Digital eye examination method for remote evaluation by physician

Abstract

To provide a method for evaluating an individual's visual acuity using a computerized device.SOLUTION: Provided is a method for conducting a visual acuity test on a user, the method including: displaying information to a user using a computerized device; initiating a visual acuity test including a graphical interface into which the user provides input via a touch-sensitive field; determining distance information relating to a measured distance between the device and the user from an image of the user captured by a camera of the device; displaying a predetermined visual target for the user to view; displaying the visual acuity test without a refractive lens assembly; presenting spoken indications relating to the visual acuity test via a speaker; recording an identification content spoken by the user upon viewing the predetermined visual target via a microphone; performing voice recognition for the identification content spoken by the user to generate a converted string corresponding to the spoken identification content; and determining a score for the visual acuity test performed by the user on the basis of the converted string.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Patent Application No. 15 / 838,029, filed December 11, 2017, the entire contents of which are incorporated herein by reference.

[0002] FIELD OF THE DISCLOSURE FIELD OF THE DISCLOSURE The present disclosure relates to eye examination methods, and more particularly to computer-assisted eye examination methods without the use of photorefractive lens assemblies. [Background technology]

[0003] 2. Background Information Myopia, hyperopia, and astigmatism are common refractive errors of the eye that affect many people. Myopia, commonly referred to as nearsightedness, is a refractive defect of the eye in which an image is focused in front of the retinal imaging plane. Hyperopia, commonly referred to as "farsightedness," is a refractive defect of the eye in which an image is focused behind the retinal imaging plane. Astigmatism is a refractive defect of the eye caused by imperfect spherical curvature of the eye's optical system, causing parallel light rays to focus at two different points on the retinal imaging plane instead of one common point. Summary of the Invention [Problem to be solved by the invention]

[0004] Traditionally, people have visited an ophthalmologist at an eye clinic to diagnose such eye conditions and to obtain a prescription to purchase corrective lenses, such as contact lenses, eyeglasses, etc. Such in-person visits to an ophthalmologist can be costly and time-consuming, for example, because an individual must leave work or other commitments early and travel to the location of the eye clinic to have an eye exam.

[0005] Since a traditional in-person eye examination by an ophthalmologist takes time and has a cost problem, some computerized eye examinations that do not require an in-person eye examination by an ophthalmologist have begun. However, the present inventors have found that the existing computerized eye examinations themselves are very complicated and time-consuming, and may not provide an optimal customer experience due to technical defects of the conventional computerized eye examinations. The present disclosure provides a technical solution to such technical problems in computerized eye examinations. [Means for solving the problem]

[0006] The inventors have discovered that existing computerized eye tests can be performed on personal computing devices without a face-to-face consultation with an ophthalmologist, but are very complicated and time-consuming. In addition, they may not provide a satisfactory customer experience when the computerized eye test needs to be re-performed due to technical defects such as insufficient test result data, ambiguous test result data, lack of verification of whether the conditions are suitable for unassisted computerized eye test, lack of technical feedback to the user during the computerized eye test, etc. These challenges arise from the technical background of computerized eye tests and do not occur in traditional face-to-face eye tests by ophthalmologists using conventional refractive lens assemblies of the type commonly found in eye clinics.

[0007] The present disclosure provides a technical solution to these technical problems by providing a computerized eye test, for example a visual acuity test performed by a user wearing corrective lenses with an existing prescription, using a personal consumer computing device such as a laptop computer, tablet computer, or smartphone, without the need for an in-person eye professional examination, providing real-time feedback to the user during the eye test to increase the reliability of the eye test data obtained, and performing advanced processing on the eye test data obtained by the personal computing device during or immediately thereafter to increase the reliability of the processed eye test data. In an exemplary approach described herein, after a human technician screens the eye test data obtained at a remote computer system, the (screened) eye test data may be further reviewed by a physician, who may reissue a prescription to allow the user to purchase corrective lenses such as contact lenses or glasses online, evaluate the eye test data for concerns, or in some cases recommend an in-person eye test by a physician for further evaluation.

[0008] In one exemplary aspect, a method is described for conducting a visual acuity test for a user using a computerized consumer device. The computerized consumer device includes a display screen, a camera, a microphone, a speaker, a computer processor, and memory, and may be, for example, a tablet computer, a smart phone, or a personal computer, such as a desktop, laptop, or notebook computer. The user is a human subject. The method includes using the computerized consumer device to initiate a visual acuity test for assessing the visual acuity of the human subject user, determining, by the computerized consumer device, a separation distance between the user and the computerized consumer device based on an image size of the person's physical features using an image of the user captured by a camera of the computerized consumer device, prompting, by the computerized consumer device, the user to adjust the distance between the user and the computerized consumer device, prompting the user when a predetermined separation distance range has been reached, presenting, by the computerized consumer device, a visual acuity test without a refractive lens assembly to the user, the presentation of the visual acuity test being displayed by the computer for viewing by the user. displaying a predetermined visual target on a display screen of a computerized consumer device; recording an identification spoken by a user while looking at the predetermined visual target via a microphone of the computerized consumer device, providing real-time feedback to the user that the computerized consumer device has detected the spoken identification, performing voice recognition on the identification spoken by the user to generate a converted character string corresponding to the spoken identification, comparing, using a look-up table, words recognized in the converted character string with words that are acceptable as corresponding to the predetermined visual target, determining a score on a visual acuity test taken by the user based on the comparison, and determining whether the user has passed the visual acuity test based on the score.

[0009] In another exemplary embodiment, a consumer-based system for administering a visual acuity test to a user is described. The system includes a computerized consumer device that includes a display screen, a camera, a microphone, a speaker, a computer processor, and memory, and may be, for example, a tablet computer, a smartphone, or a personal computer, such as a desktop, laptop, or notebook computer. The user is a human subject. The system may include one or more server computers that have access to one or more databases that accessibly store the test results of visual acuity tests administered by multiple users, and a remote computer system that is used to review and evaluate the visual acuity test data and results, for example, for a medical professional, such as a screening technician or a physician, to approve the visual acuity test results for purposes of updating the user's eye prescription, for example, to allow the user to purchase corrective lenses, such as contact lenses or eyeglasses, online.The computer processor causes the computerized consumer device to initiate a visual acuity test using the computerized consumer device to evaluate the visual acuity of a human subject user, determine a separation distance between the user and the computerized consumer device based on an image size of the person's physical features using an image of the user captured by a camera of the computerized consumer device, prompt the user to adjust the distance between the user and the computerized consumer device and indicate when a predetermined separation distance range has been reached, and display a predetermined visual target on a display screen of the computerized consumer device for viewing by the user. The visual acuity test is configured to present a visual acuity test that does not use a refractive lens assembly to a user, record an identification spoken by the user when looking at a predetermined visual target via a microphone of a computerized consumer device, provide real-time feedback to the user that the computerized consumer device has detected the spoken content, perform voice recognition on the identification spoken by the user to generate a converted string corresponding to the spoken identification content, use a lookup table to compare words recognized in the converted string with words that are acceptable as corresponding to the predetermined visual target, determine a score for the visual acuity test performed by the user based on the comparison, and determine whether the user passed the visual acuity test based on the score.

