RING HALOMETER SYSTEM AND METHOD FOR QUANTIFYING DYSPHOTOPSIAS

A ring halometer system configured to quantify dysphotopsias in a patient. The system includes a white screen and a first light source configured to emit a glare source from the white screen. The glare source is configured to form a veil of light visible to the patient when the glare source interacts with an optical surface of the eye of the patient. The system also includes a second light source configured to project a light ring with varying luminance concentric with the glare light source on the white screen, and a controller coupled to the second light source configured to adjust a size of the light ring. The system may also include an electronic device configured to determine a level of bothersomeness of the dysphotopsias experienced by the patient based on the size of the light ring.

BACKGROUND

The present disclosure relates to a ring halometer system and a method for quantifying dysphotopsias experienced by a patient having an intraocular lens implant.

2. Description of Related Art

An intraocular lens (IOL) implant is an artificial lens used to replace the natural lens of the eye that has developed cataracts. These IOL implants may be surgically placed by extracting the natural lens of the eye from the capsular bag of the eye and then inserting the IOL into the capsular bag. A variety of different types of IOL implants exist, including monofocal IOLs, presbyopia correcting IOLs (e.g., multifocal or extended range of vision IOLs), accommodating IOLs that are configured to focus through engagement with the ciliary muscle in the eye, and toric IOLs.

Dysphotopsias (e.g., unwanted entopic phenomena, such as glare, halos, and/or starbursts) are a common source of patients' complaints after cataract and refractive surgery. In general, presbyopia correcting IOLs, such as multifocal or extended range of vision IOLs, produce higher levels of dysphotopsias than monofocal lenses. Although most patients tend to adapt over time, these entopic phenomena remain the leading cause for IOL explantation (i.e., secondary correction of an undesirable post-operative entopic phenomena) in patients implanted with a presbyopia-correcting IOL.

Conventionally, the impact of dysphotopsias in the quality of life of IOL implant patients is assessed through clinical questionnaires to quantify the frequency and level of bothersome and/or severity of the halos, glares, and/or starbursts. However, these questionnaires are strongly subjective, highly variable between different studies and sites, and require large number of patients.

Although not commonly used in the clinical practice, some visual tests have been proposed to evaluate dysphotopsias in a more quantitative way. For example, the Rostock-Glare perimeter test and the Aston Glare perimeter test are able to measure different levels of dysphotopsias to distinguish between different intraocular lens technologies. However, these methodologies are based on a perimetry technique in which one location of the visual field is tested at a time until a map of the visual field is completed. Accordingly, these methodologies are quite time consuming, typically requiring approximately 10 minutes to complete. Additionally, during the time that the test is performed using these conventional methodologies, the patient must look at a screen with a very strong light source, concentrated in the test and without changing his position. These factors, combined with the average age of the cataract patients, limit the widespread adoption of these techniques in a clinical environment.

SUMMARY

The present disclosure relates to various embodiments of a ring halometer system configured to quantify dysphotopsias in a patient, such as a patient that had cataract and refractive surgery to implant a presbyopia-correcting intraocular lens (IOL), corneal refractive surgery (e.g., LASIK or presby-LASIK), cornea reshaping (orthokeratology) to treat keratoconus, or in a patient wearing contact lenses. In one embodiment, the system includes a white screen and a first light source configured to emit a glare source (i.e., an extended source of light) from the white screen. The glare source is configured to form a veil of light visible to the patient due to the light scattered from an optical surface of the patient's eye. The system also includes a second light source (stimulus) configured to project a light ring concentric with the glare source emitted from the first light source on the white screen, and a controller coupled to the second light source configured to adjust a size of the light ring. Both the glare source and second light source are controlled by an electronic device.

The system may also include a user input device of the electronic device configured to record an indication from the patient when the size of the light ring is substantially equal to a size of the veil of light.

A memory device of the electronic device may include instructions which, when executed by a processor of the electronic device, cause the processor to determine a level of bothersomeness of the dysphotopsias experienced by the patient based on the size of the light ring.

The first light source may include a light-emitting diode (LED) and the second light source may be a projector. The light ring may be a white ring or a color ring. The first light source may include a spectrum filter to select a desired emitting spectrum of the glare source.

The system may also include a lux meter configured to automatically calibrate an illuminance of the light ring projected on the white screen by the second light source and/or to automatically calibrate an illuminance of the glare source emitted by the first light source.

