WO2013059663A2 - Facteurs de dépistage de patient pour des dispositifs ophtalmiques implantables d'accommodation - Google Patents

Facteurs de dépistage de patient pour des dispositifs ophtalmiques implantables d'accommodation Download PDF

Info

Publication number
WO2013059663A2
WO2013059663A2 PCT/US2012/061124 US2012061124W WO2013059663A2 WO 2013059663 A2 WO2013059663 A2 WO 2013059663A2 US 2012061124 W US2012061124 W US 2012061124W WO 2013059663 A2 WO2013059663 A2 WO 2013059663A2
Authority
WO
WIPO (PCT)
Prior art keywords
pupil
patient
measurement
implantable ophthalmic
viewing
Prior art date
Application number
PCT/US2012/061124
Other languages
English (en)
Other versions
WO2013059663A3 (fr
Inventor
Michael Morris
Loraine Sinnott
Jean-Noel Fehr
Roland Michaely
Pier Paolo MONTICONE
Thomas MUEHLEMANN
Amitava Gupta
Original Assignee
Elenza, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Elenza, Inc. filed Critical Elenza, Inc.
Publication of WO2013059663A2 publication Critical patent/WO2013059663A2/fr
Publication of WO2013059663A3 publication Critical patent/WO2013059663A3/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/02—Subjective types, i.e. testing apparatus requiring the active assistance of the patient
    • A61B3/09—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing accommodation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/16—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring intraocular pressure, e.g. tonometers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/14—Eye parts, e.g. lenses, corneal implants; Implanting instruments specially adapted therefor; Artificial eyes
    • A61F2/16—Intraocular lenses
    • A61F2/1613—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus
    • A61F2/1624—Intraocular lenses having special lens configurations, e.g. multipart lenses; having particular optical properties, e.g. pseudo-accommodative lenses, lenses having aberration corrections, diffractive lenses, lenses for variably absorbing electromagnetic radiation, lenses having variable focus having adjustable focus; power activated variable focus means, e.g. mechanically or electrically by the ciliary muscle or from the outside
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/0008—Introducing ophthalmic products into the ocular cavity or retaining products therein
    • A61F9/0017—Introducing ophthalmic products into the ocular cavity or retaining products therein implantable in, or in contact with, the eye, e.g. ocular inserts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00—Methods or devices for treatment of the eyes; Devices for putting-in contact lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007—Methods or devices for eye surgery
    • A61F9/00781—Apparatus for modifying intraocular pressure, e.g. for glaucoma treatment
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C7/00—Optical parts
    • G02C7/02—Lenses; Lens systems ; Methods of designing lenses
    • G02C7/08—Auxiliary lenses; Arrangements for varying focal length
    • G02C7/081—Ophthalmic lenses with variable focal length
    • G02C7/083—Electrooptic lenses
    • G—PHYSICS
    • G02—OPTICS
    • G02C—SPECTACLES; SUNGLASSES OR GOGGLES INSOFAR AS THEY HAVE THE SAME FEATURES AS SPECTACLES; CONTACT LENSES
    • G02C7/00—Optical parts
    • G02C7/16—Shades; shields; Obturators, e.g. with pinhole, with slot

