US1738986A - Kratometer - Google Patents

Description

Dec- 10, 1929. H. @EMENT 1,738,986

KRATOMETER Filed June 18, 1926 5 Sheets-Sheet 1 INVENTOR JJM BY i

ATTORNEYS H. CLEMENT Dec. 10, 1929.

KRATOMETER Filed June 18, 192e 5 Sheets-Sheet 2 Juszslzlnznaxzn .1li O FIL. llllnL lllllllllll I llll nlll INVENTOR.

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A TTORNEY.

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Dec. 1o, 1929.

H. CLEMENT 1,738,986

KRATOMETER Filed June 18, 1926 5 Sheets-Sheet 3 IN VEN TOR.

B Y y ATTORNEYS DOC. 10, 14929. I H- CLEMENT I KRATOMETER A Filed June 1 8-, 1926 5 Sheets-Sheetl 5 fz AJzyr' -\RED 7/ zy//Z V Q l Y Qf-f A TTORNEYS HANS CLEMENT, OF NEW YORK, N. "1"., AESEG-NR TO GENERAL CORPORATIGN F NEW YORK eyes of the pair.

Patented Dec. 10,'1929 rre smits PAT-ENT Ncritica OPTICAL C0., INC., A

y Knirroiunrnn Application filed .Tune 18,

`nosis were developed by which it Was gradually learned that there was an interrelation of function between the intrinsic and extrinsic muscles and that in `many cases the eX- trinsic muscles Were mostly at fault.` At this time, terminatingwith the Work of llleyes, While diagnosis had progressed no satisfactory treatment had been developed. Frequently tenotomy or the surgeons knife Was resorted to butthe results were commonly disappointing. It Was beginning to be recognized that dynamic exercise and discipline of the extrinsic muscles of the eyes would bring about the desired condition of orthophoria or balance and equilibrium iii the functioning,` of the muscles but at this time there was no suitable apparatus for administering' such treatment and such efforts as were made to accomplish this desired result did not meet with much success.

`This period of `gropingcame to an end (some thirty years ago) When Hazen invented and put into successful use an apparatus, now known as a kratometer, for exercising the ere trinsic muscles and thus innervaiingl the deticieiit muscles so as to hiring about a con dition of balance Vand equilibrium of all of the muscles. Since then improvements in technique of treatment and in the apparatus have been made. More recently `it has been found through experience and experiments that not v only is there an intimate interrelation or correlation in the functioning `of the intrinsic and extrinsic muscles of the eye but that there is also a similar interrelationland correlation of functioning ofthe muscles between the tivo It `vvas foundthat the tivo eyes are not individual entities but that the as a further development of eras i926. Serial No, 116,771.

pair must beponsidered asa single binocular instrument and deficiencies corrected .from that viewpoint; that the two eyesand their intrinsic and extrinsic muscles function `as one cOinpleteWhOle, the pair of eyes as a single binocular optical apparatus and that efforts inust be made towards establishing harmony and unity of action among all the parts of this single binocular apparatus, which when functioning properly `produces clear'single vision. However the apparatus as he etjoforc developed makes no provision for this new understandinglof what is required although considerable ,advance has been made in the development of a simple technique in carrying forward Hazens Work.

The Hazen lratoiiieter employs the jump or step method of treatment, which has been found tofbe the lmost effective.

The present invention may be considered an improvement upon the Hazen lrratometer. An object of this invention is to provide a lratometer which will meet the needs arising' from the more recent discoveries in physiologic-al Ophthalmology. This includes the diagnosis and innervational treatment of the intrinsic and extrinsic muscles ofthe tyvo eyes of the pair considered as one complete Whole, the pair of eyes being considered as a sinole binocular instrument or apparatus. So rar as l am vaware such a kratoineter or apparatus has not heretofore been proposed. Another object of the invention is to fill a demand for an instrument, the necessity for Which has been long recognized, that will cn- `able the refractionist properly to care for the many'anomalous cases of eye strain that that not relieved by the prescription of glasses. Another object is to provide a more effective apparatus for successfully treating` the cause of those defects of ocular fmotility that produce eye strain, uncomfortable `vision, `poor vision, laclr of equilibrium,`indi gestion, headache, slow focussing, and many other complaints. This includes increase in speed of operation in diagnosis and treatment so as not to fatigue the patient unduly; and

further includesthe embodying ,in the appa* ,tions from one strength to the neXt in successive gradations of prism diopters one after the other, whereby thev effect on the yeye of one prism is not lost before the neXt prism can be brought into operating position. Another object is to produce an apparatus by, which a more thorough and comprehensive examination can be made than heretofore was possible.v Another Objectis to produce an apparatus by which more eifective treatments may be given than heretofore.

" Another object is to provide an apparatus by innervational prism exercises.

means of which all eye defects coming under 'the general headof'imbalance may be successfullyV treated. Another object is to provide a kratometer so built as to insure the heretofore unobtainable rigidity so essential in giving A further object isto provide animproved kratometer which is compact, simple, light in weight,

v,and easy to operate, as well as neat and attractive in appearance.'V `'advantages will hereinafter appear.

Other; objects and The invent-ion includes various features of construction and combinations of parts as will appear froml the following description.'

VThe v lratometer illustrated in the accompanyingdrawings as one embodiment Vof this invention Will'nowl be described after which n the invention will be pointed out in claims, 'reference now being had to the drawings 1n which: y Y

@,Fig. 1 is a front elevation of a complete kratometer emboc ying my invention with the horizontal prism slides thereof in place;

Fig. 2 is an enlarged vertical section taken on the line 2 2 of Fig. 1;

Fig. 3 is'a similarly enlarged front elevationrof an end portion of one of a pair of vertical prism slides forming partsof the complete kratometer and which may take the place of the horizontal prism slides shown in Fig. 1; Y y

Fig. 4 is an edge elevation of the saine partly brokeny out and partly in central vertical section as viewed from the right in Fig. 3;

F ig'. 5 is a longitudinal vertical section, with parts in elevation, of the complete kratometer taken ontheline 5 5 of Fig. 1;

Fig 6 is a rear elevation of the complete kratometer with parts broken away;

' Fig. 7 Vis a partial vertical section in offset planes substantially as indicated by the zig- .zag'lineT-T of Fig. 8, the most of the parts appearing 4in Fig. 7 being at a higher level thanrthose shown-in Fig. 8; Y

