Patent Description:
<CIT> describes an ophthalmologic apparatus capable of measuring a refractive state in a state where a pupil diameter dimension varies with respect to an eye to be examined.

Ocular aberrations typically produce unwanted results in the form of bad eyesight. To be adequately treatable, these aberrations need to be measured and characterized. To this end, various devices, apparatuses, and methods have been developed for objectively measuring characteristics, including aberrations, of a subject's eye. The measured characteristics of the eye may be employed for planning corrective actions, including for example ocular surgery such as Laser-Assisted in situ Keratomileusis ("LASIK"), laser cataract surgery, and various other treatments.

LASIK and other eye surgeries are typically planned based on the far point refractive characteristics of the eye. So it is important that an optical measurement system ensures that the subject's eye is drawn to its farthest possible refractive state when making measurements for planning the surgery.

Furthermore, when eye surgery is being planned, it is desired to measure the eye when the pupil has a large diameter so that the optical characteristics of the eye can be measured over a large area of the eye. This not only affects the treatment planning, but is also important in disqualifying a subject from being a candidate for eye surgery if certain optical abnormalities are found in the wavefront map of the eye. Such irregularities can be an indication of keratoconus or other problems. For this reason, many equipment manufacturers disqualify a subject from eye surgery if the pupil diameter is less than some minimum threshold diameter (e.g., <NUM>).

However, there are some problems in simultaneously insuring that the subject's eye is drawn to its farthest possible refractive state when making measurements, while also maintaining the pupil open with as large of a diameter as possible.

To meet the requirement that that insure that the subject's eye should be drawn to its farthest possible refractive state when making measurements, many optical measurement systems employ an internal visible target for the subject to look at or follow while the measurements are made, and the target is intended to draw the eye to its farthest possible refractive state. If this target is too bright, then the pupil will close and become smaller. Hence, it is desired to make the target as dim as possible. This is especially the case with older people, who often have a habitually small pupil. Thus, a dimmer target can open an older person's pupil to be wider.

On the other hand, however, if the target is too dim, then for some younger people, the eye might not follow the target and reach its farthest possible refractive state. In this case, it is said that the eye is "accommodated. " This occurs because young people are capable of changing the refractive state of their eyes to focus at near or far distances, which in general is not the case for older people. It has been observed clinically that, for a younger person whose eye is capable of accommodation, increasing the brightness level of the target will increase the likelihood of ensuring that optical measurements are made with the eye in its farthest possible refractive state.

To address these conflicting requirements, many optical measurement systems employ a target whose brightness level is an attempted compromise between being too bright for older subjects, and too dim for younger subjects. However, in practice, there seems to be no single target brightness level that achieves a satisfactory compromise.

Therefore, it would be desirable to provide a system and method for making objective measurements of a subject's eye which can draw the eye into its farthest possible refractive state while measurements are made while also maintaining a large pupil size so as to obviate one or more problems due to limitations and disadvantages of the related art. In particular, it would be desirable to provide a system and method for making objective measurements of a subject's eye which can accomplish these objectives for younger subjects as well older subjects.

Certain embodiments are defined by the appended dependent claims.

A better understanding of the features and advantages of the present invention will be obtained by referring to the following detailed description that sets forth illustrative embodiments using principles of the invention, as well as to the accompanying drawings of which:.

As discussed above, it would be desirable to provide an optical measurement system and method of operation of an optical measurement system which can draw the eye into its farthest possible refractive state when measurements are made, while also maintaining a large pupil size, for both younger subjects and older subjects. The following description describes various embodiments of the present invention. For purposes of explanation, specific configurations and details are set forth so as to provide a thorough understanding of the embodiments. It will also, however, be apparent to one skilled in the art that embodiments of the present invention can be practiced without certain specific details. Further, to avoid obscuring the embodiment being described, various well-known features may be omitted or simplified in the description.

