NL2035325B1 - Method of performing an eye examination test for at least examining a visual acuity of eyes of a user. - Google Patents
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- 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
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Abstract
Method of performing an eye examination test for at least examining a visual acuity of eyes of a user, comprising the steps of: - performing a first eye examination test step and a second eye examination test step; - defining the eye examination test step that is associated with the longest user-screen distance as a distant eye examination test step; - defining the other examination test step that is associated with the shortest user-screen distance as a nearby eye examination test step; - determining, based on the distant eye examination test step, a visual acuity of the user; and - determining, based on the nearby eye examination test step, a signation of the eye defect of the user to thereby distinguish between a myopic defect and an hyperopic defect. FIGURE SELECTED TO ACCOMPANY THE ABSTRACT: Figure 2
Description
Title: Method of performing an eye examination test for at least examining a visual acuity of eyes of a user.
The present invention relates to a method of performing an eye examination test for at least examining a visual acuity of eyes of a user.
Online eye exams, performed on a computer of a user without the help of a professional assistant and preferably without the help of any assistant, have been described in the patent literature since about the year 2000 and are more and more accepted by consumers.
Current online eye exams, in particular the one developed and offered by the Applicant, already provide accurate test results. However, there is an ongoing desire to further improve the quality of such online eye exams. In particular if the eye defect of a user is related to only a limited loss in visual acuity, it is sometimes challenging to distinguish between a so-called myopic defect or an hyperopic defect.
A user with a myopic eye defect, hereafter also shortly referred to as a myopic subject, results in the user not being able to see clearly things that are far away. This is also referred to as near-sightedness, or short-sightedness, and is the most common eye problem and is estimated to affect over 20% of the world population.
A myopic eye defect is related to the light being focussed in front of, instead of on, the retina. As a result of a poor visual acuity, myopic subjects often suffer from a blurry vision.
To the contrary, a user with a hyperopic eye defect, hereafter also shortly referred to as an hyperopic subject, results in the user being able to see distant objects clearly as long as the user still has a sufficient accommodation reserve. However, near objects appear blurred. This is also referred to as far-sightedness, or long- sightedness. The blur experienced by hyperopic subjects is due to incoming light being focused behind, instead of on, the retina. If the hyperopic defect is limited, a user may improve the visual acuity by accommodation of the eye. Although this may compensate the hyperopic defect to such an extent that a clear vision is obtained, it may results in complaints such as eye strain during prolonged reading or computer work, often times resulting in fatigue and possibly even leading to headaches.
In addition to myopic subjects and hyperopic subject, a type of user that does not experience any eye defect of that nature is referred to as an emmetropic subject. An emmetropic subject has a state of vision in which a faraway object at infinity is in sharp focus with a ciliary muscle of the eye in a relaxed state. That condition of the normal eye is achieved when the refractive power of the cornea and eye lens and the axial length of the eye balance out, which focuses rays exactly on the retina, resulting in perfectly sharp distance vision. A human eye in a state of emmetropia requires no corrective lenses for distance nor does it require corrective lenses to see optimally nearby; the vision scores well on a visual acuity test.
The simplest form of treatment for both a myopic defect and an hyperopic defect is the use of corrective lenses, i.e. eyeglasses or contact lenses.
Eyeglasses used to correct the myopic defect, i.e. near-sightedness, have concave lenses. To the contrary, eyeglasses used to correct the hyperopic defect, i.e. far- sightedness, have convex lenses. After having performed many thousands of test over the last five years or so, Applicant has learned that in particular if the eye defect of a user is related to only a limited loss in visual acuity, it is sometimes challenging to distinguish in an (online) eye exam between a so-called myopic defect or an hyperopic defect. This may, undesirably, lead to an incorrect prescription in which e.g. myopic- correcting glasses or contacts are prescribed to hyperopic persons. When a subject wears glasses or contacts with an incorrect prescription (in particular: a myopic correction whereas a hyperopic correction is needed) this lead to a deterioration of the sight compared to the situation wherein the glasses or contacts are not worn. On an individual level this is of course most undesirable and on a more systematic level, when it happens too often, this may even lead to a significant decrease in the trust that the general public places in online eye tests.
An objective of the present invention is to provide a method, that is improved relative to the prior art and wherein at least one of the above stated problems is obviated or alleviated. In particular it is an objective of the present invention to better distinguish between users having a myopic defect and users having a hyperopic defect.
