HK40100648A - Eye examination apparatus with cameras and display - Google Patents

Description

Eye examination equipment with camera and display screen

Related applications

This patent application claims priority to U.S. Provisional Patent Application No. 63/186,983, filed May 11, 2021, and U.S. Provisional Patent Application No. 63/209,227, filed June 10, 2021. The entire contents of these two U.S. Provisional Patent Applications are incorporated herein by reference.

Technical Field

This disclosure relates to eye examination devices for vision assessment and diagnostic purposes.

Background Technology

Every year, hundreds of thousands of people suffer from brain and eye conditions, such as concussions. When a person is injured, it is essential to assess whether they have a concussion or other symptoms of visual impairment. Portable vision diagnostic devices can help assess whether an individual is injured and/or has a concussion, enabling treatment for those with injuries and/or concussions and allowing others to resume normal activities.

In impoverished regions and countries, access to specialist medical resources can be extremely difficult or even impossible. Portable eye examination devices are invaluable in this context, offering options for eye care and vision assessment to differentiate between life-threatening or vision-threatening conditions requiring immediate medical intervention and benign eye conditions that are not urgent. Furthermore, this convenient ophthalmological and vision assessment can assist the elderly and individuals with limited mobility who find it difficult to travel to a doctor's office for eye examinations. Ophthalmological and vision assessment devices can be conveniently used anywhere in the world for eye examinations. They offer numerous benefits, such as allowing users to choose their preferred doctor for the assessment, reducing reliance on traditional eye examination equipment, and potentially eliminating the need to visit an eye center or clinic for routine or complex eye examinations.

Unfortunately, currently available portable eye examination devices are either too bulky or too complex to use. Some traditional devices only offer tailored solutions, meaning they can only identify certain specific eye conditions and are not practical for routine eye examinations, or vice versa. Typically, traditional devices lack the expected accuracy. More importantly, they cannot identify serious eye conditions (ophthalmic diseases) and are therefore unreliable.

Summary of the Invention

This article discloses an eye examination device for professional use. The device has a main body with a first eye aperture and a second eye aperture, allowing the user to view the device with both eyes. The device also includes a first camera connected to the main body and positioned to acquire ophthalmic images through the first eye aperture, and a second camera connected to the main body and positioned to acquire ophthalmic images through the second eye aperture. The device further includes at least one display screen connected to the main body and positioned where it can be seen through both the first and second eye apertures.

An eye examination device is also disclosed, which has a mask with a transparent display, such that the image displayed on the transparent display overlays a view of the environment visible through the mask. The eye examination device further includes: a first camera assembly configured to acquire ophthalmic images of a user's first eye; a second camera assembly configured to acquire ophthalmic images of the user's second eye; and a processing unit for controlling the transparent display, the first camera assembly, and the second camera assembly.

An eye examination device is also disclosed, configured to be worn by a user and having a display configured to display an image overlaid on an ambient view. The eye examination device further includes at least one semi-transparent lens or prism, a first camera configured to acquire an eye image of a user's first eye by reflection from the at least one semi-transparent lens or prism, and a second camera configured to acquire an eye image of a user's second eye by reflection from the at least one semi-transparent lens or prism. The eye examination device also includes a processing unit for controlling the display, the first camera, and the second camera.

Other aspects and features of this disclosure will become apparent to those skilled in the art after reading the following description of various embodiments thereof.

Attached Figure Description

The embodiments will now be described with reference to the accompanying drawings, in which:

Figures 1a to 1d are perspective views of an eye examination device utilizing at least one smartphone;

Figure 1e is a schematic diagram showing a user wearing an eye examination device during an ophthalmological examination;

Figure 1f is a perspective view of an eye examination device equipped with a smartphone;

Figure 1g is a side view of an eye examination device equipped with two smartphones for ophthalmic examination;

Figure 1h is an exemplary light diagram of an eye examination device, illustrating how the camera captures ophthalmic images during an eye examination;

Figure 1i is a schematic diagram of an eye examination device equipped with two smartphones and at least one convex lens for fundus examination;

Figure 1j is a schematic diagram of an eye examination device equipped with two smartphones and a lens 156 for OCT (ophthalmic coherence tomography).

Figure 1k is a schematic diagram of an eye examination device equipped with a refractometer for refractive eye examination;

Figures 11 and 1m are schematic diagrams of the refractometer in Figure 1k;

Figure 1n is a schematic diagram of the refractometer wheel in Figures 11 and 1m;

Figure 10 is a schematic diagram of an eye examination device with a pair of light shields;

Figure 1p is a flowchart of a computer-implemented ophthalmological examination method;

Figure 2a is a schematic diagram of an eye examination device that can be used in a professional environment;

Figure 2b is a schematic diagram of the sensor module of the eye examination device in Figure 2a;

Figures 2c to 2f are perspective views of an eye examination device implemented using a headband;

Figures 2g to 2l are perspective views of an eye examination device performed using a helmet;

Figures 3a to 3c are perspective views of another type of eye examination equipment that can be used in professional environments.

Detailed Implementation

First and foremost, it should be clear that although example implementations of one or more embodiments of this disclosure are provided below, the disclosed systems and/or methods can be implemented using any known or existing technology. This disclosure should not be limited to the example implementations, drawings, and techniques shown below, including the example designs and implementations shown and described herein, but modifications can be made within the scope of the appended claims and all their equivalents.

Smartphone Examples

Referring first to Figures 1a to 1d, a perspective view of an eye examination device 100 using at least one smartphone is shown. The eye examination device 100 has a closed state (Figure 1a) with a front-mounted housing 111 and an upper-mounted housing 110 disposed inside the eye examination device 100. The eye examination device 100 also has an open state (Figure 1c) with the front-mounted housing 111 and/or the upper-mounted housing 110 sliding out or being removed from the eye examination device 100. The front-mounted housing 111 and the upper-mounted housing 110 are each configured to accommodate a smartphone and are slidably inserted into the main body of the eye examination device 100. The eye examination device 100 has two eye openings 101 and 102.

Referring now to Figure 1e, a schematic diagram of a user wearing an eye examination device 100 during an ophthalmological examination is shown. In some embodiments, as illustrated in the example, the eye examination device 100 has headbands 112 and 113 for securing the eye examination device 100 to the user. The headbands 112 and 113 may include an upper band 112 and a lower band 113, both configured to be worn by the user on the head to maintain the position of the eye examination device 100 stably during the ophthalmological examination. Other securing methods are also possible.

In the example shown, the front-facing box 111 and the upper-facing box 110 each house one smartphone (i.e., a total of two smartphones) for ophthalmological examinations. As explained in further detail below, using two smartphones allows for simultaneous ophthalmological examinations of both eyes. However, it should be noted that ophthalmological examinations can also be performed using a single smartphone, such as the smartphone in the front-facing box 111, or alternatively, the smartphone in the upper-facing box 110.

Referring now to Figure 1f, a perspective view of an eye examination device 100 equipped with a smartphone 161 is shown. The smartphone 161 is placed in a front-facing camera housing 111 and inserted into a front-facing camera housing slot. Once inserted, the front-facing camera housing 111 holds the smartphone 161 in a predefined position relative to the main body, such that the smartphone 161's camera 115 is positioned to acquire ophthalmic images through a first phthalmospheric aperture 101, and the smartphone 161's display screen 116 can be viewed through a second phthalmospheric aperture 102. This allows for examination of one eye at a time.

Referring now to FIG. 1g, a side view of an eye examination device 100 equipped with two smartphones 161-162 for ophthalmic examination is shown. As described above, an ophthalmic examination of both eyes can be performed simultaneously using the two smartphones 161-162. To support this, the eye examination device 100 is equipped with a translucent lens 106 connected to the main body. For the user's right eye 171, the translucent lens 106 reflects light from the camera 117 of the smartphone 162 in the upper housing 110, while allowing light to pass through for use by the display screen of the smartphone 161 in the front housing 111. Conversely, for the user's left eye (not shown), the translucent lens 106 reflects light from the display screen of the smartphone in the upper housing 110, while allowing light to pass through for use by the camera of the smartphone 162 in the upper housing 110.