The system may include a lux meter configured to check a calibration of an illuminance of the light ring projected on the white screen by the second light source and/or to check a calibration of an illuminance of the glare source emitted by the first light source.

The system may also include a controller configured to adjust the illuminance of the first light source. The illuminance of the glare light source emitted by the first light source may be in a range from approximately 1 lux to approximately 100 lux, or more preferably from approximately 20 lux to approximately 80 lux.

A luminance of the light ring emitted by the second light source may be in a range from approximately 0.5 cd/m2to approximately 110 cd/m2or more preferably from 1 cd/m2to approximately 25 cd/m2.

The present disclosure also relates to various embodiments of a computer-implemented method of quantifying dysphotopsias in a patient after intraocular lens implantation. In one embodiment, the method includes emitting, from a first light source, a glare source surrounded by a white screen. The glare source generates a veil of light in a retina of the patient. The method also includes displaying, with a second light source, a light ring on the white screen concentric with the glare source, varying a diameter of the light ring displayed on the white screen, and receiving an indication, from the patient, in response to the diameter of the light ring being substantially equal to a diameter of the veil of light.

Varying of the diameter of the light ring may include increasing the diameter of the light ring and/or decreasing the diameter of the light ring.

The method may also include quantifying a level of bothersomeness of the dysphotopsias experienced by the patient based on the diameter of the light ring following receipt of the indication from the patient.

The method may also include measuring, with a light meter, an illuminance of the glare light source from the first light source and/or the illuminance of the light ring on the white screen, and adjusting the illuminance of the glare light source and/or the illuminance of the light ring.

The method may also include measuring, with a light meter, an illuminance of the glare light source from the first light source and/or the illuminance of the light ring on the white screen, and checking if a calibration of the illuminance of the glare light source and/or the illuminance of the light ring is correct.

In another embodiment, a computer-implemented method of quantifying dysphotopsias in a patient includes viewing a glare light source emitted from a white screen, the glare light source generating a veil of light in the patient's retina, viewing a light ring on the white screen concentric with the glare light source, and adjusting a size of the light ring until a diameter of the light ring is substantially equal to a diameter of the veil of light.

The method may also include entering a selection, with a user-input device, in response to the diameter of the light ring being substantially equal to the diameter of the veil of light.

Adjusting the size of the light ring may include increasing the diameter of the light ring until the light ring is visible from the veil of light and/or decreasing the diameter of the light ring until the light ring disappears into the veil of light.

This summary is provided to introduce a selection of features and concepts of embodiments of the present disclosure that are further described below in the detailed description. This summary is not intended to identify key or essential features of the claimed subject matter, nor is it intended to be used in limiting the scope of the claimed subject matter. One or more of the described features may be combined with one or more other described features to provide a workable system or method of quantifying dysphotopsias experienced by a patient, such as a patient that had cataract and refractive surgery to implant a presbyopia-correcting intraocular lens (IOL), corneal refractive surgery (e.g., LASIK or presby-LASIK), cornea reshaping (orthokeratology) to treat keratoconus, or in a patient wearing contact lenses.

DETAILED DESCRIPTION

The present disclosure relates to various embodiments of systems and methods for quantifying the impact (e.g., the level of bothersomeness) of various dysphotopsias (e.g., entopic phenomena, such as glare, halos, and/or starbursts) experienced by a patient. The systems and methods of the present disclosure may be used to quantify the impact of various dysphotopsias in a patient, for example, after a refractive surgery that is expected to result in increased dysphotopsias, such as cataract and refractive surgery to implant a presbyopia-correcting intraocular lens (IOL), after corneal refractive surgery (e.g., LASIK or presby-LASIK), cornea reshaping (orthokeratology) to treat keratoconus, or in a patient wearing contact lenses (multifocal or other types). The systems and methods of the present disclosure are configured to quantify the impact (e.g., the bothersomeness) of dysphotopsias in a patient with an IOL in an objective manner and more quickly than conventional perimetry techniques, such as the Rostock-Glare perimeter test and the Aston Glare perimeter test.

