WO2022156826A1 - 一种屈光测试卡及其测量方法 - Google Patents

一种屈光测试卡及其测量方法 Download PDF

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Publication number
WO2022156826A1
WO2022156826A1 PCT/CN2022/079250 CN2022079250W WO2022156826A1 WO 2022156826 A1 WO2022156826 A1 WO 2022156826A1 CN 2022079250 W CN2022079250 W CN 2022079250W WO 2022156826 A1 WO2022156826 A1 WO 2022156826A1
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Prior art keywords
astigmatism
optotype
test card
subject
spherical
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PCT/CN2022/079250
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English (en)
French (fr)
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刘振灏
刘振勃
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刘振灏
刘振勃
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Priority to US18/273,673 priority Critical patent/US20240081635A1/en
Publication of WO2022156826A1 publication Critical patent/WO2022156826A1/zh

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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
    • A61B3/028—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
    • 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
    • A61B3/0285—Phoropters
    • 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
    • A61B3/036—Subjective types, i.e. testing apparatus requiring the active assistance of the patient for testing visual acuity; for determination of refraction, e.g. phoropters for testing astigmatism

Definitions

  • the invention mainly relates to the field of optometry of ophthalmic refractive errors, in particular to a refractive test card and a measurement method thereof.
  • Refractive error means that after the parallel light passes through the refractive action of the eye, it is imaged in front or behind the retina, and a clear object image cannot be formed on the retina. It includes farsightedness, nearsightedness and astigmatism. All refractive error tests require a full set of equipment and a professionally trained optometrist or ophthalmologist to perform. Such checks include:
  • the deviation caused by the adjustment can only be approached but not completely offset.
  • the refractive error test after mydriasis can theoretically offset the refractive error caused by the adjustment, but the corrected degree obtained by such a refraction result in a subject with obvious adjustment does not represent the daily degree, so the refraction degree Often causes blurred vision in daily life.
  • Keratometer only the corneal curvature can be obtained to calculate the spherical power made by the cornea and the astigmatism and astigmatism axis caused by asymmetry, but the spherical power, astigmatism power and astigmatism axis of the whole eyeball cannot be known .
  • band photoretinography Band photoretinography. (Generally, it is used in conjunction with the lens to determine the approximate power when it is neutralized. The obtained spherical power, astigmatism power and astigmatism axis are all estimates, and plug-in refraction and cross cylinder lens and astigmatism corrector are also required. Refraction to find spherical power, astigmatism and axis of astigmatism.)
  • astigmatism is a refractive abnormality of the eye, and most of the astigmatism is related to the curvature of the cornea.
  • the parallel light enters the eye due to the different refractive power of the eyeball on different meridians, it is impossible to gather the light rays on each meridian at one point (focus), so the same optotype will form more than one object image that does not completely overlap, that is, The inability to form a clear image of the object is called astigmatism.
  • the general existing astigmatism examination usually adopts the following methods:
  • Astigmatism can be detected with distance and near vision tests. Patients with severe astigmatism have poor distance and near vision.
  • the subjective examination of astigmatism can be observed with an astigmatism table. From the relatively clear or hazy image shape on the retina, a preliminary understanding of the astigmatic meridian of the eye to be examined can be obtained.
  • the commonly used fixed astigmatism meter (bell-type astigmatism meter) is composed of multiple radial lines. Each line is based on the principle of multi-point series effect. The more points, the clearer the series. In the absence of astigmatism, of course each line has its own direction and is different in direction from each other, but the density of points along the long axis of each line is the same, so each line looks like The sharpness is the same, no line stands out. When there is astigmatism, because each line has its own direction and is different from each other, the density of points in series along the long axis of each line is different. At this time, the clarity of one or two lines is comparable. High and obvious. There are relatively many and close connections along the parallel direction of the lines, so the lines look clearer. The series that is rotated by 90° relative to the long axis of the line is the series of relatively small points, so it is relatively vague.
  • Figure 1 shows that when there is no astigmatism, the linear optotypes arranged in a diverging shape look almost clear and concentrated on the axis in different directions.
  • Figure 2 shows that when there is astigmatism, for example, the axis of astigmatism is 90°, and the smaller the deviation from the 90° direction of the axis of astigmatism, the more concentrated and clearer the line astigmatism is. The greater the deviation from the direction of the astigmatism axis, the more diffuse and blurred the line astigmatism becomes.
  • any one of the following five situations is encountered, which indicates astigmatism: (1) the reflection bandwidth is different; (2) the refraction of a pair of meridians is different; (3) the fundus reflection is irregular; (4) shearing; The direction of movement of the fundus reflective tape is inconsistent.
  • Astigmatism is measured by the cylindrical lens method and the spherical lens method.
  • the axial position of astigmatism and the degree of astigmatism can be determined. According to the degree, it can be divided into mild ( ⁇ 2.00D), moderate (2.25 ⁇ 4.00D), and severe (>4.00D) astigmatism. Below 1.00D belongs to physiological astigmatism.
  • Subjective audition refraction is generally carried out after objective refraction.
  • Including keratometer or corneal topography or quantitative corneal astigmatism Including keratometer or corneal topography or quantitative corneal astigmatism.
  • the optic disc is often oval in shape. In people with high astigmatism, the vertical edge of the optic disc can be seen clearly, while the horizontal edge cannot be seen clearly or vice versa. From the shape of the optic disc, we can roughly understand the axial direction of astigmatism.
  • the accuracy of the above refractive error detection methods is affected by many parties, and there are the following shortcomings or deficiencies:
  • the subjects must go to hospitals, clinics, optical shops and other places to have a face-to-face optometry examination with a professional doctor or optometrist.
  • test site needs to have a sufficient and diverse range of prescription and optical lens instruments and instruments.
  • the tester needs to have enough professional knowledge of optical optometry principle and proficient practical skills.
  • test time is affected and limited by the daily life and office hours of the tester and the testee, because the round-trip traffic takes a long time and is time-consuming and labor-intensive.
  • the traditional optometry requires the eyeball and the lens to operate at a fixed and very close distance, and this prerequisite is often not strictly observed by the optometrist and the tested person.
  • the inserts often need to be replaced during the optometry process, which can easily cause the subject's eyes to adjust unconsciously. These will cause the refraction to be inaccurate.
  • the inspection method and process are too complicated, and the subjects, especially young children, cannot understand what they need to do to cooperate with the optometrist for optometry, so they often get inaccurate optometry results with large deviations. Many times in the busy pediatric ophthalmology department, the tester will skip this step and directly quote the degree of the computer automatic refractometer, resulting in greater errors.
  • the commonly used vision charts in clinical practice include: International Standard Vision Chart, Ran's Ring Vision Chart, Logarithmic Vision Chart, Digital Vision Chart, English Alphabet Vision Chart and Children's Graphic Vision Chart.
  • astigmatism meters are: fixed astigmatism meter (bell-type astigmatism meter) and movable astigmatism meter (sector optotype, which consists of a fan-shaped radial reticle and a rotatable disc. There is a set of perpendicular to each other on the disc. the grid square, and an inverted V-shaped optotype).
  • the insert refraction method requires frequent replacement or rotation of the insert lens, which will easily cause confusion and adjustment changes of the tested person, resulting in a refraction error.
  • the technical problem to be solved by the present invention is to provide an innovative and simple optometry tool and its method to find out the subject: whether there is refractive error; what type of refractive error it belongs to; and the quantification of refractive error.
  • the present invention provides a refraction test card, which is characterized in that an optotype is included in the black background, and the center of the optotype includes a partition unit, and the partition unit separates the optotype at the center of the optotype. Visually separated.
  • the present invention further provides a refraction test card, characterized in that, the optotype includes a strip-shaped optotype, and the color of the strip-shaped optotype includes either white or red.
  • the present invention further provides a refraction test card, wherein the optotype includes a cross-shaped optotype, and the color of the cross-shaped optotype includes white.
  • the present invention further provides a refraction test card, characterized in that the shape of the partition unit includes either a rectangle or a circle.
  • the present invention further provides a refraction test card, characterized in that the optotype has a length of 260mm ⁇ 50mm and a width of 5mm ⁇ 2mm.
  • the present invention further provides a refractive test card, characterized in that the width of the partition unit is less than or equal to 5mm, and the height range is 5mm ⁇ 2mm.
  • the present invention further provides a refraction test card, characterized in that the test card includes an astigmatism test card and a spherical power test card, wherein the astigmatism test card includes a white striped optotype and a spherical power test card.
  • the astigmatism test card includes a white striped optotype and a spherical power test card.
  • Cross-shaped optotype, the spherical power test card includes a red strip optotype.
  • the present invention further provides a measurement method using any of the above-mentioned refractive test cards, characterized in that it includes:
  • Step a according to the degree of clarity of the contrast between the optotype and the black background in the astigmatism test card observed by the subject, determine whether the subject has astigmatism;
  • Step b if it is determined that the subject has astigmatism, measure the direction of the axis of astigmatism, if there is no astigmatism, turn to step d and end;
  • Step c according to the degree of clarity of the contrast between the optotype and the black background in the spherical power test card observed by the measured person, to determine whether the measured person has myopia or hyperopia;
  • Step d test and calculate the spherical degree of the subject
  • Step e if there is astigmatism, continue the test and calculate and obtain the astigmatism of the subject.
  • the present invention further provides a measurement method, characterized in that the measurement of the astigmatism axis direction in the step b includes:
  • Step b1 unilateral naked eye measurement of the subject, rotating the astigmatism test card at a rate not higher than 12.5°/sec, to obtain the maximum sharpness direction of the astigmatism test card observed by the subject;
  • step b2 the maximum sharpness direction ⁇ 90° is determined as the direction of the astigmatism axis.
  • the present invention further provides a measurement method, characterized in that, the step d further comprises: step d1 , obtaining a measurement of the subject's unilateral naked eye moving in the direction of the spherical power test card. Clearest spacing d, focal length f:
  • Step d2 according to the spherical degree D:
  • step d3 the spherical degree test card is rotated by 90°, and steps d1 to d2 are repeated to obtain the second spherical degree D 2 ;
  • Step d4 the spherical degree D of the eyeball of the subject:
  • step d5 steps d1 to d4 are repeated to obtain the spherical power of the other eyeball.
  • the present invention further provides a measurement method, characterized in that the step e further comprises:
  • step e1 the spherical degree test card is placed in the direction of the maximum resolution in the step b1;
  • Step e2 obtain the clearest distance d when the subject's unilateral naked eye moves in the direction of the spherical power test card for measurement, and the focal length f:
  • Step e3 according to the spherical degree D:
  • step e4 the spherical power test card is placed in the direction of the astigmatism axis, and steps e1 to e3 are repeated to obtain a second spherical power D 2 ;
  • Step e5 calculate the astigmatism D' of the subject's eyeball:
  • step e6 steps e1 to e5 are repeated to obtain the astigmatism of the other eyeball.