Each smartphone 161-162 acts as a DCS (Display Camera Group). In some embodiments, the DCS 161 in the front-facing box 111 is designed as the primary DCS, while the DCS 162 in the upper-facing box 110 is designed as the secondary DCS, although the reverse designation is also possible. The camera 117 of the secondary DCS 162 and the display 116 of the primary DCS 161 are used for the user's right eye 171, while the camera 115 of the primary DCS 161 and the display (not shown) of the secondary DCS 162 are used for the user's left eye (not shown). Thus, the image for the right eye 171 is reflected at a 90-degree angle by the translucent mirror 106 and captured by the camera 117 of the secondary DCS 162, while the image for the left eye (not shown) is directly captured by the camera 115 of the primary DCS 161. Simultaneously, the right eye 171 can see the display screen 116 of the primary DCS 161 through the semi-transparent mirror 106, while the left eye (not shown) can see the display screen (not shown) of the secondary DCS 162 through a 90-degree reflection from the semi-transparent mirror 106. In some embodiments, when executed, the software of the two DCS 161-162 can enable them to operate synchronously and present similar images to both eyes. In other embodiments, the two DCS 161-162 can operate independently and display different images. The two DCSs 161-162 can also present two images, designed as binary and stereoscopic, to represent the depth of objects or scenes. Other implementations are also possible.

In the example shown, the upper housing 110 is configured to position the secondary DCS 162 at the top portion of the eye examination device 100. In other embodiments, the lower housing (not shown) is configured to position the secondary DCS 162 at the bottom portion of the main body. More generally, the eye examination device 100 may have a second connector for receiving the secondary DCS 162 and for holding the secondary DCS 162 in a predefined position relative to the main body, regardless of whether this predefined position is at the top or bottom portion of the main body. The operation of the eye examination device 100 is independent of whether the secondary DCS 162 is at the top or bottom portion of the main body, since the translucent mirror 106 can be reflected from both the top and bottom portions of the main body.

As used herein, “ophthalmic images” can include images of the eye surface, eyelids, optic nerve, retina, and/or other images relevant to ophthalmology. Generally, to acquire ophthalmic images using a camera, the camera will be positioned in front of the patient’s eye and in line with the visual axis of the eye, or in another position, provided that the reflection and/or refraction of light (e.g., using a mirror and/or prism) allows the camera to similarly capture the front of the patient’s eye. In either case, preferably, the center of the patient’s retina (i.e., the macula and optic nerve) can be captured.

Referring now to Figure 1h, an example light diagram of an ophthalmic examination device 100 is shown, illustrating how camera 115 captures ophthalmic images during an ophthalmic examination. In some embodiments, the ophthalmic examination device 100 has a pair of convex lenses 151 for a first eye aperture 101 and a second eye aperture 102, such as, but not limited to, 50D. In some embodiments, the ophthalmic examination device 100 also has a second pair of convex lenses 152, such as, but not limited to, 20D, for camera 115 of a first smartphone 161 and camera 117 (not shown) of a second smartphone 162. In some embodiments, the convex lenses 151 and 152 provide sufficient magnification to allow for a wide range of possibilities for cameras 115 and 117 of smartphones 161-162, since the camera resolution of smartphones may be lower than expected. However, for cameras with very high resolution, this magnification can be reduced or even eliminated, in which case convex lenses 151 and 152 can be omitted. Other embodiments are also possible, such as, but not limited to, the emission, capture, and analysis of light for ophthalmic coherence tomography.

In some embodiments, the ophthalmic examination device 100 further includes at least one light emitter 153 positioned to generate infrared or visible light from the first eye aperture 101 and the second eye aperture 102 via reflection from a translucent mirror 106. In some embodiments, the at least one light emitter 153 includes a first infrared emitter and a second infrared emitter, the first infrared emitter positioned to generate infrared light from the first eye aperture 101 and the second infrared emitter positioned to generate infrared light from the second eye aperture 102. In some embodiments, the infrared light can be used for illumination within the ophthalmic examination device 100, and its reflection is captured by infrared cameras 115 and 117 on the primary DCS 161 and auxiliary DCS 162. Using this functionality of the primary and secondary DCS 161-162, the user can avoid pupil constriction and, when cameras 115 and 117 are focused and the image of the retina is clear, use an instant flash to capture an image of the back of the eye 171. In some implementations, at least one optical transmitter 153 is part of the secondary DCS 162, but other implementations in which at least one optical transmitter 153 is part of the first DCS 161 or separate from both DCS 161 and 162 are also possible.

In the example shown, the camera 115 of the primary DCS 161 is placed directly in front of the patient's eye 171 and aligned with the visual axis of the eye so that the camera 115 can capture the retinal center (i.e., the macula and optic nerve) of the eye 171. In this way, the camera 115 can obtain a line of sight from the eye aperture of the ophthalmic examination device 100. Here, the term "line of sight" refers to a fundamental straight path within the ophthalmic examination device 100 where no reflection occurs, although some degree of refraction may exist, such as through the translucent mirror 106 and/or any lens, such as the convex lens 152. Note that the camera 117 of the secondary DCS 162 is not placed directly in front of the patient's eye. Instead, the camera 117 of the secondary DCS 162 is placed in the upper housing 110, although other locations are also possible. However, by using the translucent mirror 106, the camera 117 of the secondary DCS 162 can capture the retinal center of the patient's other eye. The ophthalmic examination device 100 can correctly position the primary DCS 161 and the secondary DCS 162 to obtain ophthalmic images.

According to the eye examination device 100, users can conduct remote eye examinations without the need for specialized equipment or to visit a clinician's office. Instead, they can use their own smartphones 161-162. This is an improvement over currently available portable eye examination devices. The eye examination device 100 does not require any high-end cameras. The eye examination device 100 is relatively easy to use with one or two smartphones 161-162, making it suitable for use in homes, schools, by medical personnel, etc.

Referring now to Figure 1i, a schematic diagram of an eye examination device 100 equipped with two smartphones 161-162 and at least one converging lens 154 for fundus endoscopy is shown. Fundus endoscopy is a method of examining the fundus of the eye, including the retina and optic nerve, and is often performed using magnified or focused light. In the example shown, the converging lens 154 converts a diverging light beam emitted from the light emitter 153 of the smartphone 162 in the upper housing 110 into a parallel beam, which is reflected onto the translucent mirror 106, and the second lens 151 converges the parallel beam into a converging beam that illuminates the retina of the eye 172. In an alternative embodiment, the converging lens 154 converts the diverging beam into a converging beam that illuminates the retina, in which case the second lens 151 may be omitted. In some embodiments, one or both of the lenses 154 and 151 can be adjusted to change the focus and focal length to accommodate different eye sizes and anatomical variations. The camera 115 of the smartphone 161, located in the front housing 111, acts as a detector to capture light reflected from the retina of the eye 172 and transmits it to the camera 115 via the translucent mirror 106. Therefore, the combination of two smartphones 161-162, a semi-transparent lens 106, and at least one converging lens 154 makes fundus examination possible.

In the example shown, the light emitter 153 comes from the smartphone 162 in the upper box 110, and the camera 115 comes from the smartphone 161 in the front box 111. Alternatively, the light emitter of the smartphone 161 in the front box 111 and the camera 117 of the smartphone 162 in the upper box 110 can be used. Both of these methods can be implemented simultaneously, which allows for simultaneous ophthalmoscopy of both eyes, or separate examinations.

Referring now to Figure 1j, a schematic diagram of an eye examination device 100 equipped with two smartphones 161-162 and a mirror 156 for optical coherence tomography (OCT) is shown. Optical coherence tomography is an imaging technique that uses the principle of interference to capture high-resolution images based on the interference of superimposed waves in a reference arm and a sample arm. In the example shown, a low-coherence light source 153a generates low-coherence light that illuminates a semi-transparent mirror 106, which acts as a beam splitter. For the reference arm, a portion of the low-coherence light passes through the semi-transparent mirror 106, is reflected back to the mirror 156, and then back to the semi-transparent mirror 106, where it is received by the camera 115 of the smartphone 161 in the front-facing camera housing 111. For the sample arm, the remaining low-coherence light from the low-coherence light source 153a is reflected back to the semi-transparent mirror 106, then to the retina of the eye 172, passes through the semi-transparent mirror 106, and is received by the camera 115. Therefore, camera 115 receives a reference light wave from the reference arm and a sample light wave from the sample arm. When the reference light wave and the sample light wave are in phase, they can undergo constructive interference (i.e., intensity enhancement); when they are out of phase, they can undergo destructive interference (i.e., intensity weakening). This interference between the reference light wave and the sample light wave provides imaging information that can be detected as an analog interferometric OCT signal. In some embodiments, camera 115 is capable of detecting near-infrared (NIR) light to help capture the analog interferometric OCT signal.