. Fig'. 8 is anv enlargedl horizontal section ytakenvon the line 8 8 of Fig. 7

Fig.9 is an enlarged rear elevation of what appears in the upper part of Fig. 6, with some parts removed and with other parts broken away;

Fig. 10 is a horizontal transverse section on the line 1(1 10 of Fig. 9;

Fig. 11 is a detached front elevation of one of the rotatable battery discs, carrying auxiliary prisms, etc., and which is seen partly in rear elevation in Figs. 6 and 9 at the left;

Fig. 12 is an enlarged front elevation with the middle part broken out of the horizontal prism slide which appears at the right in Fig. r1;

Fig. 13 is an edge view of the same as viewed from the right in Fig. 12;

Fig. 14 is an enlarged front elevation of the det-ached holding bracket for this slide and vhich is shown partly in broken lines at the right in Fig. 1;

Fig. 15 is an edge view of the same as.

viewed from the right in Fig. 14.

Fig. 16 is a rear view of the same and as viewed from the right in Fig. 15.

The mechanical construction as such which constitutes the illustrated embodiment of the invention will be first described with reference to the drawings after which the operation lIy n that many details of construction in the ex- Y empliiication of the invention shown in the drawings may be departed from without thereby departing from the spirit of the invention. In order to enable a quick grasp and comprehension of the invention and of the construction shown in the drawings for carrying it out, a somewhat general description will now be given to be followed by a description in detail of the several parts and features which are combined to form the complete coorganization which constitutes the kratom eter of my invention as a whole.

In the kratometer embodying my invention shown in the drawings two main batteries,

designated generally by A and B, are sup-i ported upon a triangular base or main frame 1. These batteries are of a similar but reversed construction throughout, the battery A being for the right eye of the patient while the battery B is for the left eye. The battery A is provided with a sight aperture 2 for the right eye and the battery B is provided with a sight aperture 3 for the left eye of the patient. Each battery contains a circular rotatable disc 4, these discs being alike excepting that they are of right and left construction together with all of the parts carried thereby. Each disc is provided with a circular series of nine circumferentially equidistantly spaced auxiliaries comprising an open aperture 5, six supplemental prisms 6, 7, 8, 9, 10 and 11, a Maddox rod 12 and a red glass 18. The prisms 6 to 11 inclusive are respectively of three, five, ten, fifteen, twenty and twenty-five prism diopter strength.

, axis.

The three, five and ten diopter prisms G,

A7 and 8 and the Maddox rod 12 can be rotated in the disc l and may be set `at "any 'desired This rotative movement is accomplished by moving the handle 14 of an axis latch which can be moved through a half circle or 1S o thereby to rotate these prisms and the Maddox rod through a complete circle or 360o. The lever 15 of the axis latch Vforms a pointer and the base ofany one of these rou tatab'le prisms may lb'e thrown into the desired position by setting the latch lever 15 opposite the words ln, Out, Up `or Down which appear on a scale formed on the front side of a stationary battery plate 1G which supports the othelrparts of the battery. The Maddox rod `1 2 is so mounted in relation to its axis that when the latch lever `lgpoints at Up or Down the line lof light seen by the eye is vertical, and when the anis latch lever 15 is at lnfor Out7 the line of light appears in the horizontal'position.

The fifteen, twenty andtwenty-iive diopter prisms 9, 10 and 11 are each permanently firmly set onthe rotatable disc 4in such posi tion that the base of the prismwill always be outward from the nose ofthe patient with the prism in register with lthe sight aperture 2 or 3, since this -is the only position in which such strong "prisms can be used. The front plate 16 near the top of the` battery is `provided with a sight opening 17 in plain view from the operators ,position and through which he can easily see the'indication on the rotatable disc el of the particular auxiliary thatis in position tobe in line with 'the sight aperture 2 or 3. These indications are placed on the disc 4 one and one-half spaces in advance of the auxiliary which is indicated -as is clearly shown in Fig. 11, when this disc is rotated in the direction to increase the pi'sm strength froinprism to prism, it beip ioted that when rotated in this order the respective discs for the right and left eye tarn in opposite directions.

Two pairs of prism-carrying slides, four separate slides in all, form a feature of the apparatus, two of these slidesbeing used at a time. The two slides 18 are duplicates as are also the two slides 19. Eachprism slide 18 carries a series of thirteen horizontal prisms v2() firmly secured thereon. The prism power ofthese prisms 2O ranges successively from one to thirteen diopters in one diopter intervals. An. open aperture 21 precedes the one diopter prism and a similar `open aperture 22 succeeds the thirteen diopter prisms.

Each of the prism slides 19 carries a series of thirteen vertical prisms 23 which in successive order range in'power from 0.25 diopters to 8.25 diopters, in 0.25 diopter` steps,` these prisms beine rigidly fixed upon the slide. Each of the prism `sli-des 19 has an open aperture 241`p`recedingithe prism23iof the lowest power 'and a `similar opening 25 s-ucceedingthe 'last or highest power prism.

Each of the prism slides is provided, as

shown, with an edge flange and upon the outer side of each of these flanges upon each of the slides indications of the :prism powers are marked, as shown in Eig. 13 for the slides 1S having the horizontal :prisms 20 and in Fig. 4 for the slides 1,9 having the vertical prisms 23. The kind ofprisms in the slides, whether horizontal or vertical, and also the position of the prism base and apex are indicated by a prism diopter symbol marked upon the front of each end of each of the slides, as shown in the drawings in Figs. 1, 3 and 12.

The above described prism slides are for Eslide 18 or 19 is securely yet slidably held in" place at any position of sliding adjustment corresponding to the registering of its respective prisms with the` sight opening 2 or lby means of a spring pawl `27 to engage in Anotches shown as formed in the forward edges ofthelslide flanges, this pawl being carried `by the bracket and shown as in theslform of a U-shaped leaf spring provided at its ends with inwardly projecting studs to engage i 1n the notches for-holding the slide-while permitting automatic disengagement of these studsfrom the notches in theslide, to enable theslide to have `unrestricted sliding movementin the bracket. Theprism power of the prism ofthe slide `that is before the aperture can be noted by the operator in a convenient registeringopening 28 (Fig. 15) provided in the `lateral outer wall of the bracket 2G.