  • the present invention further provides a measuring method, characterized in that, in the step a:
  • the present invention does not need to use concave spherical lenses for correcting myopia, and utilizes that when the subject clearly sees the optotype, the focal line is moved backward to just overlap the retina, which also means that the distance between the eye and the optotype is equal to the focal length.
  • the refractive error and astigmatism are obtained, which greatly simplifies the method of optometry, and is very convenient to detect and determine the type and quantification of the refractive error.
  • the measurement method according to the above claims is characterized in that, the use of a close-range concave sheet is eliminated, and unnecessary errors caused by the adjustment rise caused by the close-range operation of traditional optometry are eliminated.
  • Figure 1 is a schematic diagram of a linear optotype seen by a subject without astigmatism when a traditional bell-type astigmatism meter is used;
  • Figure 2 is a schematic diagram of a linear optotype seen by a subject with astigmatism when a traditional bell-type astigmatism meter is used;
  • FIG. 3 is a schematic diagram of the composition of the refractive test card 30 according to the first preferred embodiment of the present invention.
  • FIG. 4 is a schematic diagram of the composition of the refractive test card 40 according to the second preferred embodiment of the present invention.
  • FIG. 5 is a schematic diagram of the composition of the refractive test card 50 according to the third preferred embodiment of the present invention.
  • Figures 6(1) and 6(2) are the comparison diagrams showing the cross-shaped optotype at different angular positions during the test
  • Figures 7(1) and 7(2) are the comparison diagrams showing the cross-shaped optotype at different angular positions during the test
  • Figures 8(1) and 8(2) are the comparison diagrams showing the cross-shaped optotype at different angular positions during the test
  • Fig. 9 is the light focusing schematic diagram of the subject with pure astigmatism
  • Figures 10(A) to 10(C) are views on the retina during the astigmatism test
  • Fig. 11 is the flow chart of the complete test method applying the test card of the present invention.
  • Figure 12 shows a schematic diagram of light focusing when looking at an optotype during the test of spherical refractive error
  • Fig. 13 is the detailed flow chart of step 1 in Fig. 11;
  • Fig. 14 is the detailed flow chart of step 3 in Fig. 11;
  • FIG. 15 is a detailed flowchart of step 4 in FIG. 11 .
  • orientations indicated by the orientation words such as “front, rear, top, bottom, left, right", “horizontal, vertical, vertical, horizontal” and “top, bottom” etc.
  • positional relationship is usually based on the orientation or positional relationship shown in the drawings, which is only for the convenience of describing the present application and simplifying the description, and these orientations do not indicate or imply the indicated device or element unless otherwise stated. It must have a specific orientation or be constructed and operated in a specific orientation, so it cannot be construed as a limitation on the protection scope of the application; the orientation words “inside and outside” refer to the inside and outside relative to the contour of each component itself.
  • spatially relative terms such as “on”, “over”, “on the surface”, “above”, etc., may be used herein to describe what is shown in the figures.
  • spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as “above” or “over” other devices or features would then be oriented “below” or “over” the other devices or features under other devices or constructions”.
  • the exemplary term “above” can encompass both an orientation of "above” and “below.”
  • the device may also be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptions used herein interpreted accordingly.
  • FIG. 3 is a schematic diagram of a refractive test card according to the first preferred embodiment of the present invention.
  • the test card 30 is a refractive test card composed of a black background 31 and a single white strip optotype 32, and is not limited to the above combination of white and strip, but requires:
  • the test card 30 has a black background 31;
  • the center of the white strip optotype 32 is provided with a partition unit 33 with a width of 1.5 mm and a height of 5 mm.
  • the partition unit 33 is not limited to a rectangle, a circle or other shapes.
  • the black and white contrast is very strong and obvious at the edges. This is beneficial to the subject who can easily distinguish blur from clarity even at a relatively long distance. This is very suitable for judging the direction of the astigmatism axis.
  • the astigmatism strip test card 30 with the above structure is a preferred embodiment.
  • FIG. 4 is a schematic diagram of the astigmatism test card according to the second preferred embodiment of the present invention.
  • the test card 40 is an astigmatism strip refractive test card composed of a black background 41 and a single white cross-shaped optotype 42, and is not limited to the combination of the above white and long strips.
  • the deformation on this basis requires:
  • the background of the test card is black
  • the center of the test card consists of two long strips at 90° to each other;
  • each strip is 260mm long and 5mm wide;
  • a partition unit 43 is ad hoc in the center of the cross shape, and the partition unit 43 is a square vacancy, and the side length of the square is 6mm.
  • the black-and-white contrast is very strong at the edges. This is beneficial to the subject who can easily distinguish blur from clarity even at a relatively long distance. This is very suitable for judging the direction of the astigmatism axis.
  • FIG. 5 is a schematic diagram of an optotype card according to the third preferred embodiment of the present invention.
  • the test card 50 is an optotype spherical diopter test card composed of a black background 51 and a single red strip-shaped optotype 52.
  • the test card 50 is not limited to the combination of red and strip, but requires:
  • the background of the test card 50 is black
  • the partition unit 53 is not limited to rectangular, circular or other shapes.
  • the measurement deviation of spherical power caused by red light and green light is about 0.5DS.
  • the red optotype is close to the retina because the image formed is relatively backward, so it can offset the involuntary increase in spherical power produced by the proximal accommodation and aggregation.
  • the green optotype is more anterior and farther from the retina than the red optotype, it does not counteract the involuntary increase in spherical power produced by proximal accommodation and aggregation. For this reason, the red spherical power optotype is applied to the original optometry method of the present invention.
  • refraction test card 30 or 40 Use the refraction test card 30 or 40 to determine whether there is any refractive error that needs to be corrected clinically. If there is refractive error, it is necessary to first determine whether there is clinically meaningful astigmatism.
  • Fig. 11 provides the main flow steps of the measuring method of the present invention, as follows:
  • Step 1 use the refractive test card 30 or 40 to determine whether the subject has astigmatism
  • Step 2 if it is determined that there is clinically significant astigmatism, find out the axis of astigmatism;
  • Step 3 measure and obtain near/far vision spherical power with a refraction test card 50;
  • Step 4 For those with astigmatism, use the difference between the strongest and weakest spherical powers to calculate the astigmatism.
  • Case 4 If there is both astigmatism and myopia and hyperopia, go through steps 2, 3 and 4 to obtain relevant parameters including astigmatism and myopia and hyperopia.
  • Step 1 the method of judging whether the subject has clinically significant astigmatism, specifically:
  • Step 11 at a distance of about 5 meters from the subject, the subject watches the astigmatism test card 30 of a single white strip optotype 32 under a black background 31;
  • the test card 30 adopts artificial lighting. If the direct lighting method is used, the illuminance should not be less than 300lx, and the lighting should be uniform, constant, non-reflective and non-dazzling.
  • step 12 the subject is measured with naked eyes and with one eye. Generally, the right eye is measured first, and then the left eye is measured.
  • the other eye When measuring one eye, the other eye needs to be covered.
  • the subject must keep their head upright and not tilted.
  • the subjects can blink naturally to ensure that the eyeballs are moist and not dry, so as not to affect the clarity of vision due to dryness.
  • Step 13 slowly rotate the test card 30 counterclockwise
  • Step 14 Determine whether there is astigmatism and determine the axis of astigmatism according to the viewing situation of the subject.
  • the subject does not have clinically meaningful astigmatism, it means that there is only a single spherical degree, so there is only one focusing line.
  • the test card 30 is rotated to any direction, the subject sees the white stripes and the long optotypes 32 and 32.
  • the contrast sharpness and blurriness of the black background 31 are similar, and there is no particularly clear situation in a certain direction, which indicates that the subject does not have clinically meaningful astigmatism.
  • the contrast sharpness of the tested person changes, and it can be determined as astigmatism with clinical significance. If the test subject says that he can't see clearly, let him move forward with small steps and slowly move closer to the long white stripe. When he sees the obvious white stripe, he stops and starts the test.
  • test card 40 of the white cross-shaped optotype 42 in Embodiment 2 can be changed.
  • step 14 the basis for the judgment is to start from the horizontal line and the vertical line. Do the two strips look similar in definition, or is one more blurred than the other?
  • the two horizontal and vertical lines look similar, and when there is no obvious difference, it means that the astigmatism axis is not above these two lines, so put the white cross-shaped optotype 42 on the four bars corresponding to 45°, 135°, and 225° respectively. , 315°. Ask the subject again if the two bars look about the same sharpness, or is one blurry relative to the other?
  • the cross-shaped optotype 42 may also correspond to 11.25°, 101.25°, 191.25°, 281.25°, and so on.
  • the rule is: the two long bars of the white cross-shaped optotype 42 are always perpendicular to each other, but the degree of the included angle changes every time it is displayed, and it is adjusted from the horizontal and vertical directions to:
  • Figures 6(1) and 6(2) to Figures 8(1) and 8(2) respectively show the comparison diagrams of the appearance of the cross-shaped optotype 42 at the above-mentioned different angular positions during the test.
  • cross-shaped optotypes shown in FIG. 6(1) correspond to 0°, 90°, 180° and 270° respectively;
  • the cross-shaped optotypes shown in Figure 6(2) correspond to 45°, 135°, 225° and 315° respectively;
  • the cross-shaped optotypes shown in Figure 7(1) correspond to 22.5°, 112.5°, 202.5° and 292.5° respectively;
  • the cross-shaped optotypes shown in Figure 7(2) correspond to 11.25°, 101.25°, 191.25° and 281.25° respectively;
  • the cross-shaped optotypes shown in Figure 8(1) correspond to 5.625°, 95.625°, 185.625° and 275.625° respectively;
  • the cross-shaped optotypes shown in Figure 8(2) correspond to 2.8125°, 92.8125°, 182.8125° and 272.8125°, respectively.
  • the subject can be judged at any position. There is no difference in any position at any angle, that is, in any case, the clarity or blurriness of the two crosses is the same, there will be no difference, and it is determined as no astigmatism.
  • step 1 determines that there is no clinically significant astigmatism, it can be identified as a simple spherical refractive error.
  • step 2 is skipped and the refractive measurement of myopia and hyperopia is directly continued, that is, the The tester continues to look at the spherical degree test card 50 of the optotype of the single red strip optotype 52 under the black background 51;
  • a suitable concave spherical lens for correcting myopia can move the focus line to the retina to get a clear image, that is, the focus line overlaps with the retina, and good vision can be achieved at this time.
  • Step 21 at a distance of about 5 meters from the subject, show him the spherical degree test card 50 of a single red striped optotype 52 under a black background 51 .
  • the test card 50 should use artificial lighting. If direct lighting is used, the illuminance should not be less than 300lx, and the lighting should be uniform, constant, non-reflective and non-dazzling.
