Supra-threshold vision testing system and method

Abstract

A method and system for supra-threshold vision testing. The method includes (a) selecting an object having a uniquely identifiable configuration at each of a plurality of successive rotational orientations, (b) presenting to a person the object in one of the rotational orientations, (c) receiving from the person a response identifying the perceived rotational orientation, (d) measuring a response time and correctness of the response, (e) repeating the steps (b)-(d) a predetermined number of times, and (f) determining a metric value using the number of correct responses and the measured response times from steps (b)-(d) according to a predetermined formula, wherein the test is performed under supra- threshold conditions.

Description

[0001] JSV7234

[0002] SUPRA-THRESHOLD VISION TESTING SYSTEM AND METHOD

[0003] Cross-Reference to Related Applications

[0004] This application claims the benefit of U.S. Provisional Application No. 63 / 723,954, filed November 22, 2024, the entire contents of which is incorporated herein by reference.

[0005] Background

[0006] Traditional visual testing for image quality (visual acuity and contrast sensitivity) are threshold tests, where the aim of the test is to find the transition point between "just visible" and "not visible." Visible acuity tests measure the eye's ability to resolve fine details and are typically viewed as the clinical measure of visual function. The patient is presented with various letters of increasingly smaller sizes, and the practitioner notes the smallest details (size) that can be detected. Contrast sensitivity tests measure the lowest contrast that can be detected by a patient. Each of these tests may make use of single letters of changing orientation, such as the "Landolt C" (see Fig. 1) or the "Tumbling E," a mix of letters, or gratings.

[0007] If quality of vision is defined by the capacity to see different spatial frequencies (x-axis) and contrast levels (y-axis), the goals of the threshold tests are to identify the line between "visible" and "not visible" as illustrated by line 201 of the contrast sensitivity curve 200 shown in Fig. 2. The area of intersection with the x-axis illustrated by reference numeral 202 represents visual acuity for a given patient.

[0008] The contrast sensitivity curve 200 is defined by both neural and optical elements of the eye. It is, therefore, expected to be different for different individuals and different optical conditions such as use of different ophthalmic lens designs (lOLs, contact lenses or glasses), different levels of defocus, pupil size, higher order aberrations, lighting conditions, etc.

[0009] "Supra-threshold" testing aims to assess vision in more comfortable or natural regions of the contrast sensitivity curve 200 rather than along the visible / non-visible threshold line 201. One example of a supra-threshold test is a reading test, where text is used rather than letters or gratings to simulate more typical or natural conditions. Patients read aloud text that is presented and the speed of response is measured, or patients can be presented with text and reply to questions about the text. It can be performed at different distances, and is often used to evaluate near vision in presbyopic patients who are to be fitted with multifocal contacts or to evaluate the performance of presbyopia correcting intraocular lenses (lOLs).

[0010] The limitations of current supra-threshold reading tests are that the outcomes often depend on the language used and knowledge of the language, the words selected, and the size. Additionally, they are not optimal for optical research (e.g., to test different optical conditions in the same subjects) because the test has a strong memorization effect since the same text is presented repeatedly. The test further requires a large field of view which may not always be possible in simulated optical conditions such as with adaptive optics.

[0011] It would be desirable to have an improved method and system for assessing vision under supra-threshold conditions.

[0012] Summary

[0013] Provided herein is a method for testing supra-threshold vision of a person including the steps of selecting an object having a uniquely identifiable configuration at each one of a plurality of successive rotational orientations, presenting to the person the object in one of the plurality of rotational orientations, receiving from the person a response identifying a perceived rotational orientation, measuring a response time of the person and the correctness of the response, repeating the preceding steps a predetermined number of times, and determining a metric value using the number of correct responses and the measured response times according to a predetermined formula. The test is performed under supra-threshold conditions. The test is performed to evaluate vision at a given eccentricity of the visual field (e.g., central vision or 0 degrees). The test is performed monocularly or binocularly.

[0014] According to one embodiment, the object may be a number, a letter, a symbol, a grating, or an image, and the presentations may be selected randomly from the predetermined number of rotational orientations. The plurality of presentations may be at least 10 or at least 15.

[0015] In various embodiments, the plurality of rotational orientations are each at successive degree increments of rotation, which may be less than 90 degrees or less than 45 degrees. According to yet another embodiment, there are at least eight different rotational orientations.

[0016] The supra-threshold conditions may be a spatial frequency between 1 and 20 cycles per degree and a contrast between 10% and 100%, and the spatial frequency may be constant during the test or may be varied. Further, the spatial frequency and contrast may be selected based on personalized vision performance or a population representative vision performance, or a given eccentricity of the visual field. The luminance of the scene containing the object may be constant during the test or may be varied. The luminance of the scene can be adjusted based on personalized vision performance or a population representative vision performance or given eccentricity of the visual field. The spatial frequency, the contrast, an artificial pupil size, and luminance may be selected based on a personalized vision performance or a population representative vision performance. The supra-threshold test may be performed with natural pupil or artificial aperture, limiting the effective pupil size of the person performing the test.

[0017] According to one embodiment, the metric value (M) is defined as M - (correct responses) / (response time). The response time may be total response time or average response time, and the correct responses may be the number of correct responses or the percentage of correct responses. According to another embodiment, the metric value (M) is the response time, where the response time can be average time, expected time, minimum time, or maximum time for correctly identifying the object or for performing the complete set of predetermined number of trials. In this embodiment, the time can be weighted according to the correctness of the object identification for each of the pre-determined number of trials. In another embodiment, the metric value (M) is the threshold time, required to correctly identify the presented object. In this embodiment, the threshold time may be estimated by using Bayesian procedures, or staircase method, or other psychophysical methods for determining threshold value.