In some embodiments, the sample arm includes a lens 151 for focusing low-coherence light into a converging beam that illuminates the retina of the eye 172. Additionally, in some embodiments, the sample arm includes a two-dimensional microelectromechanical (MEMS) mirror 155, a beam deflection device that provides lateral scanning for OCT. Parallel light is incident on the biaxial galvanometer of the two-dimensional MEMS mirror 155 and redirected to the lens 151, which acts as a telecentric objective. The lens 151 focuses the light onto the retina of the eye 172, and the reflected light is received by the lens 151 and refocused by the translucent mirror 106. In some embodiments, the lens 151 and the two-dimensional MEMS mirror 155 are adjustable to provide variable focal length and projection.

In some embodiments, camera 115 samples the analog interferometric OCT signal at equal spectral intervals. Each scan generates depth information of the interference pattern through the response at different depths, forming an A-scan. An A-scan is a one-dimensional image of the sample (e.g., the retina of the eye 172) at a specific depth. By integrating multiple A-scans, a cross-sectional microstructure image of the sample can be obtained. In some embodiments, the captured analog interferometric OCT signal is converted into a digital signal, and then the OCT fringe data is processed locally on a smartphone or sent to a host computer for signal processing.

Referring to Figure 1k, a schematic diagram of an eye examination device 100 equipped with a refractive indexer 188 is shown for refractive eye examination. A refractive eye examination is an eye examination to measure a personal prescription for eyeglasses or contact lenses. The refractive indexer 188 is an optional accessory that can be attached to the eye examination device 100 to perform the refractive eye examination and can then be detached. In some embodiments, the refractive indexer 188 is attached to the eye examination device 100 using magnetic pins mounted at the four corners of the back and front of the refractive indexer 188. However, there are other implementations for attaching the refractive indexer 188 to the eye examination device 100.

Referring now to Figures 11 and 1m, a schematic diagram of the refractive meter 188 in Figure 1k is shown. The refractive meter 188 has at least two wheels 180 and 181 on each side, for a total of at least four wheels. In some embodiments, each wheel protrudes from the side, creating a dial 189 for rotating the wheel. In some embodiments, the refractive meter 188 also has additional wheels (not shown). Additional wheels can be used to provide a more detailed refractive or ocular examination or treatment.

Referring now to Figure 1n, a schematic diagram of wheels 180 and 181 of the refractometer 188 in Figures 1l and 1m is shown. The first wheel 181 has a spherical convex lens and a concave lens 183 for testing refractive errors. The second wheel 180 has a cylindrical convex lens and a concave lens 182 for astigmatism testing. Red, green, blue, etc. filters, pinholes, any prisms, occluders, neutral density filters, or any other electronically modified, physically modified, or controlled lenses or filters can be used on wheels 180 and 181.

In the example shown, a user can use dial 189 to change lenses or filters on wheels 180 and 181. In other implementations, lenses or filters on wheels 180 and 181 can be replaced electronically via one or more actuators that can be electronically coupled to a smartphone 161. In this way, lenses or filters on wheels 180 and 181 can be changed remotely or using the smartphone 161. In some embodiments, the results of a refractive eye examination are sent to a host computer for evaluation and/or online ordering of prescription eyeglasses or contact lenses.

The ophthalmic examination device 100 can be used to examine one eye alone or both eyes simultaneously. In some embodiments, the ophthalmic examination device 100 is equipped with at least one shield, such as a pair of shields. The shield can be used to selectively block light from the eye not being examined. Alternatively, the shield can be used to distinguish visual impairments. An example will now be described with reference to FIG10.

Referring now to Figure 10, a schematic diagram of an eye examination device 100 having a pair of shields 138 is shown. In some embodiments, the shields 138 may be provided as an additional accessory. The shields 138 may slide/swipe across the lens 101 or be placed directly on the lens 101. In some embodiments, the shields 138 have a plurality of pinholes 139 (e.g., fifteen pinholes as shown). The pinholes 139 are configured to eliminate disordered arrays of refracted light that cause blurred vision in non-neuropathic eye diseases. More precisely, the pinholes 139 help to distinguish between visual impairment caused by neuropathic eye diseases, such as multiple sclerosis, stroke, etc., and visual impairment caused by non-neuropathic eye diseases, such as refractive errors, dry eye, etc. Furthermore, the pinholes 139 are very useful for testing visual acuity in an annular dilated eye (the state of the eye after using specific eye drops to paralyze the pupil and lens muscles) because they effectively reduce the intensity of incident light.

In some embodiments, each occluder 138 is secured in place by a pin 140 connected to the front surface of the eye examination device 100, allowing it to pivot downwards during use. In other implementations, the occluder 138 may be placed directly on or mounted on the lens 101. Other implementations are also available.

In some embodiments, the first eye opening 101 and the second eye opening 102 of the eye examination device 100 are separate openings, as shown. However, there are other implementations in which the first eye opening 101 and the second eye opening 102 are part of the same opening, i.e., a large opening, allowing the user to look into the eye examination device 100 with both eyes. In some embodiments, the eye examination device 100 has a central partition 109 that separates the left side for examining the user's left eye from the right side for examining the user's right eye.

The main body of the eye examination device 100 has many possibilities. In some implementations, the main body comprises a plastic material. In a particular implementation, the main body is generated using a 3D printer. The front box 111 and the upper box 110 can also be made of plastic material and generated using a 3D printer. In a particular implementation, the user can generate the eye examination device 100 themselves using a 3D printer. In other implementations, the eye examination device 100 is manufactured and distributed to the user by a manufacturer. Note that other materials besides plastic, such as cardboard, can also be used. Factory-produced head-mounted devices are also possible. There are other implementations as well.

There are many ways to secure the eye examination device 100 to a user. In some implementations, as described above, the eye examination device 100 has headbands 112 and 113 for securing it to the user. In other implementations, the eye examination device 100 is simply held against the user's face. In some implementations, the eye examination device 100 has a nose pad 175, which may help ensure a proper fit of the eye examination device 100 to the user's face. Other implementations are also possible.

While the illustrated example focuses on a specific type of connection for receiving a smartphone, it is noted that other types of connections are possible and within the scope of this disclosure. Any suitable connection can be used to receive and secure a smartphone at a predetermined location such that its camera can acquire ophthalmic images through the first eye opening 101 and its display can be seen through the second eye opening 102. A sliding box as shown can be omitted; snap-fit implementations and/or other securing methods can also be used. Other connection locations are also possible. For example, as mentioned above, the eye examination device 100 can use a lower box (not shown) instead of an upper box 110. Other implementations are also possible.

Although the example shown uses a semi-transparent mirror 106 for reflection, note that a semi-transparent prism can be used instead. It is worth noting that a semi-transparent prism may cause more refraction than a semi-transparent mirror 106, depending, of course, on the geometry. The use of a semi-transparent mirror or a prism depends on the specific implementation. In either case, light can pass through either the semi-transparent mirror or the prism, typically in a straight line or line of sight, although there will be some degree of refraction. In a particular embodiment, as in the example shown, the semi-transparent mirror is at a 45-degree angle to the first and second smartphones to reflect light, since the smartphones are orthogonal to each other. However, other geometries are possible and are within the scope of this disclosure.

Referring now to Figure 1p, a flowchart of a computer-implemented method for performing an eye examination is shown. This method can be executed by at least one processor, such as the processor of one of the smartphones described above in relation to Figures 1a to 1o. In some embodiments, the smartphone downloads and executes an application to enable the computer-implemented method described below.

In step 1-1, the processor uses the smartphone's camera to capture an image of the user's first eye. In step 1-2, the processor uses the smartphone's display screen to display an image for the user's second eye. In some embodiments, only one smartphone is used to perform the computer-implemented method. This allows for eye examinations to be performed eye-by-eye. In other embodiments, two smartphones are used to perform the computer-implemented method, allowing for simultaneous eye examinations of both eyes.

In some embodiments, as shown in steps 1-3, the processor uses the camera of a second smartphone to capture an image of the user's first eye. In some embodiments, as shown in steps 1-4, the processor uses the display screen of the second smartphone to display an image of the user's second eye. In some embodiments, as shown in steps 1-5, the processor coordinates the first and second smartphones to simultaneously capture images of the first and second eyes. This facilitates simultaneous eye examinations of both eyes.