FIGS. 1A-1Cdepict a ring halometer system100according to one embodiment of the present disclosure configured to quantify the impact (e.g., the level or degree of bothersomeness) of dysphotopsias (e.g., entopic phenomena, such as glare, halos, and/or starbursts) in a patient (e.g., dysphotopsias experienced by a patient after refractive surgery, such as cataract and refractive surgery to implant a presbyopia-correcting intraocular lens (IOL), after corneal refractive surgery, such as LASIK or presby-LASIK, after cornea reshaping (orthokeratology) to treat keratoconus, or in a patient wearing contact lenses). In the illustrated embodiment, the system100includes a screen101(e.g., a white screen, such as a white foamboard), a first light source102(e.g., at least one light-emitting diode (LED) with adjustable illuminance levels) configured to emit a glare light source (i.e., an extended source of light) from the screen101, a second light source (stimulus)103(e.g., a projector, such as a short throw or an ultra-short throw projector) configured to project a light ring on a front surface of the screen101concentric (or substantially concentric) with the first light source102, and an electronic device104electrically connected to the first light source102and the second light source103. In the illustrated embodiment, the first light source102is at least partially housed in an opening105(e.g., a hole) in the screen101, and the second light source103and the electronic device104are provided on opposite sides of the screen101.

In the illustrated embodiment, the system100also includes a power source106coupled to the first light source102. In one or more embodiments, the power source106is configured to adjust the illuminance of the first light source102. Additionally, in the illustrated embodiment, the first light source102, the second light source103, the electronic device104are connected to a power strip107(e.g., a surge protector) that is connected to an external power source.

In the illustrated embodiment, the system100also includes a lux meter108(i.e., a light meter) configured to measure the illuminance of the first light source102and/or the second light source103in lux (i.e., the lux meter108is configured to measure the luminous flux per unit area of the first light source102and/or the second light source103). The illuminance of the first light source102and/or the second light source103measured by the lux meter108may be transmitted to the electronic device104, and the electronic device104may be utilized to adjust (i.e., increase or decrease) the illuminance of the first light source102and/or the second light source103. In one or more embodiments, the system100may include a controller separate from the electronic device104configured to adjust the illuminance of the first light source102and/or the second light source103. In one or more embodiments, the illuminance of the glare source emitted by the first light source102may be adjusted in a range from approximately 1 lux to approximately 100 lux, or more preferably from approximately 20 lux to approximately 80 lux. In one or more embodiments, the luminance of the light ring emitted by the second light source103may be in a range from approximately 0.5 cd/m2to approximately 110 cd/m2or more preferably from 1 cd/m2to approximately 25 cd/m2.

The electronic device104may be a desktop computer, a laptop computer, a tablet computer, a wearable electronic device, or a “smart” cellular device. The electronic device104includes a processor109, computer-readable memory110, a display111configured to display images, a network adapter112configured to communicate with other devices over a network, and one or more input/output (I/O) devices113(e.g., a keyboard and a mouse). In the illustrated embodiment, the processor109, the memory110, the display111, the network adapter112, and the input/output (I/O) device(s)113communicate with one another over a system bus114. In one or more embodiments, the memory device110may include persistent memory, such as NAND flash memory, for storing instructions.

One of the I/O devices113of the electronic device104is configured to enable the patient to adjust the diameter of the light ring displayed on the screen101by the second light source103(i.e., the I/O device113enables the patient to increase and decrease the diameter of the light ring displayed on the screen101). In one or more embodiments, the system100may include a controller separate from the electronic device104configured to enable the patient to adjust the diameter of the light ring displayed on the screen101by the second light source103.

One of the I/O devices113of the electronic device104is configured to enable the patient to indicate (e.g., transmit a signal to the electronic device104) when the diameter of the light ring on the screen101is equal or substantially equal to the diameter of a veil of light, which is generated when the light from the first light source102interacts with an optical surface of the patient's eye (e.g., the IOL implanted in the patient), the significance of which is described below.

In one or more embodiments, the first light source102may include a spectrum filter such that the light emitted from the second light source102has a desired emitting spectrum. The light ring projected on the screen101by the second light source103may be at least one white ring and/or at least one color ring. Although in the illustrated embodiment the second light source103is configured to project a light ring on the screen101, in one or more embodiments the second light source103may be configured to project any other suitable shape on the screen101, such as, for instance, an annular segment (e.g., a semi-circle or an arc) that can increase and decrease in size, a radial segment that can expand and contract in length, Gabor gratings of different contrast levels at different eccentricities and with different dimensions to conduct a perimetry-like contrast sensitivity test, white spots at different eccentricities to perform a perimetry-like test, and/or natural (real) scene images (e.g. a traffic scene or a street at night) to conduct a more functional assessment.