  • the test card should be protected from direct sunlight or strong light.
  • Step 22 the subject is measured with naked eyes and one eye, generally the right eye is measured first, and then the left eye is measured.
  • Step 23 conduct a simulation test first, the purpose is to prevent the test subject from not reaching the focus distance or using additional adjustment beyond the focus distance, which will affect the test result; during the simulation test, it is necessary to cover one eye, and the test subject starts from a distance of about 5 meters. Slowly move forward in small steps to approach the single red striped optotype 52 on a black background, first feel the optotype being blurred, then the optotype is clearer, and then the optotype is completely clear. At this time, the subject continues to move forward and then back slowly to observe the change in the clarity of the visual mark.
  • Step 24 the formal test begins, and when the test subject is covered with one eye, start from a distance of about 5 meters and slowly move forward in small steps to approach the single red striped horizontal optotype 52 under the black background 52. Stop moving as soon as the horizontal sight mark is clear. Note that in the process of moving forward, you cannot move back and then move forward. If the subject's pace is relatively too large and too fast to distinguish the position from fuzzy to clear, it is necessary to return to the starting point, reduce the pace and start again.
  • Figure 12 shows the position of this test process, that is, a schematic diagram of light focusing when the eyeball without astigmatism looks at the optotype.
  • 04 represents the eyeball
  • C is the cornea
  • M is the retina
  • O is the optotype
  • f represents the focal length, that is, the distance d between the subject's eye and the optotype when the subject just sees the optotype.
  • the light from each point of the optotype O is parallel when it reaches the cornea C, and the spherical degree in the horizontal direction is 0DS, so the light-gathering power is the weakest . Therefore, the light in the horizontal direction will be focused on the rear focus line, and at this time the rear focus line just overlaps the retina M.
  • the subject sees the optotype O clearly, record the value of the distance d, where d is the distance from the subject's eyeball 04 to the optotype O. at this time:
  • the subject In order to improve the accuracy, the subject needs to repeat 5 times in the same inspection, because his subjective adjustment state may change during the optometry process, so he needs to do it several times to take the average value to improve the accuracy. , to reduce the difference caused by the fluctuation of his regulation state.
  • the average value of f was obtained from the 5th value.
  • D is the spherical degree, also known as the diopter.
  • Step 25 according to the horizontal and vertical directions, or the astigmatism axis, and its ⁇ 90° direction, obtain the average value as spherical degrees.
  • Step 26 After completing one eyeball, repeat the above steps 23-25 to measure the spherical degree of the other eyeball of the subject.
  • the following table data records the measured value of each distance d and the calculation result of the spherical degree.
  • the average spherical power of the eye is -2.209
  • the average spherical power of the left eye is -2.318
  • a visual acuity greater than 1.0 at 6 meters indicates a hyperopic refractive error.
  • Refractive errors for farsightedness need to be provided with some (or several) convex lenses (positive spherical power) for adjusting farsightedness.
  • the degree of hyperopia In the case where the degree of hyperopia is generalized, the degree of hyperopia, the difference between the degree of hyperopia on the two axes, the measurement method of the astigmatism of the subject with hyperopia is the same as that of the case of myopia.
  • the visual acuity is generally 1.0 or better. Trying on him with more convex + DS lenses than required for correction will cause clinical myopia. At this time, his vision will decline, at 6 meters his vision is less than 1.0, and the optotypes appear blurred.
  • Step 3 if it is judged as having clinically significant astigmatism in step 1 of FIG. 11 , it is necessary to measure the astigmatism axis and calculate the astigmatism power.
  • the details are as follows in conjunction with FIG. 9 :
  • the corneal curvature and light-gathering power in the horizontal direction are the weakest, and the spherical power is 0DS.
  • the corneal curvature and light-gathering power in the vertical direction are the strongest, and the spherical power is -2DS. Therefore, the light in the horizontal direction will be focused on the back focus line, at this time the back focus line just overlaps the retina. Likewise, the vertical ray will be focused on the front focal line at this time, and its position is in front of the retina.
  • Figures 10(A), 10(B) and 10(C) show the subject's (0/-2DC ⁇ 180) front and rear focus lines in the horizontal or vertical directions of the two viewing angles. Changes in visual clarity.
  • the focus line farthest from the center of the cornea is called the back focus line
  • the focus line closest to the center of the cornea is called the front focus line.
  • the front and rear focus lines are also offset by ⁇ 90° from each other on the axis.
  • step 11 the subject looks at the refraction test card 30 of a single white strip optotype 32 on a black background at a distance of 5 meters.
  • the test card should use artificial lighting. If direct lighting is used, the illuminance should not be less than 300lx. The lighting should be uniform, constant, non-reflective and non-dazzling. The test card should be protected from direct sunlight or strong light.
  • Step 12 the subject is measured with the naked eye and monocular, generally the right eye is measured first, and then the left eye is measured. When measuring one eye, cover the other eye. The subject must keep their head upright and not tilted.
  • Step 13 slowly rotate the white test strip counterclockwise.
  • the rotation speed is not higher than 12.5°/sec.
  • Step 14 Determine whether there is astigmatism according to the viewing situation of the subject, and determine the direction of the axis of astigmatism.
  • a subject with myopic astigmatism he is looking at a single white long-strip astigmatism test chart against a black background, and the image will focus on two focus lines, both of which are in front of the retina, and one opposite to the other. One is closer to the retina, and the other is relatively far from the retina. Focus lines relatively close to the retina produce sharper images than focus lines relatively farther away from the retina.
  • Step 31 the tested person watches the test card 50
  • Step 32 adjust the direction of the red strip optotype 52 of the test card 50 to make it consistent with the direction of the maximum clarity of the white strip optotype observed by the subject of the obtained astigmatism axis;
  • Steps 33, 34, and 35, using the subject to move forward to approach the optotype 52 will cause the focus line to move backward.
  • the subject starts from a distance of about 5 meters and slowly moves forward to approach the optotype 52 until the first sighting. Stop when the mark is clear. At this time, measure the distance between the subject's eye and the optotype, and then the spherical degree of the weakest refraction can be obtained. At this time, the subject's unilateral naked eye moves to the optotype 52 direction and the most Clear spacing d, from which the focal length f is calculated:
  • Step 35 the subject returns to 5 meters.
  • the subject After rotating the direction of the optotype 52 by 90° to make it consistent with the direction of the astigmatism axis, ask the subject to slowly move forward and approach the optotype 52 until the optotype is clear again.
  • the distance between the subject's eye and the optotype 52 is measured again, and the spherical power D 2 of the strongest refraction can be obtained.
  • the rear focus line has moved to the back of the retina. Since the image of the optotype caused by it is blurred, the subject will only notice the clear image produced when the current focus line is superimposed on the retina. .
  • step 36 the rear focus line is generated by the weakest sphere power, and the front focus line is generated by the strongest sphere power. Because the difference between the strongest and weakest steradian powers is the astigmatism power, the astigmatism power can be calculated from the difference between these two steradian powers (the strongest minus the weakest).
  • the astigmatism D' of the subject's eyeball is:
  • the angle deviation of the astigmatism axis measurement does not exceed 5° in clinical practice, and the method of the present invention can achieve that the deviation does not exceed 2.5°.
  • the average value of f obtained is the weakest daily spherical degree of the subject.
  • the white stripe optotype is the clearest angle ⁇ 90° direction. For example: From the 15° obtained by the clearest white optotype to 105°, etc. Measure, record and calculate according to the method for calculating the spherical degree described in the above process 26, so as to obtain the daily strongest spherical degree of the subject.
  • the following table data records the measured value of each distance d and the calculation result of the spherical degree.
  • the average spherical degree of the eye is -3.734DS
  • the average spherical degree of the eye is -4.160DS
  • the axis of astigmatism is 90° (indicating that the weakest spherical power is -2DS, the strongest is -5DS, the difference between the two is -3DC, and the axis is at 90°) .
  • his astigmatism axis is 90°, it means that his concentrating power is on the line of 180° The focusing power equal to this additional -3DC astigmatism is on the 180° line.
  • the spherical degree of hyperopia, the spherical degree of myopia, the degree of astigmatism and the axis of astigmatism can be obtained.
  • the present invention is not limited to the black background in the above-mentioned refraction test card, nor is it limited to red or white optotypes. It can also use a color combination with a certain contrast, including blue+yellow, etc. The sight mark.
  • test card and the optometry method using the test card of the present invention are simpler and easier to operate than traditional methods, do not require complicated equipment, and are suitable for ordinary people to measure by themselves at home.
  • the method is easy to understand, easy to master, and has high accuracy.
  • the subjects are generally tested in the most relaxed or near most relaxed adjustment state without the need for extra-insert lenses or conversion inserts. In such a case, unnecessary disturbances and therefore unwanted adjustments or changes in the adjustment state are greatly reduced. This method also avoids errors in optometry caused by subjective and empirical deviations of optometrists.
  • the above-mentioned method of the present invention can be implemented by application software.
  • the software can be installed and used on a computer, mobile phone or tablet. By operating directly on these interactive terminals, you can select the required test content, record and process data.
  • the displayed image content can be played on the computer screen, or on the TV, or can be projected on the curtain wall for playback.
  • online APP There are two versions of the application: online APP and offline APP.
  • the main core data is placed on the cloud server, and only a small amount of data is downloaded to the interactive device (iPad, etc.), allowing users to choose the device to install, and perform data processing through the communication connection with the background server.
  • the offline APP version all data is directly downloaded to the interactive device, and then bound to the device for use.
  • This simple, objective and easy-to-use method of refraction (including spherical diopter for myopia and hyperopia, diopter for astigmatism and axis of astigmatism) originally created by the present invention also adopts a simple and clear optotype.
  • the simple and unambiguous sight mark is:
  • a single white long strip astigmatism strip test card (not limited to other color and shape combinations) on a black background to measure the presence or absence of astigmatism and the axis of astigmatism, use it to check for refractive errors, and accurately find the axis of astigmatism Accurate to ⁇ 2.5°, which is more accurate than the traditional ⁇ 5°.
  • a single red striped optotype test card (not limited to other color and shape combinations) on a black background to measure spheroid. Use it to check for refractive errors, calculate spherical power and astigmatism.
  • aspects of the present application may be performed entirely in hardware, entirely in software (including firmware, resident software, microcode, etc.), or in a combination of hardware and software.
  • the above hardware or software may be referred to as a "data block”, “module”, “engine”, “unit”, “component” or “system”.
  • the processor may be one or more application specific integrated circuits (ASICs), digital signal processors (DSPs), digital signal processing devices (DAPDs), programmable logic devices (PLDs), field programmable gate arrays (FPGAs), processors , controller, microcontroller, microprocessor, or a combination thereof.
  • aspects of the present application may be embodied as a computer product comprising computer readable program code embodied in one or more computer readable media.
