An Improved Method of and Apparatus for Testing the Eyes.
Year: 1899

page_text: An Improved Method of and Apparatus for Testing the Eyes.
We, GEORGE HENRY BROWN and WILFRED ERNEST BURPEE, both of 996, Elm
Street, Manchester, County of Hillsborough, State of New Hampshire, United
States of America, Opticians, do hereby declare the nature of this invention
to be as follows:-
This invention relates to a method of testing the eyes, to aid refracting opti-
cians and occulists in detecting abnormal refraction of the eye commonly called
ametropia, and also detecting any tendency of the visual lines away from paral-
lelism commonly called heterophoria, with reference to their correction with
lenses, and also to apparatus by which said method may be carried out.
Prior to this invention it has been customary to test the eyes by the use of one
or more test cards having arranged thereon letters and figures of various kinds,
shapes, and sizes, and having lines and groups of lines variously arranged, and
when several cards are used they are used at random, but in the use of such test
cards the patient is soon confused by reason of the lines on the cards running at
many different angles and located quite close together and as a consequence many
mistakes are made.
This invention has for its object first, to devise a system, whereby the test is
accomplished or the diagnosis made step by step, that is to say, a complete test
is made to ascertain or detect abnormal refraction of the eye, and also any ten-
dency of the visual lines away from parallelism, due to incoordination of the motor
muscles, by a number of successive tests followed in a certain prearranged order,
each step being taken for the accomplishment of a certain end; secondly,. to con-
struct an apparatus by which our system may be operated.
In carrying out the first part of our invention the unaided quality of vision
will be first ascertained, then spherical lenses are employed with a view to im-
proving it, then for the purpose of detecting astigmatism, which is a very common
form of ametropia, lines disposed at many different angles will be presented to
the eye and those most plainly observed will be selected and thus the principal
meridians of the eye will be located or determined.
Having thus located or determined the meridian of greatest or least refraction,
instead of proceeding at such time to build up the visual acuity to the fullest
extent with lenses, as is now the common practice, these lines are withdrawn and
other lines presented to the eye which are disposed at an angle corresponding to
the angle of the lines most plainly observed, and while such lines are before the
eye the visual acuity can be built up to the, fullest extent with lenses in the
meridian corresponding to that heretofore most plainly observed and then in
the meridian corresponding to the other principal meridian.
As a means of verifying the work other lines are afterwards presented to the

page_text: eye which are disposed in substantially as many different angles as those first
presented but differently arranged, as for instance they may be arranged in suc-
cessive pairs or groups, disposed at right angles to each other.
Ametropia may thus be detected and corrected.
For the detection and correction of heterophoria a special object will be pre-
sented to the eye which is disposed relatively to a vertical and a horizontal row
of indications, to thereby detect any incoordination of the motor muscles of the
eye, and said indications are located at predetermined distances apart so that the
degree of muscular incoordination may be ascertained.
One form of apparatus by which our invention may be practiced consists in
placing the several cards in a box or case which is made open at one end, and
attaching said cards to cords which pass over suitable pulleys and which are
extended to a distant point, where they may be manipulated in such manner that
the cards may be brought to view separately as desired.
The cords will be extended to a point within convenient reach of the operator
who will be standing beside the patient and when so located the operator may be
questioning the patient and adjusting lenses to the eyes and at the same time
manipulating the cards to suit the case without walking to and fro to adjust each
separate card.
We will now describe somewhat more fully the method and apparatus indi-
cated above.
In carrying out our method test cards are used preliminary to the test for astig-
matism and heterophoria, for the purpose of estimating the unaided quality of the
patients vision. When this card is before the eye of the patient spherical lenses
may be used with a view to improving the vision.
A card having lines thereon arranged at many angles is next employed to
locate and determine one of the principal meridians of the eye.
