Measurement method and apparatus for the subject's field of view

Abstract

The present invention provides an improved method and apparatus for measuring the field of vision of a patient or subject. [Solution] A step of displaying a visually detectable test spot 6 on a flat display 2 of a device 1 visible to a subject P, the step of moving the test spot on the flat display along a path 7, and activating an interactive device 8 of the device when the displayed test spot becomes invisible to the subject at an instantaneous position 9 or becomes visible again while moving along the path, the step of storing relevant information that allows the activation of the interactive device to derive each instantaneous position and whether the test spot at the instantaneous position has become invisible to the subject or has become visible again; and a step of displaying the field of view of the subject on a further flat display, the step of the instantaneous position forming an edge point of the field of view.

Description

Technical Field

[0001] The present invention relates to a method for measuring the visual field of a subject and a corresponding apparatus.

Background Art

[0002] Perimetry is an inspection technique for the visual system. Human visual acuity is distinguished into central visual acuity and peripheral visual acuity. Central visual acuity is measured as the central visual power, and peripheral visual acuity is measured as the peripheral visual field. The visual field corresponds to a mountain, where the height of each point in the visual field corresponds to the visual acuity at that point. The highest value of this mountain of the visual field is above the fovea centralis, which is the center of the retina. The visual acuity continues to decrease towards this peripheral part. Peripheral visual acuity is measured using light difference sensitivity. Technically, there are two different methods for measuring this mountain of the visual field: · Kinetic perimetry · Static or profile or grid perimetry

[0003] Both methods attempt to define the peaks of the visual field by having the patient signal their perception of light stimuli. The perceptual threshold is thus subjectively determined. In dynamic perimetry, test marks move slowly towards the center around the hemisphere at a constant brightness, and then further along the meridian around the entire circumference. In static perimetry, the brightness of the test marks is initially below the threshold, and is gradually increased at a fixed test spot located on the meridian. The perceived test spot is marked in each case. In dynamic perimetry, which scans the peaks horizontally, several isopters (lines with equal sensitivity to brightness differences) are gradually created. In static perimetry, which scans the peaks vertically, the contour of the peaks is created passing through the center of the visual field peaks. Modern computer-controlled raster perimetry scans the visual field peaks vertically along a predetermined grid of test spots, creating a map in which deviations from the standard are colored black.

[0004] The difference between perimetry and campimetry is that in campimetry, the object being examined is placed on a screen or flat surface, rather than a hemisphere as in perimetry. Therefore, campimetry is suitable for measuring the paracentral visual field.

[0005] What all current methods have in common is that they slowly reach the perceptual threshold, either horizontally or vertically. This process is laborious and time-consuming. It must be considered that many patients are elderly at the time of testing, and that many patients' willingness to cooperate declines quickly.

[0006] Current perimetry testing typically requires 15 minutes of focused cooperation per eye. The long testing time makes it difficult to accurately assess perceptual thresholds at all measurement points, resulting in highly variable test results.

[0007] Computerized automated perimetry programs have freed examiners from tedious examinations, but so far, they offer no relief to patients. [Overview of the project] [Problems that the invention aims to solve]

[0008] Against this backdrop, the object of the present invention is to provide an improved method and an improved apparatus for measuring the field of vision of a patient or subject. [Means for solving the problem]

[0009] This problem is resolved by the objective of the independent claim, and preferred embodiments are shown in the corresponding dependent claims, as in the following description. [Brief explanation of the drawing]

[0010] [Figure 1] Figure 1 is a schematic diagram of one embodiment of the apparatus according to the present invention. [Figure 2] Figure 2 is a diagram of the path traced from the test spot in the method according to the present invention. [Figure 3] Figure 3 is a schematic diagram of the optic nerve for comparison with the cross-section of the pathway shown in Figure 2. [Figure 4] Figure 4 shows the detection or storage of the instantaneous position of a test spot whose visibility is altered. [Figure 5] Figure 5 is a diagram in which the area of ​​the subject's visual field, measured by the method or apparatus according to the present invention which is capable of addressing visual field defects, is highlighted in color. [Figure 6] Figure 6 shows a further traceable path from the test spot in the method according to the present invention. [Figure 7] Figure 7 is a schematic diagram of one embodiment of the apparatus according to the present invention, which is particularly suitable for telemedicine purposes. [Figure 8] Figure 8 is a schematic diagram of the instantaneous positions at which the test spot disappeared or became visible again, as recorded during the first measurement run. [Figure 9] Figure 9 is a schematic diagram of further measurements performed in the reduced area, with its center corresponding to the defect previously detected during the first measurement run. [Figure 10]Figure 10 is a schematic diagram of further measurements performed in the reduced area, with its center corresponding to a previously detected defect in a certain region. [Figure 11] Figure 11 is a schematic diagram of further measurements being performed in the reduced area, with its center corresponding to the further defects detected in the first measurement. [Figure 12] Figure 12 is a schematic diagram of further measurements performed in two reduced regions selected by an AI algorithm trained using patient data. [Figure 13] Figure 13 is a schematic diagram of further measurements being performed in two reduced areas predefined by the inspector. [Figure 14] Figure 14 is a schematic diagram of further measurement executions in which the test spot is moved along a further path, which is determined, for example, in real time by the inspector. [Modes for carrying out the invention]