  • computer readable media may include, but are not limited to, magnetic storage devices (eg, hard disks, floppy disks, magnetic tapes, ...), optical disks (eg, compact disc CD, digital versatile disk DVD, ...), smart cards, and flash memory devices ( For example, cards, sticks, key drives).
  • a computer-readable medium may contain a propagated data signal with the computer program code embodied therein, for example, on baseband or as part of a carrier wave.
  • the propagating signal may take a variety of manifestations, including electromagnetic, optical, etc., or a suitable combination.
  • a computer-readable medium can be any computer-readable medium other than a computer-readable storage medium that can communicate, propagate, or transmit a program for use by being coupled to an instruction execution system, apparatus, or device.
  • Program code on a computer readable medium may be propagated by any suitable medium, including radio, cable, fiber optic cable, radio frequency signal, or the like, or a combination of any of the foregoing.

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Abstract

一种屈光测试卡（30，40，50）及其测试方法，该测试卡（30，40，50）是在黑色背景（31，41，51）中包括视标（32，42，52），视标（32，42，52）中心位置包括一隔断单元（33，43，53），隔断单元（33，43，53）将视标（32，42，52）在视觉上分隔。该测试方法包括：根据被测者观测散光测试卡中视标（32，42，52）和黑色背景（31，41，51）对比的清晰程度，判断被测者是否有散光；如果判定被测者有散光，测定散光轴方向；根据被测者观测球面度数测试卡中视标（32，42，52）和黑色背景（31，41，51）对比的清晰程度，判断被测者是否有近远视；测试并计算获得被测者的球面度数和散光度数。该验光工具及其方法通过简单操作来确定被测者有没有屈光不正、属于哪种类型的屈光不正以及屈光不正的定量。

Description

一种屈光测试卡及其测量方法
优先权号：2021100839153
技术领域
本发明主要涉及眼科屈光不正的验光领域，尤其是一种屈光测试卡及其测量方法。
背景技术
屈光不正是指平行光线通过眼的屈光作用后，在视网膜前或后方成像，不能在视网膜上形成清晰的物像。它包括远视、近视及散光。所有的屈光不正检查都需要一整套仪器设备和受过专业训练的验光师或眼科医师来执行。这种检查包括：
1.主观检查法
只能接近却不能完全抵消调节所引起的偏差。散瞳后的屈光不正检查，理论上可以抵消调节引起的屈光不正，但是如此的验光结果在有明显调节的被测者时，得到的矫正的度数，并非代表日常的度数，所以验光度数往往会造成日常生活中的视力模糊。
(a)根据视力检查初步分析判断屈光性质法(不能定量)
(b)针孔片及裂隙片检查法(这是一个简单方法告诉我们视力能不能被去除屈光不正而改善，不能定量。)
(c)散光表验光法(只是粗略估计散光轴。也不能定量散光度数)。
(d)交叉柱镜及散光矫正器验光法(步骤繁复、费时，年纪小的被测者容易混扰，精确度受球面度数的影响)。
(e)插片验光法(检验球面度数但受散光度所影响。)
(f)云雾法(帮助更好地接近真实的球面度数。)
(g)红和绿视标的同时清晰法(避免超出真实的球面度数)
(h)激光散斑图法(不普遍，设备成本高)
2.客观检查法
(a)直接检眼镜检查法(只能知道当时所佩戴的眼镜度数，却不知道最新的度数，也不知道眼镜度数验配得准确与否。)
(b)角膜曲度计(只能得到角膜曲率来推算出角膜所做成的球面度数 和有不对称时所引起的散光和散光轴，而不能知道整体眼球的球面度数、散光度数和散光轴。)
(c)自动验光仪(能粗略估算球面度数、散光度数和散光轴。但因为受到被测者不自主的调节所影响，不能精确化，常常和真实度数不一致。)
(d)带状光检影法。(一般检查时和镜片一起配合使用，以达到中和时来判断大约的度数。得到的球面度数、散光度数和散光轴都是估值，还需要插片验光法和交叉柱镜及散光矫正器验光法以找到球面度数、散光度数和散光轴。)
(e)视网膜镜检影法。
此外，在眼科医学上，散光(astigmatism)是眼睛的一种屈光不正常的表现，大部分的散光与角膜的弧度有关。当平行光线进入眼睛后，由于眼球在不同子午线上屈光力不等，无法把各子午线上的光线聚集于一点(焦点)，所以同一视标会形成多于一个而不完全重叠的物像，也就不能形成清晰的物像，这种情况称为散光。
大部分临床上的散光纯粹是眼角膜曲率不对称所引起的，但是有时候是因为眼睛病灶，特别是前段病灶所引起的，例如：上睑下垂，眼结膜肿物压迫，角膜结痂，翼状胬肉，晶状体的形态、位置、混浊等。
一般的现有散光检查通常采用以下方式：
1.视力检查
通过远视力和近视力检查，可以发现散光。散光较重的患者，远视力和近视力都差。
2.散光表观察
散光眼的主观检查可用散光表观察，从视网膜上影像相对的清晰或蒙眬的物像形状，可以初步了解被检眼的散光子午线。
原理是基于多点串连的视觉效应：
常用的固定式散光表(钟式散光表)是由多根放射状的线条组成的，每一根线条上基于多点串联效应的原理，点越多串连越清晰。在没有散光时，当然每一根线条都有自己的方向而且互相在方向上有差异，但沿着每一根线条长轴方向的点的串连密度是一样的，所以每一根线条看起来的清晰度是相同的，没有哪根线条比较突出。有散光时，因为每根线条都有自 己的方向而且互相有差异，所以沿着每根线条长轴方向的点串联密度是不一样的，这时候有一到两根线条看起来的清晰度是比较高和明显的。顺着线条平行方向的串连，是有相对多和紧密的串连，所以线条看起来比较清晰。相对线条长轴方向转了90°的串连，是相对小一些点的串连，所以比较模糊。
以图1和图2举例说明，二者均是采用传统钟式散光表测试的情况。
图1是当没有散光的时候，发散状布置的线状视标在不同方向的轴线上看起来都是差不多的清晰和集中。
图2是当有散光时，例如散光轴是90°，随着跟散光轴的90°方向偏差越小时，线条视标越集中越清晰。跟散光轴的方向偏离越大的时候，线条视标越扩散越模糊。
为什么垂直的线条视标最清晰？因为线条上的每一个点都顺着线条的垂直方向聚拢，当许多垂直方向的聚焦线重叠的时候，观察者就看到了一条十分清晰的垂直线。一旦用一个正确的散光镜片来给观察者矫正之后，他看图2上的每一根线条的清晰度就都和图1一样了。
3、视网膜检影：
具体是：遇到以下5种情况中任何一种，即提示有散光：①反光带宽窄不一；②一对子午线的屈光不同；③眼底反光不规则；④剪动；⑤带状光与眼底反光带的运动方向不一致。
4、检查屈光度：
(a)客观验光
散光的测定方法有柱镜片法和球镜片法。可以确定散光轴位和散光度数。按程度可分为轻度(≤2.00D)、中度(2.25～4.00D)、重度(>4.00D)散光。低于1.00D属于生理性散光。
(b)主观试镜验光
主观试镜验光一般都是在客观验光之后进行。
5、角膜散光检查
包括角膜曲率计或角膜地形图或定量角膜散光检查镜。
6、眼底检查
视乳头常呈椭圆形，高度散光者，视乳头的垂直缘能看清，而水平缘 看不清或相反。从视乳头的形态，大致可了解散光的轴向。以上屈光不正检查方法的准确性受到多方影响，存在如下缺点或不足：
第一，被测者必须前往医院、诊所、眼镜店等场所和专业医生或验光师面对面进行验光检查。
第二，测试地点需要有足量且多种的验光和光学镜片仪器和器械。
第三，需要测试者有足够专业的光学验光原理知识和熟练的实际操作技能。
第四，测试时间受到测试者和被测者的日常生活和办公时间影响和限制，因为来回路上交通耗用时间长，费时费力。
第五，传统的电脑自动验光仪，因为眼睛和视标距离很近，所以会发生明显的近源性调节作用，而造成电脑验光结果不准确。
第六，传统的插镜片验光要求眼球和镜片在一个固定的很近距离来操作，这个先决条件往往没有严格被验光人员和被测者所遵守。同时，因为插片验光时并不知道最恰当的球面度数镜片，所以在验光过程中常常需要更换插片，这一过程很容易引起被测者眼睛不自觉地调节。这些都会引起验光度数不准确。此外，检查的方法过程太过繁复，被测者特别是低年龄的小孩无法理解自己需要做什么来配合验光师进行验光，所以往往得到不准确的有大偏差的验光结果。很多时候在忙碌的小儿眼科部门，测试者会跳过这一步，而直接引用电脑自动验光仪的度数，造成更大的误差。
第七，用现有的散光表检查过程繁复，而且需要在专业人士指导下才能进行，还需要配合在特殊场所的客观检查才能完成，所以使用起来比较麻烦。此外这个方法需要矫正一部分的屈光不正后，使被测者看放射状条纹看得相对比较清楚时才能检查。所以不适合在没有镜片矫正屈光不正的情况下进测定。
由于以上这些验光方法和影响因素，所以往往出现同一被测者在不同地点的验光结果有偏差。甚至同一被测者在同一场所和经同一验光师或眼科医师验光，但相隔不远不同日期验的结果也有偏差。
目前临床上常用的视力表有：国际标准视力表、兰氏环形视力表、对数视力表、数字视力表、英文字母视力表和儿童图形视力表。