In one or more embodiments, the ring halometer system100also includes a support115(e.g., a desk, table, or a cart) supporting screen101, the first light source102, the second light source103, and the electronic device104. Additionally, in the illustrated embodiment, the ring halometer system100includes a chair or other platform116to enable a patient (i.e., a user having an IOL implant) to sit in front of the screen101. In one or more embodiments, the height of the support115and/or the platform116may be configured or adjusted such that the eyeline of the patient is aligned or substantially aligned with the first light source102(i.e., the height of the patient's eyeline from the ground and the height of the first light source102from the ground are equal or substantially equal). Furthermore, in one or more embodiments, the height of the screen101and the first light source102positioned thereon may be adjusted depending, for instance, on the visual field to be measured and the distance to the patient. In one or more embodiments, the platform116(e.g., the chair) may be adjusted and positioned such that the patient's eye is at a distance D of approximately 2.5 m from the screen101and the first light source102, although in one or more embodiments the platform116(e.g., the chair) may be positioned such that the patient's eye is at any other suitable distance D from the screen101and the first light source102and the size of the light ring projected by the second light source103may be adjusted accordingly. In one or more embodiments, the platform116(e.g., the chair) may be adjusted such that the patient's eye is at a height H of approximately125cm from the floor such that the patient's eye is vertically aligned with the first light source102, although in one or more embodiments the platform116(e.g., the chair) may be such that the patient's eye is at any other suitable height H from the floor depending on the height of the first light source102from the floor.

During performance of a test utilizing the ring halometer system100, a patient (e.g., a patient that had cataract and refractive surgery to implant a presbyopia-correcting intraocular lens (IOL), corneal refractive surgery (e.g., LASIK or presby-LASIK), cornea reshaping (orthokeratology) to treat keratoconus, or a patient wearing contact lenses) faces the screen101(e.g., by sitting in the chair116) at a distance D and a height H such that the patient's eye level is substantially aligned with the first light source102(e.g., the patient's eye level is centered or substantially centered on the screen101). Once the patient is facing the screen101and the first light source102of the system100is turned on, the first light source102emits a source of light L from the plane of the screen101, which functions as a glare source. When the light L emitted from the first light source102refracts, reflects, and/or passes through an optical surface of the patient's eye (e.g., the IOL implanted in the patient's eye), it generates a veil of light in the patient's retina.FIG. 2depicts what the patient perceives during the test utilizing the ring halometer system100. In the illustrated embodiment, the patient views the glare light source L emitted from the first light source102, the veil of light V that is visible to the patient when the glare light source L emitted from the first light source102refracts, reflects, and/or passes through an optical surface of the patient's eye (e.g., the IOL implanted in the patient's eye), and the ring of light R projected by the second light source103that is concentric with the glare light L and the veil of light V. In the illustrated embodiment, the veil of light V includes a starburst pattern and a halo. As described in more detail below, the diameter of the veil of light L corresponds or correlates with the impact (e.g., the level of bothersomeness) of various dysphotopsias (e.g., entopic phenomena, such as glare, halos, and/or starbursts) experienced by the patient due to, for example, the IOL.

The patient may then adjust the diameter of the light ring R projected on the screen101utilizing one of the I/O devices113of the electronic device104(e.g., a mouse and/or keyboard) or a separate controller coupled to the second light source103. In one embodiment, the diameter of the light ring R is initially smaller than the diameter of the veil of light V, and the patient may increase the diameter of the light ring R until the light ring R becomes visible from behind the veil of light V (i.e., the patient may use one of the I/O devices113of the electronic device104or the separate controller to increase the diameter of the light ring R until the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V). In one embodiment, the diameter of the light ring R is initially larger than the diameter of the veil of light V, and the patient may decrease the diameter of the light ring R until the light ring R disappears into the veil of light V (i.e., the patient may use one of the I/O devices113of the electronic device104or the separate controller to decrease the diameter of the light ring R until the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V). In one or more embodiments, the diameter of the light ring R is equal (or substantially equal) to the diameter of the veil of light V when the light ring R has the smallest diameter such that the light ring R is still discernible from the veil of light V.

Once the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V (e.g., the light ring R appears from the veil of light V or disappears into the veil of light V), the patient may stop adjusting the diameter of the light ring R and then indicate or otherwise signal (e.g., by making a selection with the one of the I/O devices113of the electronic device104, such as the mouse) that the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V.