Definitions

  • Accommodation is the process by which an eye focuses an image of an object at near distance, e.g., less than six feet away. Accommodation occurs in response to an
  • accommodative impulse which is the intent or desire to focus on a near object.
  • the accommodative impulse follows an accommodative stimulus, which is any detectable event or set of circumstances correlated to an accommodative impulse or accommodative response.
  • accommodative stimuli include, but are not limited to, physiological cues (such as pupil constriction and other natural accommodative responses) and environmental cues (such as ambient lighting conditions).
  • the accommodative impulse is followed by one or more physical or physiological events, known as the accommodative response, that enhance near vision.
  • accommodative responses include, but are not limited to, ciliary muscle contraction, zonule movement, alteration of lens shape, iris sphincter contraction, pupil constriction, and convergence.
  • the accommodative response also known as the accommodative loop
  • the accommodative response includes at least three involuntary ocular responses: (1 ) ciliary muscle contraction, (2) iris sphincter contraction (pupil constriction increases depth of focus), and (3) convergence (looking inward enables binocular fusion at the object plane for maximum binocular summation and best stereoscopic vision).
  • Ciliary muscle contraction is related to accommodation per se: the changing optical power of the lens.
  • Pupil constriction and convergence relate to pseudo-accommodation; they do not affect the optical power of the lens, but they nevertheless enhance near-object focusing.
  • the accommodative response quickly follows the accommodative impulse.
  • the accommodative amplitude decreases with age, leading to a degradation or complete loss in the ability to focus on near objects.
  • the loss of ability to focus on near objects is called presbyopia.
  • the accommodative impulse may be followed by a sub-optimal or absent accommodative response. This degradation or loss of the accommodative response makes it difficult or impossible to focus on near objects.
  • the natural lens can be replaced or supplemented with an artificial lens to enhance near vision.
  • an artificial lens for example, many presbyopes use reading glasses or bifocals to view near objects. But reading glasses and bifocals are inconvenient because they do not provide any accommodation; rather, the user accommodates by putting the glasses on. Static intraocular lenses do not provide accommodation either because their focal lengths are fixed.
  • a dynamic intraocular lens or other implantable ophthalmic device provides an artificial accommodative response that mimics the eye's natural accommodative response.
  • a device includes one or more sensors that detect accommodative triggers (e.g., indicia of accommodative stimuli or accommodative responses) and modulates a dynamic optical element, such as a lens or shutter, to change the eye's effective focal length or depth of field as disclosed in U.S. Patent No. 7,926,940 to Blum et al., which is incorporated herein by reference in its entirety.
  • Embodiments of the disclosed technology include an apparatus and corresponding method of determining a subject's suitability for receiving a dynamic implantable ophthalmic device, such as a dynamic intraocular lens.
  • An exemplary apparatus includes a memory, a processor communicatively coupled to the memory, and a user interface communicatively coupled the processor, the memory, or both the processor and the memory.
  • the memory stores first and second measurements of a patient's pupil made under first and second viewing conditions, respectively.
  • the memory may receive these measurements from a pupil- measuring device, such as a pupillometer, via a suitable communications interface (e.g., a wired or wireless interface).
  • The provides calculates a variation in pupil size based on the first and second measurements. It also generates a probability estimate of the patient's being in a group identified as benefitting from the dynamic implantable ophthalmic device based on the calculated pupil size variation.
  • the user interface provides an indication of the probability estimate to a user.
  • An exemplary apparatus may also include a pupillometer or other pupil-measuring device to make the first and second measurements. These measurements may each include information relating to pupil size (e.g., pupil diameter and/or pupil area), a speed of a pupil response to an accommodative stimulus, a speed of a pupil response upon a change in ambient light level, a change in pupil diameter and/or pupil area associated with a change in object distance, and/or a change in pupil diameter and/or pupil area associated with a change in an ambient lighting level.
  • the first measurement is made under a first viewing condition
  • the second measurement is made under a second viewing condition that comprises a different lighting level and/or a different object distance than the first viewing condition.
  • the apparatus includes a light source to adjust the ambient lighting to a desired level (e.g., low, medium, or high) between the first and second measurements.
  • the processor uses the first and second measurements to determine the variation in pupil size as a function of object distance, to perform a logistic regression based on the variation in pupil size, and to determine the probability estimate based on the logistic regression.
  • the processor calculates a variance in pupil size based on the variation in pupil size. It then calculates a ratio of the variation in pupil size to the variance in pupil size, performs a multivariate regression based on the ratio, and determines the probability estimate based on the multivariate regression.
  • the processor may also determine the probability estimate based on the patient's age and/or the patient's visual acuity.
  • An exemplary tuning apparatus may include a communications interface that receives, from a pupil-measuring device, a first measurement of the patient's pupil made under a first viewing condition with the pupil-measuring device. The communications interface also receives, from the pupil-measuring device, a second measurement of the patient's pupil made under a second viewing condition with the pupil-measuring device.
  • These measurements may be stored in a memory communicatively coupled to the interface and to a processor, which computes a variation in pupil size based on the first measurement and the second measurement.
  • the processor uses the pupil size variation to determine and to set at least one of the dynamic implantable ophthalmic device's parameters.
  • the processor may set these parameters via an inductive antenna coupled to an implanted device or to a yet-to-be implanted device.
  • the processor may compute the pupil size variation as a function of ambient light level and/or as a function of application of an accommodative stimulus. It may determine the variation in pupil size as a function of object distance, perform a logistic regression based on the variation in pupil size, and determine the implantable ophthalmic device's parameter(s) based on the logistic regression. The processor may also calculate a variance in pupil size based on the variation in pupil size, calculate a ratio of the variation in pupil size to the variance in pupil size, perform a multivariate regression based on the ratio, and determine the dynamic implantable ophthalmic device parameter(s) based on the multivariate regression.
  • These parameters include, but are not limited to the dynamic implantable ophthalmic device's photosensor gain, the response speed of a variable aperture in the dynamic implantable ophthalmic device, a diameter of the variable aperture of the dynamic implantable ophthalmic device, a contrast ratio of the variable aperture of the dynamic implantable ophthalmic device, and a focal length of a variable lens element of the dynamic implantable ophthalmic device.
  • FIG. 1 shows a patient screening system that measures a patient's pupil
  • FIGS. 2A and 2B are concatenated plots of horizontal pupil diameter versus time for different subjects viewing objects under a variety of different viewing conditions.
  • FIG. 3 is a flowchart that illustrates a process, using a multivariate regression, of estimating a patient's likely benefit from implantation of an accommodative implantable ophthalmic device.
  • FIG. 4 is a plot of a receiver operating curve, or sensitivity versus false positive rate, for a regression analysis (squares) and a cross-correlation analysis (diamonds), with a bar graph inset (upper right corner) that indicates the prevalence of a functioning accommodative apparatus in the target population.
  • FIG. 5 is a plot of subject groupings based on a multivariate regression that illustrates the effectiveness of separating subjects into groups.
  • FIG. 6 is a flowchart that illustrates a process, using a univariate logistic regression, of estimating a patient's likely benefit from implantation of an accommodative implantable ophthalmic device.