Said objective is achieved with the method of performing an eye examination test for at least examining a visual acuity of eyes of a user according to claim 1 of the present disclosure. Said method comprises using a computing device that comprises a screen configured to display one or more than one test image, and said method comprises the steps of: - performing a first eye examination test step while the user is positioned at a first user-screen distance; - performing a second eye examination test step while the user is positioned at a second user-screen distance that is different from the first user-screen distance; - defining the one of the first eye examination test step and the second eye examination test step that is associated with the longest user-screen as a distant eye examination test step; - defining the other one of the first eye examination test step and the second eye examination test step that is associated with the shortest user-screen distance as a nearby eye examination test step; - determining, based on the distant eye examination test step, a visual acuity of the user; and - determining, based on the nearby eye examination test step, a signation of the eye defect of the user to thereby distinguish between a myopic defect and an hyperopic defect.
In the context of the present invention, visual acuity, commonly also referred to as the clarity of vision, is related to the user's ability to recognize small details with precision. The most commonly referred-to visual acuity is distance acuity or far acuity (e.g., "20/20 vision"), which describes the user's ability to recognize small details at a far distance. This ability is compromised in people with myopia, also known as short-sightedness or near-sightedness. Another visual acuity is near acuity, which describes someone's ability to recognize small details at a near distance. This ability is compromised in people with hyperopia, also known as long-sightedness or far- sightedness.
A common optical cause of low visual acuity is refractive error (ametropia): errors in how the light is refracted in the eyeball. A refractive error for myopic subjects is associated with a negative number, whereas for hyperopic subjects, the refractive error is associated with a positive number. For this reason, as also mentioned above, eyeglasses used to correct the myopic defect have concave lenses, whereas eyeglasses used to correct the hyperopic defect have convex lenses.
With regard to vision and the human eye, a refractive error is also commonly referred to as an optical defocus. The relationship between optical defocus and visual acuity is inverse: as the degree of defocus increases, visual acuity decreases. When an image is focused correctly on the retina, the light is properly directed onto the photoreceptors, allowing for clear and sharp vision. However, when the image is not properly focused, the light is spread out and the resulting image is blurry, reducing visual acuity. The degree of defocus is synonymous with the power of refractive error (i.e. spherical equivalent) and as aforementioned the direction of the defocus with either myopia or hyperopia {negative and positive defocus, respectively).
In order to distinguish between a myopic defect and an hyperopic defect, the method according to the invention proposes to apply a nearby eye examination test step in addition to a distant eye examination test step. Namely, also when comparing the visual acuity test results from the distant eye examination test step to emmetropic users, both hyperopic users as well as myopic users may have sub- optimal vision. Hence, sub-optimal vision at a distance may not be decisive when diagnosing between myopic and hyperopic defects. Therefore, the results of the nearby eye examination test step are additionally used to determine a signation of the eye defect of the user and thereby allow the method to clearly distinguish between a myopic defect and an hyperopic defect, even if the visual acuity is high, i.e. when there is only a minor eye defect that affects clarity of vision. In the context of the present invention, the term “signation of the eye defect” is to be interpreted as distinguishing between a positive signation, i.e. a plus sign, or a negative signation, i.e. a minus sign.
According to a preferred embodiment, the method further comprises the step of providing a test result based on the visual acuity and the associated myopic defect or hyperopic defect. Based on the test result provided to the user, he/she may order appropriate eyeglasses or corrective lenses that compensate the refractive error of the user's eyes.
According to a further preferred embodiment, the step of determining the signation of the eye defect of the user, comprises associating the eye defect of the user with: - a myopic defect if the visual acuity measured during the distant eye examination test step is lower than the visual acuity measured during the nearby eye examination test step; and
- an hyperopic defect if the visual acuity measured during the distant eye examination test step is higher than or equal to the visual acuity measured during the nearby eye examination test step.
After careful study and comparison of defocus curves for emmetropic, 5 myopic and hyperopic subjects, Applicant has realized that the nature of the defocus curves associated with these different subjects allows to determine a signation. This signation is determined based on a comparison between measurement results of the nearby eye examination test step and the distant eye examination test step. If the visual acuity measured during the distant eye examination test step is lower than the visual acuity measured during the nearby eye examination test step, this means that the subject has a myopic eye defect, i.e. suffers from near-sightedness. To the contrary, if the visual acuity measured during the distant eye examination test step is higher than or equal to the visual acuity measured during the nearby eye examination test step, this relates to an hyperopic eye defect, i.e. the subject suffers from far- sightedness.
