Light control apparatus and method for regional visual information and sampling variations

Abstract

The present disclosure relates to light control devices and methods for regional visual information and sampling variations' V-VIS 'that improve or stabilize vision, mitigate visual symptoms, reduce the rate of visual loss, or reduce the progression of ophthalmic or neurological conditions, diseases, injuries, or conditions. The V-VIS devices and methods may optically move one or more apertures in front of the retina between one or more positions in front of the retina that are not coaxial with the center of the pupil and a position in front of the retina that is coaxial with the center of the pupil at a sampling rate of between 50 Hz and 50 kHz. Certain of these V-VIS devices and methods may be used in combination with augmented reality or virtual reality, vision measurement, vision monitoring, or other therapies, including but not limited to pharmacological therapies, gene therapies, retina replacement therapies, and stem cell therapies.

Description

[0001] Information about divisional applications

[0002] This application is a divisional application of the Chinese invention patent application with the invention name “Light control device and method for regional visual information and sampling changes”, application number 201880089661.2 and application date December 17, 2018.

[0003] CROSS-REFERENCE TO RELATED APPLICATIONS

[0004] This application claims the benefit of priority to U.S. Provisional Application No. 62 / 608,039, filed on December 20, 2017, entitled “LIGHT CONTROL DEVICES AND METHODS FOR NOVEL REGIONAL VARIATION OF VISUAL INFORMATION AND SAMPLING,” which is incorporated herein by reference in its entirety for all purposes. Technical Field

[0005] The disclosed embodiments relate to light control apparatus and methods for regional visual information and sampling variations. Background Art

[0006] The retina is the part of the eye that responds to light from the ocular field of view and converts the light into signals to initiate image processing. Visual processing continues in the brain where retinal visual information is integrated in space, time, and with eye movements to achieve visual perception of the ocular field of view. The optical axis is a straight line perpendicular to the front of the eye and extending through the center of the pupil, which is defined herein as the coaxial line. Summary of the invention

[0007] In some examples, a light control device is configured to optically move one or more apertures in front of the retina of an eye between one or more positions in front of the retina that are not coaxial with the center of the pupil and a position in front of the retina that is coaxial with the center of the pupil. The one or more apertures are moved at a rate between 50 Hz and 50 kHz, and the light control device generates regional visual information and sampling changes of the eye's visual field.

[0008] In other examples, the anterior retina may include one of extraocular, intracorneal, or intraocular placement. Further, the light control device may electro-optically move the one or more apertures through one or more see-through displays placed anterior to the retina. The one or more see-through displays of the V-VIS device may be further configured to display at least one of an augmented reality image, a virtual reality image, or a combination of augmented and virtual reality images.

[0009] The light control device may further include one or more waveguides, and the light control device may move the one or more apertures using the one or more waveguides. In further examples, the one or more waveguides may be arranged in at least one of: vertical stacking in layers, adjacent to each other in a single layer, or holographically multiplexed.

[0010] In some examples, the one or more see-through displays may include one or more transparent carrier layers, and each of the transparent carrier layers may include one or more active optical elements. The light control device may also include an electrical component coupled to each of the transparent carrier layers. The electrical component may direct an electric current through each of the transparent carrier layers, and the directed electric current may energize the one or more active optical elements to generate and move the one or more apertures. In some cases, two or more of the transparent carrier layers may be vertically stacked in more than one plane, and when energized, the one or more active optical elements in each of the two or more transparent carrier layers may become less transparent than the apertures. The one or more apertures may be defined by at least one of: (i) an area without the one or more active optical elements surrounded by an area with the one or more active optical elements in each transparent carrier layer; or (ii) an area where the one or more active optical elements are not activated surrounded by an area where the one or more active optical elements in each transparent carrier layer are activated. The spatial position of each of the one or more apertures in each carrier layer may be displaced relative to each other.

[0011] In another example, the light control device can be configured to move one or more apertures by off-axis projection. Further, the light control device can be used to generate regional visual information and sampling changes of the eye field for at least one of vision, screening, customization, calibration, vision measurement or vision monitoring.

[0012] Further, in some instances, regional visual information and sampling changes of the ocular visual field can produce at least one of the following: (i) improving the vision of one or both eyes of a subject; (ii) stabilizing the vision of one or both eyes of a subject; (iii) correcting an ophthalmic or neurological condition; (iv) alleviating visual symptoms in one or both eyes of a subject suffering from an ophthalmic or neurological condition, disease, injury or disorder; (v) reducing the rate of vision loss in one or both eyes of a subject suffering from vision loss due to an ophthalmic or neurological condition, disease, injury or disorder; (vi) reducing the rate of progression of an ophthalmic or neurological condition, disease or disorder in one or both eyes of a subject suffering from an ophthalmic or neurological condition, disease or disorder; and (vii) measurement or monitoring of vision in one or both eyes of a subject.

[0013] The light control device may also include one or more cameras and at least one processor functionally coupled to the one or more cameras. The at least one processor may be configured to execute software instructions to capture light from at least one of around, above, below, or behind one eye, the other eye, or both eyes of the subject, and deliver the light to the retina of the one eye, the other eye, or both eyes of the subject.

[0014] In addition, the light control device may also include one or more microphones and at least one processor coupled to the one or more microphones. The at least one processor may be configured to execute software instructions to convert the audible speech into text in a preferred language and display the text within the subject's field of view. In some examples, the light control device may also include one or more light emitting diodes positioned around the perimeter of the field of view, and the processor may be further configured to execute software instructions to selectively power the one or more light emitting diodes to indicate the direction in which the audible speech is generated.

[0015] In another example, a method includes utilizing a light control device. The device is configured to optically move one or more apertures in front of a retina of an eye between one or more positions in front of the retina that are not coaxial with a center of a pupil and a position in front of the retina that is coaxial with the center of the pupil. The one or more apertures are moved at a rate between 50 Hz and 50 kHz, and the light control device generates regional variations of visual information and sampling (V-VIS) of the ocular visual field.

[0016] Additionally, in some instances, the retina may include one of an extraocular, intracorneal, or intraocular placement, and the light control device may be configured to electro-optically move one or more apertures through one or more see-through displays placed in front of the retina to generate regional visual information and sampling changes of the ocular field of view for at least one of vision, screening, customization, calibration, vision measurement, or vision monitoring. The light control device may also be configured to generate at least one of: improving vision in one or both eyes of a subject; stabilizing vision in one or both eyes of a subject; correcting an ophthalmic or neurological condition; alleviating visual symptoms in one or both eyes of a subject suffering from an ophthalmic or neurological condition, disease, injury, or disorder; reducing the rate of vision loss in one or both eyes of a subject suffering from vision loss due to an ophthalmic or neurological condition, disease, injury, or disorder; reducing the rate of progression of an ophthalmic or neurological condition, disease, or disorder in one or both eyes of a subject suffering from an ophthalmic or neurological condition, disease, or disorder; vision measurement in one or both eyes of a subject; or vision monitoring in one or both eyes of a subject.

[0017] The method may also include using the light control device to generate at least one of an augmented reality image, a virtual reality image, or a combination of augmented and virtual reality images. In other examples, the method may also include treating the eye using the light control device and administering at least one of a genetic therapy, epigenetic therapy, optogenetic therapy, retinal replacement therapy, or stem cell therapy for treating an ophthalmic or neurological condition, disease, injury, or disorder at a time before, during, or after the treatment.

[0018] In further examples, the method can comprise treating the eye using the light-management device and administering a therapeutically effective amount of an anti-angiogenic agent by at least one of intravitreal injection, orally, topically, intraretinaly, by implant, or by iontophoresis at a time before, during, or after treatment, wherein the combination therapy is used to treat or alleviate a neovascular ophthalmic condition, disease, injury, or disorder.

[0019] The method may also include treating the eye using the light-control device and administering topically, intraretinaly, by intravitreal injection, by implant, or by iontophoresis a therapeutically effective amount of at least one of the following for treating an ophthalmic or neurological condition, disease, injury, or disorder before, during, or at some time after treatment: (i) an intraocular pressure-reducing agent, including but not limited to miotic agents, alpha or alpha / beta adrenergic agonists, beta blockers, Ca2+ channel blockers, carbonic anhydrase inhibitors, cholinesterase inhibitors, prostaglandin agonists, prostaglandins, prostaglandins, cannabinoids; (ii) a retinal cell or cortical cell neuroprotective or neuroregenerative agent, including but not limited to a rho kinase inhibitor, an adenosine receptor agonist, a glutamate antagonist, a neurotrophic factor, or a neurotrophic factor modulator; or (iii) a combination of an intraocular pressure-reducing agent and a retinal cell or cortical cell neuroprotective or neuroregenerative agent. The ophthalmic or neurological condition, disease, injury or disorder may comprise glaucoma, macular degeneration, optic atrophy, optic nerve damage, autoimmune neurodegenerative disease, or cerebrovascular accident. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] Figure 1 is a flow chart illustrating the neural processing that leads to visual perception according to some examples.

[0021] Figure 2 Examples of light control devices including a transparent reflective diffuser display on which a moving aperture can be formed by off-axis projection are shown according to some examples.

[0022] Figure 3A is an illustration of a light control device according to some examples, the light control device including a substantially transparent liquid crystal or other optically active material contained in a film defined herein as a carrier layer or carrier layer unit, the illustration showing a moving orifice at a single position during a single sampling time interval.

[0023] Figure 3B is a diagram of a light control device according to some examples, the light control device comprising Figure 3A A vertical stack of a plurality of carrier layer units, each containing an optically active material, and showing five possible aperture positions for producing a moving aperture effect.

[0024] Figure 4A are side and top views of an eye according to some examples, showing the light control device within the Figure 3B The inventive carrier layer comprises a pair of glasses and a waveguide, and a moving aperture at one position during a single sampling time interval.

[0025] Figure 4Bis a side view of an eye with a light control device according to some examples, the light control device comprising a contact lens and Figure 2 An off-axis projection system is used to produce the moving orifice depicted herein at one location within a single sampling time interval.

[0026] Figure 4C is a side view of an eye with a light control device including a corneal insert showing a moving aperture at one position during a single sampling time interval according to some examples.

[0027] Figure 4D is a side view of an eye with a light control device including an intraocular lens implant showing multiple moving apertures in an exemplary configuration during a single sampling time interval according to some examples.