  • FIG. 7 is a plot of a logistic curve suitable for use in the process of FIG. 6.
  • FIG. 8 is a plot of the receiver operating curve generated using a univariate logistic regression.
  • FIG. 9 is a plot of the probably of passing viewing conditions (1) and (2) (FIGS. 2A and 2B) versus the difference in median horizontal pupil diameter under viewing conditions (5) and (6) determined using a logistic regression model.
  • FIG. 10 shows a tuning system for adjusting an accommodative implantable ophthalmic device.
  • FIG. 11 is a flowchart that illustrates a process for adjusting an accommodative implantable ophthalmic device.
  • the pupil near response which comprises accommodation and vergence (including convergence and divergence), can serve as an input for an autonomous trigger of an implantable ophthalmic device with dynamic optics.
  • the implantable ophthalmic device may include one or more photosensors, ion sensors, and intraocular pressure sensors to detect an accommodative trigger, such as an accommodative stimulus, an accommodative impulse, or an accommodative response, for actuating a dynamic optical element implanted in the eye.
  • an accommodative trigger such as an accommodative stimulus, an accommodative impulse, or an accommodative response
  • the pupil size depends on emotional state, changes in light level, and level of attention in addition to the pupil near response. Mechanical limitations of the pupil response and the effects of pharmacologic agents can also affect pupil reactions. These additional factors can hamper efforts to distinguish pupil size changes correlated with accommodative triggers from pupil size changes related to other phenomena.
  • Screening patients for dynamic implantable ophthalmic devices based on variations in pupil size may improve surgical outcomes by identifying those patients who are likely to benefit from dynamic implantable ophthalmic devices and those who are not. Such screening may be especially useful when used to determine which patients would be suitable for receiving devices that detect accommodations based on changes in pupil size.
  • an accommodative implantable ophthalmic device may include two or more sensors for distinguishing accommodative stimuli from changes in ambient lights levels and task-induced changes in the pupil diameter.
  • the first sensor's active area is disposed completely within the pupil; even when fully constricted, the pupil does not occlude the first sensor, allowing the sensor to make precise measurements of ambient luminous flux levels.
  • the pupil occludes part of the second sensor's active area(s) as the pupil dilates and constricts. As a result, the second sensor measures both ambient luminous flux and pupil diameter.
  • a processor in the accommodative implantable ophthalmic device estimates the pupil diameter and determines whether the change in pupil diameter is due to an accommodative trigger or a change in the ambient light level. If the processor determines that an accommodative trigger is present, it actuates an optical component to change the eye's effective optical power and/or depth of field.
  • a processor in the accommodative implantable ophthalmic device estimates the pupil diameter and determines whether the change in pupil diameter is due to an accommodative trigger or a change in the ambient light level. If the processor determines that an accommodative trigger is present, it actuates an optical component to change the eye's effective optical power and/or depth of field.
  • FIG. 1 illustrates an exemplary screening apparatus 100 suitable for measuring pupil variations in pupil size as a function of viewing condition of a candidate for a dynamic implantable ophthalmic device.
  • the screening apparatus includes a memory 1 10, a processor 120, a user interface 130, a pupil-measuring device (pupillometer) 140, and a light source 150.
  • This screening apparatus 100 can be used to identify candidates suitable for receiving dynamic intraocular lenses and other accommodative implantable ophthalmic devices. It can also be used to tune the performance characteristics of a dynamic implantable ophthalmic device, whether implanted or to be implanted, according to a patient's pupil response characteristics and any other relevant clinical assessments.
  • the memory 1 10, processor 120, and user interface 130 may be packaged in or take the form of a specially programmed computer 101 , e.g., a laptop, tablet, desktop computer, smartphone, or purpose-built device.
  • memory 1 10 may comprise any nontransitory computer-readable media, and may store computer instructions (also referred to as "processor-executable instructions") for implementing the various functionalities described herein.
  • the processor 120 may include one or more processing units that communicate with the memory 1 10 and other electronic devices, including the pupil-measuring device 140, via one or more wired communication interfaces (e.g., Ethernet and universal serial bus (USB) interfaces) and/or wireless communication interfaces (e.g., Wi-Fi, Bluetooth, IEEE 802.1 1 , and infrared interfaces).
  • the processor 120 also receives inputs via the user interface 130, which may include a keyboard, a touch screen, a mouse, a trackpad, or any other device suitable for receiving user inputs, and provides outputs to the user via a display, speaker(s), or any other device suitable for providing outputs to a user.
  • the user interface 130 may display various information in connection with execution of the instructions.
  • the processor 120 interacts with the pupil -measuring device 140 to obtain measurements of a subject's pupil under two or more viewing conditions.
  • the first and second viewing conditions may differ in that they involve viewing objects under different light levels (e.g., high and low) at different distances (e.g., near, intermediate, and far).
  • the processor 120 may adjust the viewing condition by increasing or decreasing the amount of light provided by the light source 150 so as to change the subject's perception of the ambient light level, or the intensity of light exterior to the eye.
  • ambient light refers more specifically to the light exterior to, but near or adjacent to the eye (e.g., light near the corneal surface).
  • Ambient light can be characterized by variables such as the amount of light (e.g., intensity, radiance, luminance) and source of light (including both natural sources, e.g., sun and moon, as well as artificial sources such as incandescent, fluorescent, computer monitors, etc.).
  • amount of light e.g., intensity, radiance, luminance
  • source of light including both natural sources, e.g., sun and moon, as well as artificial sources such as incandescent, fluorescent, computer monitors, etc.
  • the processor 120 may also cause the pupil-measuring device 140 to display objects at different apparent distances under the same or different light levels. For instance, the processor 120 may cause the pupil-measuring device 140 to display an object at what appears to the subject to be a near distance (e.g., less than 1 m, 67 cm, or 40 cm) so as to provide the first viewing condition. It may then cause the pupil-measuring device 140 to display the object at what appears to the subject to be an intermediate distance (e.g., about 1 m to about 5 m) or a far distance (e.g., more than 5 m) so as to provide the second viewing condition. The processor 120 may also actuate the light source 150 before, during, or after the pupil- measuring device 140 moves the object's apparent location.
  • a near distance e.g., less than 1 m, 67 cm, or 40 cm
  • the processor 120 may also actuate the light source 150 before, during, or after the pupil- measuring device 140 moves the object's apparent location.
  • the pupil -measuring device 140 measures selected pupil characteristics under the first and second viewing conditions and transmits indications of its measurements to the processor 120, which records the measurements in the memory 1 10.
  • the pupil- measuring device 140 may measure the pupil size (pupil area, pupil diameter, pupil radius) by taking a picture of the pupil.
  • the pupil-measuring device 140 or the processor 120 locates the pupil's center and edges as they appear in the picture and determines the pupil's diameter, e.g., by counting the number of pixels in a line that connects the pupil's edges and runs through the pupil's center.
  • the pupil-measuring device 140 or the processor 120 may estimate the pupil's asymmetry by measuring the diameter along orthogonal axes. They may also estimate the pupil ' s area by squaring the radius and multiplying by 7 ⁇ , by fitting a curve to the pupil 's edge and computing the area bounded by the curve, or by counting pixels within the pupil's edge.
  • the pupil-measuring device 140 may also measure how much the pupil 's size changes and/or how quickly this change occurs (the speed of the pupil's response) in response to an accommodative stimulus and/or to a change in ambient light level. For example, the pupil-measuring device 140 may acquire a series of images (e.g., at a rate of 10, 20, 30, 40, 50, or 60 frames per second) as the ambient light level changes and/or the object moves while simultaneously monitoring gaze angles and head movements of the subject in order to isolate pupil data collected when eye fixation on the target object was lost.