[0018] In another embodiment, the metric M can be Balanced Integration Score (as referenced in H.R. Liesefeld, X. Fu, H.D. Zimmer, "Fast and careless or careful and slow? Apparent holistic processing in mental rotation is explained by speed-accuracy trade-offs", Journal of Experimental Psychology: Learning, Memory, and Cognition, 41, 1140-1151 (2015)), which can be calculated as M = ZPC— ZRT, where ZPCand ZRTare normalized results for Percentage Correct (PC) and Response Time (RT). The normalization is done in the following way:

[0019] „ PCj- AVERAGE (PC , „ RT <- AVE RAGE (RT) „ „ , ,

[0020] ZpCc . = — - - - and Z 7 SO (PC)KRTI . = — - - . Here, PC. and 7?T. denote J SD(RT)J J

[0021] Percentage Correct and Response Time results of the j-th experiment or group of experiments. AVERAGE(PC) and AVERAGE(RT) denote average percentage correct and response time through all experiments or (sub)groups of experiments. SD(PC) and SD(RT) denote standard deviation for percentage correct and response time through all experiments or (sub)groups.

[0022] According to yet another embodiment, the method is applied to a patient having an optical correction lens, including but not limited to a contact lens, an intraocular lens, or glasses.

[0023] According to yet another embodiment, the method is applied to a patient having an optical disease, including but not limited to cataract, glaucoma or AMD. Also provided is a method of assessing the effects on a selected vision attribute of a selected first ophthalmic lens design used by a test subject under supra-threshold conditions. The method includes presenting to the test subject one of a plurality of uniquely identifiable objects, presenting a selected one of the objects to the test subject, and repeating the presenting step a predetermined number of times. For each presentation, the method further includes soliciting from the test subject a response indicating identification of the perceived object, determining whether the identification is correct, determining a response time of the identification, and calculating a metric value using the number of correct identifications and the response times.

[0024] According to another embodiment, the response time is adjusted based on the correctness of the response of the patient. The method may further include repeating the preceding steps with a second ophthalmic lens of a different design, and comparing the metric value calculated for the first ophthalmic design with the metric value calculated for the second ophthalmic design to assess which ophthalmic lens provides better quality of vision for the test subject. According to alternate embodiments, the uniquely identifiable object may be a single object having uniquely identifiable configurations at each of a plurality of successive rotational orientations, or may be different objects.

[0025] The supra-threshold conditions may be a spatial frequency between 1 and 20 cycles per degree and a contrast between 10% and 100%, and may further be 9 cycles per degree and the contrast is 20%.

[0026] According to another embodiment, the metric value (M) is defined as M - (correct responses) / (response time). The response time may be total response time or average response time, and correct responses may be the number of correct responses or the percentage of correct responses. In another embodiment, the metric M can be time, estimated as average time, expected time, minimum time, or maximum time for correctly identifying the object or for performing the complete set of pre-determined number of trials. In this embodiment, the time can be weighted according to the correctness of the object identification for each of the pre-determined number of trials. In another embodiment, the metric value (M) is the threshold time, required to correctly identify the presented object. In this embodiment, the threshold time may be estimated by using Bayesian procedures, or staircase method, or other psychophysical methods for determining threshold value. In another embodiment, the metric M can be Balanced Integration Score (as referenced in H.R. Liesefeld, X. Fu, H.D. Zimmer, "Fast and careless or careful and slow? Apparent holistic processing in mental rotation is explained by speed-accuracy trade-offs", Journal of Experimental Psychology: Learning, Memory, and Cognition, 41, 1140-1151 (2015)), which can be calculated as M = ZPC— ZRT, where ZPCand ZRTare normalized results for Percentage Correct (PC) and Response Time (RT). The normalization is done in the following way: „ „ , , Here, PC, and RT; denote J J

[0027] Percentage Correct and Response Time results of the j-th experiment or group of experiments. AVERAGE(PC) and AVERAGE(RT) denote average percentage correct and response time through all experiments or (sub)groups of experiments. SD(PC) and SD(RT) denote standard deviation for percentage correct and response time through all experiments or (sub)groups. In various other embodiments, the selected vision attribute may be astigmatism, defocus, high order aberrations, pupil size or chromatic aberrations, or any combination thereof.

[0028] The selected first ophthalmic lens design may be a contact lens, a spectacle lens or an IOL. Alternatively, the selected first ophthalmic lens design may be simulated using an optical system.

[0029] A system for assessing supra-threshold vision of a patient is also provided. The system includes a presentation device for successively presenting to the patient under supra-threshold conditions a plurality of uniquely identifiable objects, a recording device for recording data representing an identification by the patient of each presented uniquely identifiable object, and a device for calculating a metric value indicative of the quality of vision based on the recorded data.

[0030] The metric value may be defined by M - (correct responses) / (response time). In another embodiment, the metric M can be time, estimated as average time, expected time, minimum time, or maximum time for correctly identifying the object or for performing the complete set of pre-determined number of trials. In this embodiment, the time can be weighted according to the correctness of the object identification for each of the pre-determined number of trials. In another embodiment, the metric value (M) is the threshold time, required to correctly identify the presented object. In this embodiment, the threshold time may be estimated by using Bayesian procedures, or staircase method, or other psychophysical methods for determining threshold value. In another embodiment, the metric M can be Balanced Integration Score (as referenced in H.R. Liesefeld, X. Fu, H.D. Zimmer, "Fast and careless or careful and slow? Apparent holistic processing in mental rotation is explained by speed-accuracy trade-offs", Journal of Experimental Psychology: Learning, Memory, and Cognition, 41, 1140-1151 (2015)), which can be calculated as M = ZPC— ZRT, where ZPCand ZRTare normalized results for Percentage Correct (PC) and Response Time (RT). The normalization is done in the following way: „ PC ,- AVERAGE (PC , „ RT t- AVE RAGE (RT) „ „ , ,

[0031] ZpC. = — - - - — - - - and ZRT. = — - - - — - - . Here, PC. and 7?T. denote

[0032] SO (PC)KIJ SD(RT} J J

[0033] Percentage Correct and Response Time results of the j-th experiment or group of experiments. AVERAGE(PC) and AVERAGE(RT) denote average percentage correct and response time through all experiments or (sub)groups of experiments. SD(PC) and SD(RT) denote standard deviation for percentage correct and response time through all experiments or (sub)groups. The suprathreshold conditions may be a spatial frequency between 1 and 20 cycles per degree and a contrast between 10% and 100%.