According to an even further preferred embodiment, the distant eye examination test step is executed before the nearby eye examination test step. This allows for a further optimization of the test procedure, because for some eye exams it may be decided that a successive nearby eye examination test step is redundant. After all, a very poor visual acuity at far distance may already qualify a subject with sufficient accuracy as having a myopic eye defect. However, if the visual acuity at distance is only slightly decreased relative to an emmetropic subject, the eye defect may either qualify as a myopic or an hyperopic eye defect. In this situation, a signation of the eye defect of the user, determined based on the nearby eye examination test step, is proposed to distinguish between a myopic defect and an hyperopic defect. Thus, the method as a whole allows user having either a myopic or hyperopic defect to be classified to one of the myopic and hyperopic defect with high accuracy.
As mentioned in the previous paragraph, for some eye exams it may be decided that a successive nearby eye examination test step is redundant, so that said nearby eye examination test step may be omitted for such users. Therefore, according to an even further preferred embodiment, the method further comprises the steps of: - determining a visual acuity based on the distant eye examination test step, and
- at least when the visual acuity based on the distant eye examination test step is determined to be above a predetermined threshold value, executing the step of determining the signation of the eye defect of the user.
If the visual acuity based on the distant eye examination test step is determined to be below a predetermined threshold value, this means that the user has a very poor visual acuity at distance. Below the predetermined threshold value this may already qualify a subject with sufficient accuracy as having a myopic eye defect.
According to an even further preferred embodiment, the above- mentioned predetermined threshold value is -1, preferably -0,75.
According to an even further preferred embodiment, the distance associated with the distant eye examination test step is in the range of 100 — 500 cm, preferably in the range of 200 — 400 cm, more preferably in the range of 250 — 350 cm, and most preferably about 300 cm. A distance of about 300 cm has proven to be sufficiently far to measure visual acuity, and is moreover a distance that is practically feasible in most situations. Reference is for example made to international patent application WO 2023/075603 A1 of the same Applicant, wherein it is disclosed how a user may be guided to a test position at a predetermined user-screen distance.
According to an even further preferred embodiment, the distance associated with the nearby eye examination test step is in the range of 25 — 75 cm, preferably in the range of 30 — 60 cm, more preferably in the range of 35 — 50 cm, and most preferably about 40 cm. A study of defocus curves for various eye defects indicated that a distance in the ranges mentioned above is aligned with the current standard in near visual acuity testing. The above mentioned distances are ideal to perform an (online) eye exam, because an average user-screen distance for normal computer related work is about 60 cm.
According to a further preferred embodiment, the method further comprises the steps of: - performing a third eye examination test step while the user is positioned at a third user-screen distance, that differs from the first user-screen distance and the second user-screen distance; - defining the one of the first eye examination test step, the second eye examination test step and the third examination test step, that is associated with a user-screen distance that is between the longest user-screen distance and the shortest user-screen distance, as an intermediate eye examination test step; and - determining, based on a comparison of the visual acuity measured during the intermediate eye examination test step and the visual acuity measured during at least one of the nearby eye examination test step and the distant eye examination step, the signation of the eye defect of the user to thereby distinguish between the myopic defect and the hyperopic defect. The same principle as described above when comparing the visual acuity measured during the distant eye examination test step and the nearby eye examination test step may be applied to obtain additional comparisons if also an intermediate eye examination test step is performed. In this way, the accuracy of distinguishing between a myopic defect and an hyperopic defect may be increased for some users.
According to an even further preferred embodiment, at least one of the step of performing the first eye examination test step, the step of performing the second eye examination test step, and the optional third eye examination test step, comprises the substeps of: - displaying the one or more than one test image on the screen; and - receiving feedback from the user about the one or more than one test image as seen by the user.
Based on the image on the screen and how clear it is seen by the user, the visual acuity may be determined in a way that is similar or equal to the way in which the visual acuity is determined at present by several providers of online eye tests.
The various aspects and features described and shown in the specification can be applied, individually, wherever possible. These individual aspects, and in particular the aspects and features described in the attached dependent claims, may be an invention in its own right that is related to a different problem relative to the prior art.