[0011] According to claim 1, a method for measuring the field of view of a subject by an apparatus, comprising the following steps: a. A step of displaying a visually detectable test spot on a flat-panel display of a device that can be seen by the subject with the subject's eyes, wherein the spatial position of the subject's head relative to the flat-panel display is fixed, and b. A step in which, during the measurement, the device moves a test spot on a flat display along a predetermined path, and when the displayed test spot preferably becomes invisible to the subject (so-called off-point) or becomes visible again (so-called on-point) at an instantaneous position while moving along the path, the device activates an interactive device during the measurement, wherein the activation of the interactive device causes the device to store the respective instantaneous position and relevant information that allows the device to determine whether the test spot became invisible to the subject or became visible again at that instantaneous position.

[0012] Optionally, display the area of the subject's visual field, and preferably, the method includes the following further steps: c. Displaying the information and / or area (90) of the visual field of the subject (P) on a flat display (2) and / or a further flat display, wherein the instantaneous position forms an edge point of the area (90).

[0013] The method according to the invention, also called rapid campimetry, is a screening method that can measure the central 10° visual field of a subject in the shortest possible time, for example within 1 minute. Preferably, the relatively high density of test spots during the measurement execution of less than 1 minute is significantly different from the automatic computer perimetry method and facilitates the detection of scotomas. In the automatic computer perimetry method, usually only 16 or 25 test spots within a 10° visual field can be measured, but in the method of the present invention, for example, with a fine grid run that scans the entire 10° visual field above, below, left, and right of the center of the test visual field in 5 paths, the visual field of the subject can be efficiently measured with high precision. Therefore, the length of the path passing through the test points during the execution of the standard examination is from the distance from the patient to the monitor × coefficient 0.5 to the distance from the patient to the monitor × coefficient 3, particularly from the distance from the patient to the monitor × coefficient 1 to the distance from the patient to the monitor × coefficient 2, but particularly the distance from the patient to the monitor × coefficient 1.7625. Example 01: Distance from patient to monitor 40 cm × coefficient 1.7625 = distance 70.5 cm Example 02: Distance from patient to monitor 80 cm × coefficient 1.7625 = distance 141 cm

[0014] The relatively fast movement of the test spot, preferably a large contrast between the background of the flat display and the test spot, and a short examination time facilitate attention and enhance the reliability of the measurement data. Furthermore, a short examination time, for example, one minute, improves the applicability of the method in daily clinical practice. When a visual field defect is detected, additional measurements controlled by the examiner can ensure the accuracy of the measurement data collected. The course of the nerve fibers is known. The boundaries of the scotoma assigned to the coordinates of the scotoma can be accurately defined programmatically according to the course of the nerve fibers in the direction of the optic nerve (see Figure 3).

[0015] Preferably, this procedure is performed individually for each eye while covering the unmeasured eye of the subject. The said area of the visual field can be displayed, for example, by displaying or marking the instantaneous position so that an impression of the area is created for the examiner. Furthermore, the area can be more clearly emphasized by creating an outer edge line connecting the instantaneous positions on a further flat display. Alternatively or additionally, it is also possible to highlight the area within the displayed edge line (or within the non-displayed virtual edge line) in color relative to the background displayed on a further flat display.

[0016] The path along which the test spot moves does not necessarily have to be continuous and can, for example, consist of individual sections separated from each other, which are traversed one after the other. In principle, the path or the said sections can take any conceivable shape, whereby the area of the visual field of the subject being examined is preferably passed through several times by the test spot along its path, so that the area is scanned, for example, two-dimensionally (i.e., for example, in the horizontal and vertical directions or, with respect to the flat display, for example, in the row and column directions).