In some implementations, both the first and second smartphones have wireless capabilities, such as Bluetooth radio or Wi-Fi connectivity, and coordinating the first and second smartphones involves pairing the first smartphone with the second smartphone (e.g., using Bluetooth radio or Wi-Fi radio) to establish a wireless Bluetooth or Wi-Fi connection, and using the wireless connection for coordinated communication between the first and second smartphones. Other implementations are also possible.

In some implementations, the processor stores images of the first and second eyes in the memory of a first smartphone. In other implementations, each smartphone stores its own acquired images. In some implementations, as shown in steps 1-6, the method involves transmitting images of the first and/or second eyes using the transmitter of the first smartphone. The transmitted data can be sent to a clinic, such as a doctor's office, for evaluation or examination by the doctor. In other implementations, each smartphone transmits its own data. Other implementations are also possible.

Based on a computer-implemented method, users can remotely conduct eye examinations outside a doctor's office using their own smartphones, without the need for specialized equipment. This is an improvement over currently available portable eye examination devices. The eye examination device 100 is relatively easy to use, requiring only one or two smartphones, making it suitable for use in homes, schools, first responders, and more.

In some implementations, artificial intelligence (AI) and machine learning systems are used to analyze ophthalmic images to identify healthy and abnormal eye and visual structures and functions. All implementations described herein can be equipped with this capability. Using AI can help medical professionals make accurate diagnoses and promptly triage emergency patients to the emergency room or doctor's office.

According to another embodiment of this disclosure, a non-transitory computer-readable medium is provided on which statements and instructions are recorded, which, when executed by at least one processor, implement the methods described herein. For example, the non-transitory computer-readable medium may include an SSD (Solid State Drive), a hard disk drive, a CD (Optical Disc), a DVD (Digital Video Optical Disc), a BD (Blu-ray Disc), a Memory Stick, or any suitable combination thereof.

Professional Implementation Examples

Referring now to FIG. 2a, a schematic diagram of an eye examination device 200 that can be used in a professional setting is shown. Unlike the eye examination device 100 described with reference to FIGS. 1a to 1p, the eye examination device 200 of FIG. 2a does not utilize existing smartphones, but is instead equipped with its own dedicated sensor modules 121 and 122 and at least one display 119 and 120. Nevertheless, the operating principle of the eye examination device 200 of FIG. 2a is similar to that of the eye examination device 100 of FIGS. 1a to 1p.

There are many possibilities for at least one display 119 and 120. In some embodiments, as shown in the illustrated example, at least one display 119 and 120 includes a high-resolution display screen comprising a first display 119 positioned for viewing through a first eye aperture 101 and a second display 120 positioned for viewing through a second eye aperture 102. In other embodiments, at least one display 119 and 120 includes a single display having a left portion visible through the first eye aperture 101 and a right portion visible through the second eye aperture 102. Each of the displays 119 and 120 may be placed on the upper part of the eye examination device 200, as shown, or placed on another portion of the eye examination device 200, such as the front wall. Other embodiments are possible.

Numerous possibilities exist for sensor modules 121 and 122. Referring to Figure 2b, each sensor module may, for example, include a pair of infrared or visible light projectors/sensors 123 and 124, at least one high-resolution camera 125, and a laser emitter 126. Thus, each sensor module may have the ability to project a laser beam, infrared light, or visible light onto the retina of the eye, the reflection of which is captured by the high-resolution camera 125. Sensor modules 121 and 122 may be mounted in a head-mounted device or a face mask. Other implementations are possible.

Although the eye examination device 200 is depicted as having sensor modules 121 and 122, it should be noted that other implementations without such modules are also possible. For example, the eye examination device 200 may be provided with a first camera coupled to the body and positioned to acquire ophthalmic images through a first eye aperture 101, and a second camera coupled to the body and positioned to acquire ophthalmic images through a second eye aperture 102. Such cameras can be provided without the infrared projector/sensor 123 and without the laser emitter 126. Camera 125 may be mounted in a head-mounted device or in a face mask. Other implementations are also possible.

In some embodiments, as illustrated in the example, (i) a first camera (e.g., camera 125 of sensor module 121) is positioned to acquire ophthalmic images through the first eyehole 101 via the line of sight through the semi-transparent mirror 106, and a first display 119 is visible in the first eyehole 101 via the reflection of the semi-transparent mirror 106; and (ii) a second camera (e.g., camera 125 of sensor module 122) is positioned to acquire ophthalmic images through the second eyehole 102 via the line of sight through the semi-transparent mirror 106, and a second display 120 is visible in the second eyehole 102 via the reflection of the semi-transparent mirror 106.

In other embodiments, (i) a first camera (e.g., camera 125 of sensor module 121) is positioned to acquire ophthalmic images through a first eyehole 101 via reflection from a semi-transparent mirror 106, and a first display 119 is visible through the first eyehole 101 through the line of sight from the semi-transparent mirror 106; and (ii) a second camera (e.g., camera 125 of sensor module 122) is positioned to acquire ophthalmic images through a second eyehole 102 via reflection from a semi-transparent mirror 106, and a second display 120 is visible through the second eyehole 102 through the line of sight from the semi-transparent mirror 106.

Although the example shown depicts a translucent mirror 106 for reflection, a translucent prism can be used instead. It should be noted that a translucent prism may cause more refraction than a translucent mirror, depending on the geometry. Whether to use a translucent mirror or a prism depends on the specific implementation. In either case, light can pass through the translucent mirror or prism, typically in a straight line or line of sight, although there will be some degree of refraction. In a particular embodiment, as in the example shown, the translucent mirror 106 is at a 45-degree angle relative to sensor modules 121 and 122 and at least one display 119 and 120 to facilitate reflection, since sensor modules 121 and 122 and at least one display 119 and 120 are orthogonal to each other. However, other geometries are also possible and fall within the scope of this disclosure.

In some embodiments, the eye examination device 200 is equipped with at least one condenser lens 154 for fundus examination, similar to that described in FIG1i above.

In some embodiments, the eye examination device 200 is equipped with components required for an interferometer, such as a low-coherence light source 153a and a mirror 156 for OCT, as described above with reference to FIG1j. In some embodiments, the eye examination device 200 also has a lens 151 and a 2D MEMS mirror 155, as described above with reference to FIG1i.

In some embodiments, the eye examination device 200 is equipped with a refractive device 188 for refractive ophthalmological examination, as described above with reference to Figures 1k to 1n.

In some embodiments, the eye examination device 200 is equipped with at least one shield, such as a pair of shields, as described above with reference to FIG10.

In some embodiments, the first eyehole 101 and the second eyehole 102 of the eye examination device 200 are separate holes, as shown in the figure. However, there are other embodiments in which the first eyehole 101 and the second eyehole 102 are part of the same hole, i.e., a large hole, allowing the user to observe the interior of the eye examination device 100 with both eyes. In some embodiments, the eye examination device 200 has a central partition 109 that separates the area on the left side for examining the user's left eye from the area on the right side for examining the user's right eye.

Referring to Figures 2c to 2f, perspective views of an eye examination device 200 equipped with headbands 130 and 131 are shown. In some embodiments, headbands 130 and 131 include an upper headband 130 and a lower headband 131, allowing the eye examination device 200 to be worn as a face mask. In some embodiments, the eye examination device 200 has a nose pad 175 for precise positioning of the face mask. In some embodiments, the eye examination device 200 is designed as a head-mounted face mask for use in professional institutions and clinics, such as nursing stations, emergency rooms, and ophthalmology, neurology, or optometry offices. Other embodiments are also possible.

In some embodiments, the eye examination device 200 is equipped with a processing unit for controlling a first sensor module, a second sensor module, and at least one display. In some embodiments, the processing unit is configured to process ophthalmic images captured by a high-resolution camera 125 and transmit them to a clinician for further analysis and examination. In some embodiments, the processing unit is located within a processing unit housing 129 in the upper part of the eye examination device 200. Other embodiments are also possible. In some embodiments, the processing unit is a microcontroller unit (MCU), but other processors such as a central processing unit (CPU), a field-programmable gate array (FPGA), and an application-specific integrated circuit (ASIC) may also be used.

In some embodiments, the first eyehole 101 and second eyehole 102 of the eye examination device 200 are equipped with adjustable lenses 132. The adjustable lenses 132 allow the user to view the displays 119 and 120 through sight or through a 90-degree reflection from the translucent mirror 106, depending on the implementation of the eye examination device 200. The adjustable lenses 132 also facilitate the capture of images of the user's eyes using a high-resolution camera/scanner 125. Other embodiments are also possible.