[0028] Figure 5 Depicted is a light control apparatus comprising a pair of glasses viewed at different points in time according to some examples.

[0029] Figure 6 A light control device including a remotely accessible device is depicted according to some examples. DETAILED DESCRIPTION

[0030] Among the benefits and improvements disclosed herein, other purposes and advantages of the exemplary embodiments may become apparent from the following description in conjunction with the accompanying drawings. Detailed exemplary embodiments are disclosed herein; however, it should be understood that these disclosed exemplary embodiments are illustrative only and may be embodied in various forms. In addition, each of the examples given in conjunction with the various embodiments is intended to be illustrative, not restrictive. Any changes and further modifications to the features shown herein that may be generally conceivable by a person skilled in the relevant art and a person skilled in the art who possesses the present disclosure, as well as any additional application of one or more of the principles shown herein, should be considered to be within the scope of the disclosed exemplary embodiments. Although the description herein teaches certain features applied to various embodiments, it will be understood that various omissions, substitutions and changes may be made to the form and details of the apparatus or method shown without departing from the spirit of the present disclosure. As will be appreciated, since some features may be used or practiced separately from other features, some of the exemplary embodiments described herein may be embodied in a form that does not provide all the features and benefits set forth herein. All changes falling within the equivalent meaning and scope of the claims should be included within the scope of the claims.

[0031] Throughout the specification, unless the context clearly indicates otherwise, the following terms take the meanings explicitly associated herein. Although the phrases "in one embodiment" and "in some embodiments" used herein may, but do not necessarily refer to one or more of the same embodiments. In addition, the phrases "in another embodiment" and "in some other embodiments" used herein may, but do not necessarily refer to different embodiments. Therefore, as described below, various exemplary embodiments can be easily combined without departing from the scope or spirit of the exemplary embodiments.

[0032] In addition, unless the context clearly indicates otherwise, as used herein, the term "or" is an inclusive "or" operator and is equivalent to the term "and / or". Unless the context clearly indicates otherwise, the term "based on" is not exclusive and allows for being based on other factors not described. In addition, throughout the specification, the meanings of "a", "an" and "the" include plural referents. The meaning of "in..." includes "in..." and "on...".

[0033] A. introduce

[0034] This specification describes, among other things, exemplary devices and methods for performing regional variation of visual information and sampling (e.g., V-VIS) of an ocular visual field by optically moving one or more apertures anterior to the retina between one or more locations anterior to the retina that are not coaxial with the center of the pupil and a location anterior to the retina that is coaxial with the center of the pupil. The exemplary V-VIS device described herein corresponds to and functions as a light control device that produces regional variation of visual information and sampling. Further, and as described herein, "anterior to the retina" includes one of extraocular, intracorneal, or intraocular placement, and the one or more apertures are moved at a rate between 50 Hz and 50 kHz.

[0035] Certain of the exemplary V-VIS devices and methods can be used for at least one of the following: for V-VIS screening, V-VIS customization, V-VIS calibration, V-VIS vision measurement, V-VIS vision monitoring, or any combination thereof. One or more of the exemplary V-VIS devices and methods can improve and / or stabilize the vision of one or both eyes of a subject and / or correct an ophthalmic or neurological condition. In some embodiments, delivering visual information from the ocular visual field V-VIS (e.g., using the exemplary V-VIS devices and methods described herein) to the retina also alleviates visual symptoms, or reduces the rate of vision loss or reduces the progression of vision loss, or functionally measures vision (including but not limited to the visual processing effects of ophthalmic or neurological conditions, diseases, injuries, or disorders), or monitors vision.

[0036] Further, one or more of the exemplary V-VIS devices and methods described herein can provide novel delivery of visual information from the ocular field of view to different areas of the retina at a sufficiently fast rate to overcome the limitations of conventional light control devices, as well as the limitations of natural visual processing and perception, thereby improving the vision of subjects suffering from reduced vision or ophthalmic or neurological conditions or any combination thereof. Compared to conventional devices and methods for delivering visual information from the ocular field of view to the retina, one or more of the exemplary V-VIS devices and methods can provide improved monocular and / or binocular visual results and / or fewer adverse visual effects and / or more patient convenience and / or compliance with the treatment of ophthalmic and / or neurological conditions. Further compared to some conventional devices such as retinal prostheses, some of the exemplary V-VIS devices and methods can be used with existing and / or natural neural circuits in the retina and / or brain, without the need to replace natural neural circuits, and without interfering with normal natural visual processing mechanisms.

[0037] Examples of V-VIS devices and methods described herein include extraocular devices such as, but not limited to, eyeglasses, accessory devices for eyeglasses, heads-up displays, eye shields, contact lenses, accessory devices for contact lenses, and viewing screens (such as, but not limited to, remotely accessible televisions, remotely accessible computers, and remotely accessible mobile devices), corneal inserts configured as V-VIS light control devices, intraocular devices, intraocular lenses, and intraocular lens accessories. The exemplary V-VIS devices and methods described herein can produce V-VIS combined with augmented reality and / or virtual reality, or can be part of an augmented and / or virtual reality system.

[0038] In some embodiments, one or more of the exemplary V-VIS devices and methods may be combined with other treatments for retinal and / or neurological conditions, diseases, injuries, and disorders, including but not limited to genetic therapy, epigenetic therapy, optogenetic therapy, retinal replacement therapy, stem cell therapy, and / or pharmacological agents, including but not limited to anti-angiogenic agents, intraocular pressure reducing agents, neuroprotective agents, and neuroregenerative agents.

[0039] As described herein, exemplary V-VIS devices and methods are configured to improve and / or stabilize vision in one or both eyes of a subject. Some embodiments of the exemplary devices and methods described herein correct ophthalmic or neurological conditions. In some embodiments, delivering visual information from the ocular visual field V-VIS to the retina also alleviates visual symptoms of an ophthalmic or neurological condition, disease, injury, or disorder, including but not limited to age-related macular degeneration (AMD), Stargardt's disease, Bests vitelliform macular dystrophy, and / or retinal dystrophy. The invention relates to retinal diseases including, but not limited to, myopic macular degeneration, macular scarring, inherited retinal disorders, diabetic retinopathy (DR), macular edema, macular hole, macular detachment, macular pucker, vascular retinal disorders (including but not limited to retinal vein occlusion and Coats disease), retinitis pigmentosa, nutritional retinal disorders, inflammatory retinal disorders, glaucoma or other neuroretinal or ganglion cell disorders, autoimmune disorders (including but not limited to multiple sclerosis and lupus erythematosus), cerebrovascular accidents, dyslexia, amblyopia (caused by but not limited to refractive error, medial opacity or blockage, oculomotor conditions, or any combination thereof), presbyopia, and metamorphopsia.

[0040] Some embodiments of the exemplary devices and methods described herein reduce the rate of vision loss in one or both eyes of a subject suffering from vision loss caused by an ophthalmic or neurological condition, disease, injury or disorder, compared to an untreated control group. Some embodiments of the exemplary devices and methods described herein reduce the progression of an ophthalmic or neurological condition, disease or disorder, compared to an untreated control group. Some embodiments of the exemplary devices and methods described herein measure or monitor vision, including but not limited to the effects of an ophthalmic or neurological condition, disease or disorder on visual processing, and / or assist a subject in V-VIS screening and / or customization of a V-VIS and / or calibration of a V-VIS.

[0041] B. Exemplary apparatus and methods for regional visual information and sampling variation

[0042] Figure 1 The integration of various components of the visual system according to some examples is illustrated diagrammatically. Light carrying visual information from the ocular field of view is directed through the eye and delivered to the photosensitive retinal cells that absorb the light and begin processing the visual information. The photosensitive retinal cells convert the light energy into signals that are sent to other retinal cells and the brain where they are further processed in combination with feedforward and feedback loops within the retina and brain and to and from the extraocular muscles, including but not limited to encoding, filtering, and integration, to produce visual perception.

[0043] Some embodiments of the exemplary V-VIS devices and methods described herein produce novel delivery of light to the retina. Some embodiments of the exemplary devices and methods produce changes in light sampling within the ocular field of view. In some exemplary embodiments, the movement of one or more apertures in front of the retina between one or more positions in front of the retina that are not coaxial with the center of the pupil and a position in front of the retina that is coaxial with the center of the pupil causes a regional change in the ocular field of view and / or one (or more) retinal areas to which the ocular field of view is presented. In some exemplary embodiments, the regional change in one or more retinal areas to which the ocular field of view and / or the ocular field of view is delivered by one or more V-VIS devices and methods in the exemplary V-VIS devices and methods is determined by at least one of the following: the diameter of one or more apertures, the transparency of one or more apertures to a selected wavelength, the number of apertures, the diameter of the zone in which one or more apertures are moved, the position to which the apertures are moved, the order in which the apertures are moved to different positions, the transparency of a zone or portion of a zone outside one or more apertures to a selected wavelength, and the rate at which one or more apertures are moved between 50 Hz and 50 kHz.

[0044] In some exemplary embodiments, the exemplary V-VIS device and method move one or more orifices that are substantially circular or hexagonal or elliptical or oval or square or rectangular or any desired shape or any combination thereof. In some embodiments, the exemplary V-VIS device and method move one or more orifices that are configured to have a constant or adjustable diameter and / or maximum diameter in the range of 0.1 mm to 4 mm. In some embodiments, the exemplary V-VIS device is configured to move one or more orifices within a zone having a constant or adjustable diameter and / or maximum diameter in the range of 0.2 mm to 10 mm. In some embodiments, the exemplary V-VIS device and method are configured to move one or more orifices to a position that partially overlaps, does not overlap, or any combination thereof. In some embodiments, the position to which the orifice is moved overlaps a zone outside the pupil under photopic or mesopic or scotopic lighting conditions or any combination thereof. In some embodiments, under weak light lighting conditions, such as mesopic and / or scotopic conditions, electronic lighting enhancement methods known to those skilled in the art are employed. Some embodiments of the exemplary V-VIS device are configured to move each of the one or more apertures in a predetermined order, including but not limited to, alternatingly, randomly, sequentially through all positions, in any other desired order, or any combination thereof.

