Patent Application
20230320585
The present application claims priority under 35 U.S.C. § 119 to European Patent Application Number EP 22167639.8, titled “Apparatus, method and computer program for determining a refraction of an eye” filed on Apr. 11, 2022, the disclosure of which is incorporated by reference herein in its entirety.
The disclosed embodiments relate to an apparatus, a method, and a computer program for determining a refraction of an eye.
Various types of devices and methods are currently known for characterizing or measuring an eye. For example, in the field of optometry or ophthalmology there are several approaches known for determining an objective refraction and/or a subjective refraction of the eye.
For example, determining an objective refraction may be achieved by guiding light into the eye and measuring the light reflected by the eye. For example, the objective refraction can be determined by means of a retinoscopic analysis, a refractor, an autorefractor and/or an aberrometer, etc. The corresponding objective refraction information may be used as a reference for a further eye examination, for example, the subjective refraction.
Determining subjective refraction may include determining parameters of the necessary optical correction means (e.g., optical lenses) for an individual in view of his or her actual visual perception. For example, the subjective refraction can be determined by various lenses functioning as the optical correction means in combination with a reading chart and using feedback by the individual on the visual perception.
However, the known approaches for determining a refraction of an eye may not always lead to optimal results. For example, the known approaches may not consider confounding factors that result from the eye as an optical system itself which could negatively impact the correct determination of the refraction of the eye. Known approaches may thus not always be perfectly suitable for applications that require reliable information on the refraction of the eye (e.g., for applications such as eye surgery).
Accordingly, the present disclosure describes improvements in determining the refraction of an eye.
The aspects described herein address the above need at least in part.
A first aspect relates to an apparatus for determining an objective refraction of an eye where the apparatus includes an optical element configured to compensate an aberration of the eye.
The aberration to be compensated may include (or primarily consist of) a specific (optical) aberration out of a plurality of specific partial (optical) aberrations of the eye, which may be present in the optical system of the eye to be examined. For example, the specific (optical) aberration may be associated with a certain component of the eye which is part of the eye's optical system wherein the certain component may cause the specific aberration. For example, the specific aberration may be an aberration that could be difficult to measure and/or that may even falsify the measurement of the total objective refraction of the eye. By implementing the herein described optical element in the apparatus, such aberration may be compensated such that the measurement of the (remaining) aberration is improved. To that regard, the original optical output of the eye's optical system may be modified by the optical element and then measured by the apparatus. The apparatus may thus be configured to measure only a part of the total aberration of the eye (e.g. the total aberration of the eye minus the aberration compensated by the optical element). In some examples, the apparatus may be configured to subsequently determine the objective refraction (e.g. a total aberration) based on the measurement of the modified optical output.
The compensation by the optical element may thus enable selectively suppressing an effect of a specific aberration of the eye. In turn, only the remaining one or more specific aberrations of the eye may be substantially present in the modified or compensated optical output of the eye's optical system during a measurement thereof. The inventor has found out that this can enable an improved determination of the objective refraction of the eye, since a confounding influence of the compensated specific aberration may be substantially suppressed. In turn, this can enable an improved determination of the remaining one or more specific aberrations of the eye. The measurement of the optical output of the eye's optical system for determining the objective refraction can thus be performed more accurately, less noisy and with less (or almost no) crosstalk stemming from the specific aberration that has been compensated.
Surgical procedures that are based on more reliable objective refraction information which are enabled by the herein described embodiments may lead to improved results for patients since the surgery is based on more accurate information of the eye. For example, a surgical procedure may include a corneal ablation to correct a visual ametropia of the eye, wherein a more reliable objective refraction information may lead to an improved surgical parameter and thus an improvement in visual ametropia correction for a patient.
Notably, the specific aberration to be compensated may be predetermined and/or acquired prior to the determination and/or measurement of the objective refraction. In an example, the predetermined specific aberration may be based on a measurement by an ophthalmology and/or optometry apparatus which may not (necessarily) be configured to determine an objective refraction of the eye but, for example, configured to determine the specific aberration based on an according measurement method and/or to determine an aberration from which the specific aberration to be compensated may be readily derived.
In an example, the optical element may be configured, for a first objective refraction determination, to compensate a first specific aberration, however, for a second objective refraction determination, the optical element may compensate a different specific aberration. For example, the specific aberration to be compensated may be adapted to the individual eye whose objective refraction is to be determined.
It should be noted that the components of the eye's optical system may typically include a cornea, a lens, an iris diaphragm (pupil) and a retina of the eye. Further components of the eye's optical system that may also contribute to the one or more aberrations may include an anterior chamber, a posterior chamber, an axial length, a vitreous chamber of the eye, as well as any other component of the eye that may influence an optical output of the eye's optical system.
With the eye being an organ, the components of the eye can include a biological tissue. However, as it is common to replace and/or adapt certain components of the eye's optical system for medical purposes it should be noted that the present disclosure also covers and refers to implanted and/or adapted components of the eye's optical system that may include an artificial (e.g., non-organic) tissue since also the implanted and/or adapted components may cause an aberration of the eye which may in turn influence the determination of the objective refraction, as well. The disclosed embodiments are thus also suitable to compensate an aberration of the eye that is associated with an implanted and/or adapted component of the eye's optical system.