[0034] According to one embodiment, the presentation system is via adaptive optics, and in yet another embodiment, the presentation, recording and calculating is directed by software on a computer or tablet.

[0035] In aspects, a method for testing supra-threshold vision of a person is provided. The method may include selecting an object having a uniquely identifiable configuration at each one of a plurality of successive rotational orientations. The method may include presenting to the person said object in one of said plurality of rotational orientations. The method may include receiving from the person a response identifying a perceived rotational orientation. The method may include measuring a response time of said person and the correctness of the response. The method may include repeating steps a predetermined number of times. The method may include determining a metric value using said number of correct responses and the measured response times from steps according to a predetermined formula, and wherein the test is performed under supra-threshold conditions.

[0036] In aspects, a method of assessing the effects on a selected vision attribute of a selected first ophthalmic lens design used by a test subject under supra-threshold conditions is provided. The method may include presenting to said test subject one of a plurality of uniquely identifiable objects. The method may include presenting a selected one of said objects to said test subject, and repeating said presenting step a predetermined number of times. The method may include for each presentation, soliciting from said test subject a response indicating identification of the perceived object. The method may include determining whether the identification is correct. The method may include determining a response time of said identification. The method may include calculating a metric value using the number of correct identifications and the response times.

[0037] In aspects, a system for assessing supra-threshold vision of a patient. The system may include a presentation device for successively presenting to said patient under supra-threshold conditions a plurality of uniquely identifiable objects. The system may include a recording device for recording data representing an identification by the patient of each presented uniquely identifiable object. The system may include a device for calculating a metric value indicative of the quality of vision based on the recorded data.

[0038] In aspects, a method for testing supra-threshold vision of a person. The method may include selecting an object having a uniquely identifiable configuration at each one of a plurality of successive rotational orientations. The method may include presenting to the person said object in one of said plurality of rotational orientations for a pre-selected duration of time. The method may include receiving from the person a response identifying a perceived rotational orientation. The method may include measuring correctness of the response, and based on that adjusting a period of time for subsequent presentation of the object. The method may include repeating steps a predetermined number of times. The method may include determining a metric value from the correctness of responses and durations of time for presentations of the object according to a predetermined formula, wherein the test is performed under supra-threshold conditions.

[0039] Brief Description of the Drawings

[0040] Fig. 1 illustrates an exemplary, known vision test using the Landolt C;

[0041] Fig. 2 illustrates an exemplary contrast sensitivity curve;

[0042] Fig. 3 is the contrast sensitivity curve of Fig. 2, further illustrating an exemplary target for supra-threshold vision testing;

[0043] Fig. 4 illustrates an exemplary presentation of objects that can be used in the present vision test; Figs. 5A and 5B reflect experimental results of tests performed according to one embodiment of the present invention, with recorded number of correct responses and total response time;

[0044] Fig. 6 reflects experimental results of test performed according to one embodiment of the present invention, with determining the threshold time for identifying the object;

[0045] Fig. 7A is an image of a tablet; and

[0046] Fig 7B is an image of a computer.

[0047] Detailed Description

[0048] The system and method described herein leverages the concept of supra-threshold testing described above, but overcomes at least some limitations of the standard reading test. The objective of this improved system and method is to determine vision in only a portion of the contrast sensitivity curve 200, such as area 303 shown in Fig. 3. The improved system and method further establishes a set of metrics that can be used to objectively, across all patients, assess vision quality. The test can be fine-tuned for different purposes. For instance, to evaluate the impact of different levels of defocus and astigmatism or to evaluate the image quality provided by different ophthalmic lens designs. The test can be also adapted to evaluate different visual conditions such as photopic vs mesopic light conditions. The test can be also adapted to evaluate different visual field eccentricities such as central vision vs peripheral vision.

[0049] As a first step, an object is selected for presentation to the patient to be tested. In a preferred embodiment, the object must be asymmetric such that it has a uniquely identifiable rotational orientation. In other words, the object can be uniquely identified when at an initial or baseline rotational orientation, as well as at various degree increments of rotation. The object can be a letter, a number, a symbol, a simple image or illustration, a simple grating pattern or the like, as long as its rotational orientation is readily identifiable at a plurality of rotational increments. In an alternate embodiment, the object may consist of a set of different objects (rather than the same object in different rotational orientations) each of which are readily and independently identifiable by the observer to be tested. The latter can be beneficial for example in testing with younger children.

[0050] In one embodiment the object is the Landolt C as shown in Fig. 4. It is randomly presented to the patient or test subject in its baseline orientation (400a) or one of a predetermined number of rotational orientations (i.e., 400b-d). In the embodiment of Fig. 4, there are eight unique rotational orientations (only four are shown) each representing 45 degree increments of rotation. Significantly, the test is performed under supra-threshold conditions, which can vary between 1 and 20 cycles per degree spatial frequency and 10% and 100% contrast. The spatial frequency to be tested as well as the contrast can be modified independently to evaluate different visual conditions (e.g., it can be modified depending on the level of defocus to be tested and / or the light conditions). The spatial frequency may be varied. In a preferred embodiment, the supra-threshold conditions are 9 cycles per degree and 20% contrast. The Landolt C (400) is repeatedly presented to the patient in one of the eight rotational orientations (randomly selected) a predetermined number of times. In a preferred embodiment, the object is presented 15 times. In another preferred embodiment, the object is presented 30 times.