  • a series of images e.g., at a rate of 10, 20, 30, 40, 50, or 60 frames per second
  • the processor 120 may compute differences in pupil size from frame to frame and transmit indications of these differences to the processor 120, which may estimate changes in pupil size and the speed of the pupil response as a function of object distance and/or light level itself. It may also transmit the acquired images to the processor 120, which may determine the pupil size changes itself.
  • the processor 120 and/or the pupil-measuring device 140 may also compute additional indicators of pupil size, including a standard deviation of the pupil size, a median absolute deviation of the pupil size, and pupil response signal-to-noise ratio (SNR). This SNR can be calculated by dividing the change in pupil size between two states by the square root of the sum of the variances of the pupil size in each of the two states.
  • the processor 120 may also collect patient demographic information and clinical measurements of visual performance, e.g., via the user interface 130 or from another electronic device via a wired or wireless interface. Such demographics and measurements may include but are not limited to, for example, the patient's age or visual acuity. Visual acuity may further be defined, for example, as acuity measured monocularly or binocularly; acuity measured at far, intermediate, and near viewing distances; and acuity measured with or without best dioptric correction.
  • the processor 120 uses the pupil metrics, demographic information, and/or clinical measurements to determine the patient's suitability for receiving an accommodative implantable ophthalmic device. In some cases, it may estimate whether or not the patient is likely to be a member of a group known to benefit from an accommodative implantable ophthalmic device using a multivariate regression or logistic regression as described in greater detail below. For instance, the processor 120 may express the pupil metrics, patient demographics, clinical measurements, and other suitable inputs as individual numeric patient data to inform a surgical management decision about a particular patient's suitability for receiving an accommodative intraocular lens.
  • FIGS. 2A and 2B are plots of horizontal pupil diameter versus time for subjects viewing an object under a variety of different viewing conditions. These plots were created with data obtained using a pupil-measuring device such as the one described above.
  • the subject viewed an object under the following conditions: (1) far distance at a low light level; (2) near distance at the low light level; (3) object switching between far and near distances at the low light level; (4) object switching between far and near distances at a high light level; (5) object at far distance at alternating high and low light levels; and (6) object at near distance at alternating high and low light levels.
  • TABLE 1 Exemplary Viewing Conditions
  • FIGS 2A and 2B show that the horizontal pupil diameter varies with object position and ambient light.
  • FIG. 2A shows that the first subject's horizontal pupil diameter remains relatively constant under a given viewing condition
  • FIG. 2B shows that the second subject's horizontal pupil diameter varies dramatically. For instance, when viewing a near object at a low light level (condition (1)), the first subject's horizontal pupil diameter shrinks from about 4 mm to about 3.5 mm over about 300 seconds.
  • the second subject's horizontal pupil diameter varies from about 4.5 mm to about 2.5 mm under condition (1 ) over the same period.
  • FIG. 2B shows that, when the second subject views a near object under low light (condition (2)), his horizontal pupil diameter varies between about 2.5 mm and about 3.75 mm— within the variation range for condition ( 1 ). These overlapping ranges may make it difficult to detect an accommodative trigger by measuring only ambient light level and the second patient's pupil size.
  • FIG. 2A shows that the first subject's minimum horizontal pupil diameter under condition (1 ) is greater than his maximum horizontal pupil diameter under condition (2). As a result, it is possible to detect an accommodative trigger by measuring only ambient light level and the first patient's pupil size.
  • the first patient's pupil size varies more repeatably (e.g., with a smaller standard deviation) when transitioning between high and low light levels at far object distances (condition (5)) and near object distances (condition (6)). Together, these factors may make the first subject a better candidate than the second subject for an
  • accommodative implantable ophthalmic device that uses a pupil constriction sensor to detect accommodative triggers.
  • the processor 120 may screen patients by analyzing according to a multivariate regression model.
  • This multivariate regression model may be based on an experimentally determined coefficients representing the pupil response of patients within a particular group or population, e.g., those patients who benefit from receiving an
  • these coefficients may be based on experimental measurements of pupil size, the pupil response speed, etc. under a variety of viewing conditions, including conditions (l )-(6). These measurements may be assigned a continuously distributed value and the analyzed to determine which input variables affect the surgical outcome.
  • FIG. 3 illustrates a process 300 for determining a candidate's suitability for a dynamic intraocular lens using a multivariate regression model.
  • a pupillometer or other pupil-measuring device acquires a first set of pupil measurements under a first viewing condition in step 302.
  • a user or a processor adjusts the ambient light level and/or apparent object distance in step 304 to provide a second viewing condition, and the pupillometer acquires a second set of pupil measurements under this second viewing condition in step 306.
  • the pupillometer may acquire these data under static and dynamic conditions in which light level and target viewing distance are varied, and pupil diameter is measured continuously.
  • the pupillometer transmits these measurements to a processor, which receives them in step 308.
  • the processor determines the variation in pupil size, e.g., between pairs of viewing conditions and within each viewing conditions. It estimates the signal-to-noise ratio (SNR), which is defined here as the ratio of the variation in pupil size to the variance in pupil size, for each viewing condition in step 312. (In other words, the SNRs for each subject are computed by dividing the difference in median pupil diameter for distant and near targets by the sum of the variances of the respective pupil diameters.) The processor performs a multivariate regression using the SNRs for the different viewing conditions in step 314.
  • SNR signal-to-noise ratio
  • the processor Based on this multivariate regression, the processor generates a probability estimate of the patient's being in a group suited for a dynamic intraocular lens (step 31 6) and an indication of a likely surgical outcome (step 31 8). It provides the probability estimate and the surgical indication to a user via a user interface in step 320.
  • three SNRs for pupil near response under different viewing conditions are statistically significant in a population of potential patients: the combination of SNR 3 and SNR 4 with either SNRi or SNR 2 , where the subscript refers to the viewing condition in TABLE 1 (e.g., SNR
  • is the SNR for viewing condition (1 )
  • Q may be expressed as:
  • Q > 1 .0 may correlate with a high probability of success for the individual patient. That is, for Q > 1 .0, the processor may recommend that the patient is a suitable candidate for implantation of a dynamic intraocular lens or other accommodative implantable ophthalmic device.
  • FIG. 4 is a plot of a receiver operating characteristic (ROC) curve for the
  • FIG. 5 is a scatter plot illustrating how screening using multivariate regression improves patient identification. Each point represents an individual subject, and the number located on a given point indicates whether the subject tested well under viewing conditions (1 ) and (2). A “2" indicates that the subject passed both viewing conditions; a “1 " indicates that the subject passed only one viewing condition; and a "0" indicates that the patient failed both viewing conditions.
  • FIG. 5 is a plot of patient performance versus SNR(5 i6) and ⁇ .
  • TABLE 2 provides a further breakdown of the differences between positively screened patients (those in the "Included” group in FIG. 5) and negatively screened patients (those in the "Excluded” group in FIG. 5). In general, "Included” patients are more likely to be suitable candidates for accommodative implantable ophthalmic devices than "Excluded” patients.