In an example, the optical element can be configured to compensate a higher order aberration of the eye. The higher order aberration to be compensated may include an aberration which is not associated with a lower order aberration of the eye in the field of ophthalmology and/or optometry. The lower order aberration of the eye may include the lower order aberrations such as myopia, hyperopia, regular astigmatism and tilting. Typically, these lower order aberrations can be compensated, for example, via a lens with a spherical diopter value, a cylindrical diopter value with a cylinder axis orientation and a prismatic diopter value with a prismatic axis orientation that causes a compensation of the lower order aberration (e.g., this may be a common compensation mechanism present in eyeglasses). However, these lower order compensation mechanisms may not compensate further remaining aberrations of the eye, which may include higher order aberrations of the eye. The example considers, however, compensating the remaining (e.g., higher order) aberrations of the eye for an objective refraction determination. The aberration to be compensated may thus include a higher order aberration of the eye (or a component thereof, such as the higher order aberration of the cornea) other than second order myopia (e.g., positive defocus), second order hyperopia (e.g., negative defocus), second order astigmatism (e.g., regular astigmatism) and first order of tilting of the eye (or the cornea). In some examples, the aberration to be compensated may only include a higher order aberration of the eye (or a component thereof, such as the higher order aberration of the cornea) other than second order myopia (e.g., positive defocus), second order hyperopia (e.g., negative defocus), second order astigmatism (e.g., regular astigmatism) and first order of tilting of the eye (or the cornea). In some examples, the aberration to be compensated may include the entire higher order aberration of the eye and/or of the cornea other than second order myopia (e.g., positive defocus), second order hyperopia (e.g., negative defocus), second order astigmatism (e.g., regular astigmatism) and first order of tilting of the eye and/or of the cornea.
In some examples, the apparatus and/or the optical element can be configured to compensate a third order and/or an even higher order aberration of the eye, without (necessarily) compensating a spherical diopter value and/or a cylindrical diopter value with a cylinder axis orientation and/or a prismatic diopter value with prismatic axis orientation.
For example, the order of aberration of the eye may constitute the order of aberration according to the Zernike polynomials which are well known in the field. To that regard, a Zernike polynomial may be described as Zn wherein the subscript n specifies the order of aberration. In this example, the third order aberration to be compensated constitutes an aberration which corresponds to a Zernike polynomial according to Zn with n=3. The (even) higher order aberration may include an aberration of at least the fourth order according to the Zernike polynomials (e.g., with n≥4 in a Zernike polynomial according to Zn). However, the higher order aberration to be compensated is not limited to a definition according to the Zernike polynomials. As the skilled person is aware, there may be a wide range of other ways to describe aberrations (e.g., such as higher order aberrations). The inventive concept thus also considers compensating various other types of a higher order aberration (e.g., usually termed HOA). In an example, the higher order aberration may be caused by biological damage of the eye's optical system (e.g., scar tissue, injury, surgical complication and/or an eye disease) and/or any other biological irregularity of the eye's optical system (e.g., a corneal irregularity, an eye lens irregularity, etc.).
In an example, the optical element can be configured to compensate a first order aberration and/or a second order aberration of the eye. For example, the second order aberration may include myopia, hyperopia and regular astigmatism. The compensation of the second order aberration may thus include compensation by the optical element based on a spherical diopter value and/or a cylindrical diopter value with a cylinder axis orientation. The first order aberration may include a tilt of the eye's optical system which may be compensated via a prismatic diopter value with a prismatic axis orientation. The tilt may be compensated via the optical element by adapting the optical output of the eye via a horizontal and/or vertical compensating tilt, for example. Also, the herein mentioned first order aberration and/or second order aberration may constitute the order of aberration according to the Zernike polynomials which are well known in the field. In this example, the aberration to be compensated may for example include an aberration which corresponds to a Zernike polynomial according to Zn with n=1 and/or n=2. For example, the first order to be compensated by the optical element may include a tilt as defined by a Zernike polynomial of the first order. In another example, the second order aberration to be compensated by the optical element may include an astigmatism (e.g., an oblique and/or a vertical astigmatism) and/or a defocus, as defined by a Zernike polynomial of the second order.
In a further example, the optical element can be configured to compensate a lower order aberration of the eye (e.g., as defined in the field of ophthalmology and/or optometry). To that regard, the lower order aberration may include a first order and/or second order aberration of the eye according to the Zernike polynomials as described herein but no higher order aberrations. In an example, the lower order aberration to be compensated may, however, also be defined as an aberration of the eye which includes the second order myopia (e.g., positive defocus), second order hyperopia (e.g., negative defocus) and/or second order astigmatism (e.g., regular astigmatism) of the eye but not the first order aberration, for example.
In an example, the optical element can be configured to compensate an aberration of a cornea of the eye. For example, the aberration of the cornea may include a higher order aberration of the eye as described herein. The (specific) aberration to be compensated by the optical element may thus for example include a higher order aberration of the cornea. The higher order aberration of the cornea may in particular include a third order and/or one or more (e.g. all) even higher order aberrations as described herein which is induced by the cornea of the eye (whereas other aberrations of the eye may not be compensated).
In some examples, the optical element and/or the apparatus may be configured to compensate third and higher order aberrations of the cornea, but spherical and cylindrical aberration, as well as any aberrations caused by other elements of the eye may not be compensated. Since the cornea typically provides the strongest contribution to higher order aberrations caused by irregular corneal shapes, compensating specifically this effect may enable a particularly strong reduction of measurement artefacts, such that the remaining aberration of the eye may be measured more reliably.
The aberration of the cornea to be compensated may in general be derived from one or more parameters of the cornea and/or a combination of parameters of the cornea. For example, a parameter of the cornea that may invoke a respective aberration of the cornea may include a corneal surface irregularity of an anterior and/or posterior corneal surface shape, an anterior and/or posterior corneal surface topology, a corneal thickness (variation and/or distribution), a corneal refractive index (variation and/or distribution), the cornea's geometry, etc.