In some embodiments, the eye examination device 200 is equipped with at least one external sensor 128 for sensing the environment outside the eye examination device 200, and the processing unit controls at least one display based on the at least one external sensor 128. In some embodiments, the at least one external sensor 128 includes a pair of external cameras 128 for capturing the environment outside the eye examination device 200, and the processing unit uses this pair of external cameras 128 to generate an image for at least one display. This enables augmented reality functionality.

The eye examination device 200 shown in Figures 2c to 2f is secured to the user's head via headbands 130 and 131. In another embodiment, the eye examination device 200 is worn by the user in the form of a helmet. An example will be described below. Note that other securing methods are possible and are within the scope of this document.

Please refer to Figures 2g to 2l, which show perspective views of an eye examination device 200 employing a helmet 134. In some embodiments, the helmet 134 is also equipped with earpieces 133. In some embodiments, the eye examination device 200 is equipped with a nose bridge 175 for precise positioning of the helmet. In some embodiments, the eye examination device 200 is designed in the form of a head-mounted helmet for use in professional institutions and clinics, such as nursing stations, emergency rooms, and ophthalmology, neurology, or optometry offices. Other embodiments are also possible.

Please refer to Figures 3a to 3c, which show perspective views of another eye examination device 300 suitable for professional environments. Unlike the eye examination device 200 described with reference to Figures 2a to 2l, the eye examination device 300 in Figures 3a to 3c does not have an eye opening for the user to see the area containing the display/camera; instead, it is equipped with a mask having a transparent display 136 and a camera assembly 141. However, the operating principle of the eye examination device 300 in Figures 3a to 3c is similar to that of the eye examination device 200 in Figures 2a to 2l described above.

In some embodiments, the eye examination device 300 is implemented as a helmet 135. In some embodiments, the helmet 135 is also equipped with an earpiece 133. In some embodiments, the eye examination device 300 is designed in the form of a head-mounted helmet, which can be used in professional institutions and research laboratories, and can be used by pilots, top athletes, etc. Other embodiments are also possible.

Each camera assembly 141 includes a camera. In some embodiments, each camera assembly 141 includes a reflector or prism positioned such that the camera can acquire ophthalmic images via reflection from the reflector or prism. In some embodiments, the camera assembly 141 is retractable. In the illustrated example, the camera assembly 141 is in an extended position, which allows the camera assembly 141 to acquire ophthalmic images. However, when not in use, the camera assembly 141 can be retracted into the eye examination device 300.

In some embodiments, the image displayed on the transparent display 136 is overlaid on a view of the environment that can be seen through the mask, thereby achieving augmented reality. In some embodiments, the mask and the transparent display 136 are also retractable. In the illustrated example, the transparent display 136 is in an extended position, which allows the camera assembly 141 to acquire ophthalmic images. However, when not in use, the camera assembly 141 can be retracted into the eye examination device 300.

In some embodiments, the eye examination device 300 has a processing unit for the transparent display 136 and the camera assembly 141. In some embodiments, the processing unit is configured to process ophthalmic images captured by the camera assembly 141 and send them to a clinician for further analysis and examination. In some embodiments, the processing unit is disposed within a processor unit housing 137 on the upper part of the eye examination device 300. Other embodiments are possible. In some embodiments, the processing unit is an MCU, but other processors such as CPUs, FPGAs, and ASICs are also possible.

In some embodiments, the eye examination device 300 has motion and/or position sensors, and the processing unit controls the transparent display 136 based on the motion and/or position sensors.

In some embodiments, the eye examination device 300 is equipped with a refractive device 188 for examining refractive eyes, as described above with reference to Figures 1k to 1n.

In some embodiments, the eye examination device 300 is equipped with at least one shield, such as a pair of shields, as described above with reference to FIG10.

Example Application

The eye examination devices 100, 200, and 300 described herein have various applications, as described below. While many of the applications described below relate to the “smartphone embodiments” (i.e., the eye examination device 100 shown and described with reference to Figures 1a to 1p), it should be understood that they can also be used in the “professional embodiments” (i.e., the eye examination devices 200 shown and described with reference to Figures 2a to 2l and/or the eye examination devices 300 shown and described with reference to Figures 3a to 3c). Other applications are also possible.

Vision Testing: A specially designed mobile application enables the eye examination equipment, along with the primary and auxiliary DCS, to accurately define the user's visual acuity using a well-established, reliable, and currently used eye testing system, namely HOTV. The application provides instructions to the patient via verbal and/or written instructions and, upon user confirmation, prompts the user to insert the primary and optional auxiliary DCS (smartphone) into the corresponding slots of the eye examination equipment 100. The default test begins with the right eye, unless the right eye is nonfunctional or a different eye is selected by the user or examiner (optometrist/doctor). A randomly selected letter H, O, T, or V, approximately 20/50 the size of a letter on a Snellen chart, can be displayed in the center of the display, with reference letters of predetermined sizes displayed on the four sides. If the user recognizes the letter, they can be prompted to respond, with feedback provided in the form of eye or head movement toward the correct reference letter, a voice response, or touchscreen input. After three consecutive correct answers, the letter size can be decreased, and the test can be repeated. Alternatively, after two consecutive incorrect answers in the first set of presentations, the letter size can be increased. The size of the target letter can be reduced as the user identifies and correctly positions the letters on the screen. This process can continue until the user fails to provide three correct answers. The size of the last letter that the user is able to reliably identify can be considered their visual acuity. Cameras in the main and auxiliary DCSs track the user's eyes during the vision test to ensure the user is focused on the target.

Visual Field: The application, eye examination equipment, and primary and auxiliary DCS can also be used for automated visual field testing, i.e., automated visual field analysis. The patient or examiner can determine the density and span of the peripheral visual field to be tested. They can choose to test a narrow range of the visual field with a high-density test target (i.e., near the visual center) or a wider range with a variable-density test target. Using a statistical model, the brightness and location of the target light can be randomly determined, and the testing gradually becomes more difficult/complex until a defined brightness/contrast threshold is reached at any peripheral target point. This analysis allows for the diagnosis of various neurological disorders based on unique patterns of visual loss, such as inferior nasal visual field loss in glaucoma. Capturing and studying patterns of visual loss can help artificial intelligence and examiners/physicians improve the speed and accuracy of diagnosis. The results obtained can be conveniently stored in a secure system for further analysis and tracking.

Color vision: Eye examination equipment can be used to perform standard color vision deficiency tests. Patients are shown numbers of different colors, and their feedback is collected and analyzed to detect different types of color blindness.

Amsler Grid: The Amsler grid test is a screening test used to detect signs of diseases that damage the retina or optic nerve. Some examples of these conditions include age-related macular degeneration, retinal detachment, and optic neuritis, all of which can lead to permanent blindness if left untreated. Early detection and intervention are key to the successful treatment of these diseases, highlighting the importance of screening tests in detecting and managing these potentially disabling conditions. A black grid spanning 20-30 degrees across the central visual field is displayed to each eye, and the patient is asked to report any defects or distortions in the grid lines. The presence of defects prompts the doctor to conduct a more thorough examination, leading to early diagnosis and treatment of the aforementioned conditions.

Eye tracking: Both the main and auxiliary DCS cameras and applications are equipped with eye tracking capabilities. This is particularly useful for detecting and analyzing conditions that affect eye movements, such as concussion, multiple sclerosis, traumatic brain injury, and neurodegenerative brain diseases (e.g., Alzheimer's disease, Parkinson's disease, frontotemporal dementia). Using eye tracking, eye examination devices can examine a patient's eye movements while performing tasks such as self-paced saccades or smooth tracking to further analyze disease progression and assess treatment effectiveness.

With advancements in smartphones and mobile technology, display and camera resolutions continue to improve, which can enhance vision testing and other eye measurements using eye examination equipment.

Other applications of eye examination equipment include the following aspects of observation and analysis:

• Afferent and efferent visual functions;

• Static eye features: eyelids, palpebral fissures, iris, pupil shape and size, pupil color, and sclera.

• Dynamic characteristics of the eye: blinking, opening and closing the eyes, changes in pupillary light orientation and near/far vision, regularity of pupillary responses, and various eye movements.

• Test for dry eye syndrome (or equivalent eye abnormalities, such as computer eye syndrome, etc.)

• Test the eye's refractive error to determine the prescription for eyeglasses;

• Characteristics of the optic nerve, retina and its blood vessels; and

• Refractive measurements performed for other purposes.