[0017] According to one embodiment of the present method, when a test spot moves on a planar display, it is provided that it has a speed S / f in units of [cm / s], where S / f is the ratio of the distance traveled S divided by a number f in the range of 2 to 7, particularly in the range of 3 to 6, and particularly in the range of 4 to 5, where the number f is particularly 4.7.

[0018] Example 01: Distance from patient to monitor = 40cm; vertical paths of 10° above and below the center of the examination area total 14.1cm on the screen, therefore the calculation formula is 14.1cm / coefficient 4.7 = 3cm / s.

[0019] Example 02: Distance from patient to monitor = 80 cm; the sum of the vertical paths of 10° above and below the center of the examination area on the monitor is 28.21 cm; therefore, the calculated value is 28.21 cm / coefficient 4.7 = 6.00213 cm / s.

[0020] Furthermore, according to one embodiment of the present invention, during a measurement run within a one-minute period, at least 500 to 50,000 different locations (or pixels on a flat-panel display) within the field of view are examined by the test spots, particularly at least 1,000 to 25,000 different locations (or pixels on a flat-panel display), particularly at least 1,500 to 10,000 different locations (or pixels on a flat-panel display), and particularly at least 2,500 different locations (or pixels on a flat-panel display). Preferably, during the measurement run, these locations, also called test spots, are close enough to partially overlap. At a distance of 40 cm from the patient to the monitor, for example, a movement along a path of approximately 70.5 cm creates a subjective dot or test spot trajectory, and in the case of a narrow scotoma, for example, the subjectively perceived trajectory in the scotoma area is simply shorter and darker.

[0021] In particular, the present invention is based on the fundamental idea that the test spot appears to the patient as a fixed point of light in motion. Furthermore, according to one embodiment of the present invention, the path is at least 17.625 cm to 705 cm long, and in particular at least 35.25 cm to 352.5 cm, in particular at least 52.875 cm to 176.25 cm, and in particular at least 70.5 cm long, wherein the test spot is provided to move along the entire path in a time of less than one minute during the measurement process.

[0022] Furthermore, in one embodiment of this method, preferably, when the test spot is moved along the path, the subject's eyes (one or both) are at a distance of 10 cm to 400 cm from the flat display, preferably in the range of 20 cm to 200 cm, preferably in the range of 30 cm to 100 cm, and particularly at a distance of 40 cm.

[0023] In a further embodiment of the present invention, the path may have a plurality of parallel first sections. In a further embodiment, the path may have a plurality of parallel second sections. In principle, this enables two-dimensional scanning of a region of the subject's field of view or the entire field of view. In this case, preferably, the first sections are appropriately arranged to cross the second sections, so that the first and second sections define, for example, a grid.

[0024] According to one embodiment of this method, the test spot is first moved along a first section (e.g., each in a first direction), and then moved along a second section (e.g., each in a second direction). In this case, the first section of the path can run vertically on the flat display, and the second section preferably runs horizontally on the flat display (or vice versa). If one or both of the flat displays are inclined with respect to the horizontal, this is also called the vertical section and therefore runs substantially perpendicular to the horizontal section of the path.

[0025] Furthermore, according to one embodiment of the present invention, the path is provided to have at least one section that runs along or at an angle to the vertical. Furthermore, according to one embodiment of the present invention, the path is provided to have at least one section that is arc-shaped, particularly semicircular. Furthermore, according to one embodiment of the present invention, the path is provided to have at least one section that crosses nerve fibers, particularly perpendicular to the nerve fibers of the optic nerve of the eye of the subject being examined.

[0026] Furthermore, according to one embodiment, the route is provided to have multiple sections that run in a straight line.

[0027] Furthermore, according to one embodiment of the present invention, in order to visualize the region of the field of view, the instantaneous position of a measurement run in which the test spot is no longer visible is linked to a line displayed as an edge line of a region on a further planar display, and / or the instantaneous position of a measurement run in which the test spot becomes visible is linked to a line displayed as an edge line of a region on a further planar display.

[0028] A further embodiment of the present method provides that the region enclosed by the edge lines is displayed on a further planar display such that it is optically separated from the background of the further planar display.