In an example, the optical element can be configured to compensate the aberration of the cornea based at least in part on a topographic and/or a tomographic information of the cornea. The topographic and/or tomographic information may include a dataset of the cornea (e.g., a map of the cornea) that indicates for various positions of the cornea a respective corneal information (e.g., a height, a corneal radius, a curvature steepness, an axial/sagittal curvature, an elevation, a corneal thickness, a refractive power, an axial power, a corneal pachymetry information etc.), as is well known in the field. The topographic and/or tomographic information may also include an anterior and/or posterior corneal surface shape, as well as an anterior and/or posterior corneal surface topology. The respective corneal information may be indicated, for example, for positions at the anterior and/or posterior surface of the cornea. The compensation of the corneal aberration by the optical element can be further based on determining the aberration of the cornea based on the topographic and/or tomographic information of the cornea. As is known in the field, the topography/tomography of the cornea may have an irregular shape causing light, for example, to be refracted in an irregular way such that a specific aberration, which is associated with the corneal topography/tomography, is induced for the eye's optical system. The inventor, however, considered that such an induced specific aberration stemming from the irregularity of the tomography/topography of the cornea may negatively impact the determining of the remaining objective refraction of the eye (e.g., the determining of the remaining aberrations of the eye). Therefore, in an example of the present disclosure, such an irregularity of the tomography/topography of the cornea may be considered based on the topographic/tomographic information of the cornea and its induced aberration effect may be suppressed. To that regard, this induced aberration by the cornea's shape may be compensated by the optical element such that it is corrected for the eye's optical system. The apparatus may thus measure the remaining objective refraction in a highly accurate manner. By adding the measured remaining objective refraction and the compensated aberration (e.g. by the apparatus), the total objective refraction can be obtained (e.g. by the apparatus).
For example, the higher order aberration of the cornea may be derived (e.g. by the apparatus) based at least in part on a topographic and/or a tomographic information of the cornea, and the optical component may be configured (e.g. by the apparatus) to compensate the higher aberration of the cornea derived in that manner.
In an example, the apparatus further includes means for receiving the topographic and/or the tomographic information. The apparatus may further include means for determining (e.g., calculating) the (higher order) aberration of the cornea based on the received topographic and/or tomographic information. In another example, the apparatus includes means for receiving the (higher order) aberration of the cornea which is based on the topographic and/or tomographic information thereof.
In an example, the optical element can include an adaptive optics and/or an adaptive mirror. The adaptive optics and/or mirror may include a deformable optics and/or deformable mirror whose surface/s can be deformed to adapt the properties of light which is refracted and/or reflected by the deformable optics and/or the deformable mirror. The adaptive optics and/or adaptive mirror may be used to compensate the aberration of the eye by the optical element, as outlined herein. To illustrate an example, the deformable optics and/or the deformable mirror may compensate the aberration of the cornea based at least in part on a corneal topography and/or tomography map.
In an example, the optical element can include a first optical component configured to compensate the first order aberration, a second optical component configured to compensate the second order aberration and/or a third optical component configured to compensate a higher order aberration of the eye. The optical element may thus include various optical components which are constructed to compensate a specific order of the aberration of the eye's optical system. This may reduce the system complexity of the apparatus since each optical component may be optimized for a specific aberration which in turn may lead to an overall easier compensation mechanics, since not every optical component may be advantageous or suitable for compensating a plurality of specific aberrations.
In an example, the apparatus may further include a detector for detecting an electromagnetic wave reflected by the eye and/or a divider element positioned between the detector and the eye, wherein the divider element is configured such that the electromagnetic wave is divided into a plurality of wave components. The detector may thus enable the apparatus to measure the electromagnetic wave, which was shaped by the eye's optical system, as well as the optical element. To that regard, the reflection of the electromagnetic wave may have taken place at any point and/or plane of the eye's optical system such that an aberration of the eye (e.g., a specific aberration of a component of the eye's optical system) may have been invoked onto the reflected electromagnetic wave. For example, the electromagnetic wave may have been (substantially) reflected at the retina. The reflected electromagnetic wave may constitute the optical output of the eye's optical system as stated herein. Notably, the electromagnetic wave may have been actively guided into the eye's optical system for a controlled reflection thereof by the eye to determine the objective refraction of the eye. The apparatus may thus also include an emitter to emit the electromagnetic wave and means for guiding the electromagnetic wave onto a desired reflection point or plane of the eye. The electromagnetic wave may include an electromagnetic wave of various wave lengths. To that regard, the wavelength of the electromagnetic wave may include a wavelength usually associated with light (e.g., a wavelength that constitutes UV-light, visible light and/or infrared light, or a combination thereof).
The (at least one) divider element may be configured such that a single beam or a bundle of beams of the reflected electromagnetic wave impinging onto the divider element is/are separated into a plurality of wave components that may include separately defined ray bundles that may subsequently impinge onto the detector in a spatially separated manner. The apparatus may, in particular, be configured to implement a wavefront sensor via the divider element and detector assembly. For example, the divider element may include a lens array and/or a lenslet array wherein the detector may include a sensor array (e.g., to implement a Shack-Hartmann wavefront sensor). The divider element may also include a pyramidal prism (e.g., to implement a pyramid wavefront sensor). In another example, the apparatus may be configured to implement various other wavefront sensors (e.g., a wavefront curvature sensor, an interferometer-based wavefront sensor, etc.). The apparatus may be further configured to determine the objective refraction of the eye based on the detected wavefront of the reflected electromagnetic wave according to known principles in the field. However, the disclosed embodiments enable a correction of the reflected electromagnetic wave before it impinges on the detector (or divider element) since the reflected wave may be further shaped by the optical element that can compensate a (specific) aberration of the eye that may negatively interfere with the measurement of the reflected electromagnetic wave. By reducing the effect of the (specific) aberration onto the measurement the determining of the objective refraction may be significantly improved.