The said lines may be arranged in groups or otherwise as desired, and the
arrangement is such that they follow one another in sequence. Similar cards
have been used prior to this invention, but having generally located one of the
principal meridians of the eye it has been the common practice to build up the
visual acuity with lenses while a card of this kind is before the eye of the patient,
but we find in practice that on account of the many lines running at so many
different angles the patient soon becomes confused and as a result many mistakes
are made and the visual acuity in many instances cannot be built up accurately
and to its fullest extent. Therefore, the principal meridian of the eye-having
been located or determined, as it will be by selecting the lines most plainly observed
on the card just described, this card is withdrawn and a card of one of the
following descriptions is presented to the eye.
On one of these cards only certain lines appear, as for instance a set of vertical
and a set of horizontal lines, said sets of lines being disposed at right angles to
each other.
On the other also of these cards only certain lines appear, as for instance two sets
of lines, at angles between the vertical and horizontal lines, said sets of lines
being disposed at right angles to each other.
Either one of these cards will be presented to the eye according to the require-
ments of the case, it being understood that the one selected shall correspond with
the lines most plainly observed on the card used to locate and determine one of
the principal meridians of the eye.
The figures or groups of lines on the two cards last described are located far-
ther apart, so that the patient cannot become confused, and as a result the visual
acuity can be built up to the fullest extent with lenses in the meridian corre-
sponding to the lines seen plainest on the card used to locate and determine one
of the principal meridians of the eye and then in the meridian corresponding to
the other principal meridian of the eye.
This is the essential novel step in my system when using it to detect and
correct ametropia.

page_text: This result having been accomplished and the figures or groups of lines corre-
sponding to the two principal meridians of the eye made as plain as possible then
a card of the following description will be presented to the eye for the purpose of
verifying the work.
This card is in many respects the same as the card used to locate and deter-
mine the principal meridian of the eye in that it presents lines at many different
angles but the lines or groups are arranged in successive pairs, disposed at right
angles to each other, instead of being arranged in sequence or following one
another as on said card used to locate and determine the principal meridian of
the eye.
We find in practice that the contiguity of the figures and the contrast of the
lines will reveal any little uncorrected 'astigmatism that may have been "over-
looked in the previous part of the examination, thus verifying the work pre-
viously done..
$17
1.
As the system is not only intended to detect and correct any abnormal.refrac-
tion of the eye but also to detect any incoordination in the motor muscles, a fur-
ther card will then be presented to the eye. This said further card represents a
special object to be observed by the patient and a vertical and also. a. horizontal
row of indications, and, said special object is disposed relatively to said indications
so that any lack of equilibrium in these muscles may be detected and the degree
of incoordination ascertained or measured.
This card is preferably used after the card used for the purpose of verifying
the work but we desire it to be understood that it may be used after the first or
second used card, if desired.
It will thus be seen that the diagnosis is made step by step, in a regular pre-
arranged order, each step being taken for the purpose of ascertaining a certain
fact, and leading to the next step until the diagnosis is completed.
The box or case which we employ for containing the cards is made open at one
end, as for instance at the bottom, and a number of cards are contained in said
box or case. These cards are arranged-one in front of the other and guides are
provided for guiding them in a vertical direction so that they may be separately
allowed to pass down through the open bottom of the box or case by gravity to
be displayed. A cord or equivalent is attached to the upper edge of each card,
and said cords pass out through a hole in the top of the box or.case, thence over,
suitable pulleys, being extended any desired distance and to any point. desired.
A-ring is secured to the end of each cord which is adapted to engage a.hook and
when said rings are in engagement with their respective hooks the cards will be
held in their normal elevated position, being at such time concealed within the
box or case. A short distance above the hooks screw-eyes.or equivalent. devices
are provided through which the cords pass which not only serve as guides for the
cords but also serve as stops for the rings when they are disengaged from the hooks.
These hooks will be located at a suitable distance from the box.or case, as for
instance they may be located close by the patient and within convenient reach
of the operator who is standing, beside the patient.