[0029] Furthermore, in one embodiment, the method according to the present invention can provide a method for inspecting a detected area (defined by a stored instantaneous position) by repeatedly guiding a test spot controlled by an inspector on a flat-panel display from the area into a surrounding area where the test spot is again visible to the subject.

[0030] Furthermore, according to one embodiment of the present method, during the measurement, a central object is displayed on a flat display, particularly in the shape of a cross, with lower brightness than the test spot, and which the subject can see in order to fix the subject's line of sight (and therefore field of view). Preferably, the device is provided to detect whether the subject's line of sight deviates from the central object during the measurement, and to stop the movement of the test spot if a deviation is detected.

[0031] Furthermore, according to one embodiment of the present invention, the movement of a test spot during measurement is interconnected with the interaction device such that when the interaction device is activated, the test spot is stopped and moved back along the path in the opposite direction (in particular, corresponding to the subject's reaction time).

[0032] According to one embodiment of the present invention, the test spot is particularly 200 cd / m² 2 ~1000 cd / m² 2 It has a brightness in the range of 300 cd / m², particularly 300 cd / m². 2 ~400 cd / m² 2 It is provided that it has a brightness within the range.

[0033] Preferably, according to one embodiment, the test spot is displayed on a flat panel display in front of a displayed (preferably dark) monochrome background, where the brightness of the test spot is greater than the brightness of the background. The background can be displayed, for example, in a dark blue hue, particularly 000066 (hexadecimal RGB code). Alternatively, the background can be any other dark color.

[0034] Furthermore, according to one embodiment, the central object (e.g., a cross) may have a hue with the hexadecimal RGB code 1111AA. The test spot may have a hue with the hexadecimal RGB code FFFFFF. However, other color or contrast combinations are also possible.

[0035] According to one embodiment of the present invention, a test spot on a flat display is moved within a test field (i.e., the path is located within the test field and defines an edge in particular), and the test field has four corners and a height H.

[0036] Furthermore, according to one embodiment of the present invention, it is provided that the test spot is generated on a planar display such that the diameter at the corner of the test field is in the range of H / 4.7 to H / 470, and in particular the diameter at the corner of the test field is in the range of H / 20 to H / 200, and in particular the range of H / 30 to H / 100, where the diameter is in particular H / 47, where H is the height of the test field in centimeters in the vertical direction in each case.

[0037] Furthermore, according to one embodiment of the present invention, the diameter of the test spot is provided to change automatically in relation to the distance from the central object, where the diameter decreases toward the central object and has a minimum diameter in the area of ​​the central object.

[0038] Preferably, the minimum diameter of the test spot is in the range of H / 18 to H / 1800, particularly in the range of H / 75 to H / 750, particularly in the range of H / 125 to H / 500, and particularly the minimum diameter is H / 180, where H is the height of the test field in centimeters in the vertical direction in each case.

[0039] In one embodiment of the method according to the present invention, the steps described above are preferably performed automatically, except for the operation of the interaction unit by the subject, which is performed by the subject's actions. Furthermore, if necessary, the examiner can manually track the test spot to precisely audibly confirm the limits to which the visibility of the test spot changes. The processing unit may consist of (or may include) a computer on which a computer program can be executed that includes instructions for the processing unit to perform the steps of the method (using further components of the apparatus). Where a reference to a processing unit is made, this also includes embodiments in which the steps of the method are performed by a plurality of cooperating processing units. Instead of at least one computer on which a computer program is executed or at least one processing unit, the processing unit may also be formed by a hardwired control unit.

[0040] Furthermore, according to one embodiment of the method, in order to specify the instantaneous position where the test spot becomes invisible or becomes visible again (for example, when the test spot crosses the position again as needed), the speed of the test spot is temporarily significantly reduced by the inspector, particularly as needed, through interaction with the user interface of the device, for example, by at least 50%.

[0041] Furthermore, according to one embodiment of the method, after the first measurement run along the path described above, in order to more accurately detect or visualize the region (see above) when detecting the instantaneous position where the test spot disappears or becomes visible again, at least one further measurement run is performed at each of the stored instantaneous positions in each case.