In one or more embodiments, the illuminance of the first light source102and/or the second light source103may be adjusted and then the patient may repeat the tasks of adjusting the diameter of the light ring R and then indicating when the diameter of the light ring R is equal or substantially equally to the diameter of the veil of light V.FIG. 3depicts a veil of light V and a light ring R viewed by a patient (e.g., a patient that had cataract and refractive surgery to implant a presbyopia-correcting intraocular lens (IOL), corneal refractive surgery (e.g., LASIK or presby-LASIK), cornea reshaping (orthokeratology) to treat keratoconus, or in a patient wearing contact lenses) during a test utilizing the ring halometer system100ofFIGS. 1A-1C, in which the illuminance of the light ring R has been increased relative to the illuminance of the light ring R depicted inFIG. 2to evaluate the scatter level of the different structures in the dysphotopsia profile, as described in more detail below.

Based on the signal received from the patient indicating that the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V, the electronic device104is configured to determine (e.g., measure or calculate) the level of impact (e.g., the level of bothersomeness) of the dysphotopsias experienced by the patient. In one or more embodiments, the memory device110of the electronic device104stores instructions which, when executed by the processor109, cause the processor109to calculate or determine the visual angle, θ (in degrees) subtended by the light ring R when the patient indicates that the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V perceived by the patient. The visual angle, θ, is determined according to Equation (1) as follows:

where Dia is the diameter of the light ring, and D is the distance from the patient (e.g., the pupil or IOL of the patient) to the screen101, as illustrated inFIGS. 1A and 1C. The memory device110of the electronic device104also stores instructions which, when executed by the processor109, cause the processor109to calculate or determine the correspondent scatter level, Scatter, when the patient indicates that the diameter Dia of the light ring R is equal or substantially equal to the diameter of the veil of light V perceived by the patient. The scatter level, Scatter, is determined according to Equation (2) as follows:

where Lv is the luminance of the light ring R (emitted from the second light source103) and Ev is the illuminance of the glare source (emitted from the first light source102) measured at the plane of the patient's eye. The scatter level Scatter calculated according to Equation 2 above can be used to evaluate the scatter levels created by an optical surface of the patient's eye (e.g., an IOL). In one or more embodiments, the luminance Lv of the light ring R and/or the illuminance Ev of the glare source may be adjusted to different levels to measure the scatter level Scatter at one or more visual angles θ (i.e., the scatter profile can be measured in vivo by adjusting the illuminance of the glare source and the luminance of the light ring). In one or more embodiments, the patient may repeatedly perform the task of adjusting the light ring R (e.g., increasing and/or decreasing the diameter of the light ring R) until the diameter Dia of the light ring R is equal (or substantially equal) to the diameter of the veil of light V, and the visual angle θ and scatter level Scatter determined according to Equations 1 and 2 above may be averaged across the tests. The scatter level created by an IOL is described in van der Mooren, Marrie, et al. “Combining in vitro test methods for measuring light scatter in intraocular lenses.” Biomedical optics express 2.3 (2011): 505-510, the entire content of which is incorporated herein by reference,

In one or more embodiments, the memory device110of the electronic device104may store a lookup table associating different visual angles θ (or different ranges of visual angles θ) with different levels of bothersomeness of the dysphotopsias. In one or more embodiments, the level of bothersomeness may range from 1 (low level bothersomeness) to 5 (high level bothersomeness), although in one or more embodiments any other suitable scale may be utilized.

FIG. 4Ais a graph depicting the visual angle θ (in degrees) subtended by the light ring R when the patient indicates that the diameter Dia of the light ring R is equal or substantially equal to the diameter of the veil of light V, as determined by a test utilizing the ring halometer system100ofFIGS. 1A-1C, for each of five different IOLs (labeled IOL1, IOL2, IOL3, IOL4, and IOL5) at two different illuminance levels (45 lux and 78 lux) of the first light source102(which generates the glare source L emitted from the plane of the screen101and the veil of light V visible by the patient).

FIG. 4Bis a graph depicting the level of bothersomeness, on a scale of1(least bothersome) to5(most bothersome), of halos and starbursts in each of the same five different IOLs (labeled IOL1, IOL2, IOL3, IOL4, and IOL5), as determined from clinical questionnaires of patients with these IOLs.