In the following description preferred embodiments of the present invention are further elucidated with reference to the Figures, in which:
Figure 1 is a perspective view of a computing device that comprises a screen configured to display one or more than one test image to the user;
Figure 2 is a top view showing positions of the user at a first and a second user-screen distance;
Figure 3 is a diagram showing a relation between the user-screen distance and the visual acuity for different eye defects at an accommodation of 0 diopters; and
Figure 4 is a diagram showing a relation between the user-screen distance and the visual acuity for different eye defects at an accommodation of 2.5 diopters.
The method of performing an eye examination test for at least examining a visual acuity of eyes of a user 6 is performed using a computing device 3 that comprises a screen 1 configured to display one or more than one test image 4. The computing device 3 further comprises a camera 5 that may be used to determine a user-screen distance D between the user 6 and the screen 1. In order to improve the quality of the eye exam, the camera 5 may additionally obtain information on the environment wherein the eye exam is performed, such as in particular lighting conditions. Such a computing device 3 is shown in Figure 1.
The method comprises the step of: - performing a first eye examination test step while the user 6 is positioned at a first user-screen distance; - performing a second eye examination test step while the user 6 is positioned at a second user-screen distance that is different from the first user-screen distance; - defining the one of the first eye examination test step and the second eye examination test step that is associated with the longest user-screen distance Dd as a distant eye examination test step; - defining the other one of the first eye examination test step and the second eye examination test step that is associated with the shortest user-screen distance Dn as a nearby eye examination test step; - determining, based on the distant eye examination test step, a visual acuity of the user 6; and - determining, based on the nearby eye examination test step, a signation of the eye defect of the user 6 to thereby distinguish between a myopic defect and an hyperopic defect.
Optionally, the method may further comprise the steps of:
- performing a third eye examination test step while the user 6 is positioned at a third user-screen distance, that differs from the first user-screen distance and the second user-screen distance; - defining the one of the first eye examination test step, the second eye examination test step and the third examination test step, that is associated with a user-screen distance that is between the longest user-screen distance and the shortest user-screen distance, as an intermediate eye examination test step that is performed at an intermediate distance Di; and - determining, based on a comparison of the visual acuity measured during the intermediate eye examination test step and the visual acuity measured during at least one of the nearby eye examination test step and the distant eye examination step, the signation of the eye defect of the user 6 to thereby distinguish between the myopic defect and the hyperopic defect.
Figures 3 and 4 show the relation between the user-screen distance (on the X-axis) and the visual acuity (on the Y-axis) for different eye defects at an accommodation of O diopters (Figure 3) and at an accommodation of 2.5 diopters (Figure 4). The eye defects shown in these Figures relate to the defocus curve of an
Emmetropic subject (represented by the dotted line labelled curve “E”) with a refractive error D = 0, a Myopic subject (represented by the continuous line labelled curve “M”) with a refractive error D = -2, and an Hyperopic subject (represented by the broken line labelled curve “H”) with a refractive error D = 2. A refractive error of magnitude 2 is at the boundary between a low and a moderate severity of the eye defect, and therefore a very common refractive error experienced in subjects.
In Figure 3, the defocus curves are not corrected for accommodation amplitude (i.e., accommodation amplitude was equal to zero). Some users 6 will have a low accommodation capacity, which means that they have a limited capacity to temporarily increase the power of their eyes by thickening the crystalline lens of their eyes. This is especially true for older people, in particular people having an age of 55 years or older, because accommodation capacity normally decreases with age. As such, Figure 3 provides a defocus curve as expected for people of 55 years or older.
Although the curves at a refractive error having a magnitude of D = 2 differ, both the myopic subject and the hyperopic subject show a loss in visual acuity at a distance associated with the distant eye examination step. It is therefore not possible to accurately distinguish between any of the these eye defects based on the distant eye examination step alone.
In Figure 4, the defocus curves are corrected for an accommodation amplitude of 2.5 diopters. Users 6 that are young normally still have a high capacity for accommodation, and consequently the defocus curve shown in Figure 4 is especially expected for younger people. Figure 4 shows that, by integrating the accommodation amplitude into the defocus curve formula, users with all refractive states, i.e. emmetropic, myopic and hyperopic, can achieve a higher level of near visual acuity. For those with hyperopic refractive states (curve “H”), this approach also leads to an increase in distance visual acuity: curve “H” in Figure 4 is significantly higher that curve “H” in Figure 3. As a result, curve “H” in Figure 4 may be close to, or even almost coincide with, curve “E” of an Emmetropic subject.