Each bracket 26 can be angled through an arc of 300 to the right or left of the vertical position, thereby to angle the horizontal prism 20 away from the horizontal position or the vert-icalprism 23 away from the verticalposition. .The exact horizontal or vertical position of the respective prisms 20 and is indicated when aline forming a marker on t'he'circular `base of the bracket 26 is in alignment with aline forming a marker on the "stationary front battery plate 16. A set screw l29 inthe bracket 26 to be set up against `the front platel will hold the bracket and therefore its i prism slide rigidly at the desiredrangle, or `in the vertical position. YWhen the side to be angled awayfrom the vertical positionits set screw is loosened.

Hereinwhen the terms base in and base out areemployed reference is had to the position I-of the-prism base in regard to `a versight one, or more of which has a V -end forming a -yieldable pawl to engage in one or another apertures 2- and 3 and therefore midway between the eyes of the patient. VVith the prism slide 18, having thereon the horizontal prisms Y 20, used together with vtheV supplemental prisms-6 to 11 inclusive carried by the rotatable disc 4, any base in prism power from one to forty-six prism diopters, and any base out prism power from one to'seventy-six prism 'diopters, can be quickly obtained. By using the prism slides 19 having thereon the verti- 'calprisms 23 in combination with the supplemental prisms 6 to 1l inclusive carried by lthe rotatable disc 4, any desirable prism power base up or base down in quarter diopter gradients may be quickly obtained.

The pupillary distance between the sight openings 2 and 3 may be adjusted from either side of theapparatus by rotating either one of two knurled knobs 30, such adjustmentbeing vindicated by means of a stationary pointer 3l and a movable scale 32 which is easily read fromthe operators position. Raising or lowering of thebatteries A and B may be accomplished from the operators end of the instrument byV rotating, a knurled handle i knob 33. Rigidity in position ofgthe vertically adjusted batteries is maintained by means of a locking screw 434 which should be loosened for adjustingl the'batteries vertically and tightenedV 4inmnediately thereafter. A

Achinrest 35 may be adjusted vertically by means of a knurled nutB, and may also be adjustedhorizon'tally forward or back and heldby a set screw- 37, thereby affording a eomfortablerest with the head of the patient in correct'position. t

A stationary cover plate 38' at the rear of the rotatable disc 4 is secured at its ,center and its edgey to the front plate 16 in-spaced relation therewith. This cover plate hassecuredthereto at its front or inner side a threearmed leaf spring 39 the radial arms of lwhich angle forwardly towards the disc 4 and each of whichcarries a forwardly projecting stud,

y equidistantly circumferentially spaced radialgrooves 40 formed in the ladj acent vrear face of the rotatable disc 4, so that the, spring 89 forms a latch for yieldingly of f y nine holdingthe rotatable disc 4 in adjusted position 'with any one of its nine auxiliaries in j line with the sight opening Q or 3.

A trial case lens holder 4l is removably vsecured vupon the rear face of the cover plate 38. This lens holder provides three lens l.cells for the reception-of trial case lenses, a usual calibration 42vbeing provided on the back of the cover plate 38. These rear cells arev made of the size specified when the instrumentiis ordered and are interchangeable kwith cells ofa different size. These rear lens cells are for the purpose of trial case lens correction for any existing ametropia or presbyopia.

A trial lens holder providing three front lens cells is detachably mounted upon the bracket 26 at the front thereof and comprises two spaced semicircular plates 43 of which the outer plate is calibrated as shown and from the front of which three notched studs 44 project outwardly to the front. The plates 43 are provided as shown with two sets of screw holes either set of which may receive the screws which hold in place the studs 44 and the spacers shown between the plates 43, thereby providing for the reception of either size of trial ease lenses now commonly in use. These front lens cells are for the use of cross-cylinder lenses in accommodation-convergence balance tests, and for the addition of weak trial plus or minus spheres or cylinders in this test, also for the reception of plus or minus spheres and loose jrisms, the use of which may be desirable while giving exercises. Tf the patients prescription includes vertical prisms for consta-nt wear their trial case equivalents may be placed in these front lens cells during exercises of the horizontal functions.

A horizontal forwardly and rearwardly extending rod 45 is provided to hold a test chart carrier 46. The chart holder 4G is free to slide along the entire length of this rod, which is calibrated both in inches and centimeters. This rod is supported upon the base l at the front thereof and is mounted so that it may be raised or lowered or if desired it may be entirely removed, a set screw 47 being provided for holding the rod at any desired height.i Test cards are provided in sufficient variety for the tests that are to be made and the exercises that are to be given but other test cards Amay be readily added or substituted in the chart holder 46. The chart holder 46 is-so made as to keep all the cards used in near point. tests and exercises together, preserving them from loss and soiling and for maintaining them always ready for immediate use.

A stereoscope septum 48, for use in the treatment of suspenopsia and weak fusion, may be slid along and set at any needed place on the rod 45. This septum is rotatable on a vertical axis and when in use it is turned to parallel the batteries. its purpose being to hide the right side of the stereograph from the left eye of the patient, and the left side of the stereograph will be hidden from the patients right eye. Vhen not in use this septum is turned to parallel the rod 45 and is slid up to the end of the rod next to 'the batteries where it cannot obstruct the patients vision.

A breath shield 49 is provided below each of the sight openings 2 and 3 for protecting the prisms in the slides from the moisture llO s described. For each of the batteries A and B the stationary front plate 16 is centrally provided on its inner or rear side with a boss through which passes a reduced forward portion ot a shouldered journal stud which` is firmly secured in place on the plate 16 by means of a screw 51 threaded into the reduced end of this stud. This stud 5() also has a reduced rear end portion which is screwthreaded to receive thereon a washer-like nut 52. A screw 53, which is threaded into the end of this reai1 reduced portion ot the stud 50, assists in firmly binding together the rear cover plate 38, the stud 50 and the front plate 16.