[0045] In some embodiments, exemplary V-VIS devices and systems deliver light with visual information from the ocular visual field to retinal cells through each of one or more apertures by presenting a duration, referred to herein as a V-VIS sampling interval ("SI"), that is sufficient to enable perception of the ocular visual field after further processing in the retina and brain. In some embodiments, V-VIS is achieved by changing the position of one or more apertures at a rate between 50 Hz and 50 kHz and not allowing the aperture to remain in any one position for more than one V-VIS SI. In some embodiments of the exemplary V-VIS devices and methods described herein, the SI is a time interval lasting between 0.02 milliseconds and 20 milliseconds.

[0046] The V-VIS sampling rate ("SR") of one or more orifices is defined herein as the number of times per second that each SI is completed, i.e., the number of times per second that each orifice or one or more orifices is moved to each of the selected positions. In some embodiments, the SR is a rate between 50 Hz and 50 kHz. A V-VIS sampling period ("SC") is defined herein as a sequence of orifice positions. In some embodiments, a V-VIS sampling period includes some selected positions to which each orifice or one or more orifices is moved more than once during a sampling period.

[0047] In some embodiments described herein, exemplary V-VIS methods and apparatus are configured to generate SR or variable SR based on the velocity of fixational eye movements (including but not limited to microsaccades, drifts, and tremors.) The velocity of fixational eye movements typically changes due to ophthalmic and / or neurological conditions, diseases, injuries, or disorders.

[0048] In some embodiments, exemplary V-VIS devices and methods move one or more apertures at a SR rate fast enough to achieve stable perception. In some embodiments, exemplary V-VIS methods and devices deliver light with visual information from the ocular field of view to retinal cells at a presentation duration customized for one or both eyes of the subject. In some embodiments, exemplary V-VIS devices and methods move one or more apertures at different rates for different eyes and / or subjects to achieve stable perception without the subject perceiving flicker. In some embodiments, exemplary V-VIS devices and methods move one or more apertures at different rates for different eyes and / or subjects to achieve stable perception without stroboscopic and / or phantom array effects. In some embodiments, exemplary V-VIS devices and methods move one or more apertures at different rates for different eyes and / or subjects to achieve stable perception without triggering adverse effects, including but not limited to headaches, migraines, cognitive deficits, and / or photosensitive epilepsy.

[0049] In some embodiments, the exemplary V-VIS device and method move one or more apertures at different rates for different eyes and / or subjects, depending on age and / or the type and / or severity of an ophthalmic and / or neurological condition, disease, injury or disorder and / or other factors. In some embodiments, the light delivery performed by the exemplary V-VIS method and device is configured to be adjustable. In some embodiments, the exemplary V-VIS method and device delivers light with visual information from the ocular field of view through each of the one or more apertures to the retinal cells with a presentation duration, the apertures are initially too fast to be visually perceived by one eye and / or both eyes of the subject, but are configured to allow adjustability of the SR so that when the SR slows, for a given eye and / or both eyes of the subject, the SR at which visual perception first becomes possible can be determined and depends on various factors, including but not limited to the age of the subject, the type or stage of the disease. In some embodiments, the exemplary V-VIS method and device are configured for calibration of V-VIS treatment and staging of one eye and / or both eyes of a subject with an ophthalmic or neurological condition, disease, injury or disorder. In some embodiments, exemplary V-VIS methods and devices are configured to monitor improvement in one and / or both eyes having an ophthalmic or neurological condition, disease, injury or disorder following V-VIS therapy or following conventional therapy or following a combination thereof. For example, in some embodiments, the average SR required for visual perception in an eye having a certain condition, disease, injury or disorder is slower than the average SR required for visual perception in a matched control eye without the condition, disease, injury or disorder, and increases as vision improves following V-VIS therapy or following other therapies or following a combination thereof.

[0050] In some embodiments, the V-VIS device and method can be combined with methods or devices for vision testing known to those skilled in the art of vision testing, including but not limited to visual acuity testing, contrast sensitivity testing, or perimetry, to distinguish vision problems caused by visually significant defocusing of light at the retina from vision problems caused by other causes, including but not limited to functional or structural causes. Some embodiments of the exemplary V-VIS methods and devices described herein are utilized to correct and / or mitigate vision problems associated with retinal defocus and / or refractive and / or accommodative errors at speeds within a normal range for a subject who suffers from refractive and / or accommodative errors but does not suffer from other ophthalmic or neurological conditions, diseases, injuries, or disorders. In some embodiments, the exemplary V-VIS method or device can be combined with methods or devices for visual acuity testing known to those skilled in the art of vision testing, including but not limited to visual acuity testing, contrast sensitivity testing, or perimetry, to quantify and / or monitor the severity of visual impairment due to visual processing defects in the retina or brain of the eye over time. Visual impairment associated with visual processing defects in the retina and / or brain can be corrected and / or alleviated using some embodiments of the exemplary V-VIS devices and methods described herein applied to a subject, for example, at a speed within a different speed range than applied to other subjects who do not have visual processing defects in the retina and / or brain. The methods described herein include V-VIS in combination with other medical or surgical treatments.

[0051] As described herein, some embodiments of the exemplary V-VIS method and apparatus are configured to deliver light to the retina with less myopic and / or hyperopic vergence at the retina. Some embodiments of the exemplary V-VIS method and apparatus are configured to deliver approximately collimated light through one or more mobile apertures. Some embodiments of the exemplary V-VIS method and apparatus move one or more apertures having a diameter that is effective to reduce the refractive error in the eye of a subject with metametropia. Some embodiments of the exemplary V-VIS method and apparatus move one or more apertures having a diameter that is effective to increase the depth of focus of the eye of a subject with presbyopia. Some embodiments of the exemplary V-VIS method and apparatus reduce refractive error or increase depth of focus or any combination thereof, thereby reducing symptoms of metametropia or presbyopia or any combination thereof. Some embodiments of the exemplary V-VIS method and apparatus overcome the limitations of conventional devices incorporating smaller fixed apertures, including but not limited to field of view limitations, reduced amount of light reaching the retina, loss of contrast sensitivity, reduced stereoscopic vision, and diffraction blur. If the fixed aperture is small enough to collimate the light and place it in front of the retina, the fixed aperture limits the peripheral light being delivered to the retina. In eyes with maculopathy, fixed small apertures generally do not improve visual acuity and generally reduce visual acuity by limiting light to dysfunctional areas of the retina. Fixed small apertures reduce total illumination and cause less light to reach the retina, thereby reducing visual acuity under low lighting conditions. Fixed small apertures in only one eye of a subject induce anisocoria and produce harmful inter-ocular differences in visual delay, causing harmful deformation of relative movement. As described herein, some embodiments of exemplary V-VIS devices and systems overcome the limitations of fixed small apertures by clever and novel positioning and movement of one or more apertures at 50 Hz to 50 kHz, thereby providing better illumination and better vision in eyes with ophthalmic or neurological conditions, diseases, injuries or disorders, compared to conventional devices with fixed small apertures.

[0052] In some embodiments of the exemplary V-VIS devices and systems described herein, the transparency of one or more apertures to a selected wavelength is constant or adjustable. In some embodiments, the transparency of a region outside the region in which the one or more apertures are located to a selected wavelength is constant or adjustable.

[0053] In some cases, a range of light wavelengths stimulate each type of retinal receptor to a different degree. Yellow-green light stimulates L and M cones equally strongly, but only weakly stimulates S cones. Red light stimulates L cones much more than M cones, but hardly any S cones. Blue-green light stimulates M cones more than L cones, but slightly more strongly S cones, and is also a peak stimulator of rods. Blue light stimulates S cones more strongly than red or green light, and less strongly than red or green light to L and M cones. The brain combines information from each type of receptor to cause different perceptions of different wavelengths of light. Some embodiments of the exemplary V-VIS method and apparatus vary the transparency of one or more apertures and / or zones outside of the zone within which one or more apertures are moved to selected wavelengths to vary the amount of stimulation of different types of retinal photoreceptors in one or both eyes of a subject to produce a beneficial effect.

[0054] Some embodiments of the exemplary V-VIS methods and apparatus selectively change the transparency of one or more apertures and / or a zone outside of the zone within which the one or more apertures move to wavelengths in the visible spectrum, the visible spectrum ranging from about 400 nm to 700 nm. Further, in some cases, the dispersion may cause wavelengths in the visible spectrum to have a focal range of about 2.25 diopters. The refractive index is inversely proportional to the wavelength; blue light (short wavelength) is refracted more than red light (long wavelength). Some embodiments of the exemplary V-VIS methods and apparatus selectively change the transparency of one or more apertures and / or a zone outside of the zone within which the one or more apertures move to visible wavelengths to change the defocus on the retina in one or both eyes of the subject.

[0055] In some embodiments, the exemplary V-VIS methods and devices described herein may be configured to deliver light to the retina in a manner that results in less myopic and / or hyperopic astigmatism at the retina in different zones of the retina to effectively alter the refractive process of the eye and / or the refractive development of the eye. In some embodiments, the exemplary V-VIS devices and methods may be configured to reduce defocus on a retinal zone within the central retina or outside the central retina, or any combination thereof, to reduce the rate of progression of abnormal eyes (including but not limited to myopia) compared to an untreated control group, wherein the central retina is centered on the fovea, may contain the fovea or parafovea or macula, or any combination thereof, and may have any diameter between 1.5 mm and 6 mm. In some embodiments, the exemplary V-VIS methods and devices described herein may be configured to reduce defocus in a retinal zone by diameter, position, chromaticity, or any combination thereof of one or more of the mobile apertures, one or more zones without mobile apertures, or any combination thereof.

[0056] As described herein, one or more of the exemplary V-VIS devices and methods can be configured to improve and / or stabilize vision in one or both eyes of a subject. Improved and / or stabilized vision includes, but is not limited to, improvement and / or stabilization of at least one of: visual acuity (including at least one of uncorrected and best spectacle-corrected visual acuity for distance, intermediate, and near visual acuity), super acuity, stereo acuity, vernier acuity, contrast sensitivity, depth of focus, color vision, visual field, peripheral vision, night vision, facial recognition, light adaptation, dark adaptation, vision-related quality of life, or any combination thereof.