[0051] In different embodiments, the proposed test can be performed at different luminance levels, or a combination of them, representing different viewing conditions. Additionally, different embodiments of the proposed test method can include measurements with natural pupil size of the observers, or with an artificial pupil of fixed size, or a combination of them. A combination of artificial pupils with different sizes may be utilized.

[0052] Each time the object is presented, the patient or subject identifies the perceived rotational orientation of the object. The individual presenting the test will determine whether each response is correct or incorrect, and will measure response time (i.e., 0.5 seconds, 1.0 seconds etc.). Based on the number of correct versus incorrect responses as well as the response time, a metric can be calculated to measure quality of vision. One exemplary metric (M) is M - (correct responses) / (response time), where response time can be total response time or average response time. The response time may be total response time, average response time, minimal response time, maximum response time, expected response time, any combination thereof or a normalized value derived from them.

[0053] Further, "correct responses" can be a number or a percentage. This metric can be used across all patients to measure quality of vision, with a higher number representing a better quality of vision. The metric is advantageous as the information obtained (correct responses and response time) discourages both incorrect responses and long response time. The correct responses may be the number of correct responses, the percentage of correct responses, or a normalized value derived from the number of correct responses, among others.

[0054] Another exemplary metric is the Balanced Integration Score (as referenced in H.R. Liesefeld, X. Fu, H.D. Zimmer, "Fast and careless or careful and slow? Apparent holistic processing in mental rotation is explained by speed-accuracy trade-offs", Journal of Experimental Psychology: Learning, Memory, and Cognition, 41, 1140-1151 (2015)). It can be calculated as M = ZPC— ZRT, where ZPCand ZRTare normalized results for Percentage Correct (PC) and Response Time (RT). The normalization is done in the following way:

[0055] „ PC<- AV ERAGE(PC) , „ RT <- AVE RAGE (RT) ,

[0056] ZPC. = — - - - and ZRT. = — - - . Here, denote

[0057] SD(PC)KIJ SD(RT)

[0058] Percentage Correct and Response Time results of the j-th experiment or group of experiments. AVERAGE(PC) and AVERAGE(RT) denote average percentage correct and response time through all experiments or (sub)groups of experiments. SD(PC) and SD(RT) denote standard deviation for percentage correct and response time through all experiments or (sub)groups.

[0059] In a different embodiment, the outcome of the proposed test is the response time or response time threshold. In this embodiment, the response time threshold can be estimated by modifying the time that the image is presented based on the correctness of the response. A Bayesian method or a staircase method can be used to determine the response time threshold. In this embodiment, the metric is the response time threshold.

[0060] The metric can be used across all patients to measure quality of vision. The metric is advantageous as the information obtained (correct responses and / or response time) discourages both incorrect responses and long response time. The choice of spatial frequency, contrast, and number of repetitions can be selected and optimized to maximize the test sensitivity for the studied conditions, and to avoid, for example, ceiling or flooring effects where the test sensitivity is reaching its limits.

[0061] This test also provides an improvement over the reading test as it is quicker to administer, it does not depend on language skills of the patient, and it does not allow for manipulation due to memorization.

[0062] Figures 5A and 5B show experimental results for the supra-threshold testing method, performed at 9 cpd spatial frequency and 20% contrast. The supra-threshold testing method was performed on two observers (with Observer 1 represented in Figure 5A and Observer 2 represented in Figure 5B). The response time is in seconds, and the correct response is in a fraction (1.0 corresponds to 100% correct responses). The bars show an average, and the error bars show the standard deviation over 3 repetitions.

[0063] The contrast level and spatial frequency were fixed during the experiment. In each condition, the test object was presented 15 times, while the presentation time for each object was unlimited. That is, on each presentation the object was visible to the observer until the moment the observer made the decision for the perceived object orientation by pressing a corresponding key on a keyboard; after that, the next object was shown and the procedure continued. The observers performed the test with different trial lenses in front of the eye, to illustrate how defocus is affecting the proposed test method. For each condition, the supra- threshold testing was performed 3 times. In Figures 5A and 5B, the bars show the average and the error bars show standard deviations of the 3 repetitions.

[0064] It is known that commonly used vision metrics, such as visual acuity, drop with defocus. Here we also see that with increasing defocus, the amount of correct responses drops while the response time is geting longer.

[0065] In another embodiment of the test, each time the object is presented, the patient or subject identifies the perceived rotational orientation of the object. The individual presenting the test will determine whether each response is correct or incorrect. Based on whether the response is correct or incorrect, the amount of time for subsequent presentation of the object is adjusted. In one example, if the answer is incorrect the amount of time for subsequent presentation is increased, and if the answer is correct, the amount of time for subsequent presentation is decreased. In different embodiments, the presentation time can be adjusted according to the typical psychophysical methods used, for example, for visual acuity testing. These include, but are not limited to, staircase method, Bayesian estimation methods, or method of adjustments. In the latter, the presentation time may be adjusted by the observer. The outcome of this test is the time required to identify the object correctly in the given conditions (spatial frequency and contrast). A metric value may be time or threshold time. In different embodiments, the outcome time to identify the object can include, but is not limited to, total time, maximum time, minimum time, expected time, or average time, or a combination thereof. Figure 6 illustrates experimental results of this embodiment of supra-threshold test. Figure 6 is the threshold time to detect perceived orientation of the object for two observers. The figure depicts the expected time needed to detect the perceived rotational orientation of the object for different amounts of optically induced defocus. It is clear that with higher defocus, the expected time for detection is higher illustrating that larger optical defocus is associated with more challenging viewing conditions. This is also well known for routine vision evaluation tests, such as visual acuity, where larger amounts of defocus correspond to lower visual acuity (quality of vision).