A large spur gear 54 is journaled on the middleenlarged port-ion of the stud 50, this gear being maintained in place on the stud by the nut 52. At its rear side this gear 54 is shouldered to form a bearing for the rotate able disc 4, which is annular and which 4is retained in place 0n the shoulder of this gear by means oi a narrow ring 55 which is secured to the gear by means of small screws as shown in Figs. 2, 9 and 10. The rotatable auxiliary prisms 6, 7 and 8 and the rotatable Maddox rod 12 are each firmly secured, respectively, in a rotatable holder 56 journaled in the rotatable carrier disc 4 and each ot these holders 56 carries a small spur gear 57 which is oi' one-halt the diameter ot the large spur gear 54 with which it meshes. The latch lever 15 is ot' bent shape and extends inwardly through an arcuate slot 58 in the iront plate 16 and at itsinner end is lirmly secured to the large gear 54, the slot 58 being somewhat more than 180o in length. The l `tch lever l5 at its outer end carries a small pointer as shown and this latch lever is pro. vided with a slidable latch bolt" 59, to which the lever handle 14- is secured. This latch bolt is spring-pressed inwardly for having at its inner end latching engagement with notches in the radially youter edge of arcuate rib 60 on the front of the plate 16, these notches in the rib 60 being positioned directly radially inward fromthe hereinbefore mentioned scale indications Out, Up, cFlu, Down, Out, respectively.

It will be seen that when the latch lever 15 is roclred by means of its handle 14, the tour small gears 57, together with the rotatable holders 56 and the auxiliaries carried thereby, will be rotated at twice the angular' rate of movement of the latch lever 15, with the rotatable disc 4 held stationary by its spring latch 39. When the latch lever 15 is held stationaryby its bolt 59 and the disc 4 is rotated it will befnoted that the rotatable auxiliaries 6, 7, 8 and 12 will also then be rotated by reason ot their planetary travel around the then stationary central gear 54, and this rotation ot these auxiliaries will result in bringing any one ot' them desired tor use into thecorrect position in alignment with the sight opening 2 or 3, the rotative position ot such auxiliary being determined by theposition ot adjustment oi4 the latch lever 15 along the arcuate rib 60.

The slide-holding bracket 26 is provided at each of its tour corners with a small guide roller 61 to be engaged by t-he lateral flanges ofthe prism-carrying slides 18 and 19, to facilitate the free and easy movement of these slides through the bracket in successively bringing the prisms into alignment with the sight openingl 2 or 3. At its back the slide 26 has a circular shoulder by which it is journaled in the trout plate 16 and upon the rear tace of this shoulder there is secured an annular plate 62 which, at diametral point-s on its periphery, is provided with projecting radial lugs, as shown, for passing through notches 63 provided in the front plate 16, thereby rendering the entire bracket 26 readily removable and replaceable merely by rotating this bracket in its bearing through an angle ot 900, as will be clear from the drawings.

Each front battery plate 16 is secured, by means of a lug at the bottom thereof, upon the upper end ot au upstanding lateral arm 64, the lower end of which is mounted to slide laterally upon a pair ot horizontal rods 65 which are rigidly carried by and project oppositely from a head 66. A horizontal screw 67 is provided towards one end with right-hand threads and towards the other end with lett-hand threads and is journaled in the head 66 in which it is rotatably held in place by means of a screw stud 68, the inner end oit which is shaped to engage in a circumferential groove in the screw 67 at the middle of its length. The right and lett hand screw 67 is positioned between the guide rods 65 and has screw-threaded engagement with the battery-carrying arms 64.` rlhe linurled knobs 30 are fixed respectively upon the outer ends of t-he screw 67 and by rotating either the one or the other of these knobs it will be seen that pupillary adjustment` ot the batteries A and B may be ellected. The pointer 31 tor indicating the pupillary distance is lined upon the front tace oi the head 66 and the movable scale 32 with which thispointer cooperates is fixed at one oit its ends upon the iront face of the right-hand battery-supporting arm 64. The breath shields 49 are respectively supported by means oi: a stem 69 which is removably received into a socket 69a shown as provided on the front tace ot the downward projection on the iront battery plate 16 by which it is attached to the arm 64.

The chin rest 35 is slidable forward and back on a short horizontal bar 70 upon which it is held adjusted posi tion by the set screw 37. The bar 70 forms aT-head upon the upper end of a vertical screw 71 which is mountedto have sliding movement through a pair of spaced lugs which project from the rear of the head 66 and between which the adjusting nut 36 is located upon the screw 71 with which it has screw-threaded engagementfor adjusting the height of the chin rest 85.1The uppermost of these lugs is provided i', with a screw 71 the inner end of which engages inalongitudinal slot 71') in the screw 71, to prevent rotative movement of the` chin rest (Figs. 5, 6 and 7 The lower one of these lugs carriesV a downwardly extending covertube 72 for the lower portion of the i downwardly extending adjusting screw 71.

The head 66 is fixed upon the upper end of a tubular stem r7 3 which is guided for vertical sliding movement in a collar 74 fixed in the upperend of atubular standard on the basel at the rear thereof, thestem 7 3 being provided with flats as shown in Fig. 8, to prevent its rotative movement in the collar 74 f and standard. The tubular stem 73 has there- ,in a rotatable adjusting screw.7 5 which has screw-threaded engagement in the lower portion of the stem 7 3 and has fixed upon the lower end thereof a bevel pinion 76 which forms a journal for thescrew 7 3 in the basev 1 and also abuts against the vlatter to prevent upward movement of this'screw, as well as the stem 73 and all of the parts carried thereby, including the batteries A and B. The

, handle knob thereby thebatteries A and B will be verticallyv adjusted. The locking s crew134 is screw-threaded intolthe left side i of the standard'in which the tubular batterysupporting stem 7 3 slides and at its inner end engages one ofthe flats on this vstem thereby` firmlyto clamp and hold this stem'against any looseness. i Y

The test chartholder 46 is of substantially YL-shape and has split'rings 80 for removably and replaceably holding'thetest cards, which may be'readily-raised or V lowered as desired. The holder 46 also includes a mounting block 8l provided with a sleeve tovslide on the horizontal rod 45, which 'is of angular cross-sed tion, shown as square, topi-event lateral tipping ofthe holder Y46.. TheY septum'48 has a downwardlyY extending stem 82, which is pivotally'mountedron a vertical axis'on a sleeve 83 which is' slidable along the horizontal rod 45.