[0010] In another exemplary aspect, a non-transitory computer readable medium is described that includes program instructions for enabling a computerized consumer device to perform a visual acuity test on a user. The computerized consumer device includes a display screen, a camera, a microphone, a speaker, a computer processor, and a memory, and may be, for example, a tablet computer, a smart phone, or a personal computer, such as a desktop, laptop, or notebook computer. The user is a human subject. The program instructions, when executed, cause a computer processor of the computerized consumer device to initiate a visual acuity test using the computerized consumer device including the display screen, the camera, the microphone, the speaker, the computer processor, and the memory to assess the visual acuity of the human subject user, determine a separation distance between the user and the computerized consumer device based on an image size of the person's physical features using an image of the user captured by the camera of the computerized consumer device, prompt the user to adjust the distance between the user and the computerized consumer device and to indicate that a predetermined separation distance range has been reached, and display a visual acuity test on the computerized consumer device for viewing by the user. The computerized consumer device is configured to present a visual acuity test to a user, the visual acuity test including displaying a predetermined visual target on a display screen of the device, the visual acuity test not using a refractive lens assembly, record an identification spoken by the user when viewing the predetermined visual target via a microphone of the computerized consumer device, provide real-time feedback to the user that the computerized consumer device has detected the spoken content, perform voice recognition on the identification spoken by the user to generate a converted character string corresponding to the spoken identification content, use a lookup table to compare words recognized in the converted character string with words that are acceptable as corresponding to the predetermined visual target, determine a score for the visual acuity test performed by the user based on the comparison, and determine whether the user passed the visual acuity test based on the score.

[0011] In another exemplary aspect, a method is described for conducting a visual acuity test for a user using a graphical and audio interface on a computerized consumer device, the method comprising: using a computerized consumer device having a display screen, a camera, an audio interface including a microphone and a speaker, a computer processor, and a memory, initiating a visual acuity test for assessing the visual acuity of a human subject user, the visual acuity test including a graphical interface for displaying information to the user and for the user to input via touch-sensitive fields; providing guidance to the user to move to a desired predetermined distance range by displaying distance information regarding a measured distance between the computerized consumer device and the user measured from an image of the user captured by a camera of the computerized consumer device via a graphical interface configured to dynamically display the distance information in real time as the measured distance changes; displaying a predetermined visual target for viewing by the user via a voice interface; displaying a visual acuity test without a refractive lens assembly; presenting audio instructions regarding the visual acuity test via a speaker of the voice interface; recording a spoken identification made by the user upon viewing the predetermined visual target via a microphone of the voice interface; providing real-time visual feedback to the user via the graphical interface indicating that the computerized consumer device has detected the spoken identification; performing voice recognition on the identification made by the user to generate a converted character string corresponding to the spoken identification; comparing, using a lookup table, words recognized in the converted character string with words that are acceptable as corresponding to the predetermined visual target; determining a score for the visual acuity test performed by the user based on the comparison; and determining whether the user passed the visual acuity test based on the score.

[0012] These and other features, aspects, and advantages of the present disclosure will become better understood with consideration of the following description, the appended claims, and the accompanying drawings. [Brief description of the drawings]

[0013] [Figure 1] FIG. 1 illustrates an exemplary configuration for performing a computerized eye examination using a computerized consumer device according to one exemplary embodiment. [Diagram 2] FIG. 2 illustrates a flow chart of an example methodology for conducting a computerized eye test, including a vision test, using a computerized consumer device according to one example embodiment. [Diagram 3] FIG. 3 shows a flowchart of an exemplary method for imaging the ocular surface using a personal computing device according to one exemplary embodiment. [Figure 4] FIG. 4 illustrates an exemplary initial screen (sometimes referred to as a page) of a visual acuity test graphical interface (also referred to as a graphical user interface or GUI) presented on a display screen of a computerized consumer device, such as a tablet or smartphone, via an application (or app), according to one embodiment. [Diagram 5] FIG. 5 illustrates an exemplary initial screen (sometimes referred to as a page) of a visual acuity test graphical interface (also referred to as a graphical user interface or GUI) presented on a display screen of a computerized consumer device, such as a tablet or smartphone, via an application (or app), according to one embodiment. [Figure 6] FIG. 6 illustrates an exemplary initial screen (sometimes referred to as a page) of a visual acuity test graphical interface (also referred to as a graphical user interface or GUI) presented on a display screen of a computerized consumer device, such as a tablet or smartphone, via an application (or app), according to one embodiment. [Figure 7] FIG. 7 illustrates an example GUI screen of the app when entering patient information according to one embodiment. [Figure 8] FIG. 8 illustrates an example GUI screen of the app when entering patient information according to one embodiment. [Figure 9] FIG. 9 illustrates an example GUI screen of the app when entering patient information according to one embodiment. [Figure 10] FIG. 10 illustrates an example GUI screen of the app when entering patient information according to one embodiment. [Figure 11] FIG. 11 illustrates an example GUI screen of the app when performing ocular surface imaging according to one embodiment. [Figure 12] FIG. 12 illustrates an example GUI screen of the app when performing ocular surface imaging according to one embodiment. [Figure 13] FIG. 13 illustrates an example GUI screen of the app when performing ocular surface imaging according to one embodiment. [Figure 14] FIG. 14 illustrates an example GUI screen of the app when performing ocular surface imaging according to one embodiment. [Figure 15] FIG. 15 illustrates an example GUI screen of the app when performing ocular surface imaging according to one embodiment. [Figure 16] FIG. 15 illustrates an example GUI screen of the app when performing ocular surface imaging according to one embodiment. [Figure 17] FIG. 17 illustrates an example GUI screen of the app when administering a vision test according to one embodiment. [Figure 18] FIG. 18 illustrates an example GUI screen of the app when administering a vision test according to one embodiment. [Figure 19] FIG. 19 illustrates an example GUI screen of the app when administering a vision test according to one embodiment. [Figure 20] FIG. 20 illustrates an example GUI screen of the app when administering a vision test according to one embodiment. [Figure 21] FIG. 21 illustrates an example GUI screen of the app when administering a vision test according to one embodiment. [Figure 22]FIG. 22 illustrates an example GUI screen of the app when administering a vision test according to one embodiment. [Figure 23] FIG. 23 illustrates an example GUI screen of the app when administering a vision test according to one embodiment. [Figure 24] FIG. 24 illustrates an example GUI screen of the app when administering a vision test according to one embodiment. [Diagram 25] FIG. 25 illustrates an example GUI screen of the app when administering a vision test according to one embodiment. [Figure 26] FIG. 26 illustrates an example GUI screen of the app when administering a vision test according to one embodiment. [Figure 27] FIG. 27 illustrates an exemplary GUI exit screen for the app that is displayed upon completion of the vision test according to one embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0014] The inventors have developed techniques for conveniently and reliably administering vision tests using computerized consumer devices (or consumer computing devices), such as tablet computers, smartphones, and personal computers, such as laptop, desktop, and notebook computers. The results of the vision test may be transmitted to a medical professional, such as a screening technician or a physician, via a remote computer system for review and evaluation, as described herein by way of example. Such vision tests, which may include visual acuity testing and imaging of the ocular surface, may be administered in an individual's home or other location, for example, without the need to travel to a clinic for an in-person examination by an ophthalmologist, and may provide advantages over traditional computerized vision tests, such as providing real-time feedback to the user during the test to enhance the user experience, reduce complexity, and collect reliable test data, as described herein. Such tests are particularly desirable for providing convenience while lowering costs, and for verifying the accuracy of existing (and possibly expired) lens prescriptions, and for facilitating online purchase of corrective lenses using the most recent lens prescription.