In practice, most users 6 will show a defocus curve anywhere between the defocus curves shown in Figure 3 (mostly older people} and Figure 4 (mostly younger people). In Figure 3, the “M” curve at distance is above the “H” curve, whereas the opposite situation is visible in Figure 4, where the “M” curve at distance is below the “H” curve. In order to improve the quality of the test exam, the method according to the invention proposes to determine, based on the nearby eye examination test step, a signation of the eye defect of the user to thereby distinguish between a myopic defect and an hyperopic defect
According to a preferred embodiment, the step of determining the signation of the eye defect of the user 6 comprises associating the eye defect of the user 6 with: - a myopic defect if the visual acuity measured during the distant eye examination test step is lower than the visual acuity measured during the nearby eye examination test step; and - an hyperopic defect if the visual acuity measured during the distant eye examination test step is higher than or equal to the visual acuity measured during the nearby eye examination test step.
The above described embodiment is intended only to illustrate the invention and not to limit in any way the scope of the invention. Accordingly, it should be understood that where features mentioned in the appended claims are followed by reference signs, such signs are included solely for the purpose of enhancing the intelligibility of the claims and are in no way limiting on the scope of the claims.
The scope of protection is defined solely by the following claims.
Claims (11)
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| NL2035325A NL2035325B1 (en) | 2023-07-10 | 2023-07-10 | Method of performing an eye examination test for at least examining a visual acuity of eyes of a user. |
| PCT/NL2024/050376 WO2025014367A1 (en) | 2023-07-10 | 2024-07-10 | Method of performing an eye examination test for at least examining a visual acuity of eyes of a user |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| NL2035325A NL2035325B1 (en) | 2023-07-10 | 2023-07-10 | Method of performing an eye examination test for at least examining a visual acuity of eyes of a user. |
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| NL2035325B1 true NL2035325B1 (en) | 2025-01-24 |
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| NL2035325A NL2035325B1 (en) | 2023-07-10 | 2023-07-10 | Method of performing an eye examination test for at least examining a visual acuity of eyes of a user. |
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| NL (1) | NL2035325B1 (en) |
| WO (1) | WO2025014367A1 (en) |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2006263067A (en) * | 2005-03-23 | 2006-10-05 | Matsushita Electric Ind Co Ltd | Eyesight measuring device |
| US20150342459A1 (en) * | 2014-05-29 | 2015-12-03 | Kabushiki Kaisha Topcon | Ophthalmologic apparatus |
| US20170261767A1 (en) * | 2014-11-14 | 2017-09-14 | Carl Zeiss Vision International Gmbh | Optical visual aid with additional astigmatism |
| WO2023075603A1 (en) | 2021-11-01 | 2023-05-04 | Easee Health B.V. | Guiding a user to a test position for performing a computer-based eye exam |
Family Cites Families (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| AUPQ842800A0 (en) * | 2000-06-28 | 2000-07-20 | Aivision Pty Ltd | Flat screen vision testing |
| US9492344B2 (en) * | 2009-08-03 | 2016-11-15 | Nike, Inc. | Unified vision testing and/or training |
| WO2017108952A1 (en) * | 2015-12-22 | 2017-06-29 | Koninklijke Philips N.V. | System and method for dynamically adjusting a visual acuity test |
| JP2023048902A (en) * | 2021-09-28 | 2023-04-07 | 株式会社トプコン | Ophthalmologic device and target presentation device |
-
2023
- 2023-07-10 NL NL2035325A patent/NL2035325B1/en active
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2024
- 2024-07-10 WO PCT/NL2024/050376 patent/WO2025014367A1/en active Pending
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP2006263067A (en) * | 2005-03-23 | 2006-10-05 | Matsushita Electric Ind Co Ltd | Eyesight measuring device |
| US20150342459A1 (en) * | 2014-05-29 | 2015-12-03 | Kabushiki Kaisha Topcon | Ophthalmologic apparatus |
| US20170261767A1 (en) * | 2014-11-14 | 2017-09-14 | Carl Zeiss Vision International Gmbh | Optical visual aid with additional astigmatism |
| WO2023075603A1 (en) | 2021-11-01 | 2023-05-04 | Easee Health B.V. | Guiding a user to a test position for performing a computer-based eye exam |
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| Publication number | Publication date |
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| WO2025014367A1 (en) | 2025-01-16 |
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