<FIG> is a functional block diagram of one embodiment of an optical measurement instrument or optical measurement system <NUM> for measuring one or more characteristics of an eye <NUM>. Optical measurement system <NUM> includes a patient interface (e.g., a headrest and eye examination area), a camera <NUM>, a corneal topographer <NUM>, a wavefront aberrometer <NUM>, one or more displays <NUM>, one or more processors <NUM> and associated storage (e.g., memory) <NUM>, and one or more operator input devices <NUM> for receiving input or instructions from an operator <NUM>. It should be understood that optical measurement system <NUM> is simply one embodiment for illustrating principles of the invention, and that many variations are possible which may omit certain elements, add additional elements, and/or change some of the elements. For example, another optical measurement system incorporating one or more aspects of this invention may omit corneal topographer <NUM>. Some implementations may include additional elements, for example one or more loudspeakers.

In some implementations, camera <NUM> may be an eye alignment camera which is used to insure proper eye alignment when making corneal topography and/or wavefront aberrometry measurements with corneal topographer <NUM> and/or wavefront aberrometer <NUM>. Beneficially, camera <NUM> alone or in conjunction with processor(s) <NUM> may provide a continuous live display of eye <NUM> to operator <NUM> via display <NUM>.

Wavefront aberrometer <NUM> may measure wavefront aberrations of eye <NUM> from which one or more optical characteristics may be ascertained. As described in greater detail below with respect to <FIG>, wavefront aberrometer <NUM> includes a fixation target for the subject to view when measurements are made of eye <NUM>.

Although example configurations of corneal topographer <NUM> and wavefront aberrometer <NUM> will be described in further detail below with respect to <FIG>, it should be understood that these elements may employ any of a variety of other configurations.

Display(s) <NUM> may include one or more display devices which provide images and/or data to operator <NUM> under control of processor(s) <NUM>. Such images and data may include operating instructions and/or requests for input from operator <NUM>, images of eye <NUM> produced by camera <NUM>, images and data reflecting measurements of eye <NUM> performed by corneal topographer <NUM> and/or wavefront aberrometer <NUM>, etc. Display(s) <NUM> may include one or more flat panel displays, including one or more touchscreens, individual lights (e.g., light emitting diodes), or any other convenient display device(s).

Processor(s) <NUM> execute(s) computer-readable instructions for performing operations of optical measurement system <NUM>. Such operations may include adjusting one or more operating parameters of corneal topographer <NUM> and/or wavefront aberrometer <NUM>, processing data output by corneal topographer <NUM> and/or wavefront aberrometer <NUM>, interpreting and responding to inputs and/or instructions received by operator input device(s) <NUM>, generating images and/or data for display by display(s) <NUM>, etc. In particular, as described in greater detail below, processor(s) <NUM> may control or adjust a brightness level of a fixation target employed by optical measurement system <NUM>, for example as part of wavefront aberrometer <NUM>. Processor(s) <NUM> may perform into operations using instructions and/or data stored in associated storage <NUM>. Storage <NUM> may include any combination of volatile memory devices (e.g., random access memory), nonvolatile memory devices (e.g., read only memory, FLASH memory), computer readable media such as hard disk drives, optical disks, etc. In particular, storage <NUM> may store an operating system for processor(s) <NUM> and one or more computer programs which are executed by processor(s) <NUM> during operation of optical measurement system <NUM>. In some implementations, storage <NUM> may store computer-readable instructions which cause processor(s) <NUM> to execute one or more algorithms for adjusting or controlling an illumination level of a fixation target employed by optical measurement system <NUM> used when making wavefront measurements of a subject's eye <NUM>. In some implementations, storage <NUM> may store computer-readable instructions which cause processor(s) <NUM> to execute one or more algorithms described below with respect to <FIG>. In some implementations, storage <NUM> may store raw data produced by corneal topographer <NUM> and/or wavefront aberrometer <NUM>, and/or data from corneal topographer <NUM> and/or wavefront aberrometer <NUM> which has been processed by processor(s) <NUM>.

Operator input device(s) <NUM> may include any combination of the following devices: keyboard, touchscreen, touchpad, joystick, pushbuttons, roller ball, mouse, keypad, microphone, etc..