In an example, the divider element may be configured such that at least one of the wave components (or each wave component) includes a portion of the electromagnetic wave originating from a corresponding region on a surface of a cornea of the eye. The optical element may be configured to compensate the aberration such as to reduce an amount of the electromagnetic wave in the at least one of the wave components (or in each wave component) that originates from a different region of the cornea; and/or such as to increase the portion of the electromagnetic wave originating from the corresponding region of the cornea included by the at least one of the wave components. For example, for determining the correct objective refraction by the apparatus it is assumed that the divider element is positioned such that a wave component W1 detected at the detector includes substantially the portion of the electromagnetic wave originating from a particular (corresponding) region R1 of the cornea. In this example, the wave component W1 should thus map to region R1. However, due to a (specific) aberration of the eye (e.g., a (higher order) corneal aberration), an amount of the electromagnetic wave originating from a different region R2 may be significantly deflected such that it impinges onto the divider element such that its wave component W2 may crosstalk into the wave component W1 that is initially assumed to include substantially the portion of the electromagnetic wave originating from region R1. Hence, with no compensation of the aberration present, the wave component W1 may include the portion of the electromagnetic wave originating from region R1 (as intended), however, also of region R2 (as not intended) such that a measurement error is introduced which may lead to a less accurate determination of the objective refraction. The optical element, according to the present disclosure, may thus enable a correction mechanism by shaping the electromagnetic wave by compensation of the aberration of the eye such that the herein described crosstalk of the parasitic electromagnetic wave portion originating from a different (non-corresponding) region (in this example R2) is reduced. Reduction of crosstalk may similarly be achieved by increasing the amount of the electromagnetic wave originating from (the corresponding) region R1 via the compensation of the optical element, e.g. by compensating the aberration such as to reduce the portion of the electromagnetic wave originating from (the corresponding) region R1 that is deflected away and thus detected as part of a wave component that corresponds to a different region (e.g. R2).
To illustrate another example, it may also be conceivable that for determining an objective refraction it has to be assumed that a specific part of the divider element (e.g., a specific lenslet of a lenslet array) maps with a corresponding region R1 of the cornea wherein it may be further assumed that the detected wave component W1 originating from the specific part of the divider element only includes the portion of the electromagnetic wave originating from the corresponding region R1. However, without the inventive compensation, the herein described crosstalk may, also in this example, cause a portion of an electromagnetic wave originating from a different (non-corresponding) region R2 to be (e.g., partly) deflected onto the specific part of the divider element (e.g., the specific lenslet of the lenslet array) such that the detected wavefront W1 includes portions of the electromagnetic waves originating from region R1 and R2. Also in this example, the optical element, according to the present disclosure, may enable a correction mechanism by shaping the electromagnetic wave (e.g., prior to impinging onto the divider element) by compensating the aberration of the eye such that the herein described crosstalk of the parasitic electromagnetic wave portion originating from a different (non-corresponding) region is reduced.
In an example, the optical element may be configured to compensate the aberration such that the at least one of the wave components (or each of the wave components) and/or the part of the divider element from which it emerges has a one-to-one correspondence to the corresponding region of the cornea. For example, the one-to-one correspondence may include that the crosstalk of the parasitic electromagnetic wave portion (as described herein) is completely reduced. Hence, the at least one of the wave components may include substantially the complete information of the portion of the electromagnetic wave when originating from its corresponding region in the cornea without any interfering noise. The complete information may constitute that the characteristics of the portion of the electromagnetic wave, when originating from the cornea, can be deducted based on the at least one of the wave components. Notably, this may enable to determine the part of the wavefront of the electromagnetic wave in the location of the corresponding region with a one-to-one correspondence.
As stated herein, the apparatus may be configured to include the detector and the divider functioning as a wavefront sensor, wherein the determination of the objective refraction may be based on the wavefront of the electromagnetic wave when originating from the cornea.
In a further example, the aberration is compensated by the optical element such that substantially all detected wave components have a one-to-one correspondence to their corresponding regions of the cornea. This may enable to suppress the effect of the aberration substantially to a maximum degree to enable a measurement that is substantially free of the (specific) aberration noise which in turn may improve determining the objective refraction.
In a further example, the optical element may be configured to compensate the aberration such that a portion of the electromagnetic wave that originates from a specific region of the cornea when impinging on the divider element has a one-to-one correspondence to the portion of the electromagnetic wave originating from the specific region.
In an example, the apparatus can further include an optical path for determining a subjective refraction associated with the eye, wherein the optical element is arranged in the optical path. The apparatus may thus also be configured to function in addition as an apparatus to perform a subjective refraction determination wherein the compensation capabilities of the optical element (as described herein) may be used analogously for performing the subjective refraction examination. The optical path of the subjective refraction may, for example, be partly shared with an optical path used for determining the objective refraction of the eye (as described herein). The optical element may thus also be further configured to compensate a specific aberration in the field of vision of an examined individual (i.e., into the optical path for determining a subjective refraction).