[0015] FIG. 1 illustrates an exemplary configuration for performing a computerized eye test using a computerized consumer device according to an exemplary embodiment. As illustrated in FIG. 1, a computerized consumer device 102, such as a tablet computer, a smartphone, a personal computer such as a laptop computer, a desktop computer, a notebook computer, or the like, may present one or more types of vision tests to a human subject, a user 104. The computerized consumer device 102 may also be, for example, a game console or other multimedia device. The computerized consumer device 102 may include a touch-sensitive display screen (which may be referred to as a touch screen display) 114, a speaker 116 for projecting sound, a camera 118 (including a lens, a lens cover, an image sensor, and a camera circuit), and a microphone 120 for enabling collection of user-generated voice. The vision tests may be presented to the user 104 via the display screen 114 in the form of a series of screens (or pages) of a graphical interface (also referred to as a graphical user interface or GUI) that presents various test contents and instructions to the user and prompts the user to respond or instructs the user to take a particular action. 1, two or more front-facing cameras, i.e., cameras located on the same side of the display screen 114, may be provided on the consumer device 102, e.g., spaced apart from one another, e.g., on opposite ends of the consumer device 102, to allow the user to obtain images of the user from two or more different angles or directions simultaneously. Additionally, a further rear-facing camera may be provided on the opposite side of the consumer device 102 from the display screen 114. For example, both the speaker 116 and the display screen (or touchscreen display) 114 may present instructions to the user 104, and the touchscreen display 114 and microphone 120 may be used to record the user's responses and input various vision test content or instructions.

[0016] Data collected by the computerized consumer device 102 during the vision inspection may be processed by the device 102 and further transmitted to the remote computer systems 106 and 110 via a network 134, such as the Internet. Any suitable combination of wired and wireless communications, such as Wi-Fi, Bluetooth, etc., may be used. The remote computer system 106 may act as a technician screening system operated via a display 114b by a technician 108 who may screen the vision inspection data acquired by the computerized consumer device 102. The computerized consumer device 102 and the remote computer systems 106, 110 may access and transmit data to one or more server computers 130 which have access to one or more databases 132 that store the data in any desired format. The remote computer system 110 may function as a physician review computer system operated by the physician 112, who may review, via the display 114c, the vision examination data including images of the user's eye acquired by the computerized consumer device 102 and the results of the screening performed by the technician 108, which are stored over the network 134 and accessible to the physician's remote computer system 110. In some embodiments, in addition to or instead of the display screens 114b and 114c (each of which may include multiple display screens), the physician 112 and technician 108 may view the images of the user's eye using a display device such as virtual reality (VR) goggles, head mounted displays, and three-dimensional (3D) vision enhancement devices configured to operate in conjunction with the displays 114b, 114c, or other displays that enable, for example, stereoscopic or multi-perspective images of the ocular surface with three-dimensional (3D) depth perception of the images (the images of the ocular surface are obtained from two or more different directions simultaneously by multiple forward-facing cameras 118 of the consumer device 102).

[0017] The computerized consumer device 102 includes a computer processor 122a, which may include one or more computer processing units (CPUs) and may be comprised of any suitable combination of general purpose and special purpose processors. The consumer device 102 also includes one or more memories 124a, which may include RAM, ROM, and any suitable non-volatile memory. The memory 124a may be used to store instructions for executing the vision inspection app, data entered by a user, vision inspection results generated by the vision inspection app, and any associated metadata. The computerized consumer device 102 may also include one or more interfaces 126a, e.g., a cellular communication transceiver, a Wi-Fi transceiver, a Bluetooth transceiver, to facilitate communication over a network, including the Internet, and to facilitate input / output of data, as well as wired interfaces for communication and peripheral connection. It will be appreciated that the combination of speaker 116 and microphone 120 and associated circuitry may comprise a voice user interface that enables the user 104 to perceive and provide voice data to the computerized consumer device 102. The computerized consumer device 102 also includes a GPS (Mobile Positioning System) receiver for detecting the location of the consumer device 102.

[0018] Similarly, a remote computer system 106 (e.g., a computer on which a technician performs screening) includes a computer processor 122b, which may include one or more CPUs, one or more memories 124b, which may include RAM, ROM, and any suitable non-volatile memory, and one or more interfaces 126b to facilitate communication over a network, including the Internet, and to facilitate input / output of data. The remote computer system 106 may also include one or more databases 128b to facilitate storing data in a desired format. Similarly, a remote computer system 110 (e.g., a computer on which a physician performs screening) includes a computer processor 122c, which may include one or more CPUs, one or more memories 124c, which may include RAM, ROM, and any suitable non-volatile memory, and one or more interfaces 126c to facilitate communication over a network, including the Internet, and to facilitate input / output of data, and one or more databases 128c to facilitate storing data in a desired format. And, it is equipped with.

[0019] The remote computer systems 106 and 110 may store a variety of data in memory 124b, 124c and databases 128b, 128c, 132 to support the administration, administration, processing, and review of the vision tests described herein. Such data may include, for example, medical history information of the user 104, the vision test results of the user 104, processed data generated by remotely analyzing and processing the vision test results of the user 104, images of the user 104 including video footage and still images captured during the vision test, GPS location data associated with the user 104, screening comments and decisions made by the screening technician 108, physician review comments and decisions made by the physician 112, and the like.

[0020] An exemplary method of an exemplary vision test using a computerized consumer device will be described below with reference to Figures 2-3 and further with reference to Figures 4-27. In this example, the GUI screen and audio instructions of the vision test app are presented via a display screen 114 and a speaker 116 of a computerized consumer device 102, such as a tablet or smartphone, as described above, and the input of the user 104 is recorded via a touch screen display 114 and a microphone 120 that receives the user's spoken response. In this example, a case where a vision test is performed using an image test of the ocular surface and a displayed optotype (visual letters or symbols used in vision tests) is described, but additional tests, such as a color vision test, such as the Ishihara color vision test, known in the art, can also be performed.

[0021] In addition to the steps described below, it may be desirable to perform preliminary steps to enhance the user experience. For example, in some aspects, it may be advantageous to temporarily disable or stop certain features of the consumer device 102 from running during a test, such as automatic brightness adjustments of the display screen 114 that may result in undesirable screen dimming if not stopped, automatic screen saver features that may change the screen if not stopped, automatic pop-up messages that may obscure the GUI screen of the test, etc. It will be appreciated that the consumer device 102 may present a GUI screen to the user 104 so that the user can give permission to the vision test app to perform these temporary changes.

[0022] FIG. 2 illustrates a flow chart of an exemplary method for performing a computerized eye test, including a visual acuity test, by executing a vision test application (APP) on a computerized consumer device according to one embodiment. As shown in step 202, the computerized consumer device 102 receives a command to start a visual acuity test, including a visual acuity test. Exemplary GUI screens for starting such a visual acuity test using the vision test APP according to the embodiment are shown in FIGS. 4-5 (and FIG. 17). FIG. 4 illustrates an exemplary computerized consumer device 102 including a touch screen display 114, a speaker 116, a camera 118, a microphone 120, and a control field 115, as described above. Also, the display area of ​​the touch screen display 114 is shown in dotted lines as 114a. FIG. 4 illustrates an exemplary first GUI screen of the APP presented on the display screen 114. As shown in FIG. 4, the screen in this embodiment presents the company name, the application name (e.g., EXPRESS exam) at the top, and various introductory information 412. The GUI screen of Figure 4 also includes a consent field portion 414 having a checkbox that the user 104 checks to acknowledge that the user 104 understands that the vision test provided is not a substitute for a comprehensive eye exam. The initial GUI screen of Figure 4 also includes a field 414 that the user touches to continue with the test.