  • the processor 120 may screen patients by analyzing according to a univariate logistic regression model.
  • This univariate logistic regression model may be based on an experimental data representing the pupil response of patients within a particular group or population, e.g., those patients who benefit from receiving an accommodative implantable ophthalmic device. For instance, this model may be based on experimental measurements of pupil size, the pupil response speed, etc. under a variety of viewing conditions, including conditions (l )-(6).
  • FIG. 6 illustrates a process 600 for determining a candidate's suitability for a dynamic intraocular lens using a univariate logistic regression model, also called a logistic curve or a common sigmoid curve, like the one plotted in FIG. 7.
  • a pupillometer or other pupil-measuring device acquires a first set of pupil measurements under a first viewing condition in step 602.
  • a user or a processor adjusts the ambient light level and/or apparent object distance in step 604 to provide a second viewing condition, and the pupillometer acquires a second set of pupil measurements under this second viewing condition in step 606.
  • the pupillometer may acquire these data under static and dynamic conditions in which light level and target viewing distance are varied, and pupil diameter is measured continuously or at discrete intervals.
  • the pupillometer transmits these
  • step 610 the processor determines the variation in pupil size as function of object distance for different lighting levels. It performs a univariate logistic regression using this pupil size variation information in step 612. Based on this univariate logistic regression, the processor generates a probability estimate of the patient's being in a group suited for a dynamic intraocular lens (step 614) and an indication of a likely surgical outcome (step 616). It provides the probability estimate and the surgical indication to a user via a user interface in step 618.
  • a univariate logistic regression model may be derived from the experimental data, such as pupil measurement data collected from a particular population or group. Such a model assigns a probability of success, p, to each subject according to the single variable. For instance, the univariate logistic model may assign a success probability based on ⁇ , which represents the difference in median horizontal pupil diameter between conditions (5) and (6).
  • the univariate logistic model for this specific example is given by:
  • the model uses a single variable, a simple threshold criterion may be used by the surgeon. Instead of calculating the specific probability value p for a given subject, the results of the model can be interpreted according to its ROC plot as a function of ⁇ as shown in FIG. 8. The operating point may be selected based on the desired sensitivity (true positive rate) and desired specificity (false positive rate).
  • FIG. 9 is a plot that illustrates the relationship between the screening variable and the logistic regression model.
  • Each diamond represents a particular subject's probability p of passing viewing conditions (1) and (2) versus ⁇ . It shows that the probability of passing increases linearly with ⁇ for up about 0.5, at which point it continues to increase sublinearly.
  • the apparatus 100 may provide or render a screening determination and/or pupil measurement data to the user via the user interface 130.
  • This screening determination may be expressed or processed to provide a binomial, categorical, or graded output presented to the user.
  • a binomial output assigns a yes/no value such that implantation of an intraocular lens with a dynamic optic is either advisable or not advisable based on the patient's pupil response characteristics and/or other patient characteristics.
  • a categorical output assigns a patient to a category, such as optimum, sub-optimum or contraindicated, that informs a surgical recommendation or decision.
  • a graded output assigns a numeric value to the patient (e.g., a number on a scale of 0 to 100) that may be used to estimate how much the patient would benefit from a intraocular lens.
  • Categorical and graded outputs may also be used to tune the bias, gain, response speed, and other aspects of the circuit or processor that controls the intraocular lens's response to an accommodative stimulus.
  • the processor 120 identifies patient candidates whose pupil response characteristics are likely to lead to good surgical outcomes based on a PASS/FAIL criterion.
  • the processor 120 may determine this binomial output according to a generalized linear model, such as a polytomous logistic regression or a multiple linear regression.
  • the linear regression may involve coefficients that have been experimentally calibrated from a population that includes the subject, e.g., using the individual subject measurements of pupil response and/or other quantitative clinical measurements as the input variables.
  • the patient's inputs are applied as inputs to linear model, which yields a numeric value. This numeric value then compared to a threshold value previously determined to be an effective discriminator between subjects with good and poor outcomes.
  • This threshold may be derived, for example, from an ROC curve.
  • the binomial yes/no (PASS/FAIL) recommendation is based on whether the output of the model is greater than or less than the threshold value and presented to the user via the user interface 130. The surgeon and the subject may use this recommendation to decide whether or not to implant an intraocular lens having dynamic optics.
  • the processor 120 may also assign a categorical grade to patients as potential candidates for implantation of the intraocular lens with dynamic optics.
  • the processor 1 20 may apply a generalized linear model, such as a polytomous logistic regression or a multiple linear regression with experimentally determined coefficients, to the
  • the processor 120 uses this model to provide a prediction of the patent's quality of response and/or surgical outcome with an accommodative implantable ophthalmic device.
  • the processor 120 compares this model's output to categorical threshold values, and it assigns the patient to one of several categories based on this comparison.
  • categories may include, but are not limited to POOR, FAIR, GOOD, and EXCELLENT.
  • the surgeon and the subject may use this categorical information to decide whether or not to implant an intraocular lens having dynamic optics.
  • the processor 120 may also determine a numeric value for adjusting the control mechanism of an accommodative implantable ophthalmic device. As above, the processor 120 may apply inputs from the pupil-measuring device 140 to a generalized linear model, such as a polytomous logistic regression or a multiple linear regression with experimentally calibrated coefficients. It may use the model's output to generate a numeric value that represents the likelihood of a positive outcome for implanting the accommodative
  • implantable ophthalmic device may also use the model's output to generate a numeric value for setting or adjusting the autonomous accommodative trigger detection performed by the accommodative implantable ophthalmic device.
  • the processor 120 may also use a lookup table stored in the memory 1 10 to determine this numeric value. It may communicate this numeric value to the user via the user interface 1 30 and/or to the accommodative implantable ophthalmic device via a wired communications interface, such as a cable, or wireless communications interface, such as an inductive coil or radio-frequency antenna.
  • FIG. 10 is a tuning system 1000 that can be used to tune or adjust parameters in an accommodative implantable ophthalmic device 10 before, during, or after implantation.
  • the tuning system includes a pupillometer 1002 or other pupil-measuring device, a memory 1004, a processor 1006, and a wireless communications interface 1008.
  • the pupillometer 1 002 measures the patient's pupil characteristics and transmits them to the memory 1 004, which stores them for use by the processor 1006.
  • the processor 1006 computes settings and/or adjustments for the implantable ophthalmic device 10 as described below with respect to FIG. 1 1 and transmits these adjustments to the implantable ophthalmic device 10 via the wireless communications interface 1 008, which may include an inductive antenna, infrared
  • FIG. 1 1 is a flowchart that illustrates a process 1 100 for adjusting an accommodative implantable ophthalmic device using the tuning system 1 000 shown in FIG. 10.
  • the pupillometer 1 002 acquires a first set of pupil measurements under a first viewing condition in step 1 102.
  • a user or the processor 1006 adjusts the ambient light level and/or apparent object distance in step 1 104 to provide a second viewing condition; the pupillometer 1002 acquires a second set of pupil measurements under this second viewing condition in step 1 106.