In particular, the optical element may be configured to compensate a lower and/or higher order aberration as described herein for the objective refraction into the optical path for determining the subjective refraction. The optical element may thus not be exclusively configured to shape an optical output (e.g., to compensate the specific aberration) of the eye's optical system for determining an objective refraction but also to shape an optical input to the eye's optical system (e.g., compensating the specific aberration). To that extent, the optical path for determining a subjective refraction may include a screen (e.g., in form of an electronic display, or a physical poster/board) to display a visual chart in the optical path for an individual to perform a subjective refraction. With the shaping of the optical input to the individual's eye by the optical element, higher order aberrations as well as lower order aberrations may thus be compensated, e.g. with the herein described capabilities of the optical element. This example may be beneficial as the objective and subjective refraction examination is made available on a single apparatus. Moreover, the system complexity may be reduced as the need for two separate apparatuses with separate optical components for optical beam shaping may be abstained from.
A second aspect relates to an apparatus for determining a subjective refraction of an eye, comprising: an optical element configured to compensate an aberration of the eye, wherein the aberration includes a higher order aberration of the eye.
The apparatus of the second aspect may include one or more parts of the apparatus of the first aspect, however, it may not necessarily be configured to determine an objective refraction of the eye. As the apparatus of the second aspect may compensate a higher order aberration of the eye, it may also be viewed as a “higher order phoropter”. As is common in the field, usually the subjective refraction is determined based on compensating the lower order aberrations of the eye (e.g., the second order aberrations, such as myopia, hyperopia, regular astigmatism). However, the apparatus of the second aspect may enable analyzing the effects or correction of higher order aberrations for an individual's subjective refraction (e.g., for a third order and/or even higher order aberration as described herein). The complexity of the visual perception of an individual may thus be considered to a fuller extent. For example, the results of the subjective refraction via the apparatus according to the second aspect (i.e., the “higher order phoropter”) may thus improve the assessment of a surgical procedure for the eye.
The elements described for the second aspect may also apply for the subjective refraction determination described as an option for the apparatus of the first aspect.
In an example, the apparatus according to the first and/or second aspect may further include means for controlling a diameter of an iris diaphragm of the eye by illuminating the iris of the eye. For example, the means for controlling may be configured to set a predetermined diameter of the iris diaphragm for a subsequent examination of the eye. In particular, the diameter may be set for determining the objective and/or subjective refraction, respectively. The level of illumination by the means for controlling may cause the iris diaphragm of the eye to adapt to a certain diameter that can be thereby set or controlled. The level of illumination may for example include a level of an intensity, a power and/or a brightness of the illumination. The illumination itself may include an electromagnetic wave with a wavelength that corresponds to light in the visible range such that the eye may be triggered to accordingly adapt the iris diaphragm.
In a further example, the means for controlling may be further configured to measure the diameter of the iris diaphragm. This may enable to check which iris diaphragm diameter was set via the illumination of the eye. Moreover, this may enable to implement a control loop where the illumination is controlled in response to the measured diameter of the iris diaphragm to implement the setting of a desired iris diaphragm diameter. The measurement of the diameter may be based on a second illumination of the eye which may include an electromagnetic wave with a wavelength that corresponds to light in the invisible range (e.g., the infrared light range, e.g., light with a wavelength above 700 nm).
In a further example, the means for controlling may be configured such that determining the (objective and/or subjective) refraction by the apparatus according to the first and/or second aspect may be performed at the predetermined diameter of the iris diaphragm. This may ensure that each measurement for the (objective and/or subjective) refraction according to the disclosed embodiments may be based on a defined iris diaphragm. Hence, a more reliable determination of the refraction of the eye may be performed as the factor of a varying (or unknown) iris diaphragm is reduced. Moreover, the effect of the iris diaphragm diameter on the eye's optical system may thus be tuned to a specific value such that various measurements (e.g., of the subjective/objective refraction) may be more comparable. Further, the refraction of the eye can be performed for a particular set of iris diaphragm diameters to assess the characteristics of the (objective and/or subjective) refraction to a fuller extent. For example, the (objective and/or subjective) refraction may be analyzed for a darker surrounding (e.g., by a low-level illumination that may lead to a relatively increased iris diaphragm) and for a brighter surrounding (e.g., by a high-level illumination that may lead to a relatively reduced iris diaphragm).
A third aspect relates to a method for determining an objective refraction of an eye, comprising: compensating an aberration of the eye by an optical element. By compensating a (specific and/or partial) aberration of the eye, the objective refraction may be determined more accurately, as outlined herein.
In an example, the method may further include obtaining and/or measuring topographic and/or a tomographic information of a cornea of the eye, wherein the compensating includes compensating an aberration of the cornea based on the topographic and/or a tomographic information.
In an example, the compensating may further include compensating a first order, a second order, a third order and/or even a higher order aberration of the eye. In some examples, the compensating may include compensating third and/or higher order aberrations of the eye, e.g. third and/or higher order aberrations of the cornea, whereas spherical and regular cylindrical aberrations as well as aberrations caused by other elements of the eye are not compensated.
In an example, the step of compensating may include compensating a corneal refractive aberration of the eye.
In an example, the method may further include determining an aberration of the eye based on a measurement with the compensated aberration (of the optical element, as described herein). In an example, the method may then further include compensating also the determined aberration by means of the optical element. The measurement may then be repeated such that the still remaining aberration (if any) can be measured, and so forth. Hence, an iterative approach can be used, in which the total aberration of the eye is compensated step-by-step by means of the optical element until the output of the measurement device does not indicate any remaining aberration anymore.