[0057] Further, some embodiments of the exemplary V-VIS devices and methods described herein improve vision by altering visual processing, including but not limited to neural encoding and / or integration and / or filtering and / or neural adaptation and / or perception of visual field. Some embodiments of exemplary V-VIS devices and methods produce novel light delivery to retinal cells to cause at least one of the following: (i) alter the sampling of visual information so that more correct retinal visual information can be encoded by functional retinal cells in multiple retinal areas and transmitted from the retina to the brain with improved adaptive and / or predictive sensitization and / or integration; (ii) increase effective and / or spontaneous search to integrate more visual information; (iii) minimize the effects of fixation instability and / or defective gaze selection; (iv) beneficially alter neural attention regulation; (v) beneficially alter the excitatory / inhibitory balance of the visual system in the eye and brain, including but not limited to altering the convergent excitatory and inhibitory inputs in one or more visual pathways; (vi) beneficially activate previously unused or underutilized sensory, motor, and cognitive systems in the eye and brain; and (vii) use residual oculomotor and / or sensory plasticity for beneficial neural adaptation. In some embodiments, the exemplary V-VIS devices and methods described herein can improve the function of retinal circuits, including but not limited to connectivity functions in visual processing involving photoreceptors and / or ganglion cells and / or amacrine cells and / or bipolar cells and / or horizontal cells and / or Muller cells or any combination thereof. In some embodiments, the exemplary V-VIS devices and methods can improve and / or trigger certain processes of neural adaptation, including but not limited to the use of alternative, potential and / or new natural visual pathways in the retina and brain. Some embodiments of the exemplary V-VIS devices and methods can improve visual processing and / or perception without replacing existing and / or natural neural circuits in the retina and / or brain, and without interfering with normal natural visual processing mechanisms.

[0058] Some embodiments of the exemplary V-VIS apparatus and methods may generate regional visual information and sampling changes combined with augmented reality and / or virtual reality, or may be implemented as part and / or components of augmented and / or virtual reality systems. As described herein, some embodiments of the exemplary V-VIS apparatus and methods may generate regional visual information and sampling changes combined with at least one of augmented reality images, virtual reality images, or any combination thereof to improve and / or stabilize and / or restore vision. Some embodiments of the exemplary V-VIS apparatus and methods described herein combine novel V-VIS delivery to the retina with graphical and / or chromatic and / or achromatic addition, deletion, and / or attenuation of light presenting certain videos to the retina, with varying spatial, temporal, and / or brightness patterns of light superimposed on a view of a natural scene. Some embodiments of the exemplary V-VIS apparatus and methods generate multiple regional changes in chromatic and / or achromatic spatial and / or temporal and / or contrast information of light within the eye's field of view before delivery to the retinal cells by regional chromatic and / or achromatic highlighting and / or filtering and / or occlusion. Some embodiments of exemplary V-VIS devices and methods provide regional visual chromatic and / or achromatic excitatory and / or inhibitory stimulation to one or both eyes while the subject is viewing a natural visual scene within the ocular field of view during normal daily activities in order to improve vision and / or restore vision to a subject suffering from low vision or vision loss due to a condition, disease, injury, or disorder. As described herein, some embodiments of exemplary V-VIS devices and methods can generate regional visual information and sampling changes combined with at least one augmented reality image or at least one virtual reality image (or any combination thereof) to change and / or improve neural encoding, filtering, integration, and / or adaptation in the retina and / or brain to produce a more complete and / or correct perception of a natural visual scene.

[0059] In some embodiments of the exemplary V-VIS methods and devices, delivery of light to retinal cells through one or more mobile apertures reduces the cumulative exposure to light over time for retinal cells that receive light during only a portion of each sampling period in the one or more apertures when compared to retinal cells that receive light during a longer portion of a sampling period or during the entire sampling period or in an eye where light delivery is not performed by one or more of the exemplary V-VIS devices and methods described herein.

[0060] In some embodiments of the exemplary V-VIS methods and devices, light delivery attenuates the selected wavelengths to retinal cells receiving light through the one or more mobile apertures and / or retinal cells outside the zone within which the one or more apertures move, reducing cumulative exposure to light of the selected wavelengths over time. In some embodiments, as described herein, one or more of the V-VIS devices in the exemplary V-VIS devices are configured to block selected wavelengths, including but not limited to UV wavelengths between 415 nm and 455 nm or blue or blue and violet wavelengths or other predetermined wavelengths or any combination thereof, which are delivered to the retina under myopic or mesopic or scotopic lighting conditions through one or more of the mobile apertures or through a zone without mobile apertures or through any combination thereof.

[0061] In some embodiments of exemplary V-VIS devices and methods, the reduced cumulative exposure of retinal cells to light over time, with or without attenuation of selected wavelengths, reduces light stress and / or metabolic stress and / or phototoxicity of retinal cells. In some embodiments of exemplary V-VIS devices and methods, the reduced cumulative exposure of retinal cells to light over time, with or without attenuation of selected wavelengths, can last for a period of months to years. The reduced cumulative exposure to light over a period of months to years in retinal cells of a diseased retina (including but not limited to a retina with age-related macular degeneration) can prevent retinal cell damage or drusen formation due to one or more of apoptosis, necrosis, pyroptosis, and autophagy. In some embodiments of exemplary V-VIS devices and methods, selectively highlighting light to viable retinal cells can increase the activation of their repair and regeneration processes in damaged retinal areas, thereby also stimulating retinal repair and regeneration processes. In some embodiments of exemplary V-VIS devices and methods, as described herein, regional visual information and sampling changes can stimulate living cell triggering of cell repair, cell regeneration, or a combination thereof within damaged retinal cells or retinal regions.

[0062] Examples of V-VIS devices described herein include, but are not limited to, extraocular devices, eyeglasses, eyeglass attachments, contact lenses, contact lens attachments, corneal inlays, intraocular devices, intraocular lenses, and intraocular lens attachments that are collectively or individually configured as V-VIS light control devices. Some embodiments of the exemplary V-VIS light control devices and methods described herein can generate regional visual information and sampling changes in combination with augmented reality and / or virtual reality, or can be part of or incorporated into augmented reality and / or virtual reality systems.

[0063] Some embodiments of the exemplary V-VIS devices and methods may perform operations to electro-optically move one or more apertures through one or more see-through displays placed in front of the retina. For purposes of illustration, well-known features of optical technology are omitted or simplified to avoid obscuring the basic principles of the disclosed embodiments. In some embodiments, certain of the exemplary V-VIS devices are configured with components for see-through microdisplays, including but not limited to at least one of a light source, an optics, an optomechanical, or a visual system-optics interface.

[0064] Figure 2 Exemplary V-VIS light control devices and methods for producing a moving aperture according to some examples are presented. Figure 2 , the retina of the viewer's eye 10 observes the ocular field 11 through the transparent display 12. The transparent display can be one or more of a head-up display, a visor, a head-mounted display, a clip-on lens, an eyeglass lens, or an eyeglass accessory device. For example, when viewing a tree 17 in a natural environment, an area of ​​the viewer's retina is also exposed to a moving aperture 14, which is produced, for example, using off-axis projection onto a transparent reflective diffuser display system or other transparent display on the surface or inside the material of the transparent display, which contains or is coated with luminescent particles 16 activated by a projector 13. The projector 13 emits excitation light 15, including but not limited to UV or IR light.

[0065] In some examples, the projector 13 may be functionally coupled to a controller ( Figure 2 The controller may include one or more processors that, when executing software instructions (e.g., stored locally by the controller in a tangible, non-transitory memory or included in a received signal), cause the controller to generate a control signal and transmit it to the projector 13. As described above, based on the received control signal, the projector 13 may selectively emit and project the excitation light 15 onto a transparent reflective diffuse display system or another transparent display.

[0066] UV sources include, but are not limited to, solid-state lasers, semiconductor laser diodes, gas lasers, dye lasers, excimer lasers, and other suitable UV light sources. IR lasers include, but are not limited to, solid-state lasers, semiconductor laser diodes, and other suitable IR sources. The intensity of the excitation beam from the light source can be modulated to produce visible fluorescence of different chromaticities, intensities, or grayscales. The excitation light is absorbed by the luminescent particles, which emit visible light to the retina of the observer's eye. The intensity and position of the output of one or more projectors (e.g., projector 13) are modulated to create one or more moving apertures to appear in the field of view.

[0067] The luminescent particles 16 incorporated into the transparent display 12 may be chromatic or achromatic. The luminescent particles may be nanoparticles or molecules and are therefore smaller than the wavelength of visible light to eliminate light scattering, and when activated, produce a less transparent to opaque zone 18 ranging in diameter from 0.2 mm to 10 mm that surrounds and defines a transparent aperture 14 of 0.1 mm to 4 mm in diameter.

[0068] Figure 3A-3B , 4A-4D and 5 show additional exemplary embodiments of devices and methods for using regional variations of visual information to control the sampling of visual information by retinal cells of the eye to deliver visual information from the eye's field of view to the retina. This variation of visual information and sampling (e.g., V-VIS) is achieved by one or more devices and methods shown in the following figures, but should not be limited to or restricted in scope to the embodiments shown.

[0069] Figure 3A A partial cross-sectional view and a top view of the basic components of an exemplary V-VIS device are shown, which are defined herein as a carrier layer unit. A partial cross-sectional view of an exemplary V-VIS device is shown in which two transparent layers 20A and 20B form a space 22 that is partially filled with one or more active optical elements 24. In some examples, the transparent layers 20A and 20B can be flat or curved and composed of glass or plastic, and can include but are not limited to polysulfone, polyetherimide and / or other thermoplastic materials having a refractive index of about 1.67 and therefore no optical power. Further, the one or more active optical elements 24 are formed of a material having a refractive index of about 1.67, such as but not limited to one of a polymer light emitting diode (PLED), a bistable liquid crystal, a surface stabilized ferroelectric liquid crystal (SSFLF), a transparent and color tunable organic light emitting diode (OLED), a ferroelectric liquid crystal, a super twisted liquid crystal, or a liquid crystal voltammetric material.

[0070] The inner surface of each of the transparent outer layers 20A and B facing the space 22 is lined with an optically transparent conductive layer 21A and 21B made of a conductive material, such as but not limited to indium tin oxide (ITO), conductive organic materials such as poly(3,4-ethylenedioxythiophene) poly(styrene sulfonate), and / or carbon nanotubes. Further, the conductive material may also contain trace amounts of metals such as silver or aluminum to increase conductivity. The conductive layers 21A and 21B may be connected to a power supply 25 and a drive box 26, which may be housed in one unit or divided into multiple units, and may have an on / off switch, a power supply, and a drive software to apply a desired voltage to the active optical material 24 through one or more regions of the conductive layer, and then the active optical material changes its optical properties from transparent to a varying opacity in response to the voltage. By configuring some embodiments of the exemplary V-VIS device with different patterns and densities of active optical material in the space 22 between the transparent outer layers 20A, B and / or by constructing patterns for electrical stimulation via the conductive layer, a variety of variations in the color and location and size of the opaque and transparent areas can be achieved.