[0042] Furthermore, according to one embodiment of the Method, the Method further includes the following steps: performing a further measurement run for each section of a (first) measurement run path extending between two adjacent stored instantaneous positions, wherein in each case, the Device moves a test spot on a flat-panel display along a further path within a region on the flat-panel display that includes each section, and in each case, the Subject activates the Interactive Device of the Device, and when the displayed test spot disappears from view of the Subject at an instantaneous position or becomes visible again at an instantaneous position, the Interactive Device activates the Device to store the respective instantaneous position of the test spot in the region and relevant information that allows the Subject to deduce whether the test spot disappeared from view of the Subject at that instantaneous position or became visible again.

[0043] A further embodiment of the method provides that after each further measurement run, a further measurement run is performed on a further section of a further path found within each region, which in each case extends between two adjacent stored instantaneous positions of the further path and is located at the edge of the region, and the further measurement run is also performed on this section until a previously found section is found in this step during the measurement run or further measurement run, where in each case, a test spot on a flat-panel display is moved by the device along the further path within the region on the flat-panel display, and when the displayed test spot disappears from view of the subject at an instantaneous position while moving along the further path within the region, or becomes visible again, the subject activates an interactive device in each case to cause the device to store the respective instantaneous position of the test spot within the region and relevant information that can derive whether the test spot disappeared from view of the subject at the instantaneous position or became visible again.

[0044] According to one embodiment of the present method, each region is further provided to have a size of 5°, particularly 2.5°, particularly 1° around the center of the region, thereby providing that the distance between adjacent parallel sections of further paths within each region during further measurement is 2.5°, particularly 1°, particularly 0.5°, respectively.

[0045] By optionally saving the measurement results of other subjects to a database, it can be used, for example, with artificial intelligence (AI) to further identify potential visual field defects in the subjects. For this purpose, two basic AI techniques can be applied in particular: - Statistical analysis based on stored instantaneous positions (e.g., coordinate systems of a planar display or further planar displays, where each position is specified as an (x,y) coordinate pair) - e.g., using AI machine learning, or - Visualized examination results or image analysis of a region, e.g., using AI deep learning.

[0046] Based on the AI's analysis of other subjects and the likelihood of visual field defects compared to other subjects, it is possible to automatically examine further areas for potential undetected visual field defects.

[0047] Accordingly, according to a further embodiment of the Method, the Method is provided to include a further step of automatically selecting at least one region by an AI algorithm trained on multiple datasets of various subjects, wherein in each case, a further measurement run is performed, in which the device moves a test spot on a flat-panel display along a further path within the region on the flat-panel display, wherein in each case, an interactive device of the device is activated by the subject when the displayed test spot becomes invisible to the subject at an instantaneous position while moving along the further path within the region, wherein the activation of the interactive device causes the device to store the instantaneous position of each test spot in the region and relevant information that can be used to determine whether the test spot became invisible to the subject at an instantaneous position.

[0048] Furthermore, according to one embodiment of the present method, the AI ​​algorithm is designed to select at least one region based on a dataset of various subjects, where each subject's dataset includes the subject's memorized instantaneous location, or the AI ​​algorithm is designed to select at least one region based on a dataset of various subjects, where each dataset corresponds to a visualized region of the subject.

[0049] Furthermore, according to one embodiment of this method, during manual area inspection, the inspector marks areas on the inspection area, and further testing is automatically performed.

[0050] According to one embodiment of the present method, the method further includes the following steps: performing at least one further measurement on an area selected by the examiner, wherein the device moves a test spot on a flat-panel display along a further path within the area on the flat-panel display, and in each case, the subject activates the device's interactive device if, while the displayed test spot is moving along the further path within the area, the displayed test spot becomes invisible to the subject at an instantaneous position or becomes visible again, wherein the activation of the interactive device causes the device to store the instantaneous position of each test spot within the area and relevant information that can be used to determine whether the test spot became invisible to the subject at that instantaneous position or became visible again.

[0051] Furthermore, according to one embodiment of the present method, it is provided that a manual free inspection is performed in which the inspector completely manually controls the test spot on the inspection area (e.g., a flat-panel display or further flat-panel displays).

[0052] In this regard, according to one embodiment of the present method, the method further comprises the following steps: performing at least one further measurement run, wherein a test spot on a planar display is moved by the device along a further path under the control of the examiner, and in each case, the examiner activates an interactive device of the device when the displayed test spot becomes invisible to the examiner or becomes visible again at an instantaneous position while moving along the further path within the area, wherein the activation of the interactive device causes the device to store the respective instantaneous position of the test spot within the area and relevant information that can be used to determine whether the test spot became invisible to the examiner or became visible again at that instantaneous position.