A fourth aspect relates to a method for determining a subjective refraction of an eye comprising compensating a higher order aberration of the eye by an optical element.
A fifth aspect relates to a computer program comprising instructions that when executed by a computer or an apparatus according to one of the herein described aspects causes the computer or the apparatus to perform a method according to one of the herein described aspects. For example, the apparatus according to the first aspect (or second aspect) as described herein may include computing means (e.g., a computer, a processor, etc.) wherein the computer program may cause the apparatus of the first aspect (or the second aspect) to perform one of the according methods described herein.
It is noted that the method steps as described herein may include all aspects described herein, even if not expressly described as method steps but rather with reference to an apparatus (or device or system or computer). Moreover, the devices and computer programs as outlined herein may include means for implementing all aspects as outlined herein, even if these may rather be described in the context of method steps.
Whether described as method steps, computer program and/or means, the functions described herein may be implemented in hardware, software, firmware, and/or combinations thereof. If implemented in software/firmware, the functions may be stored on or transmitted as one or more instructions or code on a computer-readable medium (e.g., on the apparatus according to one of the herein described aspects). Computer-readable media include both computer storage media and communication media including any medium that facilitates transfer of a computer program from one place to another. A storage medium may be any available media that can be accessed by a general purpose or special purpose computer. By way of example, and not limitation, such computer-readable storage media can include RAM, ROM, EEPROM, FPGA, CD/DVD or other optical disk storage, magnetic disk storage or other magnetic storage devices, or any other medium that can be used to carry or store desired program code means in the form of instructions or data structures and that can be accessed by a general-purpose or special-purpose computer, or a general-purpose or special-purpose processor.
In
In some examples, optical divider DV may be omitted and only path i2 or only path i3 may be present.
The optional first optical path i1 may be connected to an optional apparatus unit that is configured to control the diameter of the iris diaphragm wherein said apparatus unit (as well as the optical path of said apparatus unit) may be referred to as the dynamic pupillometric channel DPC (or DPC unit). The second optical path i2 may be connected to an apparatus unit that is configured to determine the objective refraction of the eye wherein said apparatus unit (as well as the optical path of said apparatus unit) may be referred to as the objective refraction channel ORC (or ORC unit). The third optical path i3 may be connected to an apparatus unit that is configured to determine the subjective refraction of the eye wherein said apparatus unit (as well as the optical path of said apparatus unit) may be referred to as the subjective refraction channel SRC (or SRC unit).
Notably, in
In an example, the exemplary apparatus includes all three of the herein described units, namely the DPC unit, the ORC unit and the SRC unit. However, as stated herein, the apparatus according to the disclosed embodiments may include any combination of the three units and may not be limited to a certain number of units. For example, the apparatus D may solely include the ORC unit (and may thus solely be used to determine an objective refraction). In another example, the apparatus D may solely include the SRC unit (and may thus solely be used to determine a subjective refraction). In a further example, the apparatus may include the ORC unit and the SRC unit such that an objective, as well as a subjective refraction can be determined via the apparatus D. In addition, the apparatus may also include the DPC unit in combination with the ORC unit and/or the SRC unit such that the determination of the objective and/or subjective refraction may be accompanied by the functionality of the DPC unit. To that regard, the DPC unit may enable to measure and control the diameter of the iris diaphragm while an optometry measurement is executed via the ORC unit and/or SRC unit.
Notably, the DPC unit, the ORC unit and/or the SRC unit may be separate apparatuses and may thus be coupled by the optical divider DV to form a system that functions as if it were a single apparatus according to the disclosed embodiments. Alternatively, they may form an integrated system.
In the following, the units of the apparatus and their possible interactions and combination are explained.
As the exemplary apparatus may include various other optical components for analyzing the eye, the OR light beam may initially pass various optical components (such as an LED assembly 3 and/or an optical divider DV) that may not significantly interfere with the OR light beam. Subsequently the OR light beam may pass a focusing lens 18 which may include various lenses to focus and/or collimate the OR light beam. Subsequently, the OR light beam may be shaped by an optical element as described herein to compensate a (specific) aberration of the eye. The optical element may include various components to shape the OR light beam (however, the herein described optical element may also be included of a single optical component). In the example of
In the following, aspects of the exemplary optical element and its components are described.
The tilting mirrors 21a and 21b of the tilting mirrors group 21 may be used to correct components Kx and Ky of an angle K of the OR light beam exiting the eye E. The mirrors 21a and 21b may be preferably motorized and controlled by a control unit 13 of the apparatus which may enable a dynamical compensation of the components Kx and Ky of the angle K. For example, the tilting mirrors 21a and 21b may compensate the first order aberration of the eye which may be a vertical tilt and/or a horizontal tilt (e.g., according to the first order Zernike polynomials).
The optical correction group 9 may be motorized and include a series of lenses and/or mirrors to compensate a second order aberration (e.g., a second order spherical and/or cylindrical refractive aberration), as well as a high order aberration of the eye for the OR light beam. The optical correction group 9 may be controlled by the control unit 13 to dynamically compensate the objective refraction of the eye E measured by the wavefront analyzer 16.
The optical unit 9a may enable to compensate or correct a second order spherical aberration (e.g., a spherical refractive error, e.g., a defocus). This may be achieved with a motorized spherical optic controlled by the control unit 13. For example, the optical unit 9a may include a lens that can be shifted along the optical path of the OR light beam to correct a second order spherical aberration of the eye E that was imparted onto the OR light beam. In a further example, the compensation by the optical unit 9a may be achieved by a spherical optic with an adaptive profile controlled by the control unit 13.