[0071] In some embodiments of exemplary V-VIS devices and methods, the carrier layer may include a filter that blocks a specific range of harmful wavelengths of light, including but not limited to blue and violet wavelengths and / or UV wavelengths between 415nm and 455nm, to prevent retinal photodamage.

[0072] In some embodiments of the exemplary V-VIS device, the carrier layer incorporates a broadband anti-reflection (AR) coating that is applied to the carrier layer to minimize ghosting. The AR coating can be a single layer of MgF2 or a multilayer coating. A variety of materials and various absolute and relative thicknesses of multilayer coatings can be used to achieve AR functionality.

[0073] In some embodiments of the exemplary V-VIS methods and devices described herein, each carrier layer unit has an arrangement of active optical material 24 surrounding a zone 23 without active optical material. In some embodiments, the aperture of these exemplary V-VIS devices and methods can be defined by a zone without one or more active optical elements, the zone being defined by a zone having one or more active optical elements in each carrier layer (e.g., two or more active optical elements in each carrier layer become less transparent than the zone of the aperture when energized). The aperture can be configured to have a diameter in the range of 0.1 mm to 4 mm, while the surrounding zone is configured to have a diameter in the range of 0.2 mm to 10 mm. The degree of opacity of the aperture and / or surrounding zone depends on the density and location of the active optical material.

[0074] Multiple orifices can be formed in a single layer by placing locations of active optical materials within the layer. In some embodiments, the size, location, and opacity of the orifice and / or surrounding area are determined by changing the pattern of electrical stimulation via the conductive layer (e.g., based on control signals generated by a controller having a processor that executes locally stored or received software instructions). In some embodiments, one or more orifices in the carrier layer are defined as a zone where one or more active optical elements are not activated, and the zone is surrounded by a zone in the carrier layer characterized by activating one or more active optical elements. The location of the one or more orifices can be determined by selectively applying electrical energy to the one or more carrier layers. The location of the one or more orifices changes at a rate between 50 Hz and 50 kHz. One location of the one or more orifices is coaxial with the center of the pupil, while one or more other locations of the one or more orifices are not coaxial with the center of the pupil.

[0075] Figure 3B Based on some examples Figure 3A 29 to produce a moving aperture effect. A programmable controller 26 connected to a power source 25 sends current to the active optical material 24 in each carrier layer unit 29 by direct connection or remotely through a radio frequency antenna 27. In some examples, the programmable controller 26 may include one or more processors that, when executing software instructions (e.g., stored locally by the controller in a tangible, non-transitory memory or contained in a received signal), cause the programmable controller 26 to selectively route current (e.g., in the form of a control signal) to the active optical material 24 in each carrier layer unit 29 using any of the processes described herein.

[0076] Each carrier layer unit has an arrangement of active optical material 24 surrounding a zone 23 devoid of active optical material. The aperture of the exemplary V-VIS device and method is formed by a zone devoid of one or more active optical elements, which is surrounded by a zone having one or more active optical elements in each layer; when energized, such as by a received electric current, the one or more active optical elements within the carrier layer become less transparent than the zone of the aperture. In some embodiments of the exemplary V-VIS device, two or more transparent carrier layers are stacked vertically such that the one or more active optical elements in each of the two or more transparent carrier layers become less transparent than the aperture when energized.

[0077] In some examples, as described herein, one or more orifices may be defined by at least one of a zone without one or more active optical elements surrounded by a zone with one or more active optical elements in each carrier layer. In other examples, one or more orifices may be defined by an activated zone without one or more active optical elements surrounded by an activated zone with one or more active optical elements in each carrier layer. In further examples, the spatial position of each of the one or more orifices in each carrier layer may be shifted relative to each of the other orifices in each carrier layer. In some embodiments, the position and number of one or more orifices, the sequence of positions, and the intervals between position changes can be customized for a specific person or a specific condition, disease, injury, or disorder.

[0078] Figures 4A-4D A cross-section of an eye is depicted showing various exemplary placement locations of a V-VIS device anterior to the retina of the eye. Figure 4A In the embodiment, the eye has a cornea 30 covering an iris 31. In some examples, the Figure 2 The V-VIS device of the exemplary V-VIS device shown in FIG. 3 is placed inside or clamped to an eyeglass lens 33, or placed in one or more waveguides 34 connected to an eyeglass frame 32. The frame 32 houses a power source 25 and a programmable controller 26, which is connected to one or more carrier layers 29 in the eyeglass lens or attached to the eyeglass lens using an appropriate attachment method or mechanism. Each activated carrier layer generates one or more orifices 23 as previously described, for example, based on current selectively routed by the programmable controller 26 via control signals. In some examples, the programmable controller 26 can receive input data, for example, from a sensor or a remotely accessible device ( Figure 4A (not shown) and a calibration or configuration process may be performed based on the input received.

[0079] Figure 4A A single aperture in one position during a single sampling interval is shown. The selected sequence of positions of the moving aperture and the SI determines the sampling of light by the retina. Figure 4A An exemplary V-VIS device may be configured to optically move an aperture anterior to the retina between one or more positions anterior to the retina that are not coaxial with the center of the pupil and a position anterior to the retina that is coaxial with the center of the pupil.

[0080] Figure 4A The transparent waveguide 34 shown in the figure can be used, for example, as a see-through display. In some embodiments, the exemplary V-VIS devices and methods described herein can include a plurality of waveguides arranged in at least one of the following: vertically stacked in layers, adjacent to each other in a single layer, holographically multiplexed, or any combination thereof. Figure 2 ,3A An aperture and surrounding opaque area such as the aperture and surrounding opaque area described in 3B can be projected onto the retina through a waveguide.

[0081] In some embodiments, the see-through display of the exemplary V-VIS devices and methods described herein may be further configured to display at least one augmented reality image, at least one virtual reality image, or any combination thereof. In one example, the programmable controller 26 may maintain local data representing at least one virtual and / or augmented reality image in a tangible, non-transitory memory, and when executing software instructions, may generate control signals that cause the V-VIS device to generate at least one virtual and / or augmented reality image and display it on, for example, the transparent waveguide 34.

[0082] In other examples, the programmable controller 26 can communicate via one or more communication networks (such as using Bluetooth TM The programmable controller 26 may receive data transmitted by the VR / AR system or device and generate control signals in response to the data, the control signals causing the V-VIS device to generate and display at least one virtual and / or augmented reality image as described herein (in the example of FIG. Figure 4A not shown).

[0083] An exemplary embodiment of the use of augmented reality is in the case of a subject with both vision and hearing loss, which is often seen in elderly patients and in many inherited syndromes or conditions such as Alport, Usher, Marshall, Stickler, Duane, Leber and Norrie and in co-morbidities of infectious diseases such as cytomegalovirus and rubella. As described herein, one or more of the exemplary V-VIS devices can be configured to combine a vision-improving mobile aperture with a plurality of directional microphones 35 built into a head-mounted or eyeglass frame connected to a VR / AR system or device. In some instances, and while executing one or more applications, the VR / AR system or device can perform an operation of receiving audio data captured by one or more of the directional microphones 35. Based on the captured audio data, the VR / AR system or device can perform additional operations of sensing the source location of the voice, converting the sensed voice into text in a preferred language, and displaying the enlarged text (e.g., "Your mom is calling") 36 as an augmented reality image or layer on a waveguide 34 within the field of view of the subject with impaired vision and hearing. Further, in some embodiments, additional directional cues are given by means of one or more light emitting diodes placed around the perimeter of the field of view (e.g., around the perimeter of the waveguide 34) to indicate to the hearing impaired subject the direction in which the audible speech is produced. In some embodiments, one or more of the exemplary V-VIS devices described herein may include one or more microphones, and may include or communicate with one or more processors or processing units that execute an application or software instructions that converts the audible speech into text in a preferred language and displays the text within the subject's field of view using the exemplary V-VIS device. Further, and as described herein, one or more of the exemplary V-VIS devices may further include one or more light emitting diodes placed around the perimeter of the field of view to indicate the direction in which the audible speech is produced. The application and software instructions may include an application programming interface (API) to create visual alerts and other alerts and notifications for incoming texts and calls, and may convert speech from a phone call into visual text.

[0084] In some embodiments, one or more of the exemplary V-VIS devices may be combined with eye tracking or gaze interactive assistive technology, examples of which include, but are not limited to, technology available from Tobii Dynavox (Pittsburgh, Pa.) for subjects with speech and / or motor impairments. Because the exemplary V-VIS devices and methods can improve the ability of visually impaired subjects to see, the eye tracking or gaze interactive assistive technology allows subjects who also suffer from speech or motor impairments to better focus their gaze on words, letters, and commands, thereby improving eye tracking and infrared reflectance readings from the corneal surface of their eyes to allow them to communicate, restore personal independence, learn and interact with others and computers, write emails, access social networking sites, master new skills, and promote creativity, thereby increasing health and happiness.

[0085] In another exemplary embodiment, a head-mounted or eyeglass frame (e.g., via Bluetooth TM The invention relates to a method for treating a subject with a partial loss of normal visual field, for example, a subject with hemianopsia, quadrantanopia, or temporary unilateral loss of visual field, in combination with a peripherally directed camera. The AR technology is used concurrently with the intermittent V-VIS display of the current visual field to deliver information-carrying light from the lost portion of the total visual field to the remaining functional parts of the retina-brain complex for interpretation, integration, and viewing. The intermittent nature of the V-VIS prevents the confusion and distraction caused by the continuous display of the missing portion of the visual field with conventional picture-within-picture technology.