  • the pupillometer 1002 may acquire these data under static and dynamic conditions in which light level and target viewing distance are varied, and pupil diameter is measured continuously or at discrete intervals. These measurements may be performed before or after the accommodative implantable ophthalmic device is implanted in the patient's eye.
  • the pupillometer 1002 transmits these measurements to the processor 1006, which receives them in step 1 108 and may store them in memory 1004.
  • the 1 006 processor determines the variation in pupil size for different viewing conditions. For instance, it may determine the pupil size variation as a function of ambient light level or object distance. It may also compute the variation in pupil size in response to application of an accommodative stimulus, e.g., the appearance of an object at near distance. In some cases, the processor 1 006 may perform a univariate logistic regression or a multivariate regression using these pupil size measurements and pupil size variations as described above.
  • the processor 1006 determines one or more settings or adjustments for the accommodative implantable ophthalmic device in step 1 1 12.
  • These device settings include those parameters that affect the device's ability to detect and identify an accommodative trigger, including but not limited to sensor gain, sensor bandwidth, and the values and/or equations used by the processor 1006 to identify accommodative triggers based on sensor output.
  • the processor 1006 then transmits the settings to the device via the wireless transmitter 1 008, such as an inductive coil, an infrared transmitter, or a radio-frequency antenna.
  • a compatible wireless receiver in the device receives the settings, and the device updates its settings accordingly.
  • the device settings may also affect the dynamic optical element that responds to the accommodative trigger. For example, they may affect how quickly the processor actuates the dynamic optical element, how long the element remains actuated, and the change in effective focal length and/or depth of field obtained by actuating the element. If the dynamic optical element includes an electro-active shutter, the settings may affect the shutter's minimum aperture size, maximum aperture size, and/or contrast ratio; if it includes a variable focal- length refractive or diffractive element, such as a lens, the settings may determine the largest and smallest changes in the element's effective optical power. The settings may also affect the magnitude of the device's response (e.g., the change in effective optical power or depth of field) to detection of an accommodative trigger.
  • the dynamic optical element includes an electro-active shutter
  • the settings may affect the shutter's minimum aperture size, maximum aperture size, and/or contrast ratio; if it includes a variable focal- length refractive or diffractive element, such as a lens, the settings may determine
  • inventive embodiments are presented by way of example only and that, within the scope of the appended claims and equivalents thereto, inventive embodiments may be practiced otherwise than as specifically described and claimed.
  • inventive embodiments of the present disclosure are directed to each individual feature, system, article, material, kit, and/or method described herein.
  • the above-described embodiments can be implemented in any of numerous ways.
  • the embodiments may be implemented using hardware, software or a combination thereof.
  • the software code can be executed on any suitable processor or collection of processors, whether provided in a single computer or distributed among multiple computers.
  • a computer may be embodied in any of a number of forms, such as a rack-mounted computer, a desktop computer, a laptop computer, or a tablet computer. Additionally, a computer may be embedded in a device not generally regarded as a computer but with suitable processing capabilities, including a Personal Digital Assistant (PDA), a smart phone or any other suitable portable or fixed electronic device.
  • PDA Personal Digital Assistant
  • a computer may have one or more input and output devices. These devices can be used, among other things, to present a user interface. Examples of output devices that can be used to provide a user interface include printers or display screens for visual presentation of output and speakers or other sound generating devices for audible
  • Examples of input devices that can be used for a user interface include keyboards, and pointing devices, such as mice, touch pads, and digitizing tablets.
  • a computer may receive input information through speech recognition or in other audible format.
  • Such computers may be interconnected by one or more networks in any suitable form, including a local area network or a wide area network, such as an enterprise network, and intelligent network (IN) or the Internet.
  • networks may be based on any suitable technology and may operate according to any suitable protocol and may include wireless networks, wired networks or fiber optic networks.
  • the various methods or processes outlined herein may be coded as software that is executable on one or more processors that employ any one of a variety of operating systems or platforms. Additionally, such software may be written using any of a number of suitable programming languages and/or programming or scripting tools, and also may be compiled as executable machine language code or intermediate code that is executed on a framework or virtual machine.
  • inventive concepts may be embodied as a computer readable storage medium (or multiple computer readable storage media) (e.g., a computer memory, one or more floppy discs, compact discs, optical discs, magnetic tapes, flash memories, circuit configurations in Field Programmable Gate Arrays or other semiconductor devices, or other non-transitory medium or tangible computer storage medium) encoded with one or more programs that, when executed on one or more computers or other processors, perform methods that implement the various embodiments of the invention discussed above.
  • the computer readable medium or media can be transportable, such that the program or programs stored thereon can be loaded onto one or more different computers or other processors to implement various aspects of the present invention as discussed above.
  • program or “software” are used herein in a generic sense to refer to any type of computer code or set of computer-executable instructions that can be employed to program a computer or other processor to implement various aspects of embodiments as discussed above. Additionally, it should be appreciated that according to one aspect, one or more computer programs that when executed perform methods of the present invention need not reside on a single computer or processor, but may be distributed in a modular fashion amongst a number of different computers or processors to implement various aspects of the present invention.
  • Computer-executable instructions may be in many forms, such as program modules, executed by one or more computers or other devices.
  • program modules include routines, programs, objects, components, data structures, etc. that perform particular tasks or implement particular abstract data types.
  • functionality of the program modules may be combined or distributed as desired in various embodiments.
  • data structures may be stored in computer-readable media in any suitable form.
  • data structures may be shown to have fields that are related through location in the data structure. Such relationships may likewise be achieved by assigning storage for the fields with locations in a computer-readable medium that convey relationship between the fields.
  • any suitable mechanism may be used to establish a relationship between information in fields of a data structure, including through the use of pointers, tags or other mechanisms that establish relationship between data elements.
  • inventive concepts may be embodied as one or more methods, of which an example has been provided.
  • the acts performed as part of the method may be ordered in any suitable way. Accordingly, embodiments may be constructed in which acts are performed in an order different than illustrated, which may include performing some acts simultaneously, even though shown as sequential acts in illustrative embodiments.
  • any two components so associated can also be viewed as being “operably connected”, or “operably coupled”, to each other to achieve the desired functionality, and any two components capable of being so associated can also be viewed as being “operably couplable”, to each other to achieve the desired functionality.
  • operably couplable include but are not limited to physically mateable and/or physically interacting components and/or wirelessly interactable and/or wirelessly interacting components and/or logically interacting and/or logically interactable components.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Ophthalmology & Optometry (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Physics & Mathematics (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Biophysics (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Prostheses (AREA)
  • Eye Examination Apparatus (AREA)