In addition, eye examination equipment can be used to perform a variety of routine eye examinations to diagnose and assess common to serious eye diseases, some of which are briefly explained below.

Afferent Visual System (AVS)

AVS is related to all visual and brain functions responsible for capturing images from the environment and analyzing them to create visual perception. AVS is measured by various visual attributes, including visual acuity, visual field, color vision, stereopsis, depth perception, pupil size/shape in response to light and/or distance, and the integrity of peripheral vision, such as the Amsler grid test.

Visual acuity: Visual acuity testing is a measurement of the clarity of vision at the center of the visual field (and occasionally peripheral vision as well). Visual acuity is compared to the average visual acuity of a normal population. Different methods are used to test visual acuity at different distances, such as the E-chart, stylized letters, Landorte's rings, pediatric symbols, or illiterate symbols. In Europe and North America, the standard measurements for reporting normal visual acuity are 6/6 or 20/20. 20/20 or 6/6 visual acuity means that the observer can clearly see a target at a distance of 20 feet (or 6 meters) (representing the numerator), which is the same as someone with average normal visual acuity (representing the denominator). However, if someone's visual acuity is impaired, for example, 6/12 or 20/40, it means that the person can clearly see a target at 6 meters (20 feet), while someone with average vision can see the same size object at 12 meters (40 feet).

Traditionally, in the E-graph vision test, the size of the letters representing 20/20 visual acuity, which need to be clearly seen, is defined as 5 arcminutes (1 arcminute is 1/60th of a visual angle). The letter E has three sequences of light and dark lines, which need to be distinguished before the observer can clearly identify the letter and its direction. Recently, the HOTV method of vision testing has become a standard test. The HOTV system involves the letters (H, O, T, and V), which involves distinguishing three repetitions of light and dark pixels before differentiating the letters. Therefore, vision with a sharpness that can recognize an image at 1.6 arcminutes (the letters representing 20/20 visual acuity) can recognize the HOTV letters. Therefore, since 2012, most commercial mobile phones (over 70 models listed in the phone table) have offered performance close to or higher than 37.5 PPD (pixels per degree) (1.6 arcminutes at the resolution of eye examination equipment) and can be used for the HOTV system to test 20/20 visual acuity.

Field of vision and peripheral vision: Peripheral vision is a fundamental part of vision. It provides perception of the environment and can prevent accidents, collisions with objects approaching from the corners of the field of vision, etc.

Visual field tests can be performed by a doctor during an ophthalmological examination, such as the confrontation visual field test, but this method is neither sensitive nor specific. Another option is to have the visual field test automated by a doctor or optometrist in the doctor's office. The patient sits in front of the machine and focuses on the center of the visual field; depending on the model of the visual field test machine, the visual stimulus is either moved or flashed manually, or it is presented by the machine in different areas of the visual field; the visual stimulus is usually a point of light. The patient responds to the light by notifying the examiner or clicking a button. Advanced automated visual field tests use statistical models to improve reliability and reduce test time. Virtual visual field tests are now available using ophthalmological examination equipment.

Color vision: Color vision is defined as the visual system's ability to distinguish different wavelengths of light within the visible spectrum regardless of their intensity.¹ Humans are able to see colors because of the presence of cone photoreceptors in the retina. Their peak sensitivity varies in three ranges: short wavelength (~535 nm), medium wavelength (~565 nm), and long wavelength (~440 nm). Therefore, they are called S, M, and L photoreceptors.² Color blindness is a disorder in which colors cannot be correctly perceived. It can occur due to the loss of cone cells (trichromatic vision), changes in the spectral sensitivity of cone cells (trichromatic aberration), or damage to the optic nerve or visual cortex. These can be genetic or due to disease or toxins damaging the retina, optic nerve, or cortical cells.³

Stereoscopic vision, depth perception, and stereoscopic display: A stereoscopic display, also known as a 3D display or head-mounted display (HMD), consists of a visual display, such as an LCD or LED display, that works in front of each eye based on the principle of stereoscopic vision.⁴ It operates by displaying slightly different 2D perspective views of the same object to each eye. The tiny deviations between the images of the object are precisely equal to the natural perspective of binocular vision. This deviation creates the illusion of a 3D environment and contributes to the perception of depth.⁵

1 DeValois K, Webster M. Color vision. Academic Encyclopedia 2011; 6(4): 3073.

2 DeValois K, Webster M. Color Vision. Academic Encyclopedia 2011; 6(4): 3073.

3 DeValois K, Webster M. Color Vision. Academic Encyclopedia 2011; 6(4): 3073.

Crosstalk in 4 Woods AJ stereoscopic displays: A review. Journal of Electronic Imaging. Dec 5, 2012; 21(4): 040902.

Crosstalk in 5 Woods AJ stereoscopic displays: A review. Journal of Electronic Imaging. Dec 5, 2012; 21(4): 040902.

Pupil responses: The pupil's response to near/far objects and light is constriction and dilation. These are called near/light pupillary responses. In near-field responses, the pupil constricts because the human lens naturally distorts light in its peripheral area. The pupil naturally constricts in near-field vision to avoid this distortion and enhance visual clarity.^⁶ The pupil constricts in response to bright light to reduce the amount of light entering the eye.

Outgoing vision system

The efferent visual system (EVS) function involves all visual and brain functions related to eye movements, reflexes, and alignment. EVS assessment includes measurements of eye alignment/misalignment, saccades/tracking eye movements, and eye movement components. These components include saccade amplitude, accuracy, maximum speed, and the number of saccades in self-stepping, memory-based, and reflex-based (i.e., visual target) saccades. Furthermore, EVS measurements include abnormal eye movements such as nystagmus/oscillations/ocular intrusions at neutral or dissimilar fixation positions, and ocular reflexes such as the vestibulo-ocular reflex (VOR) and inhibition (VOI).

Smooth eye tracking: Smooth eye tracking is slower than saccades and has evolved to focus on a moving object at the visual center, i.e., when the image falls on the fovea.^⁷ This movement is under voluntary control. However, in the absence of an object, only highly trained individuals can perform smooth eye tracking; most people will only perform saccades.^⁸ Smooth tracking is highly controlled by the brain (the frontoocular region in the frontal lobe).

Saccades: Saccades are the synchronous and rapid movement of the eyes between two points.9 In contrast to the VOR response, which is controlled by relatively direct pathways, the saccadic response is driven by complex and multisynaptic pathways originating from the frontal visual field (FEF) ^, cerebellum, ^or superior colliculus.10

Self-paced saccades (SPS) are random eye movements between two fixed targets. The anterior cingulate cortex is responsible for maintaining the motivation to perform the task. The FEF, prefrontal cortex (dorsolateral portion), and superior colliculus of the midbrain constitute the pathways controlling self-paced saccades.^{^11,12} More precisely, to generate horizontal saccade initiation, signals from the FEF are sent to the paramedian reticular formation in the pons to activate cranial nerve nucleus 6. Furthermore, the signals continue from the medial longitudinal fasciculus (MLF) to the midbrain to activate cranial nerve nucleus 3. These two cranial nuclei are primarily responsible for horizontal eye movements. Vertical saccades are generated by an initiation signal from the FEF, which is transmitted to the MLF and the rostral interstitial nuclei of the 3rd and 4th cranial nerves,^{^13,14} which in turn generate and control vertical eye movements.

Studies in patients with minor traumatic brain injury (mTBI) have revealed impairment in several features of horizontal rapid eye movements (SPS), such as total number of saccades and saccade intervals.^¹⁵ Patients with mTBI perform fewer SPS and have significantly increased saccade intervals, indicating impaired prefrontal lobe function.^{^16,17} In addition to the parameters mentioned above, other parameters such as the saccade speed to accuracy ratio (S/A ratio) and saccade gain are common measures used to assess horizontal saccade performance.^{^18,19} Studies have also shown that efficiency, amplitude, peak, acceleration, and positional error of vertical rapid eye movements are all impaired after minor traumatic brain injury.^²⁰

Reflexive (visual target) saccades: Reflexive saccades are defined in contrast to voluntary saccades. While the latter involves cognitive processes of voluntary control, reflexive saccades occur at the appearance of a new target-biased fixation point.^²¹

Memory-guided saccades: Memory-guided saccades are defined as saccades of the location of a briefly flashing target. This includes remembering the location of a briefly visible target. Defects in the basal ganglia or frontal lobe, which process working memory, lead to dysfunction of memory-guided saccades.^²²

Salivary velocity: The most commonly measured velocity parameter is peak salivary velocity. It is defined as the maximum speed of the eye during a saccade. The typical peak salivary velocity in normal individuals ranges from 30 to 700 degrees per second, with an amplitude between 0.5 and ^{40 degrees.23} Variations in peak salivary velocity may be a psychophysiological arousal (sympathetic nervous system activation), mental workload, or a feasible indicator for predicting subsequent fixation values.24,25,26

Time to reach peak speed: As mentioned earlier, peak saccadic speed is defined as the maximum speed reached during a saccadic period. The time taken from the start of a saccadic period to reaching the peak speed is called the time to reach peak speed.