常用的散光表有：固定式散光表(钟式散光表)和活动式散光表(扇 块视标，由一个扇形的放射状标线和一个可转动的圆盘组成。圆盘上有一组互相垂直的栅形方块，还有一个倒V形视标)。
无论是何种类型的视力表和散光表都存在视标过多的问题，多个视标会引起被测者在观察的时候产生密集效应，从而影响被测者的判断。这时候被测者容易自动上升调节，造成需要更强的球面度数镜片来获取清晰的影像，所以球面度数容易被高估。
在正式验光场地的环境中，被测者比较难放松自己，容易产生不必要的调节，因此造成错误的验光结果。
插片验光法需要频繁更换或转动插镜片，会容易引起被测者的混扰和调节改变而造成验光度数误差。
发明内容
鉴于以上检查工具和方法在实际测量球面度数、散光度数和散光轴时，存在使用上的不便和不同操作验光人员的主观和经验偏差，发展出了一套新的屈光测试工具及其测试方法。
本发明要解决的技术问题是提供一种创新的简单的验光工具及其方法，来找出被测者：有没有屈光不正；属于哪种类型的屈光不正；以及屈光不正的定量。
为解决上述技术问题，本发明提供了一种屈光测试卡，其特征在于，在黑色背景中包括视标，所述视标中心位置包括一隔断单元，所述隔断单元将所述视标在视觉上分隔。
比较好的是，本发明进一步提供了一种屈光测试卡，其特征在于，所述视标包括长条状视标，所述长条状视标的颜色包括白色或红色中任一种。
比较好的是，本发明进一步提供了一种屈光测试卡，其特征在于，所述视标包括十字状视标，所述十字状视标的颜色包括白色。
比较好的是，本发明进一步提供了一种屈光测试卡，其特征在于，所述隔断单元的形状包括长方形或圆形中任一种。
比较好的是，本发明进一步提供了一种屈光测试卡，其特征在于，所述视标的长度为260mm±50mm，宽度为5mm±2mm。
比较好的是，本发明进一步提供了一种屈光测试卡，其特征在于，所 述隔断单元的宽度小于等于5mm，高度范围为5mm±2mm。
比较好的是，本发明进一步提供了一种屈光测试卡，其特征在于，所述测试卡包括散光测试卡和球面度数测试卡，其中，所述散光测试卡包括白色长条状视标和十字状视标，所述球面度数测试卡包括红色长条状视标。
本发明进一步提供了一种应用上述任一种屈光测试卡的测量方法，其特征在于，包括：
步骤a，根据被测者观测所述散光测试卡中视标和黑色背景对比的清晰程度，判断所述被测者是否有散光；
步骤b，如果判定所述被测者有散光，测定散光轴方向，若无散光，转入步骤d后结束；
步骤c，根据所述被测者观测所述球面度数测试卡中视标和黑色背景对比的清晰程度，判断所述被测者是否有近远视；
步骤d，测试并计算获得所述被测者的球面度数；
步骤e，若有散光，继续测试并计算获得所述被测者的散光度数。
比较好的是，本发明还进一步提供了一种测量方法，其特征在于，所述步骤b中所述散光轴方向的测量包括：
步骤b1，所述被测者单侧裸眼测量，以不高于12.5°/秒旋转所述散光测试卡，获得所述被测者观测到所述散光测试卡的最大清晰度方向；
步骤b2，将所述最大清晰度方向±90°确定为所述散光轴方向。
比较好的是，本发明还进一步提供了一种测量方法，其特征在于，所述步骤d进一步包括：步骤d1，获得所述被测者单侧裸眼向所述球面度数测试卡方向移动测量到最清晰的间距d，焦距f：
f＝d      (1)
步骤d2，根据球面度数D：
D＝1/f      (2)
获得第一球面度数D 1；
步骤d3，将所述球面度数测试卡旋转90°，重复步骤d1～d2，获得第二球面度数D 2；
步骤d4，所述被测者该眼球的球面度数D：
D＝(D 1+D 2)/2     (3)
步骤d5，重复步骤d1～d4，获得另一只眼球的球面度数。
比较好的是，本发明还进一步提供了一种测量方法，其特征在于，所述步骤e进一步包括：
步骤e1，所述球面度数测试卡置于所述步骤b1的所述最大清晰度方向；
步骤e2，获得所述被测者单侧裸眼向所述球面度数测试卡方向移动测量时最清晰的间距d，焦距f：
f＝d       (1)
步骤e3，根据球面度数D：
D＝1/f       (2)
获得第一球面度数D 1；
步骤e4，将所述球面度数测试卡置于所述散光轴方向，重复步骤e1～e3，获得第二球面度数D 2；
步骤e5，计算所述被测者该眼球的散光度数D’：
D’＝D 2-D 1      (3)
步骤e6，重复步骤e1～e5，获得另一只眼球的散光度数。
比较好的是，本发明还进一步提供了一种测量方法，其特征在于，所述步骤a中：
旋转所述散光测试卡，当所述被测者观测到所述视标和黑色背景没有清晰程度变化时，判定为没有散光，否则为有散光。
与现有技术相比，本发明不需要使用矫正近视的凹球面镜片，利用被测者清晰看到视标时对焦线被后移到刚好和视网膜重叠，也代表眼睛和视标的距离等于焦距。由此获得屈光不正度数和散光度数，大大简化了验光的方法，非常便捷地检测判定有关屈光不正的类型和定量。
根据以上权利要求所述的测量方式，其特征在于，免除了近距离的凹片的使用，而免除了传统验光近距离操作所引起的调节上升而造成的不必要误差。
附图说明
包括附图是为提供对本申请进一步的理解，它们被收录并构成本申请 的一部分，附图示出了本申请的实施例，并与本说明书一起起到解释本发明原理的作用。附图中：
图1是采用传统钟式散光表时无散光被测者看到线状视标的示意图；
图2是采用传统钟式散光表时有散光被测者看到线状视标的示意图；
图3是本发明第一较佳实施例的屈光测试卡30的组成示意图；
图4是本发明第二较佳实施例的屈光测试卡40的组成示意图；
图5是本发明第三较佳实施例的屈光测试卡50的组成示意图；
图6(1)和6(2)是测试过程中十字形视标在不同角度位置的呈现对照图；
图7(1)和7(2)是测试过程中十字形视标在不同角度位置的呈现对照图；
图8(1)和8(2)是测试过程中十字形视标在不同角度位置的呈现对照图；
图9是单纯散光的被测者的光线聚焦示意图；
图10(A)～10(C)为散光测试时视网膜上的视图；
图11是应用本发明测试卡的完整测试方法的流程图；
图12给出了球面度数屈光不正的测试过程中看视标时的光线聚焦示意图；
图13是图11中步骤1的详细流程图；
图14是图11中步骤3的详细流程图；
图15是图11中步骤4的详细流程图。
附图标记
04――眼球
30――散光测试卡
31――黑色背景
32――白色长条视标
33――隔断单元
40――散光测试卡
41――黑色背景
42――白色十字形视标
43――隔断单元
50――球面度数测试卡
51――黑色背景
52――红色长条视标
53――隔断单元
具体实施方式
为了更清楚地说明本申请的实施例的技术方案，下面将对实施例描述中所需要使用的附图作简单的介绍。显而易见地，下面描述中的附图仅仅是本申请的一些示例或实施例，对于本领域的普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图将本申请应用于其他类似情景。除非从语言环境中显而易见或另做说明，图中相同标号代表相同结构或操作。
如本申请和权利要求书中所示，除非上下文明确提示例外情形，“一”、“一个”、“一种”和/或“该”等词并非特指单数，也可包括复数。一般说来，术语“包括”与“包含”仅提示包括已明确标识的步骤和元素，而这些步骤和元素不构成一个排它性的罗列，方法或者设备也可能包含其他的步骤或元素。
除非另外具体说明，否则在这些实施例中阐述的部件和步骤的相对布置、数字表达式和数值不限制本申请的范围。同时，应当明白，为了便于描述，附图中所示出的各个部分的尺寸并不是按照实际的比例关系绘制的。对于相关领域普通技术人员已知的技术、方法和设备可能不作详细讨论，但在适当情况下，所述技术、方法和设备应当被视为授权说明书的一部分。在这里示出和讨论的所有示例中，任何具体值应被解释为仅仅是示例性的，而不是作为限制。因此，示例性实施例的其它示例可以具有不同的值。应注意到：相似的标号和字母在下面的附图中表示类似项，因此，一旦某一项在一个附图中被定义，则在随后的附图中不需要对其进行进一步讨论。
在本申请的描述中，需要理解的是，方位词如“前、后、上、下、左、右”、“横向、竖向、垂直、水平”和“顶、底”等所指示的方位或位置关系通常是基于附图所示的方位或位置关系，仅是为了便于描述本申请和简化 描述，在未作相反说明的情况下，这些方位词并不指示和暗示所指的装置或元件必须具有特定的方位或者以特定的方位构造和操作，因此不能理解为对本申请保护范围的限制；方位词“内、外”是指相对于各部件本身的轮廓的内外。
为了便于描述，在这里可以使用空间相对术语，如“在……之上”、“在……上方”、“在……上表面”、“上面的”等，用来描述如在图中所示的一个器件或特征与其他器件或特征的空间位置关系。应当理解的是，空间相对术语旨在包含除了器件在图中所描述的方位之外的在使用或操作中的不同方位。例如，如果附图中的器件被倒置，则描述为“在其他器件或构造上方”或“在其他器件或构造之上”的器件之后将被定位为“在其他器件或构造下方”或“在其他器件或构造之下”。因而，示例性术语“在……上方”可以包括“在……上方”和“在……下方”两种方位。该器件也可以其他不同方式定位(旋转90度或处于其他方位)，并且对这里所使用的空间相对描述作出相应解释。
此外，需要说明的是，使用“第一”、“第二”等词语来限定零部件，仅仅是为了便于对相应零部件进行区别，如没有另行声明，上述词语并没有特殊含义，因此不能理解为对本申请保护范围的限制。此外，尽管本申请中所使用的术语是从公知公用的术语中选择的，但是本申请说明书中所提及的一些术语可能是申请人按他或她的判断来选择的，其详细含义在本文的描述的相关部分中说明。此外，要求不仅仅通过所使用的实际术语，而是还要通过每个术语所蕴含的意义来理解本申请。
本申请中使用了流程图用来说明根据本申请的实施例的系统所执行的操作。应当理解的是，前面或下面操作不一定按照顺序来精确地执行。相反，可以按照倒序或同时处理各种步骤。同时，或将其他操作添加到这些过程中，或从这些过程移除某一步或数步操作。
实施例1
图3给出了本发明第一较佳实施例的屈光测试卡示意图。
该测试卡30为黑色背景31和单一白色长条视标32构成的屈光测试卡，并不限于以上白色和长条状的组合，但要求：
第一，测试卡30是黑色背景31；
第二，测试卡30的中央有一根水平白色长条视标32，长260mm，宽5mm。
该白色长条视标32的中心设有一个隔断单元33，宽1.5mm，高5mm，该隔断单元33不限于长方形、圆形或其他形状。
其中，在黑色背景31下，黑白对比在边缘处非常强烈明显。这有利于被测者在相对远距离的时候也可以容易区分模糊和清晰。这样就很适合用来做散光轴方向的判断。