In general, processor(s) <NUM> operate in conjunction with display(s) <NUM> and operator input device(s) <NUM> to provide a user interface for receiving instructions and data from operator <NUM> and for communicating warnings, instructions, and data to operator <NUM>.

<FIG> is a more detailed diagram of portions of one embodiment of an optical measurement instrument or optical measurement system <NUM>. System <NUM> comprises a structure <NUM> having a principal surface <NUM> with an opening or aperture <NUM> therein; a plurality of first (or peripheral) light sources <NUM> provided on the principal surface <NUM> of the structure <NUM>; a plurality of second, or central, light sources <NUM> (also sometimes referred to as "Helmholtz light sources"); a detector array <NUM>; a display <NUM>; a processor <NUM>; operator input devices <NUM>; a third light source <NUM> providing a probe beam; a wavefront sensor <NUM>; and an optical system <NUM> disposed along a central axis <NUM> passing through the opening or aperture <NUM> of the structure <NUM>. Optical system <NUM> comprises a quarterwave plate <NUM>, a first beamsplitter <NUM>, a second beamsplitter <NUM>, an optical element (e.g., a lens) <NUM>, a third beamsplitter <NUM>, and a structure including an aperture <NUM>. Beneficially, third light source <NUM> includes a lamp <NUM>, a collimating lens <NUM>, and light source polarizing beamsplitter <NUM>. Associated with third light source <NUM> and wavefront sensor <NUM> in a wavefront analysis system <NUM> also comprising: a polarizing beamsplitter <NUM>; an adjustable telescope <NUM> comprising a first optical element (e.g., lens) <NUM> and a second optical element (e.g., lens) <NUM> and a movable stage or platform <NUM>; and a dynamic-range limiting aperture <NUM> for limiting a dynamic range of light provided to wavefront sensor <NUM>. It will be appreciated by those of skill in the art that the lenses <NUM>, <NUM>, or any of the other lenses discussed herein, may be replaced or supplemented by another type of converging or diverging optical element, such as a diffractive optical element. Beneficially, system <NUM> further comprises a fixation target <NUM>, comprising one or more light sources <NUM> and lenses <NUM>, <NUM>, and <NUM>.

As used herein the term "light source" means a source of electromagnetic radiation, particularly a source in or near the visible band of the electromagnetic spectrum, for example, in the infrared, near infrared, or ultraviolet bands of the electromagnetic radiation. As used herein, the term "light" may be extended to mean electromagnetic radiation in or near the visible band of the electromagnetic spectrum, for example, in the infrared, near infrared, or ultraviolet bands of the electromagnetic radiation.

In some embodiments, lamp <NUM> of third light source <NUM> may be an <NUM> SLD (super luminescent laser diode).

Beneficially, wavefront sensor <NUM> may be Shack-Hartmann wavefront sensor comprising a detector array and a plurality of lenslets for focusing received light onto its detector array. In that case, the detector array may be a CCD, a CMOS array, or another electronic photosensitive device. Embodiments of wavefront sensors which may be employed in one or more systems described herein are described in <CIT>, and <CIT>. However, other wavefront sensors may be employed instead.

Wavefront sensor <NUM> outputs signals to processor(s) <NUM> which use(s) the signals to determine ocular aberrations of eye <NUM>. Beneficially, processor(s) <NUM> is/are able to better characterize eye <NUM> by considering the corneal topography of eye <NUM>, which may also be determined by processor(s) <NUM> based on outputs of detector array <NUM>, as explained above.

The configurations and operation of display <NUM>, processor <NUM>, and operator input devices <NUM> have been described above with respect to <FIG> and will not be repeated.

As shown in <FIG>, optical measurement system <NUM> further includes a loudspeaker <NUM> which may provide audible warnings, instructions and/or other audible feedback to operator <NUM>.