As illustrated inFIGS. 4A and 4B, there is a strong correlation between the level of bothersomeness as determined utilizing the ring halometer system100depicted inFIGS. 1A-1Cand the level of bothersomeness as indicated by the patients on the clinical questionnaires. The table below lists the coefficient of determination (R2) between the level of bothersomeness as determined by the clinical questionnaires and as determined by a test utilizing the ring halometer system100for each of two dysphotopsias (halos and starbursts) at two different levels of intensity (45 lux and 78 lux). As shown in the table below, there is a very strong correction (0.96) between the level of bothersomeness of halos and starbursts as determined by the clinical questionnaires and the level of bothersomeness of the halos and starbursts when measured utilizing the ring halometer system100at an illuminance of 45 lux. The table also shows a strong correlation (0.91) between the level of bothersomeness of halos as determined by the clinical questionnaires and the level of bothersomeness of the halos when measured utilizing the ring halometer system100at an illuminance of 78 lux, and a moderately strong correlation (0.74) between the level of bothersomeness of starbursts as determined by the clinical questionnaires and the level of bothersomeness of the starbursts when measured utilizing the ring halometer system100at an illuminance of 78 lux.

FIG. 5is a flowchart illustrating tasks of a method200of quantifying the impact (e.g., the level of bothersomeness) of dysphotopsias (e.g., entopic phenomena, such as glare, halos, and/or starbursts) in a patient, such as a patient that had cataract and refractive surgery to implant a presbyopia-correcting intraocular lens (IOL), corneal refractive surgery (e.g., LASIK or presby-LASIK), cornea reshaping (orthokeratology) to treat keratoconus, or in a patient wearing contact lenses. In the illustrated embodiment, the method200includes a task210of calibrating the ring halometer system100. In one or more embodiments, the task210of calibrating the ring halometer system100includes measuring the illuminance of the light emitted from the first light source102(e.g., the LED) and/or the illuminance of the light emitted from the second light source103(e.g., the projector) with the lux meter108(i.e., the light meter) and setting the illuminance of the light to a desired intensity, such as in a range from approximately 1 lux to approximately 100 lux, or more preferably from approximately 20 lux to approximately 80 lux (e.g., in a range from approximately 45 lux and approximately 78 lux). In task210, the lux meter108may automatically calibrate the illuminance of the light ring R projected on the white screen101by the second light source103and/or automatically calibrate an illuminance of the glare source emitted by the first light source102. In one or more embodiments, in task210, the lux meter108may be used to check (e.g., verify) a calibration of an illuminance of the light ring R projected on the white screen101by the second light source103and/or an illuminance of the glare source emitted by the first light source102is correct before the test is performed. In one or more embodiment, the luminance of the light ring emitted by the second light source103may be in a range from approximately 0.5 cd/m2to approximately 110 cd/m2or more preferably from 1 cd/m2to approximately 25 cd/m2. In one or more embodiments, the task210also includes aligning the light ring R projected from the second light source103(e.g., the projector) to be concentric or substantially concentric with the light emitted from the first light source102.FIGS. 6A-6Bdepict a task of aligning the light ring R projected from the second light source103with the glare light source L emitted from the first light source102according to one embodiment of the present disclosure includes adjusting the second light source103until the light ring R surrounds the first light source102on the screen101and four corners117of a pattern projected by the second light source103overlap corresponding alignment markers118(e.g., dots) on the screen101.FIG. 6Adepicts proper alignment between the light ring R projected by the second light source103and the first light source102, andFIG. 6Bdepicts misalignment between the light ring R projected by the second light source103and the first light source102. In one or more embodiments, the task210may include projecting a gray bar119(e.g., a gray rectangle) onto the screen101from the second light source103and confirming that a bright frame120does not appear around the gray bar119(as shown inFIG. 6A) or, if the bright frame120does appear around the gray bar119(as shown inFIG. 6B), adjusting the sharpness of the second light source103(e.g., the projector) to be zero (or substantially zero) such that the bright frame120is no longer visible.

In the illustrated embodiment, the method200also includes a task220of measuring a pupil size of one of the patient's eyes. The task220of measuring the patient's pupil size may utilize any suitable technique and/or device, such as, for example, a pupil gauge, the Rosenbaum (or equivalent) Card, a pupillometer (e.g., the Colvard pupillometer or the Procyon pupillometer), or any other device utilized by corneal topographers and tomographers. In one or more embodiments, the method200may not include the task220of measuring the pupil size of one of the patient's eyes.