The horizontal rod is supported at its ends upon and in spaced relation to a lower parallel rod 84 which at a point intermediate of its length is fixed in a T-head 85, in the construction shown extending farther forward, together with the rod 45, from this head 85 than it extends to the rear, the forward portions of these rods 45 and 84 being broken out in the drawings for lack of space. The T- head 85 is rigidly fixed upon the upper end of a downwardly extending stem 86 slidably guided in a cap collar 87 which is firmly fixed upon and extends above the upper end of a vertical Atube 88the lower end of which is rigidly fixed in the base 1. The collar 87 is provided with an internal lug to engage in a longitudinal groove shown in the stem 86, for thereby preventing rotative movement of the stem 86 and the parts carried thereby. The set screw 47, which screws through the collar 87 and tube 88, serves firmly to clamp the stem 86 against looseness as well as to hold this stem in the desired position of vertical adjustment, when it is desired to raise or lower the test chart holder 46.

Perhaps some further explanation as to the operation of' the improved kratometer forming the subject of this invention should be added. It should be understood that the prism slides 18 and 19 may be so placed in their holders 26 and so moved therein as to obtain, in combination with the auxiliary prisms carried by the rotatable discs 4, any prism power efl'ect that may be required, base out, base in, base down, or base up. In the drawings (Figs. 1, 5 and 6) for clearness of illustration the twoslides are shown at their lowermost position, however, in using this improved kratometer for obtaining similar results for the two eyes of the patient, one of the prism slides would extend downward while the other would extend upward from their respective holders 26 at the beginning of an eye examination or an innervational exercise treatment, so that these slides may be moved in opposite directions either up or down, one by the right hand and the other by the left hand of the operator. The two eyes of the patient may be either tested or treated, both eyes at the same time, and the two slides may be moved simultaneously. The effective prism power at any one time may be either the sum of o1` the difference between the prism powers of a prism in the slide and a cooperating prism carried by the rotatable disc 4.

The patient is seated comfortably on a stool at the rear end of the kratometer which may restupon a convenient support such as a table. Proper adjustments are made as to the height of the batteries A and B, of the correct pupillary distance between the sight openings thereof 2 and 3, and proper adjustment is messes made of the chin rest 35. Also, for near point or convergence work, the chart holder lo is adjusted to the proper height and to the desired distance along the calibrated rod 45, the steroscope septum d8, if used, being` set to the proper position. For distance worlr, in which the lines ot' sight in a pair of normal eyes would be parallel. the chart holder lo is adjusted downward below the plane of vision. In the drawings (Figs. l, 6 and 9) the pupillary distance between the sight apertures 2 and 3 is shown at th-e narrowest, with the inner edges of the battery plates lo abutting; each other, thereby to save space.

The operator sits at the front end ot the kratometer and somewhat to one side thereof with his right hand positioned below the right-hand battery B, to push the right-hand slide up yor pull it down, while his left hand is positioned above the lett-hand battery A. for

pushing the lett-hand slide down or pulling; it up. The slides may be jumped quickly from a prism oi any one power to the next with any desired interval between the jumps, for example, the slidesmay be thus succes` sively jumped from the prisms of low power to the prisms of high power, or vice versa.

lf'he rotatable prism-carrying discs 4 may be operated in similar manner lor changing "the prism powers. With these discs the prism power is increased by moving the top of the disc outward, i. e., away from the nose o? the patient. For accomplishing this result mosteasily the operator should rest his hands on the battery edges with the foreiinpjer extended along the lniurled edge oi' the rotary disc, when a quiclr drawing in ot this iingrer will rotate the disc to the next higher prism power. In turning the disc in the op posit@ direction, to reduce the prism power, the linger is bent and. a quick shove or straightening of the .linger pushes the oise over to the next lower prism.

llfhen prism power base in is desired this may be obtained by rotating,r the discs fi to bring); in a prism power ci? tive or ten prism diopters, hase in, and then neutralizing this with 'live or ten prism diopters, base out, on 'the slides. then the power may be reduced step by step. l/Vith this manner oi op eration the effective base in prism power be 'fore the sight aperture will be the diijlerence between the prism powers ot the roti.. 1v d and the pr r of t have to be withdrawn and reset.

ict that the prism do not 'l lt will be evident that the number of` prism power combinations obtainable is large, and the arism powers may be quickly shined by steps other.

Among; the numerous tests -liatmay be made with this improved liratoineter the folor jumps troni one to any lowing may be noted: Phoria tests, for deteru mining,` `esophoria, enophoria, hyperphoria,

slides. rlhis saves time by.

or cyclophoria, including distance and convergence tests, and horizontal and vertical tests, the horizontal tests including the abduction and the adduction tests. Also, when required, the llladdoir rod may be used in combination with the prisms on the slides. The horizontal phoria tests apply in cases of suspenopsia and suppression. and the vertical duction. tests also apply in cases of suspenopsia. Also test-s may be made as to stereoscopic vision.

For these and other eye deficiencies the proper dynamic exercises may be given with this improved lrratometer it'or successfully obtaining. ina much shorter space of time than heretofore, the desired normal condition of orthophoria and cminetropia. Exercises may be given tor suspenopsia and suppression, for increasing convergence relaxation, ior convergence insufficiency, for developinpr amplitudes and association of accommodation and convergence, 'for the restoration oiE binocular Junctions, in motility andspeed of adiustnu-nt in various positions, for the treatmentyperphcria, for develoigiing fusional sense and desire, for the correction of squint, for sectional astigmatism, for oblique astigina 'sin toi-sions and cyclophoria, for am blyopia er; anopsia, etc.

The lrratcmeter, based on principles discovered through experience and esperiments, opened an important iield which has gradually widened. llo single apparatus has :unioni-'ed that reveals so many of the idioncracics ot a iioorly 'functioning pair of eyes, nor which is so eilective in moving; eye deliri ncies. It has been found that acuity et y sion develops more rapidly under ltratometer innervatinp,l impulses than by any other method of treatment known. The iniiproved kratoineter of the present in- .tion brings this important ophthalmocal apparet into lire with the advances `in the sci nce ot Ophthalmology thereby to .till the pi cnt need and requirements. For lnrther initier.. ration on the general sub- `crence may be had to the following Qcular lrientatifiin7 by Hazen; i ocular Balance, by Peckham; also other oublications.