[0023] Touching the "Continue" field 414 displays the GUI screen shown in Figure 5. This GUI screen includes instructions 416 instructing the user to verify that they are currently wearing corrective lenses, to find a location that is quiet, well-lit, and has, for example, 10 feet of available space, and that the test requires access to the user's current location via a GPS function. Pressing the GUI's "Next" field 418 causes the app to then display the GUI screen shown in Figure 6. Figure 6 shows an example GUI screen that displays a map location 420 and requests the user to press the "Verify Location" field 422 to verify that the location is correct.

[0024] Returning to FIG. 2, in step 204, the computerized consumer device 102 may receive input of the user's patient information from the user. Exemplary GUI screens for this step of the vision testing app are shown in FIGS. 7-10. The GUI screen shown in FIG. 7 includes prompts 424 asking the user's age, when the last comprehensive eye exam was taken, and gender (optional). This screen also includes data entry fields 426 that respond to the user's touch and allow the user to enter data from a pop-up keypad or drop-down menu, as appropriate, such as selecting date information and gender, exemplary inputs of which are shown in FIG. 8. After pressing the "Continue" field 432, the app then displays the GUI screen shown in FIG. 9. The exemplary GUI screen shown in FIG. 9 allows the user 104 to continue entering patient information, such as whether they have had an eye infection, eye surgery, or have used prescription eye drops since their last in-person eye exam, using checkbox fields 434. The user 104 is also prompted to indicate whether the user 104 has experienced any of the listed symptoms in checkbox field 436 (FIG. 9) and checkbox field 438 (FIG. 10). Note that field 438 is a continuation of field 436 that the user can access by swiping a finger across the touch screen 114 to scroll through the words. After completing the eye interview shown in FIGS. 9-10, the user can proceed to the next portion of the app by pressing "continue" field 440.

[0025] Returning to FIG. 2, the method 200 includes, at step 206, imaging the ocular surface using the camera 118 of the computerized consumer device 102. This ocular surface imaging test (which may also be referred to as, for example, an ocular surface test or an eye irritation test) may be performed either before or after a visual acuity test, and may capture images of the user's ocular surface using video and / or still imaging to allow the physician 112 to assess any easily noticeable symptoms of concern, such as excessive redness of the user's eye. Exemplary GUI screens of a vision testing app for performing this step are shown in FIGS. 11-16, and an exemplary flow chart showing exemplary steps of an ocular surface test is shown in FIG. 3. Details of the ocular surface test for step 206 are described later in this specification with reference to FIGS. 3 and 11-16.

[0026] In this embodiment, the vision test can be performed either before or after the ocular surface test, and the vision test can be initiated, for example, using the GUI screen shown in FIG. 17. As shown in FIG. 17, this GUI screen includes a message to the user indicating that a vision test is about to be performed. This exemplary GUI screen also includes an information / instruction portion 466 that visually instructs the user via the display screen 114 to hold the consumer device 102 upright or to have a friend hold the display 114 facing the user 104. This exemplary GUI screen also instructs the user to step back from the consumer device 102 until the user 104 is a predetermined distance away, for example 10 feet, while facing the screen 114. All of these instructions can also be provided audibly via the speaker 116.

[0027] The user 104 can touch the "Start Vision Test Field 468" to allow the vision test app to proceed to the actual vision test. Because the user 104 may not be able to accurately determine whether or not they are at the appropriate predetermined distance, the method 200 shown in Figure 2 includes a step 208 in which the computerized consumer device 102 automatically determines in real time the separation distance between the user and the computerized consumer device 102 based on the image size of the user's physical features based on the image of the user captured by the camera 118.

[0028] More specifically, for example, the camera 118 may capture an image of the user in real time, and the computer processor 122a of the computerized consumer device 102 may process the image in real time and then calculate the distance from the consumer device 102 to the user based on the image size of the physical features whose actual body size is known or is assumed to be known in the sense of, for example, an average or median. The example GUI screenshots shown in Figures 18-19 show the consumer device 102 performing face detection processing and image analysis to determine the distance to the user 104 by determining the apparent image size (e.g., height, width and / or area) of the user's head in pixels of the image sensor and the interpupillary distance of the user's eyes in pixels of the image sensor. In this manner, the distance determination may be based on imaging of the physical features of the user 104. Since the interpupillary distance and head size are known by average or median values, a calibration of the expected pixel distance between the imaged user's eyes or the expected pixel size of the image for the user's head (e.g., width, height, and / or area) can be stored in the memory 124a of the consumer device 102. In step 210, the consumer device 102 can prompt the user to adjust the distance between the user and the computerized consumer device 102 and can also prompt the user when a predetermined separation distance range has been reached. It is noted that the separation distance between the user 104 and the consumer device 102 does not have to be exactly the desired predetermined value, but can be within a tolerance range such as within 10% of a particular predetermined distance value, within 5% of a particular predetermined distance value, and the percentages can be different, or the deviation from a particular predetermined distance value can be a different threshold value.If real-time imaging and analysis of the size of the appropriate physical feature measured in pixels (e.g., interpupillary distance measured in pixels or head size measured in pixels) matches the expected appropriate pixel value, then the computer processor 122a of the consumer device 102 can cause the consumer device 102 to indicate to the user 104 audibly via the speaker 116 and / or visually via the display screen 114 that the user has reached the appropriate predetermined distance. Thus, for example, the separation distance can be determined without the use of any additional distance detection sensors or mechanisms other than the camera, simply by processing images captured by the camera using the computerized consumer device as described above.

[0029] For example, as shown in FIG. 12, instructions 472 for adjusting the position may be presented to the user 104 both visually on the display screen 114 and audibly via the speaker 116. Also, for example, an image of the detected user may be displayed in real time on the display screen 114, and an indicator 468, such as a circle with a graphical measure 466, and a distance indicator 470 written in numbers may be displayed in real time on the display screen 114 to provide guidance to the user with real time feedback to orient the user at an appropriate distance and in an appropriate direction relative to the consumer device 102, for example, so that the user's face is approximately in the center of the display screen 114. Audio instructions, such as "step back" or "too far", may be given. Once the distance is appropriate, as shown in FIG. 19, an indicator 474, such as a check mark in a circle, may be presented on the display screen 114 to indicate that the user has reached the appropriate distance, and / or an audio confirmation may be provided to the user via the speaker 116. Of course, the physical characteristics are not limited to physical characteristics such as the interpupillary distance of the user's eyes or the size of the user's head, but other physical characteristics with known dimensions can also be used in this analysis, such as a credit card or other object of known size held close to the user's face or chest. In the latter case, the user 104 may be appropriately instructed to hold a predefined generic object of known size.

[0030] Upon reaching the predetermined distance range as shown in FIG. 19, the consumer device 102 may automatically proceed to display a visual target on the display screen 114 to perform the next portion of the vision test. Note that, as described in step 212, the consumer device 102 presents the user with a vision test that includes presenting a predetermined visual target on the display screen 114 of the consumer device 102 for viewing by the user 104. The visual target is presented for viewing by the user without the use of a refractive lens assembly of the type commonly found in eye clinics. Examples of GUI screens for the visual target portion of the vision test are shown in FIGS. 20-25. As shown in FIG. 20, a GUI screen may be displayed on the display screen 114 presenting a graphic 476 instructing the user to cover his / her right eye, and may also simultaneously provide an audio instruction via the speaker 116 instructing the user to cover his / her right eye. The GUI screen of FIG. 20 also displays an audio indicator 478, graphically displayed on the display screen 114, having a portion 480 indicating the level of ambient sound detected via the microphone 120. The vision testing app automatically proceeds to display the GUI screen shown in Figure 21, which includes an indicia portion 482 that includes one or more indicia for the user 104 to view. The vision testing app then audibly prompts the user 104 to read or identify the letters (or other indicia, as the case may be) displayed on the screen 114. In this manner, for example, the presentation of a given indicia may be provided solely on the display screen of the computerized consumer device, without the need for an additional screen or other object in the user's vicinity to present the given indicia.