[0086] In some embodiments, one or more of the exemplary V-VIS devices can be combined with concurrent display of augmented reality content (e.g., on corresponding waveguides, etc.), where augmented reality is used with V-VIS to capture light from a field of view greater than the field of view of the subject's eye, the other eye, or both eyes, and deliver the light to the retina. The field of view of the eye typically extends more than 90° in time, more than 60° from the nasal side and above, and more than about 70° from below. In some embodiments, the exemplary V-VIS devices and methods described herein can expand the field of view of the subject's eye, the other eye, or both eyes for a total field of view that can be configured to be fixed or variable and encompass any selected degree of up to 360 degrees around the subject's eye, the other eye, or both eyes. In further embodiments, the exemplary processors described herein can be combined with cameras directed around and / or above and / or below and / or behind one eye, the other eye, or both eyes. In further embodiments, one or more of the V-VIS devices may be combined with a concurrent augmented reality display, wherein augmented reality is used with V-VIS to capture light from a field of view greater than the field of view of a separate V-VIS device or a separate AR device to provide an extended field of view for the subject. In some embodiments, the combination of V-VIS and AR devices includes 3D detection and / or high-speed tracking. In some embodiments of the device and method configured for using V-VIS in combination with AR, light collimated by the V-VIS aperture may be delivered to the retina from a field of up to 360 degrees around one or both eyes of the subject. In some embodiments, one or more of the exemplary V-VIS devices may be further configured with one or more cameras and software to capture light from at least one of the surrounding, above, below, or behind one eye, another eye, or both eyes of the subject, and deliver the light to the retina of one eye, another eye, or both eyes of the subject.

[0087] Figure 4B Two different embodiments of exemplary V-VIS devices are shown that include a contact lens 40 covering the cornea 30 and the iris 31. The contact lens 40 is corneal or scleral or any combination thereof. Figure 2 As depicted, one exemplary embodiment utilizes off-axis projection. For example, the projector 13 is mounted on the outside of the contact lens 40 containing the light-emitting particles. Using the exemplary process described herein (e.g., Figure 2 In any of the exemplary processes described in the drawings, the excitation light 15 from the projector produces a moving aperture effect in or on the surface of the contact lens.

[0088] In the same Figure 4B In another embodiment shown, the contact lens 40 has a Figure 3A and 3B Depicted is one or more carrier layers 29, each of which contains active optical material 24 defining one or more apertures 23. One or more antennas, such as antenna 27, receive signals containing instructions regarding the sequence, duration and interval of activation of the apertures. Figure 4B The moving orifice is shown at one location during a single sampling period.

[0089] In one example, the received signal may include a radio frequency signal, and antenna 27 may include a radio frequency antenna capable of receiving radio frequency signals. The disclosed exemplary embodiments are not limited to radio frequency signals and antennas, and in other examples, antenna 27 may be capable of receiving transmission signals formatted according to any additional or alternative communication protocol, such as the communication protocol described herein.

[0090] Further, in some examples, antenna 27 can receive signals from a corresponding transmitter unit contained in (or mounted on) the glasses worn by the subject, contained in a mobile device operated by the subject or a physician, or from any other suitable device or system, for example, via any of the communication networks described herein. The software instructions can be generated or specified, for example, by a physician and stored in one or more tangible, non-transitory memories of the glasses, the mobile device, or another suitable device or system.

[0091] exist Figure 4C , an exemplary V-VIS device includes an intracorneal insert 45 that includes one or more internal antennas capable of receiving transmission signals, such as antenna 27. Examples of transmission signals include, but are not limited to, radio frequency signals or signals formatted according to any additional or alternative communication protocols such as the communication protocols described herein.

[0092] The corneal inlay is placed within cornea 30 overlying iris 31. When activated (eg, based on a signal received by antenna 27), active optical material 24 in one or more transparent carrier layers 29 within corneal inlay 45 forms one or more moving apertures 23. Figure 4C The moving orifice is shown at one location during a single sampling period.

[0093] exist Figure 4DIn the embodiment of the present invention, an exemplary V-VIS device includes an intraocular implant 46 that replaces the human lens and is typically placed in the capsular bag 47 of the eye behind the iris 31, but in some embodiments, the intraocular implant can be placed above the bag or above the iris 31. The exemplary V-VIS device can include an intraocular device, an intraocular lens (IOL), an intraocular lens attachment device (IOLAD), or any combination thereof for insertion into a phakic, aphakic, or pseudophakic eye, including at least one of an anterior chamber, sulcus-fixed, iris-fixed, capsular bag-fixed, or transscleral sutured IOL or IOLAD. When activated (e.g., based on a signal received by one or more internal antennas such as antenna 27), the active optical material 24 in one or more transparent carrier layers 29 inside the implant forms one or more moving apertures 23. Figure 4D Multiple moving apertures at one location during a single sampling period are shown. The exemplary V-VIS device moves one or more apertures by directing an electric current (e.g., derived from a signal received by antenna 27) through each of one or more transparent carrier layers containing one or more active optical elements.

[0094] In some embodiments, the refractive error of the eye may be corrected by incorporating an appropriate lens for correcting ametropia into one or more of the exemplary V-VIS devices described herein (such as, but not limited to, glasses, contact lenses, corneal inlays, or intraocular lenses).

[0095] In exemplary embodiments, the power source for each carrier layer inside a contact lens, corneal inlay, or intraocular implant may be a radio frequency (RF) transmission assisted by a rechargeable solar micro-battery that may be built into the corresponding exemplary V-VIS device. For example, micron-scale solar-powered micro-batteries that provide additional power to extend the range of the radio frequency (RF) power source to its RF antenna may be incorporated into one or more of these exemplary V-VIS devices.

[0096] Figure 5 Six different moments in time (e.g., moments AF) are shown with five possible orifice positions. Figure 5 As shown, a transparent aperture 51A in a position coaxial with the center of the pupil alternates with an opaque aperture 50D in each lens in a position coaxial with the center of the pupil during different sampling periods. Figure 5 In the embodiment of the present invention, the exemplary V-VIS device comprises a pair of glasses configured to treat patients with amblyopia. The exemplary V-VIS device can be built into the lens 33 of the eyeglass frame 32.

[0097] In some embodiments of an exemplary V-VIS device for treating amblyopia, the entire central visual field in front of an eye is blocked (e.g., 50A and 50D) for at least one sampling period, while a central transparent aperture coaxial with the center of the pupil simultaneously appears in front of the other eye (e.g., 51A and 51D). After each sampling period or after every several sampling periods, the completely blocked central visual field alternates between the two eyes. At other sampling intervals (SI) during each sampling period, a transparent aperture appears in front of both eyes in a position that is not coaxial with the center of the pupil, for example, in 52B, 52C, 52E, and 52F. The aperture and surrounding opaque area can be colored or opaque at a desired density of 10% to 100% opaque, depending on the density and type of optically active material placed in one or more carrier layers of the exemplary V-VIS device. The aperture position changes at a predetermined sampling rate (SR) between 50 Hz and 50 kHz. Depending on the severity and type of amblyopia, the presentation duration, color and / or density of the central opacity (e.g., 50A and 50D) may be adjusted to last longer or be made denser to enhance and / or improve visual access and perception in one or both amblyopic eyes.

[0098] As described herein, some embodiments of exemplary V-VIS devices and methods overcome the limitations of conventional treatments for amblyopia, including but not limited to insufficient improvement of visual function due to lack of strong bilateral stimulation of the visual pathway and / or obstruction of the peripheral field and / or compliance problems. It has been documented that the visual periphery is relatively immune to the loss of vision in amblyopia. Unlike some embodiments of these exemplary V-VIS devices and methods, conventional treatments for amblyopia reduce the number of spatial samples, particularly in the periphery, that can be used for accurate integration of visual information, and often result in loss of binocular coordination during treatment and / or inability to improve binocular coordination, and impaired ability to integrate peripheral visual field information in the visual cortex. Unlike conventional shutters or flashing glasses for amblyopia that block peripheral vision, some embodiments of exemplary V-VIS devices for amblyopia retain visual representations of the peripheral visual field because the peripheral vision is not blocked. Conventional visual training for amblyopia using conventional electronic devices with virtual reality (VR) displays cannot be used during normal activities, is only used for short-term training, and does not improve vision when visually impaired subjects view objects in natural scenes or during normal visual tasks. Unlike conventional amblyopia treatments, certain embodiments of V-VIS therapy for amblyopia (e.g., utilizing one or more of the exemplary V-VIS devices and methods described herein) allow for intensive binocular stimulation, thereby allowing Figure 1The entire visual pathway is involved in plasticity mechanisms. Some amblyopic eyes also have dystrophic retinal cells. Unlike conventional glasses for amblyopia, some embodiments of the exemplary V-VIS device for amblyopia can be configured to increase or decrease stimulation of different retinal areas due to a moving aperture and a combination of AR or VR with one or more of the exemplary V-VIS methods and devices in some configurations. In some embodiments of the exemplary V-VIS method and device, beneficial stimulation for amblyopia can be enhanced by adding red, green, or blue to the central opaque area in order to isolate the excitation of each group of cone photoreceptors.

[0099] One or more of the extraocular V-VIS devices shown in the previous figures, such as glasses, eyeglass accessory devices, heads-up displays, eye protection masks, contact lenses, and viewing screens (including but not limited to remotely accessible televisions, remotely accessible computers, or remotely accessible mobile devices) can be used for at least one of the following: screening for V-VIS effects, customization of V-VIS, calibration of V-VIS, vision measurement, vision monitoring, or any combination thereof. In one embodiment of the exemplary V-VIS methods and devices described herein, the SR is set at a rate that is too fast to allow perception and gradually slows down until the subject can first perceive the visual target. In some embodiments, this SR will not only allow for customization of V-VIS treatment based on feedback provided by the patient, but will also define a functional measure of a person's visual processing capabilities, which vary from subject to subject depending on the subject's age and underlying ophthalmic or neurological conditions. Therefore, the V-VIS device and method can be utilized diagnostically.

[0100] Figure 6 Another embodiment of an exemplary V-VIS method and apparatus is depicted in FIG. Figure 6 In the exemplary V-VIS devices described herein, a viewing screen of one or more V-VIS devices (e.g., a remotely accessible television, a remotely accessible computer, or a remotely accessible mobile device, etc.) can present a display 61 to the subject, the display comprising letters, numbers, and / or objects having different positions, sizes, and / or contrasts, which are delivered to the retina through one or more mobile imaging apertures. For example, display 61 can include a portion of an eye chart that can be selectively and variably blocked by the mobile aperture.