故，上述结构的散光条测试卡30是一较佳实施例。
实施例2
图4给出了本发明第二较佳实施例的散光测试卡的示意图。
该测试卡40为黑色背景41和单一白色十字形视标42构成的散光条屈光测试卡，并不限于以上白色和长条状的组合，在此基础上的变形需要求：
第一，测试卡的背景是黑色；
第二，测试卡的中央有两根互相呈90°的长条组成；
第三，每根长条的长260mm，宽5mm；
第四，为了避免密集效应，十字形的中心特设一个隔断单元43，该隔断单元43呈正方形空位，正方形边长是6mm。
前述两实施例选择白色散光条视标的理由是：
在黑色背景下，黑白对比在边缘处非常强烈明显。这有利于被测者在相对远距离的时候也可以容易区分模糊和清晰。这样就很适合用来做散光轴方向的判断。
实施例3
图5给出了本发明第三较佳实施例的视标卡的示意图。
该测试卡50为黑色背景51和单一红色长条状视标52构成的视标球面度数屈光测试卡，该测试卡50不限于红色和长条状的组合，但需要：
第一，测试卡50的背景是黑色；
第二，测试卡50的中央有一根水平长条红色视标52，长260mm，宽5mm；
第三，红色长条视标52的中心有一个黑色长方形隔断单元53，宽1.5mm，高5mm。该隔断单元53不限于长方形、圆形或其他形状。
其中，选择红色球面度数视标的理由是：
在临床上常用的验光方法中，红光和绿光所造成的球面度数的测量偏差大约是0.5DS。红色视标因为形成的视像比较偏后而贴近视网膜，所以它能抵消近源性调节和集合所产生的不自主增加的球面度数。绿色视标因为相对于红色视标是比较偏前而更远离视网膜的，所以它并不能抵消近源性调节和集合所产生的不自主增加的球面度数。基于这个原因，把红色球面度数视标应用到本发明独创的验光方法中。
应用上述实施例中的测试卡进行屈光不正测量的基本流程如下：
应用屈光测试卡30或40测定有没有临床上需要矫正的屈光不正，若有屈光不正，需要先测定有无临床上有意义的散光。
图11给出了本发明测量方法的主流程步骤，如下：
步骤1，利用屈光测试卡30或40判定被测者是否有散光；
步骤2，若判定为有临床意义上的散光，找出散光轴；
步骤3，用屈光测试卡50测定并获得近/远视球面度数；
步骤4，对于有散光者，用最强和最弱球面度数之差，计算获得散光度。
上述测量，被测者的最终结果包括以下四种情况：
情况一：既没有散光，也没有近远视；
情况二：有散光，没有近远视，通过步骤2和3获得散光的相关参数；
情况三：没有散光，但有近远视，通过步骤3获得近远视的相关参数；
情况四：如果既有散光，又有近远视，通过步骤2、3和4获得包括散光和近远视的相关参数。
下面请结合图11、图13、14和15，介绍应用本发明的屈光测试卡的测试方法及上述步骤的详细过程。
步骤1，判断被测者有没有临床意义上的散光的方法，具体是：
步骤11，在距离被测者大约5米处，被试者观看黑色背景31下的单一白色长条视标32的散光测试卡30；
该测试卡30采用人工照明，如用直接直接照明法，照度应不低于300lx，照明力求均匀、恒定、无反光、不眩目。
步骤12，被测者裸眼测量，单眼测量，一般先测右眼，后测左眼。
测一眼时，需遮挡另一眼。被测者须保持头部直立，不能歪斜。测试时，被测者可以自然眨眼以保证眼球湿润而不干燥，避免因为干燥影响视力的清晰度。
步骤13，缓慢逆时针方向旋转测试卡30；
步骤14，根据被测者的观看情况判断有无散光、确定散光轴。
当被测者没有临床上有意义的散光时，代表只有单一球面度数，所以只有一条对焦线，这时候测试卡30在转动到任一方向时，被测者看到白条长条视标32和黑色背景31的对比清晰度和模糊度都差不多，不存在某一方向特别清楚的情况，这就表明被测者没有临床上有意义的散光。
如果出现相反情况下，即在测试卡30转动过程中，被测者的对比清晰度有变化，即可判定为有临床意义的散光。如果被测者表示看不清楚，可以让他往前小步慢慢移动接近白条长视标，一看到明显白长条视标的地方就停，开始测试。
有些人对旋转可能不敏感，不太容易区分白色长条视标32在旋15转时的视觉变化。对于这类被测者，可以改为实施例2中的白色十字形视标42的测试卡40。
方法步骤同上述，在步骤14时，判断的依据变为从水平线垂直线开始，两根长条看起来清晰度是差不多，还是一根相对于另一根较模糊？
假如0°～180°方向的长条是模糊的，90°～270°方向的长条是清晰的，就针对90°～270°用旋转的方式在90°～270°方向前后±10°的范围慢慢旋转，以此可以找到较精确的散光轴的位置。
如水平线垂直线的两条看起来差不多，没有明显差别的时候，代表散光轴不在这两条线上面，就把白色十字形视标42放在四根条分别对应45°、135°、225°、315°。再次了解被测者是否两根长条看起来清晰度是 差不多，还是一根相对于另一根较模糊？
如果被测者还是觉得没有差别，就把十字形视标42放在四根长条分别对应22.5°、112.5°、202.5°、292.5°。再次问被测者同样的问题。以此类推，十字形视标42还可以对应11.25°、101.25°、191.25°、281.25°等。
规律就是：白色十字形视标42的两长条始终互相垂直，只是在每次显示的时候夹角的度数变化不同，从水平垂直方向依次调整到：
二分之90°——45°
四分之90°——22.5°
八分之90°——11.25°
十六分之90°——5.625°
三十二分之90°——2.8125°
被测者找到某个方位的十字形有一条模糊而另一条是清楚的。找到这个位置后，在上下10°的范围用单根长条旋转的方法找到确切的散光轴。
图6(1)和6(2)～图8(1)和8(2)分别给出了测试过程中十字形视标42在上述不同角度位置的呈现对照图。
即，图6(1)所示的十字形视标分别对应0°、90°、180°和270°；
图6(2)所示的十字形视标分别对应45°、135°、225°和315°；
图7(1)所示的十字形视标分别对应22.5°、112.5°、202.5°和292.5°；
图7(2)所示的十字形视标分别对应11.25°、101.25°、191.25°和281.25°；
图8(1)所示的十字形视标分别对应5.625°、95.625°、185.625°和275.625°；
图8(2)所示的十字形视标分别对应2.8125°、92.8125°、182.8125°和272.8125°。
如果被测者在任何位置下对散光测试卡30的判定都不存在对比清晰度上的变化，即可判定为无临床意义的散光；如果是散光测试卡40，被测者在任何位置下都没有任何角度任何位置上的差异，即任何情况下，十字形两条清晰度或模糊度都相同，不会有差异，确定为无散光。
回到步骤1，当步骤1判断为没有临床意义上的散光，即可认定为单纯球面屈光不正的情况，此时，跳过步骤2，直接继续进行近远视的屈光 测量，即，被测者继续看黑色背景51下的单一红色长条视标52的视标球面度数测试卡50；
需要说明的是，对于一个有近视而无临床上有意义的散光的被测者，他只有一个对焦线而且是在视网膜之前，所以影像会产生模糊，传统上这时候用一般的验光方法来找到一个合适的矫正近视的凹球面镜片把这个对焦线后移到视网膜上就可以得到清晰的影像，也就是对焦线和视网膜重叠，此时就可以达到良好视力的效果。
本发明的独创之处体现在：
不需要使用矫正近视的凹球面镜片，只是被测者前移靠近视标直至刚刚看到清晰视标。这时候对焦线被后移到刚好和视网膜重叠，也代表眼睛和视标的距离等于焦距。所以这个距离可以用来求出被测者的屈光不正度数。
更进一步，测量球面度数屈光不正的具体方法步骤，下面结合图14详细说明如下：
步骤21，在距离被测者大约5米处，给他看黑色背景51下的单一红色长条视标52的球面度数测试卡50。
测试卡50应采用人工照明，如用直接照明法，照度应不低于300lx，照明力求均匀、恒定、无反光、不眩目。测试卡应避免阳光或强光直射。
步骤22，被测者裸眼，单眼测量，一般先测右眼，再测左眼。
测一眼时，需遮盖另一眼。被测者须保持头部直立，不能歪斜。被测者可以自然眨眼以保证眼球湿润而不干燥，避免因为干燥影响视力的清晰度。
步骤23，先进行模拟测试，目的是避免被测者没有到达对焦距离或是超过对焦距离用上额外调节，影响测试结果；模拟测试时，需要遮盖单眼，被测者从5米左右的距离开始小步慢慢往前移动接近黑色背景下的单一红色长条视标52，先感受到视标模糊，接着视标比较清楚，然后视标完全清晰。这时候被测者继续往前移动然后往后慢退，来观察分辨感知视标清晰程度的变化。
步骤24，正式测试开始，让被测者在单眼被遮盖时，从5米左右的距离开始小步慢慢往前移动接近黑色背景52下的单一红色长条的水平视 标52，一旦看到水平方向视标清晰的时候立即停止移动。注意往前移动的过程中不能后退了之后再往前移动。若被测者步伐相对太大太快而分辨不出由模糊变为清晰那个位置时，需要退回起点步伐变小速度放慢重新开始。
图12给出了这个测试过程的位置情况，即没有散光的眼球看视标时的光线聚焦示意图。
其中04表示眼球，C为角膜，M为视网膜，O为视标，f代表焦距，即被测者刚看清视标时，被测者眼睛和视标间的距离d。
当被测者在≥6米处看视标O时，从视标O的每一点来的光线在到达角膜C时是平行的，水平方向的球面度数为0DS，所以聚光力是最弱的。所以，水平方向的光线会被聚焦到后对焦线上，这时候后对焦线刚好叠在视网膜M上。当被测者看到视标O清晰的时候，记录距离d的数值，d是被测者眼球04到视标O的距离。此时：
d＝f       (1)
其中，f是焦距，单位：米(m)。
为提高准确性，被测者在同一次检查中需要重复做5次，因为他的主观性的调节状态有可能在验光过程中有所改变，所以需要做几次以取平均值来提高准确性，减少他调节状态起伏造成的差异。从5次数值得到f的平均值。
在水平方向完成后，开始测垂直方向，将测试卡旋转90°使黑色背景下的单一红色长条视标52垂直，重复步骤23和24。
根据球面度数公式：
D＝1/f       (2)
其中，D(Diopter)是球面度数，又叫屈光度。
由于当被测者看到视标O清晰的时候，f刚好等于d，所以根据d的数值可以计算出被测者的球面度数。
步骤25，根据水平和垂直方向，或散光轴、及其±90°方向，获得平均值为球面度数。
取黑色背景下的单一红色长条视标52在水平和垂直方向时所得D的平均值作为这一眼的球面度数D，或散光轴和其±90°方向时所得D的平 均值作为这一眼的球面度数。(水平和垂直两者差距不大于0.25，如大于0.25则有散光，须重新测量散光轴，再以散光轴和散光轴±90°方向来测量d和D。)