The optical unit 9b may enable to compensate or correct a second order cylindrical aberration of the eye E that was imparted onto the OR light beam (e.g., a cylindrical refractive error, e.g., regular astigmatism). This may be achieved with a motorized cylindrical optic that compensates optical power and angle stemming from the second order cylindrical aberration by means of the control unit 13 (the optical unit may thus compensate a cylindrical diopter value with a certain cylinder axis value). In a further example, this may be achieved by a cylindrical optic having an adaptive profile that compensates optical power and angle stemming from the second order cylindrical aberration by means of the control unit 13. Notably, the optical unit 9b may include any correction mechanism known in the field for correcting a second order cylindrical aberration of the eye.
The optical unit 9c may enable to compensate or correct higher order aberration of the eye. The higher order aberration may include a third order or even higher order aberration of the eye (or the cornea) as described herein. The optical unit 9c may include an adaptive optic/mirror 9c which can be used to compensate one or more higher order aberrations of the eye E. This may be achieved by the adaptive optic/mirror 9c which may be shaped, by means of a set of piezoelectric actuators that may be controlled by control unit 13 such that one or more higher order aberrations of the eye E that were imparted onto the OR light beam are compensated. The adaptive optic/mirror 9c may include a deformable mirror that can be adjusted via the set of piezoelectric actuators.
In an example, the adaptive optic/mirror 9c may be shaped to compensate the higher order corneal refractive aberrations of the cornea E which were detected by means of a corneal topographer and/or tomographer 19. The corneal refractive aberrations usually represent the highest percentage of the total higher order aberrations of the eye and may thus impart the most effect onto the OR light beam.
In another example, the control unit 13 may control the shape of the adaptive optic/mirror 9c to also compensate the first order aberration of the eye E and/or the spherical second order aberration of the eye E and/or the cylindrical second order aberration of the eye E. The adaptive/mirror optic 9c may thus partially or completely replace the respective functionality of the tilting mirrors 21a and 21b and/or the optical unit 9a and/or the optical unit 9b.
In an example of the present disclosure, the control unit 13 may receive the (higher order) corneal refractive aberration of the eye E measured by means of a corneal topographer or tomographer 19 and may preventively control the shape of the adaptive optic/mirror 9c to compensate the (higher order) corneal refractive aberration of the eye E. The measured wavefront data may thus be corrected from the effect of the (higher order) corneal refractive aberrations of the eye. Subsequently, the control unit 13 may detect the compensated wavefront data measured by the wavefront analyzer 16. Based on the measured wavefront data, the aberrations of the eye without the effect of the corneal refractive aberration may be determined. However, based on the measured wavefront data, the control unit 13 may further iteratively control the other beam shaping optics in the apparatus to compensate the remaining aberrations of the eye present in the OR light beam (e.g. via the optical element and its components). For example, the control unit 13 may further control the mirrors 21a and 21b to compensate the first order aberration of the eye E and/or the optical unit 9a to compensate the second order spherical aberration of the eye E and/or the optical unit 9b to compensate the cylindrical second order aberration of the eye E and/or the adaptive optic/mirror 9c to compensate the (remaining) higher order aberrations of the eye E. The remaining wavefront may thus be substantially free of the eye's aberrations. Based on the further compensation the objective first, second and (remaining) higher order aberrations of the eye E may be determined with a high level of accuracy (e.g., in the specific conditions of far and/or near vision distance, e.g., with a preselected diameter of an iris diaphragm 20 which was set by the DPC unit).
In an example, the control unit 13 may control the shape of the adaptive optic/mirror 9c to compensate not only the (remaining) higher order aberrations but also the first order aberration of the eye, the spherical second order aberration of the eye and/or the cylindrical second order aberration of the eye.
Moreover, the herein described correction of the aberration (e.g., in particular correcting the corneal refractive aberrations) may ensure a one-to-one correspondence between the wavefront when exiting the cornea of the eye and when impinging on the divider element. This is for example, schematically represented in
An example of the dynamic pupillometric channel DPC (or DPC unit) is shown in
In an example, the illumination chamber may be equipped with a photodiode 10, positioned internally in the illumination chamber, and connected to the control unit 13, to measure the light intensity. This may enable to detect the level of light of the illumination chamber 17 during the control exercised on the iris diaphragm diameter 20. In an example, upstream of the sensor 8, with respect to the direction of the light radiation that originates from the eye E towards the sensor 8, a telecentric lens 6 may be installed (e.g., in form of a focal doublet, implemented by the optics 6a and 6b), to allow the focusing of the image of the iris diaphragm onto the sensor 8 (e.g., to avoid magnification errors of the image). Between the telecentric lens 6 and sensor 8 a narrow-band filter 7 may be positioned to allow the selective passage of the first infrared wavelength. This may allow for a more accurate extraction of the diameter of the iris diaphragm 20 by means of the control unit (13).
In an example, the control unit 13 of the DPC may be configured to enable a variation of the quantity of light inside the illumination chamber 17, to vary the diameter of the iris diaphragm 20 to a set value by an automatic or manual procedure (e.g., selectable by an operator). The method of controlling the diameter of the iris diaphragm 20 by the DPC, which is operated by the control unit 13 may include the following steps:
The extracted diameter and the predefined reference value may then be compared.