[0053] When the region of the subject's field of view is displayed on a flat-panel display and / or a further flat-panel display, the instantaneous positions stored during subsequent measurement runs now also form the edge points of the region. This improves the accuracy of the region accordingly. In particular, to visualize the region, the instantaneous positions stored during measurement runs and subsequent measurement runs, as well as the instantaneous positions where the test spot is no longer visible, can be connected by lines displayed on the further flat-panel display as edge lines of the region. Alternatively or additionally, the instantaneous positions stored during measurement runs in which the test spot became visible and during subsequent measurement runs can be connected by lines displayed on the further flat-panel display as edge lines of the region, thereby displaying the region enclosed by the edge lines on the further flat-panel display in a manner that makes it visually stand out (separate) from the background of the further flat-panel display.

[0054] During the execution of the above-mentioned measurements or any further measurements, the inspector may, at their discretion, influence each measurement in each case, for example, by: - Variable test spot size (e.g., start and end sizes of the test spot, and changes to the test spot size), - Speed ​​of test spots along each route, - Direction of movement (horizontal, vertical, diagonal, etc.) - The number of segments of a path that moves across a flat-panel display, or across further flat-panel displays, or within a region.

[0055] Another aspect of the present invention relates to a computer program that, when executed by a computer, includes instructions causing a computer or device to perform steps of a method according to the present invention.

[0056] A further embodiment of the method according to the present invention provides that the contents of a flat panel display are transmitted to a further flat panel display via a data transmission connection, and / or (particularly during measurement) the contents of a further flat panel display are transmitted to a further flat panel display via a data transmission connection.

[0057] In the examples of the embodiments described above, the data transmission connection may be a computer network connection, particularly an Internet connection, and one or more known network protocols can be used. Furthermore, the data transmission connection may be a wireless connection, or may be partially formed by a wireless connection.

[0058] According to a further embodiment of the present method, the apparatus is provided to include a processing unit for displaying and moving a visually detectable test spot on a flat display.

[0059] A further embodiment of this method provides that the processing unit is a local processing unit (client) located at the subject's location, where each instantaneous location and related information are stored in the local processing unit, transmitted to a further processing unit via a data transmission connection, evaluated in the further processing unit, and generate a resulting dataset.

[0060] In another embodiment of this method, the processing unit is a local processing unit (client) located at the subject's location, where each instantaneous location and related information are stored in the local processing unit, evaluated in the local processing unit to generate a result dataset, and the result dataset is transmitted to further processing units via a data transmission connection.

[0061] The local processing unit can be the subject's computer or client, such as a desktop computer, laptop computer, or tablet computer. Further processing units can be (remote) servers.

[0062] According to yet another embodiment of the present method, the apparatus further comprises a local processing unit located at the subject's location, connected to a flat-panel display, wherein the processing unit (in particular a server) causes the display and movement of visually detectable test spots on the flat-panel display via a data transmission connection to the local processing unit, and the respective instantaneous positions and associated information are stored and evaluated in the processing unit (server) to generate a resulting dataset.

[0063] The local processing unit can therefore be the subject's computer or client (see above). The processing unit is preferably a (remote) server connected to the local processing unit via a data transmission connection.

[0064] In the embodiments described above, the data transmission connection may be a computer network connection, particularly an Internet connection, and one or more known network protocols can be used. Furthermore, the data transmission connection may be a wireless connection, or may be partially formed by a wireless connection.

[0065] The resulting dataset may contain graphically representable data that corresponds to or encodes the aforementioned region of the subject's field of vision.

[0066] Another aspect of the present invention relates to a computer program that, when the computer program is executed on a processing unit, includes instructions causing a processing unit or device to perform a step according to any one of claims 22 to 25.

[0067] Another aspect of the present invention relates to a computer-readable storage medium on which a computer program according to the present invention is stored.

[0068] Further aspects of the present invention relate to an apparatus for measuring the field of vision of a subject, which is arranged to carry out a method according to the present invention (in this respect, the apparatus may be further formed by the individual features of the method according to the present invention as described herein). The apparatus comprises at least: - A flat-screen display configured so that the subject can see it. - A processing unit configured to display a test spot on the subject's flat-screen display and to move the test spot along a predefined path on the flat-screen display. - An interactive device configured to be activated by a subject when a displayed test spot becomes invisible to the subject or becomes visible again at a momentary position while moving along a path, wherein the processing unit is configured to store, when the interactive device is activated, the respective momentary position and relevant information that can be used to determine whether the test spot became invisible to the subject or became visible at that momentary position.