The hratometer of' the first instrinnen principles controlli.. functions oil ocular ve and binocular le vision. iliis' instrument makes possible the correct .griios's of many 'pnzsling phenomena lea dto ocular imbalance and strain,` whose gin and ii aretz ion were impossible by the older instruments and methods. It. has been found that the methods oi innervational exercisin made available with this 'inproved lratometer successfully correct many of these detects,givin@ comiort to many sui'ilerers for whom .ionsly nothing could bedone,

he present invention is to utilize the physiologic Cit ion

iso

and that in those'milder forms of imbalance which have been successfully treated by the older methods, these improved liatometer methods shorten by more than halt the time spent in establishing balance.

Itis obvious that various modiications may be made in the construction shown in .the drawings andV above particularly described, within the principle and scope of the invention yas defined in the appended claims.

I claim: 1. An ophthalmological apparatus having, in combination, a pair of stationary members rigidly supported in substantially horizontal relation,ra pair of slides one of which isguided on each said member and each slide carrying a ylongitudinal series of prisms any one of which may be brought into the line ofsight ot theveye at that side, a pair of independently krotatable discs each mountl ed upon one of said members and carrying an arcuate series of prisms any one of which may be brought int-o the line of sight to cooperate vvith one of the prisms in the slide, a baserforming a rigid frame upon which said members are rigidly mounted, a substantially horizontal rod rigidly mounted on the base trame at the front of said members in zi-'vertical plane extending between the lines of sight provided by said'inembers, and a chart holder projecting above and slidable ot sight ofthe eye at that side, a pair of independently rotatable discs each mounted upon one o't said members and carrying an arcuate series of prisms any one of which maybe brought into the line of sight to cooperate With one of the prisms in the slide,

base forming a rigid frame upon which along said horizontalrod between said meme Q5.;

sai d members are rigidly mounted, a substantially horizontal rod rigidly mounted on the v-aseframeatlthe,front of said members in a ,vertical plane He'dtending `between the lines 'otsight provided by said members, a chart holder projecting abeve and slidable along saidfro'd.,v and a stereoscope septum slidable bers and said chart holder.Y

3. An ophthalmological apparatus having,

lin, combination, a vpair of stationary members rigidly supported in substantially hor` izontal'relation, apair ot slides one of which .is-guided on eachy said membery and each `slidecarryi'ng a longitudinal' series of prisms any one of which may be broughtinto the line of sight of the eye at that side, a pair of independently rotatable discs each mounted Vupon one of said members 'and `carrying an arcuate series ot prisms any one of which may be brought into the line of' sight to cooperate with one ot the prisms in the slide. a base forming a rigid iframe upon which `said members are rigidly mounted, a substantially horizontal rod rigidly mounted on the base traine at the front of said members in a vertical plane extending between the lines of sight provided by said members, a chart holder projecting above and slidablc along said rod, and means providing for the vertical adjustment of said horizontal rod relatively to said members.

4. An ophthalmological apparatus having,

, in combination, a support, a slide guided on the support carrying a longitudinal series ot' prisms progressively increasing in prism power through the series and any one oi which may be brought into the line of sight, a rotatable disc mounted on the support car rying an arcuate series ot prisms progressively increasing in prism power through the series and any one of which may be brought into the liiie ot' sight to cooperate with one ot the prisms in the slide, means for mounting at least one of said prisms on the disc to provide for its axial rotative movement thereon, and means tor axially rotating and setting this prism to any one of t'onr ditlerent axial positions on the disc at the line ot sight and relatively thereto, viz, base out, base in, base down, base up.

5. An ophthalmological apparatus having, incombination, a support, a slide guided on the support carrying a longitudinal series ot prisms progressively increasing in prism power through the series and any one of which may be brought into the line oi sight, a rotatable disc mounted on the support carrying an arcuate series of prisms progressively increasing in prism power through the series and any one of which may be brought into the line of sight to cooperate with one oi the prisms in the slide, means for mounting a ploi'ality ot the prisms ot lower power on the disc to provide i'or their axial rotative .noveinent thereon, and means for coneomitantly axially rotating these prisms in unison in the saine direction at the same rate and setting them to any one of four dii:- erent positions on the disc, viz, base out,

, base in, base down, base up, at the line ot sight and relatively thereto.

6. An oplithalniological apparatus having, in combination, a rigidly supported stationary plate provided with a sight opening, a

Vslide guided on the plate provided with a longitudinal series oi equidistantly spaced sight apertures any one of which may be brought into line with the sight opening in the plate, a series of successive prisms progressively increasing in power throughout the series rigidly niount-ed on the slide Yso as to leave only the end apertures open and to cover all the others, a rotatable disc journaled on the plate provided with a complete circumferential series of equidistantly spaced sight apertures any one of which may be brought into line with the sight opening in the plate, and auxiliar i optical elements mounted on the disc to cover all its apertures save. one lett open, said elements comprising a series oir' successive prisms progressively increasing in power throiilgliout the series followed by a lvladdox rod and a red glass.

i". itin ophthalmological apparatus having, in combination, a rigidly supported stationary plate provided with a sight opening, a slide guided on the plate provided with a longitudinal series of equidistantly spaced sight apertures any one of which may be brought into line with the sight opening in the plate, a series ot successive prisms progressively increasing in power throughout the series rigidly mounted on the slide so as to leave only the end apertures open and to cover all the others, a rotatable disc journaled on the plate provided with a complete circumferential series oi" equidistantly spaced sight fr ajiertures any one of which may be brought into line with the sight opening in the plate, aiuriliary optical elements mounted on the disc to cover all its apertures save one lett open, said elements comprising a series of f successive prisms progressively increasing in power throughout the series followed by a liladdoir rod and a red glass, means formounting a plurality of the successive low power prisnis and the Maddox rod to provide for their axial rotation on the disc, and means tor concomitantly axially rotating these same direction at the same rate and setthem to tour diliferent positions when i any one ot them is in line with the sight opening in the plate, vie', with the prisms base out, base in, e down, base up, relatively to said sight opening, and with the Maddox rod having vertical. positions and horizontal positionsn tl., il opththalmological apparatus having, in combination, a support, a rotatable disc mounted. on the support carrying an arcuate ot prisms progressively increasing in prism power through the series and any one ot' which may be brought into the line oit sight,4

a slide guided on the support carrying a longi- Vnal series ot prisms progressively increasing in prism power through the series and amv one oit which may be brought into the line j t to cooperate with a prism on t-he ro e disc, a trial case lens holder carried l support adjacent the line ot sight outwardly trom said disc, and another trial case lens holder carried by said support adjacent the line ot sight outwardly trom the slide.