[0031] When the user 104 views and speaks out loud the displayed letters (or other visual indicia), the consumer device 102 records the identification that the user 104 vocalizes in response to viewing a given visual indicia, as described in step 214 of FIG. 2. The consumer device 102 also provides real-time feedback to the user indicating that the identification vocalized by the user has been detected by the consumer device 102. This feedback can be provided, for example, by graphically displaying on the screen 114 an audio indicator 478 and a portion 480 proportional to the level of detection of the user's vocal identification. In this way, the consumer device 102 provides the user with real-time feedback that the test is proceeding normally, so that the user is not confused as to whether the device 102 properly captured the user's vocal response to the displayed visual indicia.

[0032] The vision test app then automatically proceeds to display a GUI screen as exemplarily shown in FIG. 22, where a new graphic 484 is displayed on the display screen 114 instructing the user 104 to cover his left eye. Also, a voice instruction is given to the user 104 via the speaker 116 to cover his left eye, and another voice instruction is given to the user 104 to read out the visual indicators shown in portion 486 of the display screen 114 in FIG. 23. The consumer device 102 also records the user 104's response (step 214) and provides the user 104 with real-time sound level feedback via indicators 478 and 480 as described above. The vision test app then automatically proceeds to display a GUI screen as exemplarily shown in FIG. 24, where a new graphic 488 is displayed on the display screen 114 instructing the user to uncover both eyes. Audio instructions are communicated to the user 104 via speaker 116 to keep their eyes uncovered, and another audio instruction is given to the user 104 to read out the visual indicators shown in portion 490 of the display screen 114 in Figure 25. The consumer device 102 similarly records the responses of the user 104 (step 214) and provides real-time sound level feedback to the user 104 via indicators 478 and 480 as described above.

[0033] The predetermined visual target may be displayed on the display screen 114 of the computerized consumer device 102 without changing the size of the predetermined visual target displayed on the display screen 114 from a first size to a second size based on the separation distance between the user 104 and the computerized consumer device 102 as determined by the computerized consumer device 102 in each case, since the separation distance has already reached the predetermined distance range as described above. The size of the visual target is configured to match that of a suitable visual acuity test performed at the specific distance set for the visual acuity test, but there is no need to dynamically change the size of the visual target based on the measured distance between the user 104 and the consumer device 102.

[0034] It will be appreciated that a variety of optotypes may be used for visual acuity testing, including, but not limited to, Snellen optotypes, such as those described above. Any suitable optotype may be used, such as the Landolt rings, which are a series of rings with gaps cut in different directions (e.g., up, down, left, right), the "Tumbling E" chart, which is an "E"-shaped symbol with the "finger" pointing in a given direction, e.g., left, right, up, or down, geometric symbols (e.g., circles, squares, triangles, stars, diamonds, etc.), mathematical symbols (e.g., divide, add, multiply, subtract), shapes of common objects (e.g., balls, scissors, pencils, etc.), fruits (e.g., apples, bananas, pears, strawberries, etc.), animals, or other suitable shapes that may serve as unique symbols for use as optotypes, or other optotypes now known or hereafter developed in the art. Appropriate look-up tables may be created for suitable optotypes, such as those shown in the examples described below.

[0035] Upon completion of recording the user's responses to the displayed predetermined targets, the vision testing app may automatically proceed to display a GUI screen as shown in FIG. 26, which shows a graphic 492 instructing the user that the vision test is complete. The exemplary screen prompts the user to confirm that the user 104 maintained a predetermined distance, e.g., 10 feet, from the screen 114 of the consumer device 102 and covered their eyes as instructed. The GUI screen also includes a touch field 494 that allows the user 104 to answer in the negative to repeat the test, and a touch field 496 that allows the user to answer in the affirmative to continue. The vision testing app may then automatically proceed to display a GUI screen as shown in FIG. 27, which includes a graphic 498 instructing the user that the eye test is complete, that the test results have been submitted for review, that the doctor 112 will review the test results, and that the corrective lenses ordered by the user will be shipped once the doctor 112 issues confirmation that the test was passed. It should be noted that an attempt to purchase contact lenses may precede the vision test, and the user 104 may proceed with the vision test upon determining that the user's current prescription has in fact expired. Re-issuing corrective lens prescriptions in this manner may be used to allow a user to purchase contact lenses or glasses online from an online eyeglass retailer or in person at an eyeglass retailer's brick-and-mortar store.

[0036] After the user's spoken response is recorded (step 214), speech recognition may be performed on the vocalized identification to generate a converted string corresponding to the vocal identification of the visual indicator spoken by the user 104, as described in step 216. Any suitable language recognition algorithm may be used, such as those conventionally known in the art. This step may be performed either at the consumer device 102 or at a remote computer system, such as one or more of the remote computer systems 106, 110. At step 218 of FIG. 2, a lookup table may be used to compare words found in the converted string to words that are acceptable for a given visual indicator spoken by the user 104. It should be noted that, for example, the lookup table may include entries of multiple acceptable words for at least any one of the given visual indicators. That is, the lookup table may be a many-to-one lookup table, in the sense that the language recognition may generate several different words that may correspond to a single particular visual indicator (letter or other graphic). As an example, a hypothetical lookup table is shown in Table 1 below.

[0037] [Table 1]

[0038] In this case, it should be understood that words may include in their scope, for example, single alphabetic characters corresponding to the letter symbols of the Snellen chart, and are not limited to words of two or more letters, although if desired, the lookup table may be configured to include only words of two or more letters and exclude single, separate alphabetic characters.

[0039] As shown in Table 1, in language recognition, a language recognition engine for a given character / symbol optotype may return several possible results. A determination of whether the user 104 correctly identified the displayed optotype may be made taking these variations into account. Also, the lookup table may be updated by performing data analysis on the visual acuity test results collected from multiple, e.g., many, users 104 who have taken a visual acuity test. Specifically, the lookup table may be updated to adjust entries based on, e.g., analysis of test results in multiple instances of visual acuity tests taken by multiple users 104. For example, based on analysis of user data, it may be determined that certain words need to be added to the lookup table and other words need to be removed. It should be appreciated that both the language recognition and the comparison of the lookup table may be performed on either the consumer device 102 or a remote computer system, such as one or more of the remote computer systems 106, 110.

[0040] It should also be appreciated that the use of language recognition and a look-up table to evaluate whether a user's spoken response is a correct response as described above is not limited to the example of a visual acuity test using a Snellen chart. The exemplary visual acuity test using language recognition for a user's spoken response and a look-up table to evaluate the user's response can be performed using any suitable visual acuity test. For example, as described above, a Landolt ring chart consisting of a series of rings with gaps cut in different orientations can be used, in which case the user's spoken response can, for example, identify whether a "C" of the same or different size is "open" or "closed" in sequence, in which case a suitable look-up table can be refined to create a list of suitable responses representing correct answers. In this example, the user 104 can be prompted to identify whether the gap in the "C" points to the "left," "right," "up" or "down," and a suitable look-up table can be refined to create a list of words representing correct answers. As another example, in the case of the "Tumbling E-Chart" optotype described above, in which the "finger" of an "E"-shaped symbol is oriented in a given direction, e.g., pointing left, right, up, or down, the user's spoken response may sequentially identify whether the "E" finger is pointing "left," "right," "up," or "down" for the same or different sized optotypes, which can be refined with an appropriate look-up table to create a list of words that represent correct answers. Other optotypes can be used as well, including, but not limited to, geometric symbols (e.g., circles, squares, triangles, stars, diamonds, etc.), various characteristic shapes such as mathematical symbols (e.g., divide, add, multiply, subtract), common objects (e.g., balls, scissors, pencils, etc.), fruits (e.g., apples, bananas, pears, strawberries, etc.), animal shapes, or other suitable shapes. Whatever the optotype, an appropriate look-up table can be provided to create a list of words that correspond to the correct responses.