Beneficially, system <NUM> includes fixation target <NUM> for the subject to view. Fixation target <NUM> is used to control the subject's accommodation, because as mentioned above it is often desired to measure the refraction and wavefront aberrations when eye <NUM> is focused at its far point (e.g., because LASIK treatments are primarily based on this).

<FIG> illustrates rays for fixation target <NUM> in optical measurement system <NUM>.

Light originates from the light source <NUM>. As shown in <FIG>, light source <NUM> is controlled by one or more signals from processor <NUM>. In particular, processor(s) <NUM> may turn on, turn off, and control the intensity of light source <NUM> and thereby the brightness level of fixation target <NUM>. In various implementations, this could be a back lit reticule or an LCD microdisplay. Lens <NUM> collects the light and forms an aerial image T2 of light source <NUM>. This aerial image is what the subject actually views. In some embodiments, the aerial image T2 has the pattern and shape of a spoked wheel with a clear center which attracts subjects to stare at it. Rays drawn from T1 to T2 indicate this imaging condition. Lens <NUM> may be used to magnify the aerial image T2 to the appropriate size and also to provide mechanical clearance as the movable stage or platform <NUM> moves.

<FIG> shows the rays from the retina of eye <NUM> to T2. This indicates a condition when the target T2 would appear in focus to the subject. This state would tend to induce accommodation and would not be desired for measuring the far point of the eye.

From this condition, movable stage or platform <NUM> is moved down until eye <NUM> can no longer focus the target T2 and the target T2 appears fuzzy. This relaxes the subject's accommodation until the far point is reached, at which point the refraction and aberrations of eye <NUM> are measured.

<FIG> shows that the subject views the fixation target T2 through lenses <NUM> and <NUM>. Two lenses are used in order to form a retrofocus lens so that the principal plane of the lens group can be made to coincide with the principal plane of lens <NUM> of wavefront analysis system <NUM>. This makes it so the vergences on the path of wavefront sensor <NUM> and the fixation target path match for all positions of movable stage <NUM>, which is a necessary condition for the fogging function to work properly.

<FIG> illustrates rays for a probe beam employed in system <NUM> of <FIG> for wavefront analysis.

Beneficially, in system <NUM> the refraction and aberrations of eye <NUM> are measured using light that is injected into eye <NUM> and that scatters off the eye's retina.

In <FIG> rays leave lamp <NUM> and are collimated by lens <NUM>. The light passes through light source polarizing beam splitter <NUM>. The light entering light source polarizing beam splitter <NUM> is partially polarized. Light source polarizing beam splitter <NUM> reflects light having a first, S, polarization, and transmits light having a second, P, polarization so the exiting light is <NUM>% linearly polarized. In this case, S and P refer to polarization directions relative to the hypotenuse in light source polarizing beam splitter <NUM>.

Light from light source polarizing beam splitter <NUM> enters polarizing beamsplitter <NUM>. The hypotenuse of polarizing beamsplitter <NUM> is rotated <NUM> degrees relative to the hypotenuse of light source polarizing beamsplitter <NUM> so the light is now S polarized relative the hypotenuse of polarizing beamsplitter <NUM> and therefore the light reflects upwards.

The light from polarizing beamsplitter <NUM> travels upward and passes through telescope <NUM> comprising lenses <NUM> and <NUM>. Back reflections off of lenses <NUM> and <NUM> will be S polarized so they will reflect off polarizing beamsplitter <NUM> and be directed toward lamp <NUM>. In the figure, the polarization is perpendicular to the plane of the paper. This reflection prevents back reflections off <NUM> and <NUM> from reaching wavefront sensor <NUM>. In practice, the reflectivities of <NUM> and <NUM> should be less than <NUM>% for no back reflections to appear on wavefront sensor <NUM>.

After passing through lens <NUM>, the light reflects off first beamsplitter <NUM>, retaining its S polarization, and then travels through quarterwave plate <NUM>. Quarterwave plate <NUM> converts the light to circular polarization. The light then travels through aperture <NUM> in principal surface <NUM> of structure <NUM> to eye <NUM>. Beneficially, the beam diameter on the cornea is between <NUM> and <NUM>. Then the light travels through the cornea and focuses onto the retina of eye <NUM>.