It will be seen that when the operator desired to display any one of the cards
he will disengage one of the rings from its hook and the card which is attached
to the cord having said ring will be permitted to fall by gravity sufficiently to
display it, after which said card may be restored to its normal elevated position.
by replacing the ring on the hook.
1511
fu 1800
.
HASELTINE, LAKE & Co.,
45, Southampton Buildings, London, W.C.,
Agents for the Applicants.

page_text: 4.2
An Improved Method of and Apparatus for Testing the Eyes.
We, GEORGE HENRY BROWN and WILFRED ERNEST. BURPEE, both of 996, Elm
Street, Manchester, County of Hillsborough, State of New Hampshire; United
States of America, Opticians, do hereby declare the nature of this invention
and in what manner the same is to be performed, to be particularly described
and ascertained in and by the following statement:-
This invention relates to a method of testing the eyes, to aid refracting opti-
cians and occulists in detecting abnormal refraction of the eye commonly called
ametropia, and also detecting any tendency of the visual lines away from paral-
lelism commonly called heterophoria, with reference to their correction with
lenses, and also to apparatus by which said method may be carried out.
Prior to this invention it has been customary to test the eyes by the use of one
or more test cards having arranged thereon letters and figures of various kinds,
shapes and sizes, and having lines and groups of lines variously arranged, and
when several cards are used they are used at random, but in the use of such test
cards the patient is soon confused by reason of the lines on the cards running at
many different angles and located quite close together and as a consequence many
mistakes are made.
This invention has for its object first, to devise a system, whereby the test is
accomplished or the diagnosis made step by step, that is to say, a complete test
is made to ascertain or detect abnormal refraction of the eye, and also any ten-
dency of the visual lines away from parallelism, due to incoordination of the motor
muscles, by a number of successive tests followed in a certain prearranged order,
each step being taken for the accomplishment of a certain end; secondly, to con-
struct an an apparatus by which our system may be operated.
In carrying out the first part of our invention the unaided quality of vision
will be first ascertained, then spherical lenses are employed with a view to im-
proving it, then for the purpose of detecting astigmatism, which is a very common
form of ametropia, lines disposed at many different angles will be presented to
the eye and those most plainly observed will be selected and thus the principal
meridians of the eye will be located or determined.
Having thus located or determined the meridian of greatest or least refraction,
instead of proceeding at such time to build up the visual acuity to the fullest
extent with lenses, as is now the common practice, these lines are withdrawn and
other lines presented to the eye which are disposed at an angle corresponding to
the angle of the lines most plainly observed, and while such lines are before the
eye the visual acuity can be built up to the fullest extent with lenses in the
meridian corresponding to that heretofore most plainly observed and then in
the meridian corresponding to the other principal meridian.
As a means of verifying the work other lines are afterwards presented to the
eye which are disposed in substantially as many different anglès as those first
presented but differently arranged, as for instance they may be arranged in suc-
cessive pairs or groups, disposed at right angles to each other.
Ametropia may thus be detected and corrected.
For the detection and correction of heterophoria a special object will be pre-
sented to the eye which is disposed relatively to a vertical and a horizontal row
of indications, to thereby detect any incoordination of the motor muscles of the
eye, and said indications are located at predetermined distances apart so that the
degree of muscular incoordination may be ascertained.
Une form of apparatus by which our invention may be practiced consists in
placing the several cards in a box or case which is made open at one end, and

page_text: attaching said cards to cords which pass over suitable pulleys and which are
extended to a distant point, where they may be manipulated in such manner that
the cards may be brought to view separately as desired.
The cords will be extended to a point within convenient reach of the operator
who will be standing beside the patient and when so located the operator may be
questioning the patient and adjusting lenses to the eyes and at the same time
manipulating the cards to suit the case without walking to and fro to adjust each
separate card.
We will now describe the invention with reference to the accompanying draw-.
ings in which:
Figures 1 to 7 show a set of test cards by means of which the eyes may be
tested in accordance with the method forming the subject of this application, said
test cards being used in a certain prearranged order as will be described.