[0101] In some cases, a subject may establish a communication channel with a testing, diagnostic, monitoring or assay provider by telephone (e.g., by dialing a toll-free number), by instant messaging, or by other Internet-based or electronic communication mechanisms. Figure 6, the subject may be guided to fixate on a target coaxial with the center of the pupil on an otherwise dimmed display 61 (e.g., by contrast) (e.g., Figure 6 At least one imaging aperture 63 moves between one or more positions 64 on the display anterior to the retina that are not coaxial with the center of the pupil (e.g., the imaging characters "Z" and "N" in an eye test chart) and a position 65 on the display 61 anterior to the retina that is coaxial with the center of the pupil (e.g., the imaging character "H" on an eye test chart) at a rate between 50 Hz and 50 kHz. Figure 6 As shown, at least one imaging aperture 63 (eg, at locations 64 and 65) delivers to the retina a portion of the total field of view of display 61 that would otherwise be blocked by the darkened screen, and the total field of view of display 61 includes the test image.

[0102] The subject's visual perception of the test images is measured and monitored through the subject's responses using recording and data collection methods known to those skilled in the art. For example, the subject may provide information identifying each of the letters or numbers visible within display 61 to the institution across an established communication channel, and a computing system maintained by the institution may receive the provided information (e.g., through one or more programmatic interfaces or based on input provided by an agent or employee of the institution).

[0103] In some cases, the computer can execute stored software instructions that generate (and store) a record of the identified letters and numbers, and determine one or more letters or numbers that the subject has missed based on a comparison between the identified record and information characterizing the movement and positioning of at least one imaging aperture relative to the text image. Based on the determination, the computer can perform operations that generate a map of the subject's complete visual field using any of the exemplary V-VIS methods described herein. For example, the generated map can identify the location or size of the dark spot exhibited by the subject, and additionally or alternatively, identify the area of ​​visual distortion exhibited by the subject. Further, changes in the size of the presented letters or numbers can help determine the subject's potential visual acuity based on the generated map. Some embodiments of the exemplary V-VIS devices and methods described herein are more convenient and / or more accurately measure and monitor visual perception and / or vision than conventional devices and methods.

[0104] As described herein, one or more of the exemplary V-VIS devices and methods include or utilize a light control device to optically move one or more apertures in front of the retina between one or more positions in front of the retina that are not coaxial with the center of the pupil and a position in front of the retina that is coaxial with the center of the pupil. The one or more apertures can be moved, for example, at a rate between 50 Hz and 50 kHz to produce regional visual information and sampling changes (V-VIS) of the ocular visual field. Further, the phrase "in front of the retina" includes one of extraocular, intracorneal, or intraocular placement, and the device can electro-optically move the one or more apertures through one or more see-through displays placed in front of the retina.

[0105] In further embodiments, the light control device can be used in at least one of the V-VIS performed by the subject, for at least one of the following: for screening of V-VIS, customization of V-VIS, calibration of V-VIS, V-VIS vision measurement, V-VIS vision monitoring, or any combination thereof. In some cases, the V-VIS device can be configured to produce at least one of the following: improving vision in one or both eyes of the subject; stabilizing vision in one or both eyes of the subject; correcting an ophthalmic or neurological condition; alleviating visual symptoms in one or both eyes of a subject with an ophthalmic or neurological condition, disease, injury, or disorder; reducing the rate of vision loss in one or both eyes of a subject with vision loss due to an ophthalmic or neurological condition, disease, injury, or disorder compared to an untreated control group; reducing the rate of progression of an ophthalmic condition, disease, or disease in one or both eyes of a subject with an ophthalmic condition, disease, or disorder compared to an untreated control group; vision measurement in one or both eyes of a subject; vision monitoring in one or both eyes of a subject; or any combination thereof.

[0106] In some embodiments, one or more of the exemplary V-VIS devices and methods combine V-VIS teachings with certain ophthalmic and neurological treatments. Some therapeutic embodiments include treating the eye with a method comprising utilizing a V-VIS device and administering another therapy for an ophthalmic or neurological condition, disease, injury, or disorder. The V-VIS device can be configured to optically move one or more apertures in front of the retina of the eye between one or more locations in front of the retina that are not coaxial with the center of the pupil and a location in front of the retina that is coaxial with the center of the pupil (e.g., according to any of the processes described herein), and the one or more apertures move at a rate between 50 Hz and 50 kHz. In some embodiments, one or more of the exemplary V-VIS devices and methods may be combined with other ophthalmic and neurological treatments, including but not limited to: pharmacological therapy and / or nutritional supplement therapy and / or laser therapy and / or radiotherapy and / or retinal replacement therapy and / or stem cell transplantation therapy and / or epigenetic therapy and / or genetic therapy and / or optogenetic therapy and / or retinal prosthesis therapy and / or other therapies (hereinafter referred to as other therapies) to improve the treatment of ophthalmic conditions, diseases, injuries and disorders, including but not limited to macular degeneration and / or diabetic retinopathy and / or glaucoma and / or axial myopia and / or other neovascular and / or atrophic and / or inflammatory and / or genetic and / or nutritional and / or age-related retinal conditions, diseases, injuries or disorders (hereinafter referred to as "ophthalmic diseases") and / or neurological diseases, disorders or conditions (hereinafter referred to as "neurological diseases"). Some of the exemplary V-VIS devices and methods described herein overcome the shortcomings and deficiencies of conventional therapies by introducing different mechanisms of visual sampling and / or visual processing and / or visual perception and / or retinal repair processes and / or neural repair processes associated with ophthalmic and / or neurological diseases. Further, some of the exemplary V-VIS devices and methods overcome the shortcomings and deficiencies of other therapies by combining them with V-VIS to improve visual and / or anatomical results, which also improves the patient's compliance with other therapies. In combination therapy with V-VIS, other therapies can be applied before, during or after V-VIS. In some embodiments of the combination therapy, V-VIS therapy is applied before non-V-VIS therapy or at a certain time after the start of non-V-VIS therapy.

[0107] In some embodiments, V-VIS treatment can be combined with other therapies for ophthalmic and neurological diseases, including but not limited to laser therapy, including but not limited to photobiomodulation, laser photocoagulation, laser photodynamic therapy, subthreshold micropulse laser therapy, glaucoma laser therapy (including but not limited to laser trabeculoplasty and cyclophotocoagulation), glaucoma filtering surgery (including but not limited to trabeculectomy, microtrabeculectomy, intra- or extra-canalicular shunt implantation, suprachoroidal shunt implantation), vision correction (including but not limited to refractive surgery, laser vision correction, and genetic therapy), optic nerve surgery (including but not limited to decompression and repair surgery), retinal prosthesis, stem cell transplantation, and radiation therapy (including but not limited to focal intraocular strontium 90β radiation).

[0108] Some embodiments comprise treating the eye using V-VIS in combination with administering at least one of a genetic therapy, epigenetic therapy, optogenetic therapy, retinal replacement therapy, or stem cell therapy for treating an ophthalmic condition at a time before, during, after, or any combination thereof. In further embodiments, a therapeutic agent or treatment method for treating the eye (e.g., a "combination" method) may comprise utilizing a V-VIS device and administering at least one of a genetic therapy, epigenetic therapy, optogenetic therapy, retinal replacement therapy, or stem cell therapy for treating an ophthalmic or neurological disease at a time before, during, after, or any combination thereof. As described herein, the device can be configured to optically move one or more apertures anterior to the retina of the eye between one or more positions anterior to the retina that are not coaxial with the center of the pupil and a position anterior to the retina that is coaxial with the center of the pupil (e.g., according to any of the processes described herein), and the one or more apertures move at a rate between 50 Hz and 50 kHz.

[0109] In some embodiments of the combination therapy, V-VIS treatment improves and / or promotes and / or accelerates and / or speeds up the recovery and / or restoration of visual function after genetic therapy, epigenetic therapy, optogenetic therapy, retinal replacement therapy, or stem cell therapy, including but not limited to at least one of neural connectivity, neural integration, visual sampling, or visual perception. In some embodiments, the combination of V-VIS and retinal replacement therapy and / or stem cell therapy overcomes the limitations of retinal replacement therapy and / or stem cell therapy, including but not limited to incorrect or insufficient targeted delivery of stem cells or other retinal cells. In some embodiments, unlike retinal prostheses and optogenetic therapy alone, treatments for retinal dystrophy and / or degeneration combined with V-VIS treatment overcome the limitations of dystrophic retina, including but not limited to abnormal remodeling of intraretinal connections and pathological spontaneous overactivity in dystrophic retina. In some embodiments, treatments for retinal dystrophy and / or degeneration combined with V-VIS therapy overcome limitations of retinal prostheses and optogenetic therapies in dystrophic retina, including but not limited to central scotoma formation due to displacement of retinal ganglion cells from the fovea and color coding difficulties due to insufficient knowledge of which ganglion cells encode which color channels.

[0110] In further embodiments, one or more of the exemplary V-VIS devices and methods described herein can be combined with anti-angiogenic therapy for treating or alleviating symptoms of a neovascular ophthalmic condition, disease, injury, or disorder, including but not limited to macular degeneration, choroidal neovascularization, and diabetic retinopathy. Some embodiments include using V-VIS (e.g., utilization of one or more of the exemplary V-VIS devices and methods described herein) in combination with administering a therapeutically effective amount of an anti-angiogenic agent at a time before V-VIS, during V-VIS, after V-VIS, or any combination thereof, to treat the eye, the anti-angiogenic agent being administered intravitreally, orally, topically, intraretinaly, by implant, or by iontophoresis. As used herein, the term "alleviate" or "treat" or "compensate" refers to a reduction in clinical signs and / or symptoms associated with an ocular disorder (e.g., macular degeneration) as a result of the action performed. The signs or symptoms to be monitored will be characteristic of the ocular condition, and the signs or symptoms and methods for monitoring signs, symptoms and conditions will be well known to physicians skilled in the art. Combination therapy utilizing V-VIS and anti-angiogenic therapy will be advantageous over anti-angiogenic alone or V-VIS alone because the combination therapy will further improve functional vision, further stabilize functional vision, reduce treatment burden and / or improve patient compliance.

[0111] Some embodiments described herein provide a method of reducing or treating a neovascular ophthalmic condition, disease, injury, or disorder by treating the eye using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of an anti-angiogenic agent, including but not limited to vascular endothelial growth factor (VEGF) antagonists (VEGF activity inhibitors), including but not limited to aflibercept, ranibizumab, bevacizumab, and brolucizumab.

[0112] Some embodiments described herein provide a method of reducing or treating a neovascular ophthalmic condition, disease, injury, or disorder by treating the eye using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of an anti-angiogenic agent, including but not limited to a platelet-derived growth factor (PDGF) antagonist, including but not limited to volociximab and P200.