Saccadic accuracy, latency, and amplitude: Saccadic accuracy refers to the accuracy with which a saccade fixates a target on the fovea. Mean eye-focusing error and mean eye-focusing variability are two parameters that measure saccade accuracy and precision, respectively.^²⁷ Studies have shown that even small saccades (between 14 and 20 degrees) are sufficient to accurately focus a stimulus on the fovea.^²⁸ Studies have demonstrated changes in sacdic accuracy following mild traumatic brain injury. ^²⁹ This suggests the potential of these parameters for the diagnosis and follow-up of patients with mTBI.

Sag Gain: Sag gain is calculated based on sag amplitude and is a parameter used to measure sag accuracy. This parameter defines whether the sag is under-measured or over-measured, and is calculated by dividing the actual sag amplitude by the desired sag amplitude ^.

Position error: This is a parameter that measures the accuracy of saccades. It is closely related to saccade gain. Mean absolute position error measures the difference between the expected and actual eye positions. However, the amplitude of the saccade can clarify orientation by showing whether there are low- or high-degree accommodation errors. These parameters are effective means of measuring the impact of traumatic brain injury on rapid eye movements.^³¹"Mean absolute position error of final eye position [PEreflexive = |(EPfin - SP)/SP| × 100], gain of primary saccade (Gp = EPprim/SP) and gain of final eye position (Gf = EPfin/SP), where EPprim is the eye position of the initial saccade, EPfin is the final eye position, and SP is the stimulus position."^³²

Saccadic disturbances: Saccadic disturbances are defined as saccades that interrupt fixation. They occur irregularly and are categorized based on whether they occur within a brief fixation interval. Some examples of saccades with fixation intervals include square wave jitter, macroscopic rapid eye movement oscillations, and macroscopic square wave jitter. Those saccades without any fixation interval include optic muscle nystagmus, voluntary nystagmus, and oculomotor nystagmus.^³³ While saccade disturbances can be found in normal individuals, they can also indicate underlying disease/functional disorder in the brainstem, cerebellum, superior colliculus, basal ganglia, or cerebellum.

Vestibular-ocular reflex and inhibition: The vestibular-ocular reflex (VOR) is a three-dimensional reflex controlled by the vestibular system of the inner ear, involving cranial nerves III, IV, VI, and VIII and their corresponding nuclei, as well as the central longitudinal fasciculus (MLF), to maintain visual stability during head movements. The VOR stabilizes fixation by moving the eyes in the opposite direction to the head movement. Defects in the vestibular system, related nuclei, or the pathways connecting them can lead to vestibular-ocular reflex dysfunction.^³⁴ Conversely, vestibular-ocular inhibition (VOI) demonstrates the vestibular system's ability to suppress the vestibular-ocular reflex by rotating the whole body and maintaining stable fixation on the target when the head follows a moving object.

Dynamic visual acuity: Maintaining visual acuity during head movements (dynamic visual acuity) is the result of interactions between the vestibular, optomotor, and visual systems. ^³⁵ Visual acuity typically decreases to some extent during movement. An excessive decrease in visual acuity during movement (nystagmus) indicates uncompensated damage to the pathways responsible for the vestibular-ocular reflex.^³⁶ Recent studies have established a relationship between the recovery of dynamic visual acuity parameters and improvement in post-concussion syndrome.^³⁷

Nystagmus: Nystagmus is defined as involuntary eye movements that can be horizontal, vertical, or rotational. Based on the speed of movement, nystagmus can be divided into ^two different types.38 Pendular nystagmus is a type characterized by slow, sinusoidal vibrations in both phases, while jerknystagmus is ^{characterized} by slow drift and rapid corrective saccades.39

A proper description of the defect and pathology causing the nystagmus is helpful in diagnosis. The first step in finding the cause of nystagmus is to determine the effect of removing the fixation point on the severity of the nystagmus. For example, if the severity of the nystagmus worsens after removing the fixation point, it indicates that its origin is ^{peripheral.40} Peripheral nystagmus caused by peripheral vestibular pathology usually presents as sudden nystagmus, with the nystagmus direction opposite to the side of the lesion. In contrast, congenital nystagmus is usually horizontal and ^worsens with fixation and anxiety.41 Furthermore, the presence of pure torsional or vertical sudden nystagmus when the eye is in a near-central position primarily indicates a central lesion involving the vestibular ^pathway.42

Structure of the visual system

These measurements include: (1) the thickness and shape of the optic nerve, (2) the thickness and shape of the retina/macula, and (3) the vascular structure and vascular function and response to different maneuvers, such as valsalva maneuvers or rapid breathing, or visual stimuli, such as still and moving images. Fundus coherence tomography will be placed on a display screen and equipped with a camera capable of displaying the microstructures of the optic nerve, retina, and its blood vessels.

Virtual Reality (VR)

A platform that uses one or more stereoscopic displays to present a computer-generated 3D rendered environment to a viewer, incorporating a host of novel technologies such as head and eye tracking sensors, software frameworks, development tools, and input devices encapsulated within a head-mounted device designed to create the illusion of reality. The input devices enable the user to interact with the virtual environment.^⁴³

Eye tracking

Eye tracking is a method for objectively assessing eye function. Eye tracking systems and software are designed to measure various aspects of eye function, including eye movements, position, delay, and frequency. ^⁴⁴ Eye tracking can also measure eye movement patterns between fixation points, including saccade amplitude (in degrees), velocity, and number of saccades.^{^45,46} Position measurements calculate the Cartesian coordinates of the fixation point, while delay measurements quantify the duration of saccades and fixations (defined as a stay at a spatial location exceeding 99 milliseconds). Furthermore, the number of saccades, fixations, and blinks is one of the most frequently studied frequency measurements.^⁴⁷

A typical eye-tracking setup includes an infrared or semi-infrared light source, a camera, and software that processes the image and tracks eye movements primarily through pupil tracking.^⁴⁸ More sophisticated tracking systems also include light emitters to generate light reflections from the surface of the eye. The position of the reflection point relative to the pupil is used to calculate the eye position vector and the gaze point. ^⁴⁹

Ophthalmic examination instruments can help diagnose and monitor rehabilitated diseases.

Another eye examination device that can help diagnose and monitor rehabilitation in mild traumatic brain injury (mTBI) is the eye examination device used for this condition. Proper eye movement depends on the functional integrity of the brain and its neural pathways. Furthermore, attention, response inhibition, memory, motor planning, and information processing speed play important roles in controlling eye movement. Studies have established a significant correlation between mTBI and EVS damage. ^⁵⁰ Interestingly, eye movement disorders are not associated with the neuropsychological symptoms of mTBI.^⁵¹ Meta-analyses of studies on the neuropsychological sequelae of mTBI have shown that the neurocognitive determinants of post-concussion syndrome fully recover within 1–3 months after the impact. Furthermore, imaging entities have limited ability to detect abnormalities in patients with post-concussion syndrome.^{^52,53}

Assessing abnormalities in EVS and AVS using eye examination equipment can help identify many eye and brain diseases, such as: a. eye diseases, such as macular degeneration, glaucoma, optic neuropathy, etc. (AVS abnormalities); b. neurodegenerative diseases, such as Parkinson's disease, Alzheimer's disease, etc.; c. mental illnesses, such as schizophrenia, attention deficit hyperactivity disorder, etc. (AVS and EVS abnormalities); d. common eye diseases, such as amblyopia.

Supported smartphones

The eye examination device 100 described herein can be used with many different smartphones. Below is a non-exclusive list of smartphones that can be used with the eye examination device 100. It should be clarified that it is also compatible with other smartphones.

Based on the foregoing teachings, various modifications and variations can be made to this disclosure. Therefore, within the scope of the appended claims, this disclosure can be implemented in a manner not specific to that described herein.