Figure 8 shows in side elevation a box or case containing the cards.
Figure 9, a front elevation of said box or case, and
Figure 10 a detail showing the means for holding or locking the ends of the
cords.
Figures 1 and 2 show the test cards which are used preliminary to the test for
astigmatism and heterophoria, said cords being employed for the
purpose of
estimating the unaided quality of the patients vision. When this card is before
the eye of the patient spherical lenses may be used with a view to improving the
vision.
Figure 3 represents a card having lines thereon arranged at many angles.
These lines may be arranged in groups or otherwise as desired, and it will be
noted that the arrangement is such that they follow one another in sequence.
This card is employed to locate and determine one of the principal meridians of
the eye.
Similar cards have been used prior to this invention, but having generally
located one of the principal meridians of the eye it has been the common practice
to build up the visual acuity with lenses while a card of this kind is before the
eye of the patient, but we find in practice that on account of the many lines run-
ning at so many different angles the patient soon becomes confused and as a
result many mistakes are made and the visual acuity in many instances cannot be
built up accurately and to its fullest extent. Therefore, the principal meridian
of the eye having been located or determined, as it will be by selecting the lines
most plainly observed on the card shown in Figure 3, this card is withdrawn and
a card such as shown in Figure 4, or Figure 5, will be presented to the eye.
On the card shown in Figure 4, only certain lines appear, as for instance a set
of vertical and a set of horizontal lines, said sets of lines being disposed at right
angles to each other.
On the card shown in Figure 5, like the card shown in Figure 4, only certain
lines appear, as for instance two sets of lines at angles between the vertical and
horizontal lines, said sets of lines being disposed at right angles to each other.
Either one of these cards will be presented to the eye according to the require-
ments of the case, it being understood that the one selected shall correspond with
the lines most plainly observed on the preceding card shown in Figure 3.
The figures or groups of lines on the cards shewn in Figures 4 and 5, are located
farther apart, so that the patient cannot become confused and as a result the
visual acuity can be built up to the fullest extent with lenses in the meridian
corresponding to the lines seen plainest on the card shewn in Figure 3 and then
in the meridian corresponding to the other principal meridian of the eye.
This is the essential novel step in my system when using it to detect and correct
ametropia.
This result having been accomplished and the figures or groups of lines corre-
sponding to the two principal meridians of the eye made as plain as possible then
the card shown in Figure 6 will be presented to the eye for the purpose of veri-
fying the work.

page_text: This card is in many respects the same as the card shown in Figure 3 in that
it "présents lines at many different angles, but the lines or groups are arranged
in successive pairs, disposed at right angles to each other, instead of being
arranged in sequence or following one another as shown in Figure 3.
We find in practice that the contiguity of the figures and the contrast of the
lines will reveal any little uncorrected astigmatism that may have been over-
looked in the previous part of the examination, thus verifying the work pre-
viously done..
.
As the system is not only intended to detect and correct any abnormal refrac
tion of the eye but also to detect any incoordination in the motor muscles, a card
such as shown in Figure 7, will then be presented to the eye. This card repre-
sents a special object to be observed by the patient and a vertical and also a hori-
zontal row of indications, and said special object is disposed relatively to said
indications so that any lack of equilibrium in these muscles may be detected and
the degree of incoordination ascertained or measured.
This card is preferably used after the card shown in Figure 6, but we desire it
to be understood that it may be used after cards shown in Figures 1 or 2 if desired.
It will thus be seen that the diagnosis is made step by step, in a regular pre-
arranged order, each step being taken for the purpose of ascertaining a certain
fact, and leading to the next step until the diagnosis is completed.
Referring to Figures 8 and 9 a represents the box or case which is made open
at one end, as for instance at the bottom, and represents a number of cards con-
tained in said box or case there being seven cards in the example therein shown.
