WO2016101204A1 - Dispositif de mesure d'hétérophorie et procédé de mesure d'hétérophorie utilisant le dispositif - Google Patents

Dispositif de mesure d'hétérophorie et procédé de mesure d'hétérophorie utilisant le dispositif Download PDF

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Publication number
WO2016101204A1
WO2016101204A1 PCT/CN2014/094910 CN2014094910W WO2016101204A1 WO 2016101204 A1 WO2016101204 A1 WO 2016101204A1 CN 2014094910 W CN2014094910 W CN 2014094910W WO 2016101204 A1 WO2016101204 A1 WO 2016101204A1
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WO
WIPO (PCT)
Prior art keywords
subject
phoria
lenses
optical means
front side
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Application number
PCT/CN2014/094910
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English (en)
Inventor
Jinhua BAO
Bjorn Drobe
Xinping YU
Binbin SU
Ge Wu
Hao Chen
Original Assignee
Essilor International (Compagnie Generale D'optique)
Shanghai Essilor Optical Co. Ltd
Wenzhou Medical University
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.)
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Publication date
Application filed by Essilor International (Compagnie Generale D'optique), Shanghai Essilor Optical Co. Ltd, Wenzhou Medical University filed Critical Essilor International (Compagnie Generale D'optique)
Priority to CN201480084311.9A priority Critical patent/CN107106002B/zh
Priority to PCT/CN2014/094910 priority patent/WO2016101204A1/fr
Publication of WO2016101204A1 publication Critical patent/WO2016101204A1/fr

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    • 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
    • A61B3/08—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing binocular or stereoscopic vision, e.g. strabismus
    • 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
    • A61B3/028—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing visual acuity; for determination of refraction, e.g. phoropters
    • A61B3/032—Devices for presenting test symbols or characters, e.g. test chart projectors
    • 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
    • A61B3/028—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing visual acuity; for determination of refraction, e.g. phoropters
    • A61B3/04—Trial frames; Sets of lenses for use therewith