The focused spot of light becomes a light source that is used to characterize eye <NUM> with wavefront sensor <NUM>.

<FIG> illustrates rays from the focused spot on the retina that to the wavefront sensor <NUM> in system <NUM> of <FIG>.

Light from the probe beam that impinges on the retina of eye <NUM> scatters in various directions. Some of the light travels back out of the cornea and to the wavefront sensor <NUM>. Measurements indicate that of the light sent into the cornea, only about <NUM>/4000th is reflected back out. This light then travels as a semi-collimated beam back towards system <NUM>.

Upon scattering, about <NUM>% of the light retains its polarization. So the light traveling back towards system <NUM> is substantially still circularly polarized. The light then travels through aperture <NUM> in principal surface <NUM> of structure <NUM>, through quarterwave plate <NUM>, and is converted back to linear polarization. Quarterwave plate <NUM> converts the polarization of the light from the eye's retina so that is it is P polarized, in contrast to probe beam received from third light source <NUM> having the S polarization. This P polarized light then reflects off of first beamsplitter <NUM>, travels through telescope <NUM>, and then reaches polarizing beamsplitter <NUM>. Since the light is now P polarized relative the hypotenuse of polarizing beamsplitter <NUM>, the beam is transmitted and then continues onto wavefront sensor <NUM>.

When wavefront sensor <NUM> is a Shack-Hartmann sensor, the light is collected by the lenslet array in wavefront sensor <NUM> and an image of spots appears on the detector array (e.g., CCD) in wavefront sensor <NUM>. This image is then provided to processor <NUM> and analyzed to compute the refraction and aberrations of eye <NUM>.

Although not shown in <FIG>, in some implementations optical measurement system <NUM> further includes one or more eye illumination sources and camera <NUM> for capturing images of a subject's eye <NUM>.

Further details of various example implementations and operations of optical measurement system <NUM> may be found in <CIT>.

As explained above, when making measurements of a subject's eye <NUM> it is desired to simultaneously insure that the subject's eye <NUM> should be drawn to its farthest possible refractive state by fixation target <NUM>, while also maintaining the pupil of eye <NUM> open with as large of a diameter as possible, and at least a diameter which is large enough to qualify the subject as a candidate for eye surgery (if such surgery is otherwise appropriate).

As further explained above, for older subjects fixation target <NUM> should be maintained at a relatively dim level by decreasing the intensity of light source <NUM> to open the pupil of eye <NUM>. The present inventors have come to appreciate that a target brightness level of <NUM> cd/m<NUM> at eye <NUM> can produce good measurement results for many older subjects (e.g., subjects <NUM> years old and older).

On the other hand, the present inventors have come to appreciate that if fixation target <NUM> has the dim brightness level (e.g., <NUM> cd/M<NUM>) that is suitable for such older subjects, this brightness level is often not suitable for many younger subjects (e.g., subjects younger than <NUM> years old), because when a younger person views an object this dim, then the refractive state of the subject will frequently be accommodated. The present inventors have come to appreciate that it is only when a brighter target is moved into a fogged position, optically beyond the most accommodative state that a younger person's eye can achieve, that the eye reaches its farthest refractive state. In particular, the present inventors have come to appreciate that a target brightness level of <NUM> cd/m<NUM> at eye <NUM> can produce good measurement results for many younger subjects (e.g., subjects younger than <NUM> years old). Further, it has been found that at such a light level, the diameter of the pupil of such a younger person's eye will remain large enough to qualify the subject for eye surgery, such as LASIK.

Accordingly, beneficially optical measurement systems <NUM> and <NUM> execute one or more methods or algorithms for adjusting the brightness level of fixation target <NUM>, and particularly the intensity of light source <NUM>, according to a relevant characteristic of the subject whose eye <NUM> is being measured. An explanation of various embodiments of such methods and algorithms will be described now with respect to optical measurement system <NUM>, but it should be understood that these descriptions also may be applied to optical measurement system <NUM>.