[0069] In particular, the apparatus may be configured to perform or be used in performing a step of the method described in any one of claims 1 to 25.

[0070] According to one embodiment of the present invention, the interactive device comprises an actuation element for operating the interactive device. This may be, for example, one of the following actuation elements: a switch, a microphone, a touchscreen, a rotary knob, or a slider.

[0071] If the area or field of view being inspected moves away from the test spot so that the test spot alternately becomes invisible and then visible again, it is sufficient for the interaction device to be activated by a single signal, which is generated, for example, by activating one of the aforementioned actuation elements once when the visibility of the test spot changes. In this respect, the microphone is also understood to be an actuation element. The signal from the interaction device can reach a processing unit in various ways, by which it can be received and processed. Possible examples include electrical signals, electromagnetic signals, optical signals, and acoustic signals.

[0072] Furthermore, according to one embodiment of the apparatus, it is provided that the apparatus is configured to generate a central object (particularly a cross shape) on a flat display, which can be fixed by the subject by the eye being measured. According to a further embodiment of the apparatus, it is provided that the apparatus comprises an additional flat display configured to be viewable by the examiner.

[0073] Furthermore, according to one embodiment of the present device, a planar display is provided that is formed by a screen or comprises a screen.

[0074] Furthermore, in one embodiment of the apparatus, an additional planar display for the inspector is provided, which is formed by a screen or comprises a light source for generating an image on a projection surface.

[0075] According to a further embodiment of the apparatus, the processing unit is further configured to determine the area of ​​the subject's field of vision and display it to the examiner on an additional planar display, where the detected or stored instantaneous positions form the edge points of this area.

[0076] According to a further embodiment of the present apparatus, the apparatus is provided to include a fixing unit configured to fix the position of the subject's head relative to a flat-panel display.

[0077] According to a further embodiment of the apparatus, the apparatus is provided to include a further processing unit configured to transmit instantaneous location and related information to a further processing unit via a data transmission connection, and the further processing unit configured to evaluate the instantaneous location and related information to generate a resulting dataset.

[0078] The resulting dataset may have graphically representable data that corresponds to or encodes the aforementioned area of ​​the subject's field of view. The flat-panel display and interaction device may be connected to a processing unit that is located at or can be located at the subject's location. The further processing unit may be a remote server. The data transmission connection may also be a computer network connection, particularly an internet connection, and these may use one or more known network protocols. The data transmission connection may also be a wireless connection, or may be partially formed by a wireless connection. Furthermore, the further flat-panel display may be connected to a server or a client connected to a server via the computer network connection. Thus, the above embodiment allows the patient to perform measurements on a local flat-panel display at home and transmit the corresponding data (instantaneous position and related information) to a remote server for evaluation.

[0079] A further embodiment of the present apparatus provides that the apparatus comprises a further processing unit configured to evaluate instantaneous position and related information to generate a resulting dataset and to transmit the resulting dataset to the further processing unit via a data transmission connection.

[0080] The resulting dataset may then have graphically representable data corresponding to or encoding the said area of ​​the subject's field of view. The flat-panel display and interaction device may be connected to a processing unit located at or configurable at the subject's location. The further processing unit may be a remote server. The data transmission connection may also be a computer network connection, particularly an internet connection, and may use one or more known network protocols. The data transmission connection may also be a wireless connection, or may be partially formed by a wireless connection. Furthermore, a further flat-panel display may be connected to a server or a client connected to a server via the computer network connection. In this embodiment, the patient may also perform the measurement on a local flat-panel display at home, thereby performing the evaluation of the measurement data (instantaneous position and related information) locally, with only the resulting dataset being sent to the remote server or examiner.

[0081] In a further embodiment of the apparatus, the apparatus further comprises a local processing unit located at the subject's location, connected to a flat-panel display, the processing unit (particularly a server) causes the display and movement of visually detectable test spots on the flat-panel display via a data transmission connection to the local processing unit, the instantaneous position and associated information of each spot being stored in the processing unit (server) and evaluated to generate a results dataset.