Claims (30)

1. An eye examination device, comprising: The main body has a first eye hole and a second eye hole, allowing the user to look into the eye examination device with both eyes; A first camera is attached to the body and positioned to acquire ophthalmic images through the first eye opening; A second camera, connected to the main body and positioned to acquire ophthalmic images through the second eye socket; and At least one display is attached to the body and positioned so that it can be viewed through the first eyehole and the second eyehole. 2. The eye examination device according to claim 1, further comprising: A translucent mirror or prism connected to the main body; in: At least one display is positioned where the semi-transparent mirror or prism is visible through the line of sight or through the reflection of the semi-transparent mirror or prism; When the display is visible via a line of sight through the translucent mirror or prism, the first camera and the second camera are positioned to acquire ophthalmic images via reflection from the translucent mirror or prism; and When the display is visible through the reflection of a semi-transparent mirror or prism, the first and second cameras are positioned to acquire ophthalmic images through the line of sight passing through the semi-transparent mirror or prism. 3. An eye examination device according to claim 2, wherein: The at least one display includes a first display and a second display, wherein the first display is positioned to be viewed through the first eyehole and the second display is positioned to be viewed through the second eyehole. The first camera is positioned to acquire ophthalmic images through the first eyehole via reflection from the semi-transparent mirror or prism, and the first display can be viewed through the first eyehole via the semi-transparent mirror or prism. The second camera is positioned to acquire ophthalmic images through the second eyehole via reflection from the semi-transparent mirror or prism, and the second display can be viewed through the second eyehole via the semi-transparent mirror or prism. 4. An eye examination device according to claim 2, wherein: The at least one display includes a first display and a second display, wherein the first display is positioned to be viewed through the first eyehole and the second display is positioned to be viewed through the second eyehole. The first camera is positioned to acquire ophthalmic images through the first eye opening via a line of sight through the semi-transparent lens or prism, and the first display is visible through the first eye opening via reflection from the semi-transparent lens or prism; and The second camera is positioned to acquire ophthalmic images through the second eyehole via a line of sight passing through the semi-transparent mirror or prism, and the second display is visible through the second eyehole via reflection from the semi-transparent mirror or prism. 5. The eye examination device according to any one of claims 2 to 4, wherein the at least one display is orthogonal to the first camera and the second camera, and the translucent mirror or prism is a translucent mirror positioned at a 45-degree angle relative to the at least one display and the first and second cameras to promote reflection. 6. The eye examination device according to any one of claims 2 to 5, further comprising: A first light emitter and at least one first condenser lens are configured to convert a diverging light beam emitted by the first light emitter into a focused light beam for image capture via a first camera for fundus examination; and The second light emitter and at least one second condenser lens are configured to convert the diverging beam of the second light emitter into a focused beam for capturing fundus examination images by a second camera. 7. The eye examination device according to any one of claims 3 to 5, further comprising: The components used for interferometry include a first low-coherence light source, a second low-coherence light source, and at least one reflector; and The first low-coherence light source is positioned facing the at least one reflecting mirror via the semi-transparent mirror or prism, such that the low-coherence light from the first low-coherence light source can be separated by the semi-transparent mirror or prism into a first reference light wave passing through the semi-transparent mirror or prism and a first sample light wave reflected from the semi-transparent mirror or prism; wherein the first reference light wave is reflected from the reflecting mirror, reflected from the semi-transparent mirror or prism, and received by the first camera; wherein the first sample light wave is reflected from the first sample, passes through the semi-transparent mirror or prism, and is received by the first camera; and wherein the first camera is positioned to detect the interference between the first reference light wave and the first sample light wave; and The second low-coherence light source is positioned facing at least one mirror via a semi-transparent mirror or prism, such that the low-coherence light from the second low-coherence light source can be split by the semi-transparent mirror or prism into a second reference light wave passing through the semi-transparent mirror or prism and a second sample light wave reflected from the semi-transparent mirror or prism; wherein the second reference light wave is reflected from the mirror, reflected from the semi-transparent mirror or prism, and received by the second camera; wherein the second sample light wave is reflected from the second sample, passes through the semi-transparent mirror or prism, and is received by the second camera; and wherein the second camera is positioned to detect interference between the second reference light wave and the second sample light wave. 8. The eye examination device according to claim 7, wherein the component for interferometry further comprises: A first 2D MEMS (microelectromechanical system) mirror is used to direct the beam of a first sample wave; and a first lens is used to converge the first sample wave into a converged beam at the first sample location; and A second 2D MEMS (microelectromechanical system) reflector is used to direct the beam of the second sample wave; and a second lens is used to converge the second sample wave into a converged beam at the second sample location. 9. The eye examination device according to any one of claims 1 to 8, further comprising a refractive device for refractive eye examination. 10. The eye examination device according to claim 9, wherein the optometry device is selectively attachable to the eye examination device. 11. The eye examination apparatus according to any one of claims 1 to 10, wherein the first camera is part of a first sensor module and the second camera is part of a second sensor module. 12. The eye examination device according to claim 11, wherein: The first sensor module includes a first laser emitter, which is positioned to emit laser light through the first eyehole; and The second sensor module includes a second laser emitter, which is positioned to emit a laser through the second eyehole. 13. The eye examination device according to claim 11 or claim 12, wherein: The first sensor module includes a first infrared projector and a first infrared sensor. The first infrared projector is positioned to project infrared light through the first eyehole, and the first infrared sensor is positioned to receive infrared light from the first eyehole. The second sensor module includes a second infrared projector and a second infrared sensor. The second infrared projector is positioned to project infrared light through the second eyehole, and the second infrared sensor is positioned to receive infrared light from the second eyehole. 14. The eye examination device according to any one of claims 11 to 13, further comprising: A processing unit is used to control the first sensor module, the second sensor module, and the at least one display. 15. The eye examination device according to claim 14, further comprising: At least one external sensor is configured to sense the environment outside the eye examination device; The processing unit controls the at least one display based on the at least one external sensor. 16. The eye examination device of claim 15, wherein the at least one external sensor comprises a pair of external cameras configured to capture the environment outside the eye examination device, and the processing unit uses the pair of external cameras to generate images for the at least one display. 17. The eye examination device according to any one of claims 1 to 16, comprising: Adjustable lenses for first and second eye sockets. 18. The eye examination device according to any one of claims 1 to 17, further comprising at least one shielding element. 19. The eye examination device of claim 18, wherein the at least one shield comprises a pair of shields, each shield having a plurality of pinholes configured to eliminate disordered refractive light arrays that cause blurred vision in non-neural eye conditions. 20. The eye examination device according to any one of claims 1 to 19, wherein the first eye aperture and the second eye aperture are separate apertures. 21. The eye examination device according to any one of claims 1 to 20, further comprising a headband for securing the eye examination device to the user. 22. The eye examination device according to any one of claims 1 to 20, further comprising a means for securing the eye examination device to the user's helmet. 23. An eye examination device, comprising: A face mask, the face mask including a transparent display, such that an image displayed on the transparent display overlays a view of the environment visible through the face mask; A first camera component, configured to acquire an ophthalmic image of the user's first eye; A second camera assembly configured to acquire an ophthalmic image of the user's second eye; and The processing unit is used to control the transparent display, the first camera assembly, and the second camera assembly. 24. The eye examination apparatus of claim 23, wherein each camera assembly has a camera and a mirror or prism, the mirror or prism being positioned such that the camera can acquire ophthalmic images via reflection from the mirror or prism. 25. The eye examination device of claim 24, wherein each camera assembly is retractable. 26. The eye examination device according to any one of claims 23 to 25, further comprising: Motion and/or position sensors; The processing unit controls the transparent display based on the motion and/or position sensors. 27. The eye examination apparatus according to any one of claims 23 to 26, further comprising a refractive device for examining refractive eyes, wherein the refractive device is selectively attachable to the eye examination apparatus. 28. The eye examination apparatus according to any one of claims 23 to 27, further comprising at least one shielding element. 29. The eye examination device of claim 27, wherein the at least one shield comprises a pair of shields, each shield having a plurality of pinholes configured to eliminate disordered refractive light arrays that cause blurred vision in non-neural eye conditions. 30. An eye examination device configured for wear by a user, comprising: The display is configured to show an image overlaid on a view of the environment; At least one semi-transparent mirror or prism; A first camera is configured to acquire an ophthalmic image of the user's first eye via reflection from the at least one translucent mirror or prism; A second camera, configured to acquire an ophthalmic image of the user's second eye via reflection from the at least one translucent mirror or prism; and The processing unit is used to control the display, the first camera, and the second camera.