The method according to the invention includes providing a fixation target for a subject to view; determining or ascertaining the size or diameter of the subject's eye <NUM>; and adjusting the brightness level of the fixation target to a selected brightness level corresponding to the ascertained diameter of the pupil of the eye <NUM>. In some versions of these embodiments, a camera such as camera <NUM> may be used to ascertain the size or diameter of eye <NUM>. For example, in some versions of these implementations an image of eye <NUM> may be displayed on display <NUM> and the operator may use an operator input device <NUM> (e.g., a roller ball, mouse, or touchscreen) to note on display <NUM> boundaries defining an extent of the pupil for ascertaining its diameter. In other versions, processor(s) <NUM> may execute a pattern recognition algorithm on an image of eye <NUM> produced by camera <NUM>.

The optical measurement system <NUM> automatically determines a selected brightness level for the fixation target based on the ascertained diameter of the pupil of eye <NUM>. In some implementations, optical measurement system <NUM> may allow operator <NUM> to manually adjust the brightness level of the fixation target via an operator input device <NUM> in response to the detected pupil diameter.

In some implementations, processor(s) <NUM> of optical measurement system <NUM> provides an output signal to a light source of the fixation target which adjusts the intensity of the light source and thereby the brightness level of the fixation target to produce the selected brightness level.

In some embodiments, the method may include: receiving data pertaining to the subject; assigning the subject to an assigned age category based on the data pertaining to the subject; adjusting a brightness level of a fixation target to a selected brightness level corresponding to the assigned age category; and providing the fixation target for a subject to view. In various implementations, the data may include the subject's birth date, an age group or category to which the subject belongs, the subject's actual age, or any other information or data from which the subject may be assigned to a defined age category.

In some implementations, this data may be provided via on a data storage device or medium such as a FLASH card, optical disk, smart card, etc. In some implementations this data may be received from operator <NUM>, via the user interface (e.g., operator input devices <NUM>) of optical measurement system <NUM>, for example as described below with respect to <FIG>.

In some embodiments, optical measurement system <NUM> processes the received data to assign the subject to one of two defined age categories based on an age threshold, and sets or adjusts the brightness level of the fixation target to a selected brightness level corresponding to the assigned age category while optical measurement system <NUM> measures one of more characteristics of the subject's eye <NUM>. In some implementations, the age threshold is <NUM> years old. In that case, a subject may be assigned to either a first age category, less than <NUM> years old, or assigned to a second age category, <NUM> years old or older. However it should be understood that a different age threshold may be employed, for example <NUM> years old. When a subject is assigned to the first age category, then optical measurement system <NUM>, and particularly processor(s) <NUM> of optical measurement system <NUM>, sets or adjusts the fixation target to have a first intensity or brightness level, and when a subject is assigned to the second age category, then optical measurement system <NUM>, and particularly processor(s) <NUM> of optical measurement system <NUM>, sets or adjusts the fixation target to have a second intensity or brightness level which is less than the first intensity or brightness level. For example, the first brightness level may be about <NUM> cd/m<NUM>, and the second brightness level may be about <NUM> cd/m<NUM>. In other implementations, different brightness levels may be employed.

In some embodiments, optical measurement system <NUM> processes the received data to assign the subject to one of three defined age categories based on an two age thresholds, and sets or adjusts the brightness level of the fixation target to a selected brightness level corresponding to the assigned age category while optical measurement system <NUM> measures one of more characteristics of the subject's eye <NUM>. In some implementations, the age thresholds are <NUM> years old and <NUM> years old. In that case, a subject may be assigned to either a first age category, under <NUM> years old, or assigned to a second age category, between <NUM> and <NUM> years old, or assigned to a third age category, <NUM> years old or older. However, it should be understood that different age thresholds may be employed. When a subject is assigned to the first age category, then optical measurement system <NUM>, and particularly processor(s) <NUM> of optical measurement system <NUM>, sets or adjusts the fixation target to have a first intensity or brightness level, when a subject is assigned to the second age category, then optical measurement system <NUM>, and particularly processor(s) <NUM> of optical measurement system <NUM>, sets or adjusts the fixation target to have a second intensity or brightness level which is less than the first intensity or brightness level, and when a subject is assigned to the third age category, then optical measurement system <NUM>, and particularly processor(s) <NUM> of optical measurement system <NUM>, sets or adjusts the fixation target to have a third intensity or brightness level which is less than the second intensity or brightness level.