[0113] Some embodiments also provide a method of treating or reducing a neovascular ophthalmic condition, disease, injury, or disorder by treating the eye using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of an anti-angiogenic agent, including but not limited to an angiopoietin antagonist, including but not limited to an angiopoietin-2 antagonist, including but not limited to RG7716.

[0114] Some embodiments described herein provide a method of reducing or treating a neovascular ophthalmic condition, disease, injury, or disorder by treating the eye using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of an anti-angiogenic agent, including but not limited to an endoglin antagonist, including but not limited to carotuximab.

[0115] Some embodiments described herein provide a method of reducing or treating a neovascular ophthalmic condition, disease, injury, or disorder by treating the eye using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of an anti-angiogenic agent, including but not limited to, phosphorylation inhibitors of VEGF and PDGF receptors, including but not limited to, tyrosine kinase inhibitors, including but not limited to vetalanib or pazopanibor.

[0116] Some embodiments described herein provide a method of reducing or treating a neovascular ophthalmic condition, disease, injury, or disorder by treating the eye using V-VIS (e.g., using one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of an anti-angiogenic agent, including but not limited to an integrin antagonist, including but not limited to an anti-integrin peptide, an inhibitor of α5β1 integrin activity, and an oligopeptide that binds to an integrin receptor site, including but not limited to a luminate.

[0117] Some embodiments described herein provide a method of reducing or treating a neovascular ophthalmic condition, disease, injury, or disorder by treating the eye using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of two or more anti-angiogenic agents including, but not limited to, any VEGF antagonist, any PDGF antagonist, any angiogenin antagonist, any endoglin antagonist, and any integrin antagonist at a time before V-VIS, during V-VIS, after V-VIS, or any combination thereof, wherein the two or more anti-angiogenic agents are delivered together or sequentially.

[0118] In other embodiments, a method of treating or ameliorating an ophthalmic disease such as, but not limited to, neovascular ophthalmic disease and / or wet macular degeneration and / or diabetic retinopathy in a subject comprises treatment using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administration of a therapeutically effective amount of an anti-inflammatory agent, including, but not limited to, fluocinolone acetonide, wherein the anti-inflammatory agent is administered by intravitreal injection, orally, topically, intraretinaly, by an implant, or by iontophoresis.

[0119] In some embodiments, a method of treating or ameliorating an ophthalmic disease in a subject, such as but not limited to geographic atrophy and / or dry macular degeneration, comprises treating with a therapeutically effective amount of a complement inhibitor, including but not limited to complement 3 or 5 activity inhibitors, including but not limited to avacincaptad pegol, LEG316, or a therapeutically effective amount of an anti-inflammatory agent, or a therapeutically effective amount of an immunomodulator, administered by intravitreal injection, orally, topically, intraretinaly, by implant, or by iontophoresis. Eculizumab, JPE-1375, ARC1905, the anti-inflammatory agents include but are not limited to tetracycline antibiotics, including but not limited to doxycycline, the immunomodulators include but are not limited to T helper 2 inducers, including but not limited to glatiramer acetate.

[0120] In some embodiments, a method of treating or ameliorating an ophthalmic disease in a subject, such as but not limited to geographic atrophy and / or dry macular degeneration, comprises administering a therapeutically effective amount of OT551 or a protein complex of nuclear factor Any other overexpression down-regulator of the invention or any other antioxidant or combination of antioxidants, including but not limited to vitamin C, vitamin E, beta-carotene or lutein and zeaxanthin in combination with omega-3 fatty acids, such as in the Age-Related Eye Disease Study (AREDS) and AREDS2 studies, can be treated using V-VIS (e.g., using one or more of the exemplary V-VIS devices and methods).

[0121] In some embodiments, a method of treating or ameliorating an ophthalmic disease in a subject, such as but not limited to geographic atrophy and / or dry macular degeneration, comprises treatment using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of nicotinamide adenine dinucleotide (NAD) or any precursor of NAD, including but not limited to nicotinamide riboside or nicotinamide mononucleotide.

[0122] In some embodiments, a method of treating or ameliorating an ophthalmic disease in a subject, such as but not limited to geographic atrophy and / or dry macular degeneration, comprises treatment using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of a trophic factor, including but not limited to pigment epithelium-derived factor (PEDF), fibroblast growth factor (FGF), and lens epithelium-derived growth factor (LEDGF).

[0123] Some embodiments comprise using V-VIS (e.g., using one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of at least one of the following for treating an ophthalmic or neurological condition, disease, injury or disorder (glaucoma, macular degeneration, optic atrophy, autoimmune neurodegenerative disorder, or cerebrovascular accident) topically, intraretinally, by intravitreal injection, by implant, or by iontophoresis at a time before V-VIS, during V-VIS, after V-VIS, or any combination thereof The invention relates to treating the eye with: i. an intraocular pressure reducing agent, including but not limited to a miotic agent, an α or α / β adrenergic agonist, a β-blocker, a Ca2+ channel blocker, a carbonic anhydrase inhibitor, a cholinesterase inhibitor, a prostaglandin agonist, a prostaglandin, a prostaglandin, a cannabinoid, or any combination thereof; ii. a retinal cell or cortical cell neuroprotective or neuroregenerative agent, including but not limited to a rho kinase inhibitor, an adenosine receptor agonist, a glutamate antagonist, a neurotrophic factor, or a neurotrophic factor modulator; or iii. any combination thereof. This combination therapy will further improve functional vision, further stabilize functional vision, reduce treatment burden, and / or improve patient compliance.

[0124] In some embodiments, a method of treating or ameliorating an ophthalmic or neurological disease in a subject such as, but not limited to, geographic atrophy and / or dry macular degeneration and / or glaucoma comprises treatment using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of ciliary neurotrophic factor (CNTF) or any other neurotrophic factor or any other inhibitor of photoreceptor apoptosis.

[0125] In some embodiments, a method of treating or ameliorating an ophthalmic or neurological disease in a subject, such as but not limited to geographic atrophy and / or dry macular degeneration and / or glaucoma, comprises treatment using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of a neuroprotectant, including but not limited to brimodinine.

[0126] In some embodiments, a method of treating or ameliorating an ophthalmic or neurological disease in a subject, such as but not limited to geographic atrophy and / or dry macular degeneration, comprises treatment using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of a Fas inhibitor or other agent designed to protect retinal cells from cell death.

[0127] In some embodiments, a method of treating or ameliorating an ophthalmic or neurological disease in a subject such as but not limited to geographic atrophy and / or dry macular degeneration and / or neovascular macular degeneration and / or glaucoma comprises treatment using a V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of a statin, including but not limited to atorvastatin, lovastatin, rosuvastatin, fluvastatin, or simvastatin.

[0128] In some embodiments, a method of treating or reducing an ophthalmic disease such as, but not limited to, glaucoma or ocular hypertension in a subject comprises treating with V-VIS (e.g., using one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of an intraocular pressure (IOP) lowering agent, including, but not limited to, miotic agents, alpha or alpha / beta adrenergic agonists, beta blockers, Ca 2+ inhibitors, or sedatives. 2+ Channel blockers, carbonic anhydrase inhibitors, cholinesterase inhibitors, prostaglandin agonists, prostaglandins, prostaglandins, cannabinoids, and combinations thereof.

[0129] In some embodiments, a method of treating or ameliorating an ophthalmic disease such as, but not limited to, glaucoma in a subject comprises treatment using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of a pharmacological agent that reduces retinal ganglion cell dysfunction and / or pathology associated with ischemia or excitotoxicity.

[0130] In some embodiments, a method of treating or alleviating an ophthalmic disease in a subject, including but not limited to glaucoma, comprises treatment using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of a pharmacological agent that reduces excessive excitatory amino acid (EAA) stimulation, the pharmacological agent including but not limited to a glutamate antagonist and / or any combination of a glutamate antagonist and at least one IOL reducing agent.

[0131] In some embodiments, a method of treating or ameliorating an ophthalmic disease such as, but not limited to, glaucoma in a subject comprises treatment using V-VIS (e.g., utilizing one or more of the exemplary V-VIS devices and methods) in combination with administering a therapeutically effective amount of a pharmacological agent that provides neuroprotection and / or neuroregeneration of retinal ganglion cells, including, but not limited to, a rho kinase (ROCK) inhibitor or an adenosine receptor agonist.

Claims

1. A light control device comprising one or more layers placed in front of the retina of an eye and configured to deliver ambient light from the eye's field of view through the one or more layers, wherein: The placement before the retina includes extraocular placement, intracorneal placement or intraocular placement, The one or more layers include one or more orifices or are configured to be adjustable to include one or more orifices; The one or more apertures have different optical properties than an area surrounding the one or more apertures; as well as The one or more orifices generate a moving orifice effect at a rate between 50 hertz and 50 kilohertz.

2. A light control device according to claim 1, wherein the light controller is configured to change at least one of the size, shape, defocus, refractive index, color, contrast, chromaticity or optical device of the one or more apertures or the area surrounding the one or more apertures.

3. The light control device of claim 1, wherein the light control device comprises at least one of an optical component, an active optical component, or an optomechanical component, and at least one or more of a lens, a sensor, an eye tracker, a camera, a microphone, a projector, or a waveguide.

4. The light control device of claim 1, wherein the optical controller is configured to deliver approximately collimated light from the ocular field of view to the retina through the one or more apertures.

5. The light control device of claim 1, wherein the one or more apertures generate the moving aperture effect at a rate based on a speed of a fixational movement of the eye.

6. The light control device of claim 1, wherein the optical controller is configured to display at least one of an augmented reality image, a virtual reality image, or a camera-derived image.

7. The light control device of claim 1, wherein the optical controller is configured to couple to at least one of a power source, a controller, a processor, an augmented reality device, a virtual reality device, or a remote access device through one or more Internet-based, electronic, or other communication networks.

8. The light control device of claim 1, wherein the optical controller is configured for at least one of remote calibration, customization, measurement, screening, or monitoring of at least one of a device, vision, or vision processing.

9. The light control device of claim 1, wherein the one or more apertures generate the moving aperture effect at a variable rate.

10. The light control device according to claim 1, wherein the light control device comprises: one or more microphones; as well as One or more light emitting diodes positioned around the perimeter of the eye field of view to indicate the direction of audio captured by the one or more microphones.

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