[0066] Although use of the Landolt C is described in detail, any other suitable letter (i.e., Tumbling E) or symbol can be used that meets the requirements described above. Similarly, other values may be chosen for the constants in the test (spatial frequency and contrast), and also for the number of presentations of the letter or symbol to the patient (higher or lower than 15 presentations). Additionally, spatial frequency and contrast can be constant during one test, different with pre-defined sequences (e.g., 2-times at 9 cycles per degree then 2-times at 8 cycles per degree), or adapted during the experiment based on, for example, a subject's responses. The presentation time (how long the object is shown to the subject) can also be either fixed in time, unlimited in time until a response is received, given a maximum upper limit of time, be different or varied for different pre-defined sequences, or adapted during the experiment based on a subject's responses. A system using the methods described above will include a display visible to the patient including the object and in its various rotational orientations as described above. The display may be a static display (either on a poster, sheet, or displayed by projector onto such a medium or a wall) where the successive rotational orientations are displayed one at a time by selective enabling the patient to view only the desired object at the desired time. In the alternative, only one object may be displayed at a time by any known means, such as via a projector on a flat surface such as a wall, via software control on a computer or tablet screen, or via a suitable adaptive optics device and software. Each patient response and response time may be recorded by the practitioner manually, or with the assistance of software programmed to receive this input and automatically output the described metric value by any means well-known to those in the art. Figure 7A, for example, illustrates a tablet 700 that may be utilized in a system for assessing supra-threshold vision. The tablet 700 may include a presentation device 702 (e.g., a tablet screen) for presenting the object to the patient or other person being assessed. The tablet 700 may include a device 704 in the form of a processor for calculating a metric value indicative of the quality of vision based on the recorded data. The tablet 700 may include a memory 706 that may serve as a recording device for recording data representing an identification by the patient of each presented uniquely identifiable object. The memory 706 may record the inputs from the patient. The memory 706 may store software programmed to receive the input. Other forms of recording device may be utilized as desired. Figure 7B illustrates a computer 708 that may be utilized in a system for assessing supra-threshold vision. The computer 708 may operate in a similar manner as the tablet 700. The computer may include a presentation device 710 (e.g., a computer screen) that may operate in a similar manner as the presentation device 702. The computer 708 may similarly include a device in the form of a processor for calculating a metric value indicative of the quality of vision based on the recorded data. The computer 708 may similarly include a memory that may serve as a recording device for recording data representing an identification by the patient of each presented uniquely identifiable object. Presentation, recording and calculating may be directed by software on a computer or tablet. The test described above can be used as a functional vision test for far vision, or alternatively for near or intermediate vision in monocular or binocular conditions. Further, the test can be used for central vision or for peripheral vision. The test may be at a fixed angle from an optical axis for peripheral vision. The test may be at a combination of angles in examples. Spatial frequencies, contrast levels, and object luminance may be varied for different angles from the optical axis. The example above supports the use of this test to evaluate the effect of defocus on vision for different lens designs. However, it can be used to evaluate other optical conditions (e.g. astigmatism, high-order aberrations), light conditions and specific optical designs (contact lenses, lOLs and spectacles). A method may be applied to a patient or observer with optically or otherwise induced effect of an optical correction lens, including but not limited to effects of a contact lens, a spectacle lens, or an IOL.

[0067] EXAMPLE CLAUSES

[0068] Example Clause 1: A method for testing supra-threshold vision of a person comprising: a. selecting an object having a uniquely identifiable configuration at each one of a plurality of successive rotational orientations; b. presenting to the person said object in one of said plurality of rotational orientations; c. receiving from the person a response identifying a perceived rotational orientation; d. measuring a response time of said person and the correctness of the response; e. repeating steps b-d a predetermined number of times; and f. determining a metric value using said number of correct responses and the measured response times from steps b-d according to a predetermined formula, wherein the test is performed under supra-threshold conditions.

[0069] Example Clause 2. The method according to claim 1, wherein said object is selected from the group consisting of a number, a letter, a grating, a symbol, or an image.

[0070] Example Clause 3. The method according to claim 1, wherein said plurality of presentations are selected randomly from said predetermined number of rotational orientations. Example Clause 4. The method according to claim 1, wherein said plurality of presentations is at least 10 presentations.

[0071] Example Clause 5. The method according to claim 4, wherein said plurality of presentations is at least 15 presentations.

[0072] Example Clause 6. The method according to claim 1, wherein said plurality of rotational orientations are each at successive degree increments of rotation.

[0073] Example Clause 7. The method according to claim 6, wherein said successive degree increment is 90 degrees or less.

[0074] Example Clause 8. The method according to claim 7, wherein said successive degree increment is 45 degrees or less.

[0075] Example Clause 9. The method according to claim 8, wherein the number of rotational orientations is at least 8.

[0076] Example Clause 10. The method according to claim 1, wherein the supra-threshold conditions are a spatial frequency between 1 and 20 cycles per degree and a contrast between 10% and 100%.

[0077] Example Clause 11. The method according to claim 10, wherein the spatial frequency is constant throughout steps a through f.

[0078] Example Clause 12. The method according to claim 10, wherein the spatial frequency varies during steps a through f.

[0079] Example Clause 13. The method of claim 10, wherein the contrast is constant throughout steps a through f.