These cards are arranged one in front of the other and guides are provided for
guiding them in a vertical direction so that they may be separately allowed to
pass down by gravity through the open bottom of the box or case to be displayed.
A corde or equivalent is attached to the upper edge of each card b, and said. cords
pass out through a hole in the top of the box or case a thence over suitable
pulleys, being extended any desired distance and to any point desired.
A ring e is secured to the end of each cord which is adapted to engage a
hook f, and when said rings are in engagement with their respective hooks the
cards will be held in their normal elevated position, being at such time concealed
within the box or case a. A short distance above the hooks f screw-eyes gor
equivalent devices are provided through which the cords pass which not only
serve as guides for the cords but also serve as stops for the rings when they are
disengaged from the hooks as represented in Figure 10.
These hooks f will be located at a suitable distance from the box or case a, as
for instance they may be located close to the patient and within convenient
reach of the operator who is standing beside the patient.
It will be seen that when the operator desires to display any one of the cards
he will disengage one of the rings from its hook and the card which is attached
to the cord having said ring will be permitted to fall by gravity sufficiently to
display it, after which said card may be restored to its normal elevated position
by replacing the ring on the hook.
Having now particularly described and ascertained the nature of our said
invention and in what manner the same is to be performed, we declare that what
we claim is:-
1. The method of testing eyes which consists in ascertaining the unaided
quality of vision, then attempting to improve the same with spherical lenses,
then presenting to the eye lines disposed at many different angles and selecting
'the lines most plainly observed, and then presenting lines disposed at an angle
corresponding to said plainly observed lines and also lines at right angles thereto,
substantially as described.
2. The method of testing eyes which consists in ascertaining the unaided
quality of vision, then attempting to improve the same with spherical lenses, then
presenting to the eye lines disposed at many different angles and selecting the

page_text: lines most plainly observed, and then presenting lines disposed at an angle
corresponding to said plainly observed lines and also lines at right angles thereto,
and then presenting lines disposed in substantially as many different angles as
at first presented but differently arranged, substantially as described.
3. The method of testing eyes which consists in ascertaining the unaided
quality of vision, then attempting to improve the same with spherical lenses,
then presenting to the eye lines disposed at many different angles but arranged
in sequence as described and selecting the lines most plainly observed, and then
presenting lines disposed at an angle corresponding to said plainly observed lines
and also lines at right angles thereto, and then presenting lines disposed in sub-
stantially as many different angles as at first presented but arranged in succes-
sive pairs, the lines of each pair being disposed at right angles to each other,
substantially as described.
4. The method of testing eyes which consists in ascertaining the unaided.
quality of vision, then attempting to improve the same with spherical lenses,
then presenting to the eye a special object to be observed disposed relatively to
a vertical and a horizontal row of indications, whereby incoordination of the
motor muscles of the eye may be detected, said indications being located at pre-
determined distances apart whereby the degree of muscular incoordination may
be ascertained, substantially as described.
5. In a device for detecting and measuring muscular incoordination of the
eyes, a chart having thereon a special object to be observed by which incoordina-
tion of the motor muscles may be detected, and also having indications above and
below it and also at each side of it, located at predetermined distances apart, by
which the degree of incoordination may be ascertained, substantially as described.
6. The combination of a box or case open at one end, a number of cards con-
tained therein and means operated from a distant point for bringing said cards
separately to view through the open end of said box or case, substantially as
described.
7. The combination of the box or casc a, made open at one end, a number of
cards contained therein, cords to which said cards are attached adapted to be
engaged and operated separately from a distant point, substantially as described.
8. The combination of the box or case a made open at one end, a number of
cards contained therein, a corresponding number of cords to which said cards are
attached, a corresponding number of guide-eyes for said cords, a ring attached to
the end of each cord and a hook for each ring, substantially as described.
Dated this 1ith day of March 1000
HASELTINE, LAKE & Co.,
45, Southampton Buildings, London, W.C.,
Agents for the Applicants.