If they match to within a threshold that may be predefined or at the operator's discretion, the method may end. Otherwise, the operator and/or the DPC may automatically adjust the lighting condition to move closer to the predefined reference value. The acquisition and extraction steps may then be repeated, as well as the comparing step.
Subsequently, the functionality that can be implemented from the herein mentioned DPC, when equipped with the photodiode 10 is described. In an example, the control unit 13 may be configured, not only to control the dimension of the diameter of the iris diaphragm 20 during the execution of objective refraction and/or subjective refraction and/or quality of vision measurements. The control unit 13 may also be configured to execute measurements of the diameter of the iris diaphragm 20 for several, numerable and possibly predefined, values of illumination of the chamber 17. In this scenario, the photodiode 10, by means of the control unit 13, may allow to set different predefined values of the lighting of the chamber 17 and, to correspondingly determine the size of the diameter of the iris diaphragm 20. Said illumination values may be determined in the range that varies between the photopic condition of the patient, that is in the condition of maximum environmental lighting (for example 100.000 lux), and the scotopic condition, that is absolute darkness (for example 0 lux). In an example, the control unit 13 may be suitable to allow multiple acquisitions (that may be repeated) of the value of the diameter of the iris diaphragm 20, with the purpose to detect the dynamic stabilization of the iris diaphragm for each predefined condition of lighting and therefore, to allow the detection of the average diameter of the iris diaphragm 20 for each predefined condition of illumination. Notably, the DPC may enable the detection of the iris diaphragm average and/or maximum and/or minimum diameter, as well as related angles of orientation with respect to a predefined reference system.
The DPC may include an optical divider 5, which may be totally reflective in the first infrared wavelength that images the eye E by means of the LEDs 3 such that the image is transmitted via the first infrared wavelength onto the sensor 8. However, the optical divider 5 may be totally transparent in a second infrared wavelength, for example, for a wavelength between 800 nm and 900 nm, to allow the injection of the second infrared wavelength onto the retina 22 of the eye E which may be focused thereon. The laser diode 4 may be the emitter of the second infrared wavelength which may be guided onto the retina 22 of the eye E to allow the execution the objective refractometric measurement by means of the ORC unit as described herein. The laser diode 4 may also include any other light source that is suitable to execute the objective refractometric measurement (e.g., a light emitting diode, any other types of laser light sources) and may thus not be limited to a laser diode, as such.
Coming back to the ORC unit of
Subsequently, an interplay of the DPC unit, the ORC unit and the SRC unit of the exemplary apparatus is explained. In an example, the optical divider 11 shown in
Furthermore,
The SRC unit may implement means and functions to execute the subjective refraction determination of the eye E and the determination of the quality of vision of the eye E. As a main component to perform the subjective refraction determination, the SRC unit may include the display 14 that may display various signs, shapes, images. In other examples, the SRC unit may not include a display. The optical path of the SRC unit may be connected to a part of the ORC unit via the optical divider 11, which can be seen in
As seen in
The subjective refraction of the eye E and the quality of vision of the eye E may be determined via the SRC unit in far distance vision condition and/or in accommodated near distance vision condition by means of the remoter lens 12 (which may include an afocal doublet, implemented by the optics 12a and 12b) to stimulate the lens 23 of the eye E for far distance vision or to accommodate for near distance vision, preferably at a preselected diameter of the iris diaphragm 20. The display 14 may project the image of the display on the remoter lens 12. The image projected by the display 14 may be adapted to simulate the vision of the display 14 to an eye E both in “far vision” and “near vision” conditions. The apparatus may thus be configured to adapt an image the eye perceives of the display 14 to a remote location, as well as a closer location to inflict the “far vision” and/or “near vision” conditions. The stimulation with respect to a “far vision” or “near vision” may also be performed for the ORC unit when performing an objective refraction determination (since also for performing the objective refraction the display 14 may be used to have the patient focus on a certain displayed object).
The control unit 13 (and/or an operator communicating to the control unit 13 via a man/machine interface) may iteratively control the display 14 and the optical correction group 9, according to the feedback of the patient, to determine the subjective refraction and the quality of vision of an eye E both in “far vision” and “near vision” conditions. The subjective refraction examination may be performed at a preselected diameter of the iris diaphragm 20 via the mechanism of the DPC unit described herein.
The evaluation of the quality of vision of the patient (e.g., in conditions of controlled diameter of the iris diaphragm 20) can be executed by projecting one or more tests on the display 14 which may permit to evaluate interactively, as a function of the feedback of the patient in relation to the test, the quality of vision in conditions of controlled diameter of the iris diaphragm 20. The test displayed on the display 14 may include a “Contrast Sensitivity Chart”, a visual acuity test, etc.
For illustrative purposes
The disclosed embodiments can be realized very conveniently via a computer program that includes coding means for the realization of one or more steps of the method when this program is executed on a computer. Therefore, it is intended that the scope of protection is extended to said program for computers and additionally to means readable by computers that include a recorded message, said means readable with a computer include means of coding of the program for the realization of one or more steps of the method, when said program is executed on a computer.
Some realization variants to the non-limiting example described are possible, without exiting the scope of the present disclosure.
From the description mentioned above, the expert in the field can realize the objects of the present disclosure without introducing further construction details. The elements and the characteristics illustrated in the preferred different forms of realization can be combined with each other without exiting the scope of the present application. What is described with reference to the state of the art, unless specifically excluded, must be considered in combination with the characteristics of the disclosed embodiments, forming an integral part of the disclosed embodiments.
| Number | Date | Country | Kind |
|---|---|---|---|
| 22167639.8 | Apr 2022 | EP | regional |