[0080] Example Clause 14. The method according to claim 10, wherein the contrast varies during steps a through f.

[0081] Example Clause 15. The method according to claim 10, wherein an object luminance perceived by the person is constant during the test. Example Clause 16. The method according to claim 10, wherein an object luminance perceived by the person varies during the test.

[0082] Example Clause 17. The method according to claim 10, wherein the measurements are performed with a natural pupil size of the person.

[0083] Example Clause 18. The method according to claim 10, wherein the measurements are performed with an artificial pupil, or a combination of artificial pupils with different sizes.

[0084] Example Clause 19. The method according to claim 10, wherein the spatial frequency, the contrast, an artificial pupil size, and a luminance are selected based on personalized vision performance or a population representative vision performance.

[0085] Example Clause 20. The method according to claim 10, wherein the supra-threshold conditions are 9 cycles per degree and 20% contrast.

[0086] Example Clause 21. The method of claim 1, wherein the test is done for central vision, at a fixed angle from an optical axis for peripheral vision, or for a combination of angles.

[0087] Example Clause 22. The method of claim 1, wherein spatial frequencies, contrast levels, and object luminance levels are varied for different angles from an optical axis.

[0088] Example Clause 23. The method according to claim 1, wherein the object presentation time is fixed during steps a through f.

[0089] Example Clause 24. The method according to claim 1, wherein the object presentation time is unlimited during steps a through f.

[0090] Example Clause 25. The method according to claim 1, wherein the object presentation time is varied during steps a through f.

[0091] Example Clause 26. The method according to claim 1, wherein the metric value (M) is defined as M - (correct responses) / (response time). Example Clause 27. The method according to claim 26, wherein the response time is total response time, average response time, minimal response time, maximum response time, expected response time, any combination thereof or a normalized value derived from them.

[0092] Example Clause 28. The method according to claim 26, wherein the correct responses is the number of correct responses, percentage of correct responses, or a normalized value derived from number of correct responses.

[0093] Example Clause 29. The method according to claim 1, wherein the metric value (M) is defined as a balanced integration score of M - Z_pc - Z_rt, wherein Z_pc is normalized percentage of correct responses and Z_rt is normalized response time.

[0094] Example Clause 30. The method according to claim 29, wherein normalization is done according to Z_pc = (PC - AVERAGE(PC)) / SD(PC) and Z_rt = (RT - AVERAGE(RT)) / SD(RT), wherein AVERAGE denotes average value, and SD denotes standard deviation.

[0095] Example Clause 31. The method according to claim 1, wherein the metric value (M) is defined as time or threshold time.

[0096] Example Clause 32. The method according to claim 31, wherein the time is total time, expected time, average time, minimum time, maximum time, or a combination thereof.

[0097] Example Clause 33. The method according to claim 31, wherein the threshold time is estimated using Bayesian procedure, staircase method, or method of adjustments.

[0098] Example Clause 34. The method according to claim 1, wherein the method is applied to a patient having an optical correction lens, including but not limited to a contact lens, an intraocular lens, or glasses.

[0099] Example Clause 35. The method according to claim 1, wherein the method is applied to a patient or observer with optically or otherwise induced effect of an optical correction lens, including but not limited to effects of a contact lens, a spectacle lens, or an IOL. Example Clause 36. A method of assessing the effects on a selected vision attribute of a selected first ophthalmic lens design used by a test subject under supra-threshold conditions, comprising: a. presenting to said test subject one of a plurality of uniquely identifiable objects; b. presenting a selected one of said objects to said test subject, and repeating said presenting step a predetermined number of times; c. for each presentation, soliciting from said test subject a response indicating identification of the perceived object; d. determining whether the identification is correct, e. determining a response time of said identification; and f. calculating a metric value using the number of correct identifications and the response times.

[0100] Example Clause 37. The method according to claim 36, further comprising: g. repeating steps a through f with a second ophthalmic lens of a different design; and h. comparing the metric value calculated for the first ophthalmic design with the metric value calculated for the second ophthalmic design to assess which ophthalmic lens provides better quality of vision for said test subject.

[0101] Example Clause 38. The method according to claim 36, wherein said plurality of presentations is at least 10 presentations.

[0102] Example Clause 39. The method according to claim 36, wherein said uniquely identifiable object is a single object having uniquely identifiable configurations at each of a plurality of successive rotational orientations.

[0103] Example Clause 40. The method according to claim 36, wherein said uniquely identifiable objects are different objects.

[0104] Example Clause 41. The method according to claim 36, wherein the supra-threshold conditions are a spatial frequency between 1 and 20 cycles per degree and a contrast between 10% and 100%. Example Clause 42. The method according to claim 41, wherein the spatial frequency is constant throughout steps a through f.

[0105] Example Clause 43. The method according to claim 41, wherein the spatial frequency varies during steps a through f.

[0106] Example Clause 44. The method of claim 41, wherein the contrast is constant throughout steps a through f.

[0107] Example Clause 45. The method according to claim 41, wherein the contrast varies during steps a through f.

[0108] Example Clause 46. The method according to claim 41, wherein an object luminance perceived by the test subject is constant during the method.

[0109] Example Clause 47. The method according to claim 41, wherein an object luminance perceived by the test subject is varying during the method.

[0110] Example Clause 48. The method according to claim 41, wherein the method is performed with a natural pupil size of the test subject.

[0111] Example Clause 49. The method according to claim 41, wherein the method is performed with an artificial pupil, or a combination of artificial pupils with different sizes.

[0112] Example Clause 50. The method according to claim 41, wherein the spatial frequency, the contrast, an artificial pupil size, and a luminance are selected based on personalized vision performance or a population representative vision performance.

