result - both eyes see and with the correct answer at the second level - the final result - binocular vision;
if the answer is correct at the first level, the recorded result corresponds to the number of figures, fix the intermediate result - both eyes see and when answering the second level, which coincides with the number of figures increased by the number of figures visible to both eyes, the final result is simultaneous vision;
with the correct answer at the first level, only for one eye the intermediate result is fixed - monocular vision of one eye, which is specified at the third level, and with the correct answer for the same eye - the final result is the monocular vision of the corresponding eye;
with the correct answer at the first level, for one or the other eye, an intermediate result is fixed - monocular vision with alternating suppression, which is specified at the third level, and if the figures are visible, the final result is fixed to the left or right eye - alternating suppression;
if the answer is correct at the first level, then for one eye, then for the other, then for both eyes, an intermediate result is recorded - unstable binocular vision, which is specified at the third level, and when the figures are visible, then to the left, then to the right eye, then for both eyes simultaneously record the final result - unstable binocular vision. 2. The method according to p. 1, characterized in that the presentation of images of the figures to the patient, the fixation of the patient’s responses and their analysis is carried out by means of a device containing coordinately working functional blocks interconnected by bidirectional multi-bit buses: power supply unit, block of separation of the left and right field of view eye, a test display unit for presenting a standard Vors test, a block for scaling the angular dimensions of the test formed on the test display, a control unit, a result display unit, a unit test settings, block of testing algorithms, block of operating modes, block of visual content, data block of test results, block of interactive recording of patient responses, data input block and verbal accompaniment block.

Images