Abstract

L'invention concerne un appareil de dépistage de patient qui identifie des candidats appropriés pour recevoir des dispositifs ophtalmiques implantables d'accommodation, tels que des lentilles intraoculaires dynamiques, sur la base de mesures de pupille sous différents états de visualisation. Un pupillomètre mesure la dimension de la pupille (diamètre de la pupille ou région de la pupille) et change la dimension de la pupille en fonction du niveau d'éclairage ambiant et/ou de la distance d'objet. Par exemple, le pupillomètre peut déterminer à quel point la dimension de la pupille change lorsque le sujet passe d'une visualisation soutenue d'une cible distante à une visualisation soutenue d'une cible proche. Ces mesures peuvent être utilisées pour déterminer des variations de la réponse de la pupille, comprenant l'écart-type et/ou l'écart absolu médian de la dimension de la pupille sous un état de visualisation donné, et des rapports de dimensions de pupille et des variances de la dimension de la pupille. L'appareil utilise ces mesures pour estimer si un patient est ou non susceptible de bénéficier d'un dispositif ophtalmique implantable d'accommodation. Il peut également les utiliser pour régler un dispositif ophtalmique implantable.
PCT/US2012/061124 2011-10-20 2012-10-19 Facteurs de dépistage de patient pour des dispositifs ophtalmiques implantables d'accommodation WO2013059663A2 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US201161549280P 2011-10-20 2011-10-20
US61/549,280 2011-10-20
US201161556536P 2011-11-07 2011-11-07
US61/556,536 2011-11-07

Publications (2)

Publication Number Publication Date
WO2013059663A2 true WO2013059663A2 (fr) 2013-04-25
WO2013059663A3 WO2013059663A3 (fr) 2015-06-25

Family

ID=48141630

Family Applications (2)

Application Number Title Priority Date Filing Date
PCT/US2012/061115 WO2013059656A2 (fr) 2011-10-20 2012-10-19 Procédés et appareil pour détecter des éléments déclencheurs d'accommodation
PCT/US2012/061124 WO2013059663A2 (fr) 2011-10-20 2012-10-19 Facteurs de dépistage de patient pour des dispositifs ophtalmiques implantables d'accommodation

Family Applications Before (1)

Application Number Title Priority Date Filing Date
PCT/US2012/061115 WO2013059656A2 (fr) 2011-10-20 2012-10-19 Procédés et appareil pour détecter des éléments déclencheurs d'accommodation

Country Status (1)

Country Link
WO (2) WO2013059656A2 (fr)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2016073887A1 (fr) * 2014-11-07 2016-05-12 Ohio State Innovation Foundation Procédés et appareil permettant d'effectuer une détermination concernant un œil dans des conditions d'éclairage ambiant
FR3058037A1 (fr) * 2016-10-28 2018-05-04 Paul Bonnel Procede de determination d'une donnee ophtalmique
US20200229870A1 (en) * 2019-01-22 2020-07-23 Alcon Inc. Systems and methods for intraocular lens selection using emmetropia zone prediction
US11622682B2 (en) 2019-12-27 2023-04-11 Ohio State Innovation Foundation Methods and apparatus for making a determination about an eye using color temperature adjusted ambient lighting
US11969212B2 (en) 2019-12-27 2024-04-30 Ohio State Innovation Foundation Methods and apparatus for detecting a presence and severity of a cataract in ambient lighting