步骤26，一眼球完成后，重复上述步骤23～25，测得被测者另一眼球的球面度数。
针对步骤21～26，结合图12，举例说明球面度数的计算过程：
以下表格数据，记录了每一次的距离d的测量值，以及球面度数的计算结果。
近视的时候，度数前要加“-”。
请参考下表1所示例：
Figure PCTCN2022079250-appb-000001
视标水平时，该眼的平均球面度数是-2.209
视标垂直时，左眼的平均球面度数是-2.318
→该眼的平均球面度数D＝[(-2.209)+(-2.318)]÷2＝-2.264
而对于单纯远视屈光不正球面度数的测量：
对于一个有远视而无临床上有意义的散光的被测者，在6米时，若视 力大于1.0时，则提示有远视性的屈光不正。对于远视的屈光不正需要提供给他一些(或几个)调整远视的凸镜片(正的球面度数)。
在远视度数被概括的情况下，远视的度数，两个轴线上的远视度数之差，远视被测者的散光的测量方法和近视的时候是一样的。
远视的时候针对不同被被测者有三个度数的镜片供选择，一个镜片是+2DS，一个镜片是+4DS，一个镜片是+6DS。理论上的组合，最多可以6+4+2＝+12DS，(最小+2DS)，不同镜片的叠加组合可以有+2，+4，+6，+8，+10和+12DS，可以囊括几乎所有的度数情况。
例如：有一个人，他有100度的远视，从视觉上来讲，在6米和以外，物体所发出来的光线到达眼睛的时候是平行的，(假如眼睛没有屈光问题的话)，平行的光线进入眼睛后，对焦点就会对焦到视网膜上，所以远视不能用以上近视度数测量常规方法去做。常规方法是去眼镜店、医院或诊所由视光人员或眼科医生用一个个凸镜片去把它矫正回来。而这个矫正回来的过程就是达到中和的时候，就是他的远视度数。而中间会牵涉到矫正不够和过度，过度的时候再调下来，所谓过度就是当你调上去的镜片超过他原有的远视的时候就是把他变成了近视状态，这时他会产生视力的模糊。
对于一个有远视而无临床上有意义的散光的被测者，在6米时，能够看到清晰的视标，他的视力一般都在1.0或以上。给他试戴超过矫正需要的凸+DS镜片，会引起临床上近视效果。这时候他的视力会下降，在6米处视力低于1.0，视标看起来模糊。
假设这个有+1DS的度数的人，他本人和测试者都不知道有这个+1DS，就先给他摆+2DS的镜片上去试试看，理论上过度矫正了他，人为使他产生了100度近视的状态，也就是产生了-1DS的近视效果，只要他达到近视效果的时候，就可以引用上述那套流程测近视屈光不正球面度数去找那个被测者看清视标的距离，通过测量距离计算得到度数，然后放上这个度数的镜片，两者相加，这样就可以得知原来的远视度数是多少。避免了需要大量的镜片到现场给他量，需要专业人士给他配镜和矫正。举一反三，假如他是+3DS的，给他+2DS的镜片，他站在6米的地方可以看得很清楚，就说明+2DS的镜片不够，就给他+4DS，这时又产生了-1DS 的效果了，需要往前走才看得清楚，又可以通过测量距离计算度数得到真实的度数；如果他是+5DS，给他+6DS，又可以达到效果，超过+6DS，就三个镜片叠加使用达到+8、+10、+12DS，等。足以满足大部分远视的范围。临床上达到+6DS以上远视的人毕竟非常少。
步骤3，如果在图11的步骤1中判断为有临床意义的散光，接下来需要对散光轴测定和散光度数的计算，结合图9具体说明如下：
被测者在≥6米处看视标32时，从视标32的每一点来的光线在到达角膜时是平行的，假定被测者没有近视远视而只有单纯散光(0/-2DC×180)，代表水平方向的角膜曲率和聚光力是最弱的，球面度数为0DS。而垂直方向的角膜曲率和聚光力是最强的，球面度数为-2DS。所以，水平方向的光线会被聚焦到后对焦线上，这时候后对焦线刚好叠在视网膜上。同样，这时候垂直方向的光线会被聚焦到前对焦线上，而它的位置是在视网膜之前。
图10(A)、10(B)和10(C)表示了这位被测者(0/-2DC×180)的前和后对焦线在观看水平方向平行的或垂直方向平行的两条视标视象清晰度的变化。
对于有近视性散光的被测者，他也有两个不同的球面度数，一个最弱，一个最强。最弱的球面度数和最强的球面度数会各自形成自己的一条对焦线，这两条对焦线各自相对于视网膜的距离是不同的。这时候，最远离角膜中心的这一条对焦线叫做后对焦线，最靠近角膜中心的这一条对焦线叫做前对焦线。前后两条对焦线在轴线上也是互相偏差±90°。
对散光轴进行测定，具体方法步骤如下：
步骤11，被测者在5米的距离看黑色背景下的单一白色长条视标32的屈光测试卡30。
测试卡应采用人工照明，如用直接照明法，照度应不低于300lx，照明力求均匀、恒定、无反光、不眩目。测试卡应避免阳光或强光直射。
步骤12，被测者裸眼单眼测量，一般先测右眼，后测左眼。测一眼时，需遮住另一眼。被测者须保持头部直立，不能歪斜。
步骤13，缓慢逆时针方向旋转白色测试长条。
慢慢地逆时针方向转动散光测试卡，让被测者看白色长条在哪个方向 看起来比较清晰。旋转速度不高于12.5°/秒。
步骤14，根据被测者的观看情况判断有无散光，确定散光轴的方向。对于有近视性散光的被测者，他在看黑色背景下的单一白色长条状的散光条测试卡，影像会对焦到两条对焦线上，这两条对焦线都在视网膜前，一条相对比较靠近视网膜，另一条相对比较远离视网膜。相对靠近视网膜的对焦线所产生的影像比相对远离视网膜的对焦线所产生的影像更清晰。
先把他看到相对清晰程度最大(由后对焦线所产生的)的那个方向角度记录下来。再把单一白色长条状的散光条顺时针和逆时针方向反复来回慢慢转动，让被测者找出最清晰的方向。找到的最清晰方向(角度)再±90°就是散光轴。
此外，还需对散光度数进行测量计算，具体步骤如下：
步骤31，被测者观看测试卡50；
步骤32，调整测试卡50的红色长条视标52方向，使其与获得的散光轴被测者观测到白色长条状视标的最大清晰度的那个方向一致；
步骤33、34、35，利用被测者前移接近视标52会产生对焦线后移的现象，被测者从大约5米的距离开始，慢慢前移接近视标52直到第一次视标清晰的时候停，这时候测量出被测者眼睛到视标的距离，便能得出这个最弱屈光的球面度数，获得此时被测者单侧裸眼向视标52方向移动测量时最清晰的间距d，由此计算得到焦距f：
f＝d       (1)
则球面度数D为：
D＝1/f       (2)
由此，获得第一球面度数D 1。
步骤35，然后，被测者回到5米处。将视标52的方向旋转90°使其与散光轴的方向一致后，再请被测者慢慢前移接近视标52直到视标又清晰时停。此时再次测量被测者眼睛到视标52的距离，就能得到这个最强屈光的球面度数D 2。(注意：此时，后对焦线已经移到视网膜后面去了，由于它所造成的视标影像是模糊的，所以被测者只会注意到当前对焦线在叠到视网膜时所产生的清晰影像。)
步骤36，后对焦线是由最弱球面度数所产生的，而前对焦线是由最 强球面度数所产生的。因为最强和最弱的球面度数之差就是散光度数，所以根据这两个球面度数(最强减去最弱)的差别就可以计算出散光度数。
即：被测者该眼球的散光度数D’为：
D’＝D 2-D 1     (3)
在屈光不正检查球面度数时，选择先检查后对焦线叠到视网膜时的最弱球面度数(近视为负数)。再检查前对焦线叠到视网膜时的最强的球面度数(近视为负数)。然后，最强的球面度数减去最弱的球面度数就可以得到散光度数，而且这个散光度数也是负的。例如：(-5DS)-(-3DS)＝-2DC。
这样计算的好处是每一次的散光都是以负数来代表，大一点的负数减小一点的负数，结果还是得到一个负数。就不会出现有时候是正数，而有时候是负数的混乱和错误。
一般临床上散光轴测量的角度偏差不超过5°是可以接受的，本发明的方法则可以做到偏差不超过2.5°。
重复上述步骤，获得另一只眼球的散光度数。
结合图15，散光度的测量和计算方法步骤如下：
1.在已测得的散光轴方向的基础上进一步测散光的球面度数，用黑色背景下的单一红色长条状视标球面度数测试卡，红色长条状视标的角度要与上面被测者看单一白色长条状的散光条旋转时测得的最清晰的角度方向一致，按照上述步骤24和步骤25描述的计算球面度数的方法进行测量、记录和计算，从而得出最弱和最强的球面度数。同样，在正式测试前需要给被测者进行模拟测试。
2.和其他正常人一样，在验光过程中，被测者一般状态下总会有一点主观性的调节状态起伏。测量共做5次，这样会大大减少被测者调节状态起伏和只做单次测量所造成的数值差异偏大。5次的平均值会大大减少偏差而达到临床所需要的准确性。这时候得到f的平均值就是被测者日常最弱的球面度数。
3.然后把红色长条状视标旋转90°指向散光轴的方向(也就是“散光轴的测定方法步骤13”中，白色长条状视标最清的角度±90°的方向。例如： 从最清白色视标得到的15°转到105°，以此类推。按照上述流程26描述的计算球面度数的方法进行测量，记录和计算，从而得出被测者日常最强的球面度数。
4.从测定的最弱和最强球面度数来求出散光度数。
从“散光度的测定方法步骤35”得到的最强球面度数来减去“散光度的测定方法步骤34”得到最弱球面度数，也就是“旋转90°后的球面度数”减去“旋转90°前的球面度数”，就能够获得被测者的散光度数。
举例说明散光度数的计算过程：
以下表格数据，记录了每一次的距离d的测量值，以及球面度数的计算结果。
近视的时候，度数前要加“-”。
请参见下表示意：
Figure PCTCN2022079250-appb-000002
视标旋转90°前，该眼的平均球面度数是-3.734DS
视标旋转90°后，该眼的平均球面度数是-4.160DS
→该眼的散光度数D＝[(-4.160)-(-3.734)]＝-0.426DC
近视加散光的被测者：
当某被测者有-2DS近视和-3DC散光，散光轴90°(说明最弱的球面度数是-2DS，最强的是-5DS，两者之差是-3DC，轴是在90°)。这代表他的后对焦线是由-2DS近视产生的，他的前对焦线是由这额外的-3DC近视散光所产生的。(事实上是因为他是(-2)+(-3)，所以是(-5DS)的结果。当他的散光轴是90°的时候，代表他的聚光力是在180°的线上。等于这额外的-3DC散光的聚焦能力是在180°的线上。
就这个被测者而言，当视标和后对焦线同方向时，-2DS近视代表被测者距离视标0.5米时，他会产生一个清晰的视标影像，因为这时后对焦线刚好重叠在视网膜上，所以会产生清晰的视标。而前对焦线因为和视标方向偏差90°，所以它没有构成清晰的视标影像。再来把视标转90°，这时候，视标方向和前对焦线是同方向的，而后对焦线和视标方向偏差90°，所以它没有构成清晰的视标影像。当被测者前行至0.2米处时(这时D是-5DS)，前对焦线刚好重叠在视网膜上产生清晰的视标影像。