In the illustrated embodiment, the method200also includes a task230of emitting, with the first light source102(e.g., at least one LED), a glare source of light from the plane of screen101(e.g., a white screen) viewed by a patient (e.g., a patient that had cataract and refractive surgery to implant a presbyopia-correcting intraocular lens (IOL), corneal refractive surgery (e.g., LASIK or presby-LASIK), cornea reshaping (orthokeratology) to treat keratoconus, or in a patient wearing contact lenses). In one or more embodiments, the illuminance of the first light source utilized in task230may be in a range from approximately 1 lux to approximately 100 lux, or more preferably from approximately 20 lux to approximately 80 lux (e.g., in a range from approximately 45 lux to approximately 78 lux). As described above, the first light source102functions as a glare source, and when the light L emitted from the first light source102refracts, reflects, and/or passes through an optical surface of the patient's eye (e.g., the IOL implanted in the patient's eye), it generates a veil of light V in the patient's retina (seeFIGS. 2-3).

In the illustrated embodiment, the method200also includes a task240of displaying, with the second light source103, a light ring R on the screen. In task240, the light ring R is concentric or substantially concentric with the light L emitted from the screen101by the first light source102. Additionally, in one or more embodiments, the light L emitted from the first light source102and the light ring R emitted from the second light source103may be centered (or substantially centered) on the screen101.

The method200also includes a task250of adjusting the diameter of the light ring R projected on the screen101such that the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V. If the diameter of the light ring R is initially smaller than the diameter of the veil of light V, the task250may include increasing the diameter of the light ring R until the light ring R becomes visible to the patient from behind the veil of light V (i.e., the task250may include increasing the diameter of the light ring R until the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V). If the diameter of the light ring R is initially larger than the diameter of the veil of light V, the task250may include decreasing the diameter of the light ring R until the light ring R disappears into the veil of light V such that the light ring R is no longer visible by the patient (i.e., the task250may include decreasing the diameter of the light ring R until the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V). In one or more embodiments, the task250may include adjusting the diameter of the light ring R until the light ring R has the smallest diameter such that the light ring R is still discernible from the veil of light V. The task250of adjusting the diameter of the light ring R may be performed by the patient (e.g., the patient may operate an I/O device, such as a mouse and/or keyboard, to increase or decrease the diameter of the light ring R) or may be performed by a technician (e.g., a clinician) running the test.

In the illustrated embodiment, the method200also includes a task260of receiving a signal or other indication from the patient when the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V (e.g., a signal or other indication from the patient that the light ring R has decreased from its initial diameter to be visually obstructed by the veil of light V, or that the light ring R has sufficiently increased from its initial diameter to now be visible to the patient from behind the veil of light V).

In the illustrated embodiment, after the patient indicates that the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V in task260, the method200includes a task270of determining (e.g., measuring or calculating) the level of impact (e.g., the level of bothersomeness) of the dysphotopsias on the patient (e.g., due to the IOL) based on the diameter of the light ring R and thus the diameter of the veil of light V. In one or more embodiments, the task270includes determining the visual angle subtended by the light ring (according to Equation 1 above) and the correspondent scatter level (according to Equation 2), and then determining the corresponding level of bothersomeness of the dysphotopsias. In one or more embodiments, the task270may reference a database, such as a lookup table, associating different visual angles (or different ranges of visual angles) with different levels of bothersomeness of the dysphotopsias. In one or more embodiments, the level of bothersomeness determined in task270may range from 1 (low level bothersomeness) to 5 (high level bothersomeness), although in one or more embodiments any other suitable scale may be utilized. In this manner, the systems and methods of the present disclosure are configured to quantify the level of bothersomeness of dysphotopsias in a more objective and less invasive manner than conventional techniques.

In one or more embodiments, the task250of adjusting the light ring (e.g., increasing and/or decreasing the diameter of the light ring) until the diameter of the light ring is equal (or substantially equal) to the diameter of the veil of light, and the task260of receiving a signal or other indication from the patient when the diameter of the light ring R is equal or substantially equal to the diameter of the veil of light V, may be repeatedly performed. Additionally, the task270of determining (e.g., measuring or calculating) the level of impact (e.g., the level of bothersomeness) of the dysphotopsias may be repeated performed each time tasks250and260are performed, and then the results may be averaged.

In one or more embodiments, the method200described above may not be performed with the ring halometer system100described above. In one or more embodiments, the method200of quantifying dysphotopsias in a patient may be performed in the Aston Glare perimeter system or the Rostock Glare perimeter system.

The above presents a description of the best mode contemplated of carrying out the concepts disclosed herein, and of the manner and process of making and using it, in such full, clear, concise, and exact terms as to enable any person skilled in the art to which it pertains to make and use the concepts described herein. The systems, methods and devices disclosed herein are, however, susceptible to modifications and alternate constructions from that discussed above which are fully equivalent. Consequently, it is not the intention to limit the scope of this disclosure to the particular embodiments disclosed. On the contrary, the intention is to cover modifications and alternate constructions coming within the spirit and scope of the present disclosure as generally expressed by the following claims, which particularly point out and distinctly claim the subject matter of the implementations described herein.