[0041] Also, before performing the portion of the visual acuity test in which visual indicators are displayed on the display 114 and the user's vocalized identification is recorded, a sound level test can be performed (before the user 104 performs that portion of the test) to determine whether the user's speech and test conditions are sufficient to enable the visual acuity test with the portion that actually displays the visual indicators to be performed. For example, the user 104 can be instructed to repeat a phrase spoken by the computerized consumer device 102 while the user 104 and the computerized consumer device 102 are separated by a predetermined separation distance range in order to analyze the user's voice sample using the microphone 120 of the computerized consumer device 102. The computer processor 122a can then calculate voice quality metrics based on voice processing of the voice samples and determine whether the voice quality metrics are sufficient to enable the visual acuity test to be performed before displaying the predetermined visual indicators on the display screen of the computerized consumer device 102. For example, the audio metrics may include testing the intensity level of the user's voice against the ambient sound level, or the audio metrics may be more complex metrics involving an analysis of frequencies attributable to the user's voice against ambient frequencies. Such audio quality testing before presenting the visual indicators may improve the customer experience by avoiding attempts to collect full test data when sound conditions are not adequate. If the computer processor 122a determines that sound conditions are not adequate, it may cause the consumer device 102 to audibly instruct the user 104 via the speaker 116 that the test should be discontinued due to insufficient voice recognition, and to audibly instruct the user 104 to move to a quieter location and / or repeat the test speaking louder. Reference data constituting sufficient voice recognition to proceed to the visual indicator recognition portion of the visual indicator test may be gathered by trial and error testing at various sound and / or frequency levels to ensure speech recognition.

[0042] Returning to FIG. 2, in step 220, the user's vision test score may be determined based on a comparison of words found in the converted string with words that are accepted as corresponding to a given optotype. The score may be any suitable numerical score, such as a percentage of correct answers, a simple number of correct answers, or a score level determined based on achieving a certain threshold of correct answers. In step 222, a determination may be made as to whether the user passed the vision test based on the score, for example, based on achieving a sufficient number of correct answers to pass. The scoring and pass / fail determination may be made automatically by the consumer device 102, automatically by a remote computer, such as the remote computers 106, 110 to which the results are communicated, and / or with further review by the screening technician 108 and / or the physician 112. In step 224, the results of the vision test may be communicated to the user 104 by any suitable means, such as, for example, a next GUI screen at the consumer device 102 conveying the result (e.g., "pass"), email, short message, voicemail, regular mail, etc. A copy of the updated prescription may also be sent. If an ocular surface test is also performed, it may be desirable, as a practical matter, to report the results of the vision test along with the results of the ocular surface test. In this case, if the ocular surface test includes review of ocular surface images (recorded video footage and / or recorded still images) by the physician 112, it may be preferable not to report the results of the vision test to the user 104 until the physician 112 has reviewed the ocular surface test images and made a determination as to whether the eye test was overall successful, e.g., that a current prescription may be updated, that the user 104 may proceed to order corrective lenses online, etc.

[0043] Additionally, the consumer device 102 may capture a full video and audio recording of the vision test so that, should there be any ambiguities or deficiencies in the test data obtained from the user 104 by the consumer device 102 during the vision test, such ambiguities or deficiencies may be resolved by review by the screening technician 108 and / or physician 112. This review by a medical professional and resolution of potential deficiencies or ambiguities may improve the customer experience by avoiding, for example, instructing the user 104 to repeat the vision test when in fact it is not necessary to repeat the vision test. After final review and evaluation by the medical professional, the test results may be communicated to the user 104.

[0044] Returning to FIG. 2, step 206 associated with imaging the ocular surface using the camera 118 of the consumer device 102 will now be described in more detail, as previously mentioned. FIG. 3 illustrates a flow chart of an exemplary method 300 for imaging the ocular surface according to step 206 of FIG. 2. See also FIGS. 11-16. As shown in step 302 of FIG. 3, the consumer device 102 may receive a user command to initiate imaging of the ocular surface with the consumer device 102 to capture an image of the user's ocular surface to enable a physician to evaluate the user's eye for easily noticeable symptoms of concern, such as excessive redness of the user's eye. The exemplary GUI screen of FIG. 11 includes an informational portion 422 explaining that the test involves capturing images of the user's ocular surface using a camera, such as the camera 118 of the computerized consumer device 102, and instructing the user to hold the device 102 approximately one foot from the user's face, turn up the volume of the consumer device 102, and follow the audio prompts. The consumer device 102 may also present these instructions audibly via the speaker 116. The ocular surface imaging test is initiated when the user presses the "Start Surface Test" field 444, which proceeds to cause the vision testing app to display the exemplary GUI screen shown in FIG.

[0045] As described in step 304 of Fig. 3 and shown in Fig. 12, the consumer device 102 displays a GUI screen displaying an outline graphic 446 of a predetermined size on the display screen 114, e.g., roughly the shape of a head, an oval, or other suitable outline shape, and activates the (front-facing) camera 118 and starts capturing and displaying video footage of the user 104 in real time, although the images are not necessarily recorded and stored in memory at this stage. As described in step 306, while capturing and displaying an image of the user 104 on the display screen 114 with the outline 446 in real time, the consumer device prompts the user to properly position the consumer device 102 relative to the user 104, thereby providing the user with real-time visual feedback for properly positioning the computerized consumer device 102. The computer processor 122a performs face detection on the real-time image of the user 104 and processes the image of the user 104 to determine when the user's face is correctly positioned relative to the consumer device by aligning with the outline 446. For example, as described in step 308, the computer processor 122a can determine when the separation distance and / or camera alignment between the user 104 and the consumer device 102 meets a threshold for capturing an image of the ocular surface, e.g., when the separation distance is determined to be approximately 12 inches. For example, the computer processor 122a can perform dynamic face detection, e.g., compare the size and position of the head in the image of the user 104 to the size and position of the contour 446 by analyzing pixel placements mapped to pixels of the image sensor of the camera 118 or mapped to pixels of the display screen 114, respectively. Additionally or alternatively, the computer processor 122 can detect and monitor, for example, the user's interpupillary distance in pixels until the distance corresponds to an expected pixel distance obtained when the consumer device 102 and the user's face are separated by 12 inches, e.g., based on a known average or median interpupillary distance in a population of human subjects.In step 310, the consumer device 102 may indicate to the user 104, for example with an audible and / or visual message, that the consumer device 102 is correctly positioned relative to the user's face and imaging of the ocular surface may begin.