Families Citing this family (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8941488B2 (en) * 2013-05-17 2015-01-27 Johnson & Johnson Vision Care, Inc. System and method for a processor controlled ophthalmic lens
EP3420888A1 (fr) 2014-07-03 2019-01-02 AMO WaveFront Sciences, LLC Système de mesure optique et procédé de réglage de niveau de luminosité cible
CN111201479B (zh) * 2017-10-10 2022-09-27 威里利生命科学有限责任公司 用于人至眼科设备通信的高效的基于姿势的眼科设备和方法
EP3740113A4 (fr) * 2018-01-19 2021-08-11 Children's National Medical Center Appareil et procédé pour la détection non invasive de la consommation de tétrahydrocannabinol et de la dégradation du tétrahydrocannabinol
MX2020007661A (es) * 2018-01-19 2020-11-12 Childrens Nat Medical Ct Un bioensayo para la detección no invasiva del uso de drogas y afecciones fisiológicas.
EP3742134B1 (fr) 2019-05-23 2023-11-29 IMEC vzw Circuit et procédé de détection de changement de lumière ratiométrique
EP3839613A1 (fr) * 2019-12-20 2021-06-23 IMEC vzw Iris artificiel, procédé de commande d'iris artificiel et procédé permettant de déterminer un profil spécifique à l'utilisateur pour un iris artificiel

Family Cites Families (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0489027A (ja) * 1990-07-31 1992-03-23 Kowa Co 眼科測定装置
US7290875B2 (en) * 2004-11-02 2007-11-06 Blum Ronald D Electro-active spectacles and method of fabricating same
US6638304B2 (en) * 2001-07-20 2003-10-28 Massachusetts Eye & Ear Infirmary Vision prosthesis
WO2004036182A2 (fr) * 2002-10-17 2004-04-29 Control Delivery Systems, Inc. Procede de suivi de traitement de maladie
US20050113744A1 (en) * 2003-11-21 2005-05-26 Cyberkinetics, Inc. Agent delivery systems and related methods under control of biological electrical signals
KR101301053B1 (ko) * 2004-11-02 2013-08-28 이-비젼 엘엘씨 전기-활성 안구내 렌즈
CA2688170C (fr) * 2007-05-24 2016-10-18 Amo Development, Llc Systemes et procedes de compensation d'accommodation
US7964833B2 (en) * 2007-08-02 2011-06-21 Elenza, Inc. Multi-focal intraocular lens system and methods
US7744215B2 (en) * 2007-12-25 2010-06-29 Pixeloptics, Inc. Multiple layer multifocal composite lens
WO2009117506A2 (fr) * 2008-03-18 2009-09-24 Pixeloptics, Inc. Dispositif optique électroactif perfectionné
WO2010117386A1 (fr) * 2009-04-10 2010-10-14 Doheny Eye Institute Procédés, dispositifs et systèmes d'examen ophtalmique
US20100324454A1 (en) * 2009-06-22 2010-12-23 Kircher John C Deception detection using oculomotor movements
US8257295B2 (en) * 2009-09-21 2012-09-04 Alcon Research, Ltd. Intraocular pressure sensor with external pressure compensation

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2016073887A1 (fr) * 2014-11-07 2016-05-12 Ohio State Innovation Foundation Procédés et appareil permettant d'effectuer une détermination concernant un œil dans des conditions d'éclairage ambiant
US10219687B2 (en) 2014-11-07 2019-03-05 Ohio State Innovation Foundation Methods and apparatus for making a determination about an eye in ambient lighting conditions
US10986991B2 (en) 2014-11-07 2021-04-27 Ohio State Innovation Foundation Methods and apparatus for making a determination about an eye in ambient lighting conditions
US11642017B2 (en) 2014-11-07 2023-05-09 Ohio State Innovation Foundation Methods and apparatus for making a determination about an eye in ambient lighting conditions
FR3058037A1 (fr) * 2016-10-28 2018-05-04 Paul Bonnel Procede de determination d'une donnee ophtalmique
US20200229870A1 (en) * 2019-01-22 2020-07-23 Alcon Inc. Systems and methods for intraocular lens selection using emmetropia zone prediction
CN113330522A (zh) * 2019-01-22 2021-08-31 爱尔康公司 使用正视区预测来选择人工晶状体的系统和方法
US11622682B2 (en) 2019-12-27 2023-04-11 Ohio State Innovation Foundation Methods and apparatus for making a determination about an eye using color temperature adjusted ambient lighting
US11969212B2 (en) 2019-12-27 2024-04-30 Ohio State Innovation Foundation Methods and apparatus for detecting a presence and severity of a cataract in ambient lighting
US11969210B2 (en) 2019-12-27 2024-04-30 Ohio State Innovation Foundation Methods and apparatus for making a determination about an eye using color temperature adjusted lighting

Also Published As

Publication number Publication date
WO2013059656A3 (fr) 2015-06-11
WO2013059656A2 (fr) 2013-04-25
WO2013059663A3 (fr) 2015-06-25

Similar Documents

Publication Publication Date Title
WO2013059663A2 (fr) Facteurs de dépistage de patient pour des dispositifs ophtalmiques implantables d'accommodation
AU2017248115B2 (en) A device and method for measuring viewing distances
KR102414777B1 (ko) 시력훈련장치
US20160078594A1 (en) Method of customizing an electronic image display device
US11406257B2 (en) Vision screening device and methods
US10964435B2 (en) Method of monitoring the behavior of a cohort group of members
JP2020512120A (ja) ユーザーの健康状態を評価するシステム
US20220354436A1 (en) Technique for determining a risk indicator for myopia
EP3655314B1 (fr) Procédé de réalisation d'un examen ophtalmologique
US20130242256A1 (en) Method and apparatus for detecting accommodation
US20160147083A1 (en) Focal Length Adjustment
EP3789816A1 (fr) Dispositif et procédé de mise en correspondance de scène visuelle sur une surface de projection
CN109008937A (zh) 屈光度检测方法和设备
KR102474483B1 (ko) 원근조절 및 이접의 공동 결정
EP3113135A1 (fr) Module et procédé de détermination de la fatigue visuelle
KR20230038248A (ko) 시각 작업을 수행하는 대상자의 피로 상태의 변화의 자동 예측을 제공하기 위한 방법 및 장치
Or et al. Oriented texture detection: Ideal observer modelling and classification image analysis
KR20230031952A (ko) 타깃 사용자의 거동을 결정하기 위한 디바이스 및 컴퓨터-구현 방법
CN117243560A (zh) 一种视野检测用视野计系统及其方法

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 12841794

Country of ref document: EP

Kind code of ref document: A2

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 12841794

Country of ref document: EP

Kind code of ref document: A2