远视加散光的被测者：
对于此类被测者，先加上一个超过被测者远视度数的凸镜，这个眼睛就变成近视了，再按照上述近视加散光的流程步骤方法，就可以得到被测者远视的球面度数、散光度数和散光轴。
综上所述，通过以上操作，可以得到远视的球面度数、近视的球面度数、散光度数和散光轴。
需要特别说明的是，本发明不仅限于上述屈光测试卡中黑色背景，也不限于红色或白色视标，也可以采用包括蓝色+黄色等具有一定对比度的色彩组合，旨在测试时辨识出该视标。
本发明的测试卡及其利用该测试卡的验光方法，较传统手段操作简便，不需要复杂的设备仪器，适合普通人居家自行测量。方法通俗易懂，容易掌握，准确度高。
更重要的是，被测者一般是在不需要外插镜片或转换插片情况下以最放松或接近最放松的调节状态下来进行测试。在这样的情况下极度地减少了非必要的干扰和因此引起不需要的的调节或调节状态的改变。这套方法 同时避免了验光人员因为主观和经验偏差所造成不应该的验光度数上的错误。
此外，本发明的上述方法可以通过应用程序软件实现的。该软件可以在电脑，手机或者平板电脑上安装使用，通过直接在这些交互端上的操作，可以选择所需要的测试内容，记录并处理数据。显示的图像内容可由电脑显示屏播放，或电视机播放，也可以投影到幕布墙上播放。
该应用程序有在线APP和离线APP两种版本。在线APP版，主要核心数据都放在云端服务器，只有简单少量数据下载到交互设备端(iPad等)让用户自行选择设备安装，通过与后台服务器的通信连接进行数据处理。离线APP版，所有数据都直接下载到交互端设备，然后绑定设备进行使用。
本发明独创的这套简单客观、使用方便的屈光不正(包括近视远视球面度数，散光度数和散光轴)的验光方法，也同时独创采用了简单明确的视标。
该简单明确的视标为：
在黑色背景下的单一白色长条状的散光条测试卡(不限于其他颜色和形状的组合)来测量有无散光和散光的轴，使用它进行屈光不正的检查，可以准确找出散光轴精确到±2.5°，比传统的±5°更要精确。
在黑色背景下的单一红色长条状的视标测试卡(不限于其他颜色和形状的组合)来测量球面度数。使用它进行屈光不正的检查，可以计算出球面度数和散光度数。
上文已对基本概念做了描述，显然，对于本领域技术人员来说，上述发明披露仅仅作为示例，而并不构成对本申请的限定。虽然此处并没有明确说明，本领域技术人员可能会对本申请进行各种修改、改进和修正。该类修改、改进和修正在本申请中被建议，所以该类修改、改进、修正仍属于本申请示范实施例的精神和范围。
同时，本申请使用了特定词语来描述本申请的实施例。如“一个实施例”、“一实施例”、和/或“一些实施例”意指与本申请至少一个实施例相关的某一特征、结构或特点。因此，应强调并注意的是，本说明书中在不同位置两次或多次提及的“一实施例”或“一个实施例”或“一替代性实施例” 并不一定是指同一实施例。此外，本申请的一个或多个实施例中的某些特征、结构或特点可以进行适当的组合。
本申请的一些方面可以完全由硬件执行、可以完全由软件(包括固件、常驻软件、微码等)执行、也可以由硬件和软件组合执行。以上硬件或软件均可被称为“数据块”、“模块”、“引擎”、“单元”、“组件”或“系统”。处理器可以是一个或多个专用集成电路(ASIC)、数字信号处理器(DSP)、数字信号处理器件(DAPD)、可编程逻辑器件(PLD)、现场可编程门阵列(FPGA)、处理器、控制器、微控制器、微处理器或者其组合。此外，本申请的各方面可能表现为位于一个或多个计算机可读介质中的计算机产品，该产品包括计算机可读程序编码。例如，计算机可读介质可包括，但不限于，磁性存储设备(例如，硬盘、软盘、磁带……)、光盘(例如，压缩盘CD、数字多功能盘DVD……)、智能卡以及闪存设备(例如，卡、棒、键驱动器……)。
计算机可读介质可能包含一个内含有计算机程序编码的传播数据信号，例如在基带上或作为载波的一部分。该传播信号可能有多种表现形式，包括电磁形式、光形式等等、或合适的组合形式。计算机可读介质可以是除计算机可读存储介质之外的任何计算机可读介质，该介质可以通过连接至一个指令执行系统、装置或设备以实现通讯、传播或传输供使用的程序。位于计算机可读介质上的程序编码可以通过任何合适的介质进行传播，包括无线电、电缆、光纤电缆、射频信号、或类似介质、或任何上述介质的组合。
上文已对基本概念做了描述，显然，对于本领域技术人员来说，上述发明披露仅仅作为示例，而并不构成对本申请的限定。虽然此处并没有明确说明，本领域技术人员可能会对本申请进行各种修改、改进和修正。该类修改、改进和修正在本申请中被建议，所以该类修改、改进、修正仍属于本申请示范实施例的精神和范围。
同时，本申请使用了特定词语来描述本申请的实施例。如“一个实施例”、“一实施例”、和/或“一些实施例”意指与本申请至少一个实施例相关的某一特征、结构或特点。因此，应强调并注意的是，本说明书中在不同位置两次或多次提及的“一实施例”或“一个实施例”或“一替代性实施例” 并不一定是指同一实施例。此外，本申请的一个或多个实施例中的某些特征、结构或特点可以进行适当的组合。
同理，应当注意的是，为了简化本申请披露的表述，从而帮助对一个或多个发明实施例的理解，前文对本申请实施例的描述中，有时会将多种特征归并至一个实施例、附图或对其的描述中。但是，这种披露方法并不意味着本申请对象所需要的特征比权利要求中提及的特征多。实际上，实施例的特征要少于上述披露的单个实施例的全部特征。
一些实施例中使用了描述成分、属性数量的数字，应当理解的是，此类用于实施例描述的数字，在一些示例中使用了修饰词“大约”、“近似”或“大体上”来修饰。除非另外说明，“大约”、“近似”或“大体上”表明所述数字允许有±20％的变化。相应地，在一些实施例中，说明书和权利要求中使用的数值参数均为近似值，该近似值根据个别实施例所需特点可以发生改变。在一些实施例中，数值参数应考虑规定的有效数位并采用一般位数保留的方法。尽管本申请一些实施例中用于确认其范围广度的数值域和参数为近似值，在具体实施例中，此类数值的设定在可行范围内尽可能精确。
虽然本申请已参照当前的具体实施例来描述，但是本技术领域中的普通技术人员应当认识到，以上的实施例仅是用来说明本申请，在没有脱离本申请精神的情况下还可作出各种等效的变化或替换，因此，只要在本申请的实质精神范围内对上述实施例的变化、变型都将落在本申请的权利要求书的范围内。

Claims (12)

  1. 一种屈光测试卡，其特征在于，在黑色背景中包括视标，所述视标中心位置包括一隔断单元，所述隔断单元将所述视标在视觉上分隔。
  2. 根据权利要求1所述的屈光测试卡，其特征在于，所述视标包括长条状视标，所述长条状视标的颜色包括白色或红色中任一种。
  3. 根据权利要求2所述的屈光测试卡，其特征在于，所述视标包括十字状视标，所述十字状视标的颜色包括白色。
  4. 根据权利要求3所述的屈光测试卡，其特征在于，所述隔断单元的形状包括长方形或圆形中任一种。
  5. 根据权利要求4所述的屈光测试卡，其特征在于，所述视标的长度为260mm±50mm，宽度为5mm±2mm。
  6. 根据权利要求5所述的屈光测试卡，其特征在于，所述隔断单元的宽度小于等于5mm，高度范围为5mm±2mm。
  7. 根据权利要求6所述的屈光测试卡，其特征在于，所述测试卡包括散光测试卡和球面度数测试卡，其中，所述散光测试卡包括白色长条状视标和十字状视标，所述球面度数测试卡包括红色长条状视标。
  8. 一种应用权利要求1至7中任一种屈光测试卡的测量方法，其特征在于，包括：
    步骤a，根据被测者观测所述散光测试卡中视标和黑色背景对比的清晰程度，判断所述被测者是否有散光；
    步骤b，如果判定所述被测者有散光，测定散光轴方向，若无散光，转入步骤d后结束；
    步骤c，根据所述被测者观测所述球面度数测试卡中视标和黑色背景对比的清晰程度，判断所述被测者是否有近远视；
    步骤d，测试并计算获得所述被测者的球面度数；
    步骤e，若有散光，继续测试并计算获得所述被测者的散光度数。
  9. 根据权利要求8所述的测量方法，其特征在于，所述步骤b中所述散光轴方向的测量包括：
    步骤b1，所述被测者单侧裸眼测量，以不高于12.5°/秒旋转所述散光测试卡，获得所述被测者观测到所述散光测试卡的最大清晰度方向；
    步骤b2，将所述最大清晰度方向±90°确定为所述散光轴方向。
  10. 根据权利要求9所述的测量方法，其特征在于，所述步骤d进一步包括：
    步骤d1，获得所述被测者单侧裸眼向所述球面度数测试卡方向移动测量到最清晰的间距d，焦距f：
    f＝d      (1)
    步骤d2，根据球面度数D：
    D＝1/f       (2)
    获得第一球面度数D 1；
    步骤d3，将所述球面度数测试卡旋转90°，重复步骤d1～d2，获得第二球面度数D 2；
    步骤d4，所述被测者该眼球的球面度数D：
    D＝(D 1+D 2)/2       (3)
    步骤d5，重复步骤d1～d4，获得另一只眼球的球面度数。
  11. 根据权利要求10所述的测量方法，其特征在于，所述步骤e进一步包括：
    步骤e1，所述球面度数测试卡置于所述步骤b1的所述最大清晰度方向；
    步骤e2，获得所述被测者单侧裸眼向所述球面度数测试卡方向移动测量时最清晰的间距d，焦距f：
    f＝d      (1)
    步骤e3，根据球面度数D：
    D＝1/f       (2)
    获得第一球面度数D 1；
    步骤e4，将所述球面度数测试卡置于所述散光轴方向，重复步骤e1～e3，获得第二球面度数D 2；
    步骤e5，计算所述被测者该眼球的散光度数D’：
    D’＝D 2-D 1       (3)
    步骤e6，重复步骤e1～e5，获得另一只眼球的散光度数。
  12. 根据权利要求8或9任一项所述的测量方法，其特征在于，所述 步骤a中：
    旋转所述散光测试卡，当所述被测者观测到所述视标和黑色背景没有清晰程度变化时，判定为没有散光，否则为有散光。
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