[0046] As shown in step 312 of FIG. 3, the consumer device 102 can instruct the user 104 to direct the user's gaze to a first predetermined location, e.g., "look left," and can use the forward-facing camera 118 to capture a first ocular surface image of the user's eye at the first predetermined location (or can use two or more forward-facing cameras to capture the image simultaneously from two or more angles or directions relative to the user's eye). The image can include video footage and / or still images. In some examples, the user can be prompted to capture images of the eye simultaneously from two or more angles or directions, which can result in a stereoscopic or multi-perspective image (e.g., video or still images) of the eye with three-dimensional (3D) depth that can then be reviewed by a physician using suitable 3D glasses, virtual reality (VR) goggles, or the like. As an example of capturing an image according to step 312, an exemplary GUI screen is illustrated in FIG. 13, which shows the user's head approximately aligned with contour 446 (approximately within a suitable tolerance as discussed elsewhere herein) and an instruction 452 indicating, in this example, "Look left." The consumer device 102 may also issue an audio instruction saying "Look left." The consumer device 102 may then capture an ocular surface image of the user's eyes by either waiting a predetermined time, e.g., 1 second, 2 seconds, 3 seconds, etc., after providing the instruction, or by detecting that the user's eyes are in the correct position using face detection and analysis as described elsewhere herein.

[0047] Upon capturing an image of the ocular surface at the first predetermined location, the consumer device 102 may automatically proceed to instruct the user 104 to look at a second predetermined location and capture a second ocular surface image of the eye at the second predetermined location (step 314). An example is shown in FIG. 14, where a GUI screen is shown including a real-time image of the user 104 superimposed with an outline 446 and an instruction 454, "Look up." The consumer device 102 may also provide an audio instruction to "Look up." The consumer device 102 may then capture an ocular surface image of the user's eye by either waiting a predetermined time, e.g., 1 second, 2 seconds, 3 seconds, etc., after providing the instruction, or by using face detection and analysis to detect that the user's eye is in the correct position. This image may include video footage and / or still images.

[0048] Upon capturing an image of the ocular surface at the second predetermined position, the consumer device 102 may automatically proceed to instruct the user to look at a third predetermined position and capture a third ocular surface image of the eye at the third predetermined position (step 316). An example is shown in FIG. 15, where a GUI screen is shown including a real-time image of the user 104 superimposed with an outline 446 and an instruction 456, "Look right." The consumer device 102 may also provide an audio instruction, "Look right." The consumer device 102 may then capture an ocular surface image of the user's eye by either waiting a predetermined time, e.g., 1 second, 2 seconds, 3 seconds, etc., after providing the instruction, or by using face detection and analysis to detect that the user's eye is in the correct position. This image may include video footage and / or still images. The ocular surface image may then be sent to the remote computer system 106, 110 along with, for example, the results of the vision test obtained from the user (responses made by the user) for access and review by a medical professional such as a technician 108 or a physician 112 (step 318).

[0049] Upon completion of acquisition of a test image of the ocular surface of the user's eye, the vision testing app may display a GUI screen, as shown in FIG. 16, indicating that the surface test is complete and asking the user 104 to confirm that the test requirements were properly followed. For example, the GUI screen may include an information portion 458 including a graphic indicating completion, such as a check mark in a circle with the words "Surface test completed" or "Eye irritation test completed." The GUI screen may also include a question portion 460 asking whether the consumer device 102 was a specified distance from the user's face, e.g., about one foot, and whether the user 104 followed the guide. Also displayed is a touch field 462 that allows the user to answer in the negative to perform the ocular surface test again, and a touch field 464 that allows the user to answer in the positive to continue. In this example, continuing may include moving on to another vision test, such as a visual acuity test, a color blindness test, or any other vision test, as previously described. Alternatively, if the ocular surface imaging test is the last in a series of tests, continuing may include completing the testing session and entering confirmation that the test is complete in a touch field, such as touch field 499 in FIG. 27.

[0050] In connection with step 318, a medical professional such as the technician 108 and the physician 112 may review an ocular surface image of the user's eye along with the user's response (result) to the vision test. As previously mentioned, this image may include video footage and / or still images, and such eye images may be captured simultaneously from two or more angles or directions to the user. Thus, in some examples, the physician and technician may review the eye images using a stereoscopic or multi-perspective image of the video footage or still images of the eye with three-dimensional (3D) depth, for example, using appropriate 3D glasses, virtual reality (VR) goggles, etc. The physician 112 may then take into account further overall information about the ocular surface image when assessing whether the user's 104 corrective lens prescription may be updated, whether potentially concerning symptoms are evident in the ocular surface image, and / or whether the physician 112 should prepare further recommendations to be sent to the user 104 for this purpose, for example, instructing the user 104 to visit a clinic for an in-person eye examination, etc.

[0051] As discussed above, face detection and analysis may be used to detect when the user's eyes are in a suitable position for imaging the ocular surface. This may be useful when it is desired to capture still images of the user's ocular surface at high resolution, which is not possible with video footage that captures images of the ocular surface in real time. Image analysis for face detection is generally known in the art and may utilize any suitable face detection technology. For example, Apple's "Vision" API framework may be utilized on iOS devices and Google's "Face" API framework on Android devices to detect the user's face and features against other background images. Face detection and analysis algorithms, such as OpenCV (an open source library for computer vision) known in the art, may also be used to detect the user's face and features against other background images. After detecting the user's eyes, image processing may be used to detect the whites of the eye in the left and right halves of the imaged user's eyes and determine whether such measurements meet one or more thresholds to determine whether the user's eyes are looking far enough right or far enough left to capture an image of the ocular surface at these predetermined positions. Alternatively or additionally, image processing may be used to detect the location of the black pupil of the user's eye, and determine whether any position of the pupil meets a right or left position threshold to determine whether the user's eye is looking sufficiently right or left to capture ocular surface images at those predefined positions. Similarly, after detecting the user's eye, such an API may be used to detect the percentage of white of the imaged lower (or upper) half of the user's eye, and determine whether that percentage meets a threshold to determine whether the user's eye is looking sufficiently up (or down) to capture ocular surface images at those predefined positions. Such measurements may be made for both eyes of the user 104, although it should be appreciated that since both eyes are expected to move simultaneously, it may be sufficient to make such measurements one or more times for one eye of the user 104.Further information regarding applicable known face recognition techniques is disclosed, for example, in Yang et al., "Detecting faces in images: A survey," IEEE Transactions on Pattern Analysis and Machine Intelligence, Vol. 24, No. 1, 2002, pp. 34-58; Hjelmas et al., "Face detection: A Survey," Computer Vision and Image Understanding, Vol. 83, No. 3, 2001, pp. 236-274; and U.S. Patent Nos. 9,832,452, 9,053,354, 8,811,726, 8,442,327, 8,254,691, and 7,372,981, the contents of each of which are incorporated herein by reference in their entireties.

[0052] The methods and systems described herein may be implemented using any suitable computer processing system with any suitable combination of hardware, software and / or firmware. As shown in FIG. 1, for example, a computerized consumer device 102 that allows a user 104 to perform a visual inspection may communicate with remote computer systems 106 and 110 and a server computer 130 that can access a database 132 via a network 134. The remote computer systems 106 and 110 may also be hosted on one or more server computers 130 via a network such as the network 134. The computer processors 122a, 122b, 122c, etc. may execute software operations, program instructions or routines to perform the calculations and analyses described herein. Such program instructions, stored data and processed data may be stored in one or more non-transitory computer readable memories 124a, 124b, 124c, etc., using databases 128b, 128c, 132, etc. Communications may be conducted according to a client-server architecture in which computerized consumer devices 102 used by users 104 access remote computer systems 106 , 100 and / or server computers 130 via one or more networks 134 .

[0053] The system may include an element manager, a real-time data buffer, a conveyor, a file input processor, a database index, a data buffer, and a data manager for data management and processing. The systems 102, 106, 110 may also include multiple displays, display interfaces, and input / output devices such as keyboards, microphones, mice, touch screens, etc. to enable users, support personnel, and medical personnel to manage the systems 102, 106, 110.