Each and every feature described herein, and each and every combination of two or more of such features, is included within the scope of the present invention provided that the features included in such a combination are not mutually inconsistent.

Although embodiments have been described and pictured in an example form with a certain degree of particularity, it should be understood that the present disclosure has been made by way of example, and that numerous changes in the details of construction and combination and arrangement of parts and steps may be made without departing from the spirit and scope of the disclosure as set forth in the claims hereinafter.

As used herein, the term “processor” refers broadly to any suitable device, logical block, module, circuit, or combination of elements for executing instructions. In a processor, as used herein, each function is performed either by hardware configured, i.e., hard-wired, to perform that function, or by more general purpose hardware, such as a CPU, configured to execute instructions stored in a non-transitory storage medium. The processor may include any combination of hardware, firmware, and software, employed to process data or digital signals. For example, the processor109can include any conventional general purpose single- or multi-chip microprocessor such as a Pentium® processor, a MIPS® processor, a Power PC® processor, AMD® processor, ARM processor, or an ALPHA® processor. In addition, the processor109can include any conventional special purpose microprocessor such as a digital signal processor. The various illustrative logical blocks, modules, and circuits described in connection with the embodiments disclosed herein can be implemented or performed with a general purpose processor or special purpose central processors (CPUs), a digital signal processor (DSP), graphics processors (GPUs), an application specific integrated circuit (ASIC), a field programmable gate array (FPGA), or other programmable logic device, discrete gate or transistor logic, discrete hardware components, or any combination thereof designed to perform the functions described herein. Processor109can be implemented as a combination of computing devices, e.g., a combination of a DSP and a microprocessor, a plurality of microprocessors, one or more microprocessors in conjunction with a DSP core, or any other such configuration. A processor may be fabricated on a single printed wiring board (PWB) or distributed over several interconnected PWBs. A processor may contain other processors; for example, a processor may include two processors, an FPGA and a CPU, interconnected on a PWB

Computer readable memory110can refer to electronic circuitry that allows information, typically computer or digital data, to be stored and retrieved. Computer readable memory110can refer to external devices or systems, for example, disk drives or solid state drives. Computer readable memory110can also refer to fast semiconductor storage (chips), for example, Random Access Memory (RAM) or various forms of Read Only Memory (ROM), which are directly connected to the communication bus114or the processor109. Other types of memory include bubble memory and core memory. Computer readable memory110can be physical hardware configured to store information in a non-transitory medium.

Methods and processes described herein may be embodied in, and partially or fully automated via, software code modules executed by one or more general and/or special purpose computers. The word “module” can refer to logic embodied in hardware and/or firmware, or to a collection of software instructions, possibly having entry and exit points, written in a programming language, such as, for example, C or C++. A software module may be compiled and linked into an executable program, installed in a dynamically linked library, or may be written in an interpreted programming language such as, for example, BASIC, Perl, or Python. It will be appreciated that software modules may be callable from other modules or from themselves, and/or may be invoked in response to detected events or interrupts. Software instructions may be embedded in firmware, such as an erasable programmable read-only memory (EPROM). It will be further appreciated that hardware modules may comprise connected logic units, such as gates and flip-flops, and/or may comprised programmable units, such as programmable gate arrays, application specific integrated circuits, and/or processors. The modules described herein can be implemented as software modules, but also may be represented in hardware and/or firmware. Moreover, although in some embodiments a module may be separately compiled, in other embodiments a module may represent a subset of instructions of a separately compiled program, and may not have an interface available to other logical program units.

In certain embodiments, code modules may be implemented and/or stored in any type of computer-readable medium or other computer storage device. In some systems, data (and/or metadata) input to the system, data generated by the system, and/or data used by the system can be stored in any type of computer data repository, such as a relational database and/or flat file system. Any of the systems, methods, and processes described herein may include an interface configured to permit interaction with users, operators, other systems, components, programs, and so forth.

As used herein, the terms “about” or “approximately”, when used in reference to a lux value of illuminance, mean within plus or minus 0.5 lux of the referenced illuminance. As used herein, the terms “about” or “approximately”, when used in reference to a linear dimension (e.g., length, width, thickness, distance, etc.) mean within plus or minus one percent (1%) of the value of the referenced linear dimension.