Definitions

  • the present invention relates generally to optometric tools, in particular it relates to a device for measuring phoria. In addition, this invention also relates to a method for measuring phoria using the device.
  • General optometry usually refers to the measurement for single eye parameter, such as the degrees of myopia, hyperopia, astigmatism and presbyopia.
  • binocular vision value especially phoria (heterophoria) , which can be used for advanced and personalized eyeglass prescription, such as for determining near addition value for ophthalmic progressive lenses.
  • phoria is a type of eye condition in which the directions that the eyes are pointing at rest position, when not performing binocular fusion, are not consistent with each other.
  • a person with two normal eyes has single vision (usually) because of the combined use of the sensory and motor fusional systems.
  • the motor fusional system acts to point both eyes at the target of interest; any offset is detected visually (and the motor system corrects it) .
  • Phoria only occurs during dissociation of the left eye and right eye, when fusion of the eyes is absent. If one covers one eye (e.g. with his/her hand) one removes the sensory information about the eye′s position in the orbit. Without this, there is no stimulus to binocular fusion, and the eye will move to a position of ′′rest′′ . The difference between this position, and where it would be were the eye uncovered, is the phoria.
  • Phoria can be found on almost each human being, and only the degree is different and dependent on different situations. Phoria is usually asymptomatic. This is when it is said to be ′′compensated′′ . When fusional reserve is used to compensate for heterophoria, it is known as compensating vergence. In severe cases, when the heterophoria is not overcome by fusional vergence, signs and symptoms appear. This is called decompensated phoria, which leads to eyestrain. In addition, phoria may result in squint or also known as strabismus.
  • Phoria tests can be performed at any distance, but the phoria value varies with distance of measurement.
  • phoria can be measured for different accommodation values, either by shifting the plane of the target or by adding plus or minus lenses in front of the eyes of the subject. This requires either a phoropter or a trial lens set (which are both expensive) and need experienced examiner to be used. For near vision, the phoria test must be placed at the right distance manually. With trial frames, this will induce experimental errors as the test is usually held by the subject and cannot be placed at a precise distance.
  • an object of the present invention consists in providing a device for measuring phoria, such as near phoria, with a fixed and precise distance as well as under different accommodation conditions, so as to overcome the abovementioned disadvantages mentioned.
  • the device for measuring phoria of a subject comprises:
  • -a front side which comprises an opening corresponding to the position of the eyes of the subject
  • the device further comprises optical means, which contain at least one set of lenses with different powers corresponding to different accommodation demands of the subject, wherein the optical means are positioned corresponding to the opening and in front of at least one eye of the subject, so that the visual display patterns are adapted to be viewed by the subject through the optical means.
  • the visual display pattern is adapted to be adjusted
  • the optical means contain two sets of the lenses respectively positioned in front of the eyes of the subject, and both sets contain the same lenses, wherein the order of the lens on both sets are configured to be reversed so as to ease binocular rotation.
  • the distance between the optical centers of the lenses in use of said two sets of the lenses are adjustable, corresponding to the pupillary distance of the subject, so as to be aligned with the visual axis of the subject;
  • the optical means comprise a null position where no lens or lens with zero power (0.00D) is positioned and viewed by the subject;
  • the number of the lenses of said at least one set of the lenses is limited, for example, limited in five lenses, the power values of which, for example, are+1.00D, +1.50D, +2.00D, +2,50D, +3.00D.
  • the power value of one lens of said at least one set of lenses is zero diopter;
  • variable prisms positioned corresponding to the opening and in front of at least one eye of the subject, and the visual display pattern is changed to be utilized in the Fusional Amplitude measurement;
  • the device comprises at least one specific lens, for example a Maddox filter or a vertical prism, positioned corresponding to the opening to assist the phoria measurement;
  • the device further comprises an indicator which is adapted to be adjusted by the subject to indicate a value of the phoria that subject obtains.
  • the device further comprises a memory unit which records the value of the phoria for each lens, and recorded phoria values can be transmitted to a computer system which will send the values to a data base for further analysis;
  • the device is mainly made of translucent plastic
  • the device further comprises a padded forehead rest positioned on the front side for receiving the forehead of the subject.
  • the device according to the present invention can facilitate the phoria measurement with accommodation conditions provided by the lens means as well as under fixed measuring distance owing to the configuration of the device, and provide more precise measurement results without expensive equipment in the art and experienced examiner using the same.
  • a second aspect of the invention provides a method for measuring phoria of a subject by using the device.
  • the method comprises the following steps:
  • the step e further comprises a step of memorizing the identification by a memory unit.
  • the present invention provides cheap, simple, fast and precise device and method to measure phoria (especially near vision phoria) with different accommodation values (different additions) . Meanwhile, the efficacy of measuring phoria is improved compared to the measurement devices and methods in the art.
  • - Figure 1 is a perspective view of a device for measuring phoria according to a first embodiment
  • - Figure 2 is a perspective view of the device in figure 1 without the optical means
  • FIG. 3 is a front view of the optical means of the device in figure 1;
  • FIG. 4 is an enlarged front view of the visual display pattern for phoria test of the device in figure 1;
  • - Figure 5 is a perspective view of a device for measuring phoria according to a second embodiment
  • - Figure 6 is a perspective view of the device in figure 5 without the optical means which shows a phoria test side;
  • - Figure 7 is a perspective view of the device in figure 5 without the optical means which shows a fusional amplitude test side;
  • Figures 8 and 9 are front views of the optical means of the device in Figure 5;
  • - Figure 10 is an enlarged front view of the visual display pattern for fusional amplitude test of the device in figure 5.