[0054] Although exemplary embodiments of the invention are described herein, other configurations are within the scope of this disclosure. For example, the systems and methods may be used including data signals transmitted over a network (e.g., a local area network, a wide area network, the Internet, combinations thereof, etc.), fiber optic media, carrier waves, wireless networks, etc., for communicating with one or more data processing devices. The data signals may carry any or all of the data to or from the devices disclosed herein.

[0055] The methods and systems described herein may be implemented in many different types of processing devices by program code that includes program instructions executable on the device processing system. The software program instructions may include source code, object code, machine code, or any other stored data executable to cause a processing system to perform the methods and operations described herein. As will be appreciated by those skilled in the art, any suitable computer language, such as C, C++, Java, HTML, XML, etc., and APIs available to developers for a given operating system platform may be used. Also, firmware and other suitable designs may be implemented such as hardware configured to perform the methods and systems described herein.

[0056] The data of the systems and methods (e.g., associations, mappings, data inputs, data outputs, intermediate data results, final data results, etc.) may be configured to be stored using any suitable data structure and may be stored and used in one or more different types of computer-implemented data stores, such as different types of storage devices, programming structures, etc. (e.g., RAM, ROM, flash memory, flat files, databases, programming data structures, programming variables, IF-THEN (or similar type) statement structures, etc.) It should be noted that data structures refers to formats used to organize and store data in databases, programs, memories, or other non-transitory computer readable media for computer programs.

[0057] The computer components, software modules, functions, data stores and data structures described herein may be connected directly or indirectly to each other to enable the data flows necessary for their operation. It should also be noted that a module or processor includes, but is not limited to, a unit of code that performs a software operation and may be implemented, for example, as a unit of subroutine code, or as a unit of software function code, or as an object (such as in an object-oriented paradigm), or as an applet, or in a computer scripting language, or as another type of computer code. The software components and / or functionality may reside on a single computer or may be distributed across multiple computers, depending on the circumstances at hand.

[0058] The meanings of "a," "an," and "the" as used throughout this specification and the following claims are understood to include the plurals unless otherwise clear from the context. Also, the meaning of "in" as used throughout this specification and the following claims is understood to include "in" and "on," unless otherwise clear from the context. Furthermore, the meanings of "and" and "or" as used throughout this specification and the following claims are understood to include both conjunctive and disjunctive meanings and are used interchangeably unless otherwise clear from the context, and the phrase "exclusive or" may be used to indicate a situation where only the disjunctive meaning is applicable. Also, the meanings of "about" and / or "approximately" as used throughout this specification and the following claims are understood to mean ±10% of the indicated amount, unless otherwise specified.

[0059] While the present invention has been described with exemplary embodiments, those skilled in the art will recognize that various modifications may be made without departing from the scope of the invention as set forth in the claims. U.S. Patent Application No. 15 / 838,029, filed December 11, 2017, and U.S. Patent Application No. 29 / 629,114, filed December 11, 2017, are incorporated herein by reference in their entireties.

Claims

1. 1. A method for administering a visual acuity test to a user, comprising: initiating the visual acuity test using a computerized device having a display screen, a camera, a voice interface including a microphone and a speaker, a computer processor, and a memory, the visual acuity test including a graphical interface for displaying information to the user and for the user to input via touch sensitive fields; determining distance information relating to a measured distance between the computerized device and the user measured from an image of the user captured by the camera of the computerized device, the graphical interface being configured to dynamically display the distance information in real time as the measured distance changes; displaying the visual acuity test without a refractive lens assembly through the graphical interface, including displaying a predetermined visual target for viewing by the user, and presenting audio instructions regarding the visual acuity test through the speaker of the audio interface; Recording the identification content spoken by the user while looking at the predetermined visual target via the microphone of the voice interface; performing speech recognition on the identification content spoken by the user to generate a character string converted to correspond to the identification content spoken by the user; and determining a score for the visual acuity test taken by the user based on the converted character string.

2. displaying a contour of a predetermined size and approximate shape of a head superimposed on an image of the user captured in real time by the camera, providing real-time feedback to the user for proper positioning of the computerized device; determining whether at least one of a separation distance between the user and the computerized device and an alignment of the camera with respect to the user's face meets a threshold for capturing an image of an ocular surface; notifying the user by at least one of a visual indication and an audio indication that proper alignment has been achieved; and capturing an image of the ocular surface of the user with the camera of the computerized device.

3. 10. The method of claim 1, comprising simultaneously capturing images of the ocular surface with multiple cameras of the computerized device, the multiple cameras configured to obtain images of the ocular surface from multiple different directions.

4. processing images of the user's eyes using real-time image analysis to detect when the user's eyes are in a proper position; acquiring a still image of the user's eye with the user's eye in the appropriate position; The still image is designated as an image of the ocular surface and saved.

10. The method of claim 1, further comprising: the computer processor controlling the computerized device to capture an image of the ocular surface.

5. instructing the user to position the computerized device relative to the user by displaying the imaged user's head against a contour in real time, while providing real time feedback to the user for proper placement of the computerized device; 10. The method of claim 1, further comprising determining whether at least one of a separation distance between the user and the computerized device and an alignment of the camera relative to the user's face meets a threshold for capturing an image of an ocular surface.

6. 10. The method of claim 1, comprising suspending automatic brightness adjustment of the display screen of the computerized device prior to presenting the visual acuity test.

7. 2. The method of claim 1, wherein the display of the predetermined visual target on the display screen of the computerized device is performed without changing the size of the predetermined visual target displayed on the display screen based on a separation distance between the user and the computerized device determined by the computerized device.

8. The method of claim 1 , wherein the computerized device comprises a tablet computer, a smartphone, or a personal computer.

9. 1. A method for conducting a visual acuity test on a user using a computerized device, comprising: initiating the vision test to assess the user's vision using the computerized device, the computerized device comprising a display screen, a camera, a microphone, a speaker, a computer processor, and a memory; determining, by the computerized device, a separation distance between the user and the computerized device based on an image size of a physical feature of the user using an image of the user captured by the camera of the computerized device; instructing the user, by the computerized device, to adjust the separation distance between the user and the computerized device to within a predetermined separation distance range; displaying a predetermined visual target on the display screen of the computerized device for viewing by the user, the visual acuity test being presented to the user by the computerized device without a refractive lens assembly; recording, on the computerized device, an identification of the user seeing the predetermined indicia; and determining a score for the visual acuity test taken by the user based on the identification.

10. Capturing an image of an ocular surface of the eye of the user includes: processing an image of the user's eye by real-time image analysis to detect when the user's eye is in a proper position; capturing a still image of the user's eye with the user's eye in the appropriate position; and saving the still image as an ocular surface image.

11. displaying an outline of a head of a predetermined size on said display screen and activating said camera; instructing the user to position the computerized device while providing real-time feedback to the user for proper placement of the computerized device by displaying in real-time the imaged user's head relative to the contour; determining whether at least one of the separation distance between the user and the computerized device and the alignment of the camera with respect to the user's face meets a threshold for capturing an image of an ocular surface; 10. The method of claim 9, further comprising capturing an image of the ocular surface of the user with the camera of the computerized device.

12. Capturing an image of an ocular surface of the user's eye includes:

10. The method of claim 9, comprising simultaneously capturing images of the ocular surface with multiple cameras of the computerized device, the multiple cameras being spaced apart from one another to obtain images of the ocular surface from a plurality of different directions.

Images