9. An ophthalmological apparatus having, in combination, a pair of stationary members rigidly supported in substantially horizontal relation, a pair of slides one of which is guided on each of said members and each slide carrying a longitudinal series ot prisms progressively increasing in prism power through the series and any one oi which may be brought into the line ot sight ot' the eye at 4that side, a pair of independently rotatable discs each mounted upon one ot said members and carrying an arcuate series of prisms progressively increasing in prism power' through the series and any one of which may e brought into the line of sight to cooperate with one of the prismsin the slide, a pair of trial case lens holders one oit which is carried by each of said members outwardly from the slide adjacent the liner oi sight,4 and another pair of trial case lens holders one of which is carried by each ot said members outwardly from said disc adjacent the line of sight.

l0. An ophthalmological apparatus having, in combination, a pair of stationary members rigidly supported in substantially horizontal relation, a pair of slides one ot' which is guided on each said member and each slide carrying a longitudinal series of prisms any one of which may be brought into the line otsight of the eye at that side, a pair oli' independently rotatable discs each mounted upon one of said members and carrying an arcuate Series of prisms any one ot which may be brought into the line oi sight to cooperate with one of' the prisms in the slide, a base forming a rigid frame upon which said inembers are rigidly mounted, a substantially horizontal rod rigidly mounted on the base frame at the front of said members in a vertie cal pla-.ne extending between the lines of sight provided by said members, a chart holder projecting above and slidable along said rod, and a stereoscope septum rotatable on a vertical axis and slidable along said horizontal. rod between said members and said chart hold 1l. An ophthalmological apparatus han ing, in combination, a rigidly supported stationary plate provided with a. sight opening, a slide rigidly carrying a longitudinal series of prisms, a guide tor the slide pivotally mounted on the plate on an airis coincident with the siglitopening, releasable means for holding the slide at dilerent angular positions, and a rotatable disc journaled on the plate` carrying an arcuate series ot prisms any one oi` which may be brought into line with the sight opening to cooperate with one of the prisms carried by the slide.

12. An ophthalmological apparatus having, in combination, a support, a slide rigidly carrying a longitudinal series ot' prisms with their bases and apices respectively adj accntly directed on parallel lines transverse to the slide, another slide rigidly carrying a longitudinal series ot prisms with their bases and apices directed respectively towards the opposite ends of the slide on the same line, means for interchangeably mounting the leo slides on said support for sliding movement to bring any prism into the line of sight, a rotatable disc mounted on thesupport carry-l ;.ing an arcuate'series of prisms any one pi Which may be brought into the line of sight to cooperate with one vof the prisms carried by one of the slides, and means providing for settingneach of aplurality of the prisms on the disc to different axial positions relatively to the line of sight so as thereby to cooperateA With the prisms on the respective slides.

13. An ophthalmological apparatus having, in combination, a pair of stationary .members rigidly supported in substantially horizontal relation, a pair of slides guided respectively :tor sliding movement on said members and each slide carrying a longitudinal series of prisms any one of which may be brought into the line of sight of the eye at that side, a pair oit-independently rotatable discs mounted respectively upon said members and each carrying an arcuate series of prisms any oneof which may be brought into s the line of sight to cooperate With oneof the Y of the line of sight provided by said members through said prisms. Y s

14. An ophthalmological apparatus having, .in combination, apair of stationary members vrigidly supported in substantially horizontal. relation, a pair of slides guided respectively for sliding movement on said v members and each slide carrying a longitudinal series of prisms any one of which may be brought into the line of sight ofthe eye-at that side, a pair of independently rotatable discs mounted respectively upon said members and each carrying an arcuater-seriesof prisms any one of which may be brought into thetline ofsight to cooperate With oneot the prismsintheslide, a baseforming a rigid frame provided With a standard, a head rigidly carried by the top 'of the standard, a pair 'of lateral arms rigidly Vupstanding from the head and'upon the upper ends of Which said membersrespectively are rigidly carried, andV a Achin rest'mount'edon the `head for both vertical and horizontal forward and back adjustment.

V15.v The invention defined in claim 13, vin combination with means providing forl the vertical adjustment relatively to the base oi said head together with the parts carried thereby, anda chin rest mounted on the head for both vertical and horizontal forward and back adjustment thereon.

16. An ophthalmological apparatus having, in combination, a pair or stationary members rigidly supported in substantially horizontal relation, a pair of slides guided respectively for sliding movement on said members and each slide carrying a longitudinal series of prisms any one oi which may be brought into the line ot sight of the eye at that side, a pair of indejiiendently rotatable discs mounted respectively upon said members and each carrying an arcuate series of prisms any one of Which may be brought into the line of sight to cooperate with one of the prisms on the slide, a base forming a rigid trame provided ivith a tubular standard,a tubular internally screw-threaded stem telescoping into the standard, means `for rigidly supporting said members upon the upper end of said stem, and a manuaily rotatable screw journaled at its lovver end in the iirame and threaded into said stem tor vertically adjusting said members together with the parts carried thereby.

17. An ephthalmological apparatus having, in combination, a support, a manually rotatable disc mounted on the support carrying an arcuate series of prisms any one of which may be brought into the line ot sight, rotatable holders for mounting a plurality oi the prisms on the disc to provi de for axially rotating these prisms on the disc, a gear earried by each oli' these holders, a manually rotatable master gear engaging all of' the holder gears, and releasable means tor holding the master gear stationary at a plurality of rotative positions thereof, whereby said rotatable prisms Will be axially rotated when the disc is rotated and also when the master gear is rotated thereby to bring these prisms to a desired axial position at the line oi'f sight.

18. An ophthalmologieal apparatus having, in combination, a base forming a rigid. :trame provided with a front and a rear standard, a pair ot stationary members mounted upon the rear standard tor unitary vertical adjustment and individual lateral adjustment, a pair ot slides guided respectively -for independent sliding movement on said members and each slide carrying a longitudinal series of prisms any one of which may be brought into the line et sight ot the eye at that side, a pair ot independently rotatable discs mounted respectively7 upon said members and each carrying an arcuate series of prisms any one of which may be brought into the line or' sight to cooperate with one of the prisms in the slide, a substantially horizontal rod mounted upon the lront standard for vertical adjustment and arranged in a vertical plane extending between the lines ot sight provided by said members. and a chart holder projecting above and slidable along said rod.