  • Figures 1 to 4 show a first embodiment of the device according to the present invention.
  • This embodiment is a simple version which contains a rectangular box and optical means 5 attached to the rectangular box for measuring horizontal phoria under different accommodative conditions.
  • the rectangular box comprises a front side 1 and a rear side 2 which is parallel to the front side 1.
  • the front side 1 comprises two openings 11, 13, as shown in Figure 2, corresponding to the position of left and right eyes of a subject whose phoria value is intended to be tested.
  • a notch 16 for receiving nose of a subject.
  • the distance between the two openings 11, 13 is adapted to be adjusted according different subjects, and in this embodiment the distance corresponds to the pupillary distance of the subject ranging from 55 mm to 65mm, preferably 60mm.
  • the rear side 2 is opposite to the front side 1 and is located on the other end of the box.
  • a visual display pattern 21 is disposed on the rear side 2, towards the front side 1.
  • the visual display pattern 21 is a phoria value indication for the phoria test, such as modified Thorington, which is printed on paper or plastic and can be changed and adjusted according to different phoria measurements, for example, Von Graeffe, Modified Thorington test, Howell test, Maddox rod, and etc.
  • the visual display pattern 21 further comprises a light source 23, such as LED light, for phoria measurement, as shown in Figure 4, as well as a battery and a switch, for turning on and off the light, fixed at the rear side of the device, not shown.
  • a light source 23 such as LED light, for phoria measurement, as shown in Figure 4, as well as a battery and a switch, for turning on and off the light, fixed at the rear side of the device, not shown.
  • the front side 1 and the rear side 2 are connected by two side connection components 3, 4 the length of which can be adjusted by adjustment means, for example expansion link, according to the measurement requirement, for example 33cm, and can be temporally fixed during the measurement.
  • adjustment means for example expansion link
  • the optical means in the form of a wheel 5, comprise a set of lenses on the periphery of the wheel, as shown in Figure 3, and these lenses have a limited number, for example six, with different powers corresponding to different accommodation demands of the subject, such as +1.00D, +1.50D, +2.00D, +2,50D, +3.00D, 0,00D (or no lens, a null position) .
  • the wheel further comprises an open hole 51 in its central corresponding to a mounting point 15 on the left of the front side 1 for attaching to the latter by a screw, bolt or the like, so as to be rotatably mounted on the front side with at least one lens (or null position) covering the left opening 11.
  • the rectangular box is made of frosted polycarbonate to ensure light weight
  • the wheel 5 is made of same material
  • the lenses are made of transparent polycarbonate.
  • the accommodation variation is only produced monocularly on left eye when rotating the wheel 5, and the right eye uses a Maddox rod 131 which is positioned on the right opening 13 as shown in Figure 1.
  • the device can be used to measure horizontal phoria under different accommodative conditions through the following steps:
  • the wheel 5 is set to no power lens or null position where no lens disposed for the left eye of the subject.
  • the subject is asked to look through the openings in the device and fixate the light at the center of the graduation. With his left eye, he will see the graduation and the light, with his right eye, due to the Maddox rod, he will see a vertical line.
  • the task is to read on which graduation is located the vertical line (value of his phoria without addition lens) and report it to the examiner.
  • the wheel 5 is turned to an addition lens, wherein one of the following three modes can be adapted: (1) increasing power: +1D, +1.5D, +2D, etc. (2) Decreasing power: +3D, +2.5D, etc. (3) random order.
  • Steps 2, 3 and 4 are repeated and values written down until all lenses are tested (or a limited number, according to the judgment of the examiner) .
  • step 1 it is also possible to start step 1 with a different power. However, it is better to start the measurement with zero addition or null position.
  • the values obtained with the device are the horizontal phoria values under different accommodative conditions, which can be used for example to determine a personalized addition value, to be prescribed for example for progressive addition lenses, bifocals or reading single vision lenses.
  • the device can further comprise an indicator (not shown) which is adapted to be adjusted by the subject to indicate a value of the phoria that subject obtains.
  • an indicator (not shown) which is adapted to be adjusted by the subject to indicate a value of the phoria that subject obtains.
  • the device can also comprise a memory unit which records the value of the phoria for each lens tested. Such recorded value can be transmitted to data base of a computer or cloud system which further analyzes the data for further process, such as determination of the personalized addition value for the subject, for example a child or a teenager.
  • Figures 5 to 10 show a second embodiment of the device according to the present invention. This is a more sophisticated version. It changes accommodation for phoria measurement binocularly (for both left and right eyes) and, preferably, can be reversed to measure fusional amplitudes without any change in accommodation.
  • This second embodiment contains a rectangular box, two optical means 5L, 5R attached to the rectangular box for measuring phoria values binocularly under different accommodative conditions, and a Risley prism system for fusional amplitude test.
  • the rectangular box comprises a front side 1, a back side 6 which is parallel to the front side, and a rear side 2 which is positioned between the front side 1 and the back side 6 and is also parallel to the front side 1.
  • the front side 1 comprises two openings 11, 13, as shown in Figure 6, corresponding to the position of left and right eyes of a subject whose phoria value is intended to be test.
  • the distance between the two openings 11, 13 is adapted to be adjusted according different subjects, and in this embodiment the distance corresponds to the pupillary distance of the subject ranging from 55 mm to 65mm, preferably 60mm.
  • the back side 6 is opposite to the front side and is located on the other end of the box.
  • the back side 6 also comprises two openings 61, 63, as shown in Figure 7, corresponding to the position of left and right eyes of a subject whose fusional amplitude value is intended to be tested.
  • the rear side 2 is arranged between the front side 1 and the back side 6, and located in the box.
  • a visual display means is disposed on the rear side 2, wherein a visual display pattern 21 for phoria value is facing the front side 1 and a visual display pattern 22 for fusional amplitude value is facing the back side 6.