In general, optical measurement system <NUM>, and particularly processor(s) <NUM> of optical measurement system <NUM>, may utilize any number of different age categories and may assign a subject to one of these age categories based on the received data pertaining to the subject. In some implementations, optical measurement system <NUM>, and particularly processor(s) <NUM> of optical measurement system <NUM>, may employ a look-up table or an equation to map the subject's age to a brightness level for the fixation target. For example, the brightness level of the fixation target may be gradually decreased with increasing age over some transition interval, say from <NUM> to <NUM> years or, or from <NUM> to <NUM> years old.

In some embodiments, optical measurement system <NUM> determines or ascertains one or more vision parameters of the subject, and adjusts the brightness level of the fixation target according to the determined vision parameter(s) for the subject while optical measurement system <NUM> measures one of more characteristics of the subject's eye <NUM>. In some implementations, the vision parameter(s) may include a level of myopia of eye <NUM> and/or a level of astigmatism of eye <NUM>. In some implementations, optical measurement system <NUM>, and particularly processor(s) <NUM> of optical measurement system <NUM> may increase the brightness level of the fixation target when eye <NUM> exhibits strong myopia or strong astigmatism. In some implementations, optical measurement system <NUM> may ascertain the vision parameter(s) from data supplied to optical measurement system <NUM> by operator <NUM> via operator input device(s) <NUM>. In other implementations, optical measurement system <NUM> may ascertain the vision parameter(s) from one or more initial measurements made by optical measurement system <NUM>, for example by wavefront aberrometer <NUM>. In some implementations, optical measurement system <NUM> may determine from hazy spots on a wavefront detector of wavefront aberrometer <NUM> that the subject's eye <NUM> has a cataract. In that case, optical measurement system <NUM>, and particularly processor(s) <NUM> of optical measurement system <NUM> may increase the brightness level of the fixation target.

In some implementations, optical measurement system <NUM> may include a light detector or sensor which can sense an ambient level of level or a brightness level in the vicinity of optical measurement system <NUM>. In that case, optical measurement system <NUM> may adjust one or all of the age-dependent brightness levels of fixation target depending on the ambient light level or brightness level. For example, if the level of ambient light is high (i.e., optical measurement system <NUM> is located in a bright room) then reducing the brightness level of the fixation target may have little or no effect in the diameter of the subject's pupil. In that case, the brightness level of the fixation target may be maintained at a higher level.

<FIG> illustrate several example embodiments of part of a user interface for an optical measurement system.

In <FIG>, optical measurement system <NUM> displays a message <NUM> to operator <NUM> via display <NUM> instructing or requesting the operator to enter the subject's birth date in a data entry box <NUM>. In this case, if processor(s) <NUM> of optical measurement system <NUM> also have access to data which indicates the current date, then processor(s) <NUM> can determine the age of subject whose eye <NUM> is being measured.

<FIG> illustrates a more direct way for optical measurement system <NUM>, and more specifically processor(s) <NUM>, to obtain data indicating the age of subject whose eye <NUM> is being measured. In this embodiment, optical measurement system <NUM> displays a message <NUM> to operator <NUM> via display <NUM> instructing or requesting the operator to enter the subject's age in a data entry box <NUM>.

In the example embodiment of <FIG>, optical measurement system <NUM> displays an inquiry message <NUM> to operator <NUM> via display <NUM> asking the operator whether the subject is aged <NUM> or older. Operator <NUM> responds to the inquiry by entering a "Y" or "N" in data entry box <NUM>.