19. An ophthalmological apparatus having, in combination, a support, a slide guided mas-,esc

on the support carrying a longitudinal series oit prisms progressively increasing in prism power through the series and any one of which may be brought into the line of sight, a rotatable disc mounted on the support carrying an arcuate series of prisms progressively increasing in prism power through the series and any one oi which may be brought into the line ot sight to cooperate with one` of the prisms in the slide, means for mounting a plurality ot' the successive prisms on the disc to provide tor their axial rotative movement thereon, and means ior concomitantly axially rotating these prisms in unison in the same direction at the same rate and setting them to different axial positions on the disc at the line of sight and relatively thereto.

20. An ophthalmological apparatus having, in combination, a pair ot' stationary members igidly supported in substantially horizontal relation, a pair of slides guided respectively for sliding movement on said members and each slide carrying a longitudinal series of prisms any one of which may be brought into the line of sightof the eye at that side, a pair of independently rotatable discs mounted respectively upon said members and each carrying an arcuate series of prisms any one of which may be brought into the line of sight to cooperate with oneu of the prisms in the slide, a rigid main support, a head rigidly carried thereby, a pair of lateral arms rigidly projecting from the head and upon the outer ends of which said members respectively are rigidly carried, and manually operable means engaging said head and arms for moving these arms together with the parts carried thereby simultaneously in opposite directions horizontally for there-` by varying the pupillary distance apart of the lines of sight provided by said members through said prisms.

21. An ophthalmological apparatus having, in combination, a pair of stationary members rigidly supported in substantially horizontal relation, a pair of slides guided respectively for sliding movement on said members and each slide carrying a longitudinal series of prisms any one ot which may be brought into the line ot sight of the eye at that side, a pair of independently rotatable discs mounted respectively upon said members and each carrying an arcuate series of prisms any one of which may be brought into the line ot sight to cooperate with one ot the prisms in the slide, a base forming a rigid frame provided with a standard, a head rigidly carried by the top ot the standard, a pair of horizontal guide rods rigidly carried by the head and each projecting laterally at opposite sides thereof in parallel relation, a pair of lateral upstanding arms the lower ends of which are supported and guided upon said guide rods and upon the upper ends of which said members respectively are rigidly carried, and a horizont-al manually rotatable screw journaled in said head and provided towards one end with righthand threads engaging in one of said arms and provided towards its otherend with leithand threads engaging in the other ot said arms for moving these arms together `with the parts carried thereby simultaneously in opposite directions horizontally for thereby varying the pupillary distance apart of the lines of sight provided by said members through said prisms.

2Q. The invention delined in claim 2Q, in combination with means providing ior the vertical adjustment relatively to* the said main support of said head together with the parts carried thereby.

23. An ophthalmologieal apparatus having, in combination, a pair of stationary members rigidly supported `in substantialiy horizontal relation, a pair of slides guided respectively for sliding movement on said members and each slide carrying a longiriir dinal series oi prisms any one ot which may be brought into the line oi' sight ot the eye at that side, a pair ot' independently re tatable discs. mounted respectively upon said members andeach carrying an `arcuate series oit prisms any one of which may be brought into the line oi sight to `cooperate with one of the prisms on the slide, a base forming a rigid frame provided with a tubular standard, a screw-threaded stem telescoping into the standard, means tor rigidly supporting said members `upon the upper end of said stem, and a manually rotatable screw journaled in the frame rand having threaded engagement with said stem for vertically adjusting said members together with the parts carried thereby. u 24.. An ophthalmological apparatus having, in combination, a base forming a rigid frame provided with a standard, a pair ot stationary mem-bers mounted upon the standard for unitary vertical adjustment and individual lateral adjustment, a Vpair of slides guided `respectively for independent sliding` movement on said members and each slide carrying longitudinal series ot prisms any one of whichmay be brought into the linie of sigljit of `the eye at that side, and `a `pair of independently rotatable `discs mounted respectively upon, said members and each carrying an arcuate series ot prisms any one of which may be brought into theline o'f'sight tocooperate with one of the prisms in the slide.

25, On ophthalmological apparatus havmg, in combination, a rigid supporting member, a prism carrier movably mounted on the supporting member carrying a series of prisms of iiXed value progressively increasing in steps of prism power through the series and which may be brought successively into the line of sight by the movement ofthe carrier to cooperate With a selected prism on a second prism carrier, and a second vprism carrier movably mounted on the supporting member carrying a series or prisms of fixed value progressively mcreasing in Vsteps of prism power through the series and which may be brought successively` into the line of sight by the movement of thev second carrier to cooperate with a selected prism on the'other prism carrier, in combination with means providing for concomitantly reversing the position of the bases and apices of theV prisms in one of the said series relatively to the said supporting member, and means providing for concomitantly reversing the position of the bases and apices of the'prsms in the other p said series relatively to the said supporting member.

26. An ophthalmological apparatus having, in combination, a rigidly supported stationary plate provided with a sight openinga slide rigidly carrying a longitudinal series of prisms, a guide bracket for the slide having on its back a circular shoulder'passing through the sight. opening and by which the slide is pivotably mounted on the plate on an axis coincident with the sight opening, radial lugs on the inner end of the .said shoulder for engagement with the inner side of the plate to hold the guide thereon, the sight opening in the plate being provided with notches for the passage of said lugs to permit the removal and replacement of the Guide bracket upon rotative movement thereo, anda set screw carried by the guide bracket tobe setup against the said plate for holding the guide bracket and thus the slide atdifferent angular positions.

27. An o hthalmological apparatus havn ing, in com ination, a rigid main support,

a pair of stationary members mounted upon Y the main support for unitary vertical adl series of prisms any one of which may be my signature.

justment and individual lateraladjustment, a pair of shdes 'guided respectively for independent sliding movement on said members and each slide` carrying a longitudinal series ofprisms any one of which may beA Vbrought into A,the line of sight of the eye at-that sidefand va pair of independently Vrotatable discs -mounted respectively upon said members and each carryingan arcuate brought into the linel of sight to cooperate With one of the prisms in the slide.

' In witness whereof, I hereunto subscribe "1 HANS CLEMENT.

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