  • the visual display means is, for example, a LCD or OLED display, which presents the visual display pattern 21 for phoria test, such as for Modified Thorington test, and the visual display pattern 22 for fusional amplitude, such as line of vertical letters.
  • the front side 1 and the back side 6 are connected by two side connection components 3, 4 which have fixed length and the rear side 2 is attached to the two connection components and is adapted to slide thereon, so that the distance d1 between the front side 1 and the rear side 2 and the distance d2 between the back side 6 and the rear side 2 is adjustable according to the requirement, for example between 0cm and 40cm.
  • the visual display means can automatically adjust the display patterns depending on distances d1 and/or d2, so that the graduation of the phoria test corresponds always to 1 prismatic diopter and that the angular letter size of the Fusional amplitude test always equals 6/10.
  • the distance d1 or d2 is measured electronically and used for the automatic display of right graduation and the angular size.
  • Letter size (mm) tan (8.33min of arc) x Distance d2 (mm) .
  • the optical means are in the form of two wheels 5L, 5R, and each wheel comprises a set of lenses on the periphery of the wheel, as shown in Figures 8 and 9, and each set of lenses has a limited number, for example six, with different powers corresponding to different accommodation demands of the subject, such as +1.00D, +1.50D, +2.00D, +2,50D, +3.00D, 0,00D (or no lens, a null position) .
  • the orders of the lenses on both sets are configured to be reversed so as to ease binocular rotation.
  • the wheels respectively comprise an open hole 51L/51R in their center corresponding to two mounting points 15L, 15R on the left and the right of the front side 1 for attaching to the latter by a screw, bolt or the like, so as to be rotatably mounted on the front side where at least one lens (or null position) of the wheel 51L covers the left opening 11 and at least one lens (or null position) of the wheel 51R covers the right opening 13.
  • the wheels are adapted to move horizontally to adjust the distance therebetween according to the different pupillary distance of the subject, so as to be aligned with the visual axis of the subject
  • the risley prism system for fusional amplitude test is in the form of the horizontal Risley prisms positioned on the openings 61, 63 for the two eyes of the subject.
  • the distance between the two Risley prisms are adapted to be adjusted by adjustment means 68, such as adjustment wheels, so as to be aligned with the visual axis of the subject.
  • the rectangular box is made of frosted polycarbonate to ensure light weight
  • the two wheels are made of same material, preferentially polycarbonate
  • the lenses are made of transparent polycarbonate.
  • the second embodiment comprises two working sides, the phroria side where the subject faces the front side and looks through the openings 11, 13 for the phoria measurement, and the fusional amplitude side where the subject faces the back side and looks through the openings 61, 63 for the fuional amplitude measurement.
  • the optical means can change the accommodation binocularly, whereas during the fusional amplitude measurement, there is no need to change the accommodation.
  • the accommodation variation is produced binocularly on both left and right eyes when rotating the wheels 5L, 5R, and the right eye also uses a Maddox rod 131 which is positioned on the right opening 13 as shown in Figure 7.
  • the subject faces the front side 1 and looks through the two wheels 5L, 5R, and the phoria values of the subject are measured through the following steps:
  • Distance d1 of display means on the rear side is adjusted according to examiner’s decision (could be usual working distance at near, for example) .
  • the device can automatically change the size of graduation on the display means accordingly to this distance, i.e. so that 1 graduation equals one prismatic diopter.
  • the wheels are set to no power lens or null position.
  • the subject is asked to look through the openings 11, 13 in the device and fixate the light at the center of the graduation. With his left eye, he will see the graduation and the light, with his right eye, due to the Maddox rod, he will see a vertical line.
  • the task is to read on which graduation is located the vertical line (value of his phoria without addition lens) and report it to the examiner.
  • Both wheels are turned to an addition lens, wherein one of the following three modes can be adapted: (1) increasing power: +1D, +1.5D, +2D, etc. (2) Decreasing power: +3D, +2.5D, etc. (3) random order.
  • Steps 3, 4 and 5 are repeated and values written down until all lenses are tested (or a limited number, according to the judgment of the examiner) .
  • step 2 it is also possible to start step 2 with a different power. However, it is better to start the measurement with zero addition.
  • the device of the second embodiment can further comprise an indicator (not shown) which is adapted to be adjusted by the subject to indicate a value of the phoria that subject obtains.
  • the device can also comprise a memory unit which records the value of the phoria for each lens test. Such recorded value can be transmitted to data base of a computer or cloud system which further analyzes the data for further process, such as determination a personalized addition value for the subject.
  • the subject faces the back side 1, opposite side of the phoria measurement, and looks through the two Risley prims, and the fuional amplitudes of the subject are measured through the following steps:
  • the distance d2 of the display means is adjusted to the same distance as for the phoria measurement.
  • the device automatically changes the size of the vertical letters on the display accordingly to this distance so that the letters have the same angular size whatever the distance.
  • the subject is asked to fixate the target on the display, usually a vertical line of letters.
  • the values obtained with the second embodiment can be used for example to determine the personalized addition value.
  • a third embodiment of the present invention is similar to the second embodiment, whereas it can only be used in one direction (phoria side) on the second embodiment, wherein the Risley prisms are placed between the lens wheels and the eye opening on the front side to be able to measure fusional amplitudes with different accommodation values.
  • the phoria measurement can be changed to a fusional amplitude measurement by rotating the wheels.
  • the phoria values are measured according to phoria measurement steps in the second embodiment.
  • the Risley prisms are set to zero.
  • the fusional amplitude can be determined in this embodiment for all addition lenses, including zero addition or no lens condition, similarly to the second embodiment.
  • the device further comprises a padded forehead rest (not shown) positioned on the front side for positioning and receiving the forehead of the subject.