It should be understood that <FIG> illustrate but a few examples of the many possible ways that optical measurement system <NUM> may receive data pertaining to the subject from which the subject may be assigned to a defined age category, as described above.

<FIG> illustrates a first example embodiment of a process <NUM> of measuring a characteristic of a subject's eye with an appropriately lit fixation target. In some implementations, optical measurement systems <NUM> and/or <NUM> may employ process <NUM>.

In an operation <NUM>, an optical measurement system receives data pertaining to a subject whose eye is to have at least one characteristic measured by the optical measurement system. In some implementations, the data may comprise data received from an operator via one or more operator input devices as a user response to an inquiry presented to the operator by the optical measurement system via its user interface. In that case, in various implementations the user data may comprise any user data shown in <FIG> as discussed above. In other implementations, the user data may be received stored on a data storage media, such as an optical disk, FLASH memory device; etc., which is interfaced to the optical measurement system.

In an operation <NUM>, the optical measurement system assigns the subject to one of a plurality (e.g., <NUM> or <NUM>) defined age categories based on the received data pertaining to the subject, as described above.

In an operation <NUM>, the optical measurement system adjusts the brightness level of the fixation target to a selected brightness level corresponding to the assigned age category for the subject, as described above. In some implementations, a processor of the optical measurement system provides an output signal to a light source of the fixation target which adjusts the intensity of the light source and thereby the brightness level of the fixation target.

In an operation <NUM>, the optical measurement system provides the fixation target for the subject to view. In some implementations, operation <NUM> may be performed before any one or all of the operations <NUM>-<NUM> so that the fixation target is displayed to the subject at some nominal intensity or brightness level, and then the intensity or brightness level is adjusted to the selected value corresponding to the assigned age category for the subject.

In an operation <NUM>, the optical measurement system measures one or more characteristics of the subject's eye while the subject views the fixation target at the selected brightness level which corresponds to the assigned age category for the subject.

<FIG> illustrates a first example embodiment of a process <NUM> of measuring a characteristic of a subject's eye with an appropriately lit fixation target.

In an operation <NUM>, the optical measurement system provides a fixation target for the subject to view while optical measurements are made. In some implementations, the fixation target may be presented at a nominal brightness level which may be subsequently adjusted in operation <NUM> below. In other implementations, operations <NUM> and <NUM> may be performed before the fixation target is presented to the subject.

In an operation <NUM>, the optical measurement system determines or ascertains the diameter of the pupil of the subject's eye, as described above.

In an operation <NUM>, the optical measurement system adjusts the brightness level of the fixation target to a selected brightness level corresponding to the ascertained diameter of the pupil of the subject's eye, as described above. In some implementations, a processor of the optical measurement system provides an output signal to a light source of the fixation target which adjusts the intensity of the light source and thereby the brightness level of the fixation target.

In an operation <NUM>, the optical measurement system measures one or more characteristics of the subject's eye while the subject views the fixation target at the selected brightness level which corresponds to the ascertained diameter of the pupil of the subject's eye.

The use of the terms "a" and "an" and "the" and similar referents in the context of describing the invention (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The term "connected" is to be construed as partly or wholly contained within, attached to, or joined together, even if there is something intervening. The use of any and all examples, or exemplary language (e.g., "such as") provided herein, is intended merely to better illuminate embodiments of the invention and does not pose a limitation on the scope of the invention unless otherwise claimed.

Claim 1:
A method for measuring a characteristic of an eye of a subject, the method comprising:
providing a fixation target for a subject to view (<NUM>);
ascertaining a diameter of a pupil of the eye of the subject while the subject views the fixation target (<NUM>);
automatically determining a selected brightness level for the fixation target based on the ascertained diameter of the pupil of the eye;
adjusting a brightness level of the fixation target to the selected brightness level corresponding to the ascertained diameter of the pupil of the eye (<NUM>); and
objectively measuring at least one characteristic of the eye of the subject while the subject views the fixation target at the selected brightness level (<NUM>).