[0113] Example Clause 51. The method according to claim 41, wherein the spatial frequency is 9 cycles per degree and the contrast is 20%.

[0114] Example Clause 52. The method of claim 36, wherein the method is done for central vision, at a fixed angle from an optical axis for peripheral vision, or for a combination of angles.

[0115] Example Clause 53. The method of claim 36, wherein spatial frequencies, contrast levels, and object luminance levels are varied for different angles from an optical axis. Example Clause 54. The method according to claim 36, wherein the object presentation time is fixed during steps a through f.

[0116] Example Clause 55. The method according to claim 36, wherein the object presentation time is unlimited during steps a through f.

[0117] Example Clause 56. The method according to claim 36, wherein the object presentation time is varied during steps a through f.

[0118] Example Clause 57. The method according to claim 36, wherein the metric value (M) is defined as M - (correct responses) / (response time).

[0119] Example Clause 58. The method according to claim 57, wherein the response time is total response time, average response time, minimal response time, maximum response time, expected response time, any combination thereof or a normalized value derived from them.

[0120] Example Clause 59. The method according to claim 57, wherein the correct responses is the number of correct responses, percentage of correct responses, or a normalized value derived from number of correct responses.

[0121] Example Clause 60. The method according to claim 36, wherein the metric value (M) is defined as balanced integration score of M - Z_pc - Z_rt, wherein Z_pc is normalized percentage of correct responses and Z_rt is normalized response time.

[0122] Example Clause 61. The method according to claim 60, wherein normalization is done according to Z_pc = (PC - AVERAGE(PC)) / SD(PC) and Z_rt = (RT - AVERAGE(RT)) / SD(RT), wherein AVERAGE denotes average value, and SD denotes standard deviation.

[0123] Example Clause 62. The method according to claim 36, wherein the metric value (M) is defined as time or threshold time.

[0124] Example Clause 63. The method according to claim 62, wherein the time is total time, expected time, average time, minimum time, maximum time, or a combination thereof.

[0125] Example Clause 64. The method according to claim 62, wherein the threshold time is estimated using Bayesian procedure, staircase method, or method of adjustments. Example Clause 65. The method according to claim 36, wherein the selected vision attribute is selected from the group consisting of astigmatism, defocus, high order aberrations, pupil size, and chromatic aberrations, or any combination thereof.

[0126] Example Clause 66. The method according to claim 36, wherein the selected first ophthalmic lens design is an optical lens selected from the group consisting of a contact lens, a spectacle lens, and an IOL.

[0127] Example Clause 67. The method according to claim 36, wherein the method is applied to a patient or observer with optically or otherwise induced effect of an optical correction lens, including but not limited to effects of a contact lens, a spectacle lens, or an IOL.

[0128] Example Clause 68. The method according to claim 36, wherein the selected first ophthalmic lens design is simulated using an optical system.

[0129] Example Clause 69. A system for assessing supra-threshold vision of a patient, comprising: a presentation device for successively presenting to said patient under supra-threshold conditions a plurality of uniquely identifiable objects; a recording device for recording data representing an identification by the patient of each presented uniquely identifiable object; and a device for calculating a metric value indicative of the quality of vision based on the recorded data.

[0130] Example Clause 70. The system according to claim 69, wherein the supra-threshold conditions are a spatial frequency between 1 and 20 cycles per degree and a contrast between 10% and 100%.

[0131] Example Clause 71. The system according to claim 70, wherein the spatial frequency of presented objects is constant.

[0132] Example Clause 72. The system according to claim 70, wherein the spatial frequency of presented objects is different.

[0133] Example Clause 73. The system according to claim 70, wherein the contrast of presented objects is constant. Example Clause 74. The system according to claim 70, wherein the contrast of presented objects is different.

[0134] Example Clause 75. The system according to claim 70, wherein an object luminance perceived by the patient is constant for presented objects.

[0135] Example Clause 76. The system according to claim 70, wherein an object luminance perceived by the patient is different for presented objects.

[0136] Example Clause 77. The system according to claim 70, wherein the spatial frequency is 9 cycles per degree and the contrast is 20%.

[0137] Example Clause 78. The system according to claim 69, wherein the presentation time is fixed for presented objects.

[0138] Example Clause 79. The system according to claim 69, wherein the presentation time is unlimited for presented objects.

[0139] Example Clause 80. The system according to claim 69, wherein the presentation time is different for presented objects.

[0140] Example Clause 81. The system according to claim 69, wherein the system is via adaptive optics.

[0141] Example Clause 82. The system according to claim 69, wherein the metric value is defined by M - (correct responses) / (response time).

[0142] Example Clause 83. The system according to claim 82, wherein the response time is total response time, average response time, minimal response time, maximum response time, expected response time, any combination thereof or a normalized value derived from them.

[0143] Example Clause 84. The system according to claim 82, wherein the correct responses is the number of correct responses, percentage of correct responses, or a normalized value derived from number of correct responses. Example Clause 85. The system according to claim 69, wherein the metric value (M) is defined as a balanced integration score of M - Z_pc - Z_rt, wherein Z_pc is normalized percentage of correct responses and Z_rt is normalized response time.

[0144] Example Clause 86. The system according to claim 85, wherein normalization is done according to Z_pc = (PC - AVERAGE(PC)) / SD(PC) and Z_rt = (RT - AVERAGE(RT)) / SD(RT), wherein AVERAGE denotes average value, and SD denotes standard deviation.

[0145] Example Clause 87. The system according to claim 69, wherein the metric value (M) is defined as time or threshold time.

[0146] Example Clause 88. The system according to claim 87, wherein the time is total time, expected time, average time, minimum time, maximum time, or a combination thereof.