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Abstract

L'invention concerne un dispositif pour mesurer l'hétérophorie comprenant : un côté avant (1), qui comprend une ouverture (11) correspondant à la position des yeux du sujet ; un côté arrière (2) qui est parallèle au côté avant (1) et présente un motif d'affichage visuel (21) disposé vers le côté avant (1) et configuré pour être utilisé pour la mesure d'hétérophorie ; et des moyens optiques (5) qui contiennent au moins un ensemble de lentilles de différentes puissances correspondant à différentes demandes de réception du sujet, les moyens optiques (5) étant positionnés de façon correspondante à l'ouverture (11) et en face d'au moins un œil du sujet, de telle sorte que les motifs d'affichage visuel (21) sont conçus pour être vus par le sujet à travers les moyens optiques (5). Le dispositif fournit un moyen peu coûteux, simple, rapide et précis pour mesurer l'hétérophorie dans différentes valeurs de réception.
PCT/CN2014/094910 2014-12-25 2014-12-25 Dispositif de mesure d'hétérophorie et procédé de mesure d'hétérophorie utilisant le dispositif WO2016101204A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
CN201480084311.9A CN107106002B (zh) 2014-12-25 2014-12-25 用于测量隐斜视的设备以及使用该设备测量隐斜视的方法
PCT/CN2014/094910 WO2016101204A1 (fr) 2014-12-25 2014-12-25 Dispositif de mesure d'hétérophorie et procédé de mesure d'hétérophorie utilisant le dispositif

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PCT/CN2014/094910 WO2016101204A1 (fr) 2014-12-25 2014-12-25 Dispositif de mesure d'hétérophorie et procédé de mesure d'hétérophorie utilisant le dispositif

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US10338409B2 (en) 2016-10-09 2019-07-02 eyeBrain Medical, Inc. Lens with off-axis curvature center
US10908434B2 (en) 2018-01-01 2021-02-02 Neurolens, Inc. Negative power lens with off-axis curvature center
US10921614B2 (en) 2017-12-31 2021-02-16 Neurolens, Inc. Low-convergence negative power spectacles
US11360329B2 (en) 2017-12-31 2022-06-14 Neurolens, Inc. Negative power eye-strain reducing lens
US11589745B2 (en) 2017-09-05 2023-02-28 Neurolens, Inc. Method and system for measuring binocular alignment

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TWI768807B (zh) * 2021-04-01 2022-06-21 林翔 手持式隱斜視量測裝置

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Publication number Priority date Publication date Assignee Title
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