[0147] Example Clause 89. The system according to claim 87, wherein the threshold time is estimated using Bayesian procedure, staircase method, or method of adjustments.

[0148] Example Clause 90. The system according to claim 69, wherein the presentation, recording and calculating is directed by software on a computer or tablet.

[0149] Example Clause 91. A method for testing supra-threshold vision of a person comprising:

[0150] I. selecting an object having a uniquely identifiable configuration at each one of a plurality of successive rotational orientations;

[0151] II. presenting to the person said object in one of said plurality of rotational orientations for a pre-selected duration of time;

[0152] III. receiving from the person a response identifying a perceived rotational orientation;

[0153] IV. measuring correctness of the response, and based on that adjusting a period of time for subsequent presentation of the object;

[0154] V. repeating steps l-IV a predetermined number of times; and

[0155] VI. determining a metric value from the correctness of responses and durations of time for presentations of the object according to a predetermined formula, wherein the test is performed under supra-threshold conditions. Features across various embodiments may be combined, substituted, modified, or utilized solely or in combination as desired.

[0156] Although shown and described are preferred embodiments, it is apparent that departures from specific designs and methods described and shown will suggest themselves to those skilled in the art and may be used without departing from the spirit and scope of the invention. The present invention is not restricted to the particular constructions described and illustrated, but should be constructed to cohere with all modifications that may fall within the scope of the appended claims.

Claims

What is Claimed is:

1. A method for testing supra-threshold vision of a person comprising: a) selecting an object having a uniquely identifiable configuration at each one of a plurality of successive rotational orientations; b) presenting to the person said object in one of said plurality of rotational orientations; c) receiving from the person a response identifying a perceived rotational orientation; d) measuring a response time of said person and the correctness of the response; e) repeating steps b-d a predetermined number of times; and f) determining a metric value using said number of correct responses and the measured response times from steps b-d according to a predetermined formula, wherein the test is performed under supra-threshold conditions.

2. The method according to claim 1, wherein said object is selected from the group consisting of a number, a letter, a grating, a symbol, or an image.

3. The method according to claim 1, wherein said plurality of presentations are selected randomly from said predetermined number of rotational orientations.

4. The method according to claim 1, wherein said plurality of presentations is at least 10 presentations.

5. The method according to claim 4, wherein said plurality of presentations is at least 15 presentations.

6. The method according to claim 1, wherein said plurality of rotational orientations are each at successive degree increments of rotation.

7. The method according to claim 6, wherein said successive degree increment is 90 degrees or less.

8. The method according to claim 7, wherein said successive degree increment is 45 degrees or less.

9. The method according to claim 8, wherein the number of rotational orientations is at least 8.

10. The method according to claim 1, wherein the supra-threshold conditions are a spatial frequency between 1 and 20 cycles per degree and a contrast between 10% and 100%.

11. The method according to claim 10, wherein the spatial frequency is constant throughout steps a through f.

12. The method according to claim 10, wherein the spatial frequency varies during steps a through f.

13. The method of claim 10, wherein the contrast is constant throughout steps a through f.

14. The method according to claim 10, wherein the contrast varies during steps a through f.

15. The method according to claim 10, wherein an object luminance perceived by the person is constant during the test.

16. The method according to claim 10, wherein an object luminance perceived by the person varies during the test.

17. The method according to claim 10, wherein the measurements are performed with a natural pupil size of the person.

18. The method according to claim 10, wherein the measurements are performed with an artificial pupil, or a combination of artificial pupils with different sizes.

19. The method according to claim 10, wherein the spatial frequency, the contrast, an artificial pupil size, and a luminance are selected based on personalized vision performance or a population representative vision performance.

20. The method according to claim 10, wherein the supra-threshold conditions are 9 cycles per degree and 20% contrast.

21. The method of claim 1, wherein the test is done for central vision, at a fixed angle from an optical axis for peripheral vision, or for a combination of angles.

22. The method of claim 1, wherein spatial frequencies, contrast levels, and object luminance levels are varied for different angles from an optical axis.

23. The method according to claim 1, wherein the object presentation time is fixed during steps a through f.

24. The method according to claim 1, wherein the object presentation time is unlimited during steps a through f.

25. The method according to claim 1, wherein the object presentation time is varied during steps a through f.

26. The method according to claim 1, wherein the metric value (M) is defined as M - (correct responses) / (response time).

27. The method according to claim 26, wherein the response time is total response time, average response time, minimal response time, maximum response time, expected response time, any combination thereof or a normalized value derived from them.

28. The method according to claim 26, wherein the correct responses is the number of correct responses, percentage of correct responses, or a normalized value derived from number of correct responses.

29. The method according to claim 1, wherein the metric value (M) is defined as a balanced integration score of M - Z_pc - Z_rt, wherein Z_pc is normalized percentage of correct responses and Z_rt is normalized response time.

30. The method according to claim 29, wherein normalization is done according to Z_pc - (PC - AVERAGE(PC)) / SD(PC) and Z_rt = (RT - AVERAGE(RT)) / SD(RT), wherein AVERAGE denotes average value, and SD denotes standard deviation.

31. The method according to claim 1, wherein the metric value (M) is defined as time or threshold time.

32. The method according to claim 31, wherein the time is total time, expected time, average time, minimum time, maximum time, or a combination thereof.

33. The method according to claim 31, wherein the threshold time is estimated using Bayesian procedure, staircase method, or method of adjustments.

34. The method according to claim 1, wherein the method is applied to a patient having an optical correction lens, including but not limited to a contact lens, an intraocular lens, or glasses.

35. The method according to claim 1, wherein the method is applied to a patient or observer with optically or otherwise induced effect of an optical correction lens, including but not limited to effects of a contact lens, a spectacle lens, or an IOL.

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