[0082] Here again, the resulting dataset may have graphically representable data corresponding to or encoding the aforementioned area of ​​the subject's field of view. The flat-panel display and interaction device may be connected to a local processing unit, which may be located at or positioned at the subject's location. The processing unit may be a remote server. The data transmission connection may be a computer network connection, particularly an internet connection, which may use one or more known network protocols. The data transmission connection may also be a wireless connection or may be partially formed by a wireless connection. Furthermore, an additional flat-panel display may be connected to a server or a client connected to a server via the computer network connection. Thus, according to the embodiments described above, the patient can perform measurement executions on a local flat-panel display at home, whereupon the measurement executions are performed and evaluated on the server. The patient can access internet pages via the patient's local processing unit using, for example, a web browser, which forms a user interface for performing measurement executions. The corresponding application is executable on the server.

[0083] Furthermore, the apparatus according to the present invention can be further formed by the above-mentioned features related to this method.

[0084] Flat-panel displays are particularly characterized by the fact that they have an inherently flat (planar) surface for displaying graphics.

[0085] Hereinafter, embodiments of the present invention, as well as further features and advantages of the present invention, will be described with reference to the figures.

[0086] The method according to the present invention is also referred to below as rapid campimetry (RAP CAMP or RAP-CAMP). In one embodiment of this method, the following steps are basically carried out using the apparatus shown in Figure 1, which is described in detail below: The process involves displaying a visually detectable test spot 6 on a flat-panel display 2 of the device 1, as seen by the subject P's eyes, while the spatial position of the subject P's head relative to the flat-panel display 2 remains unchanged. The process involves the device 1 moving a test spot 6 on a flat display 2 along a path 7 during measurement, and when the displayed test spot 6 becomes invisible to the subject P at a momentary position 9 (see Figure 4) while moving along path 7, or becomes visible again, the subject P activates the dialogue device 8 of the device 1, and the activation of the dialogue device 8 causes the device 1 to store the respective momentary position and related information that allows the subject P to determine whether the test spot 6 at that momentary position became invisible to the subject P or became visible again, and The step of displaying a region 90 of the subject P's field of view on a further planar display 3, wherein the instantaneous position 9 forms an edge point of the region 90.

[0087] This can directly bring about the decisive advantages of the method according to the present invention or of individual embodiments thereof: - Redundancy of test spot 6 and acceleration of testing. - Within a 10° field of view, hundreds to thousands of inspection points can be performed (unlike 16 or 25 points, as with the latest computerized perimeters), which improves the ability to detect absolute scotoma. - The ease of implementation, taking approximately one minute, allows for greater focus and cooperation from patients. This, in turn, increases the reliability of patient information. - In contrast to perimetry, the increased usability of this method, such as its timeframe of approximately one minute, allows it to be incorporated into routine testing. - RAP-CAMP provides an easily applicable absolute scotoma screening method. - Anyone suspected of having normal-tension glaucoma can be tested. In Germany, approximately 0.3% of the population over 40 years old has normal-tension glaucoma. - Risk factors for normal-tension glaucoma are myopia and migraine. The incidence of migraine in Germany is approximately 1%. All patients over 40 years of age with myopia and migraine should be screened. The frequency of normal-tension glaucoma diagnoses will increase as scotomas can be detected more quickly and reliably, allowing more patients to be screened. - Glaucoma patients (about 1% of the population over 40 in Germany) are easier to screen more frequently. - However, the methods described herein are measurement methods only, and not diagnostic methods in particular, and do not include any diagnostic steps, and specifically perform only visual field measurements.

[0088] According to one embodiment, the method according to the present invention can be carried out by, for example, the following steps: The patient sits in front of a flat display 2 in the form of a screen, for example, at a distance A of 40 cm. Patient P's head is fixed via a fixation unit 4 that includes support for the jaw and forehead. • A bright white test spot 6 rapidly moves across a dark screen 2 in a continuous sequence. • Because test spot 6 passes through the field of view horizontally, vertically, and diagonally, the test procedure covers a grid of quadrants. • Patient P will notify the patient of the change as soon as test spot 6 becomes invisible to the patient and then becomes visible again in each case. At the end of the test, all of the instantaneous positions 9 of the detected test spots where the test spot 6 disappeared (off-point) or became visible again (on-point) are preliminarily linked together so that a field of view region 90 that can correspond to a visual field defect can be recognized (see Figure 4). Subsequently, this visual field defect can be identified using dynamic perimetry.

[0089] Figure 1 shows an embodiment of a device 1 for measuring the field of view of a subject P, suitable for carrying out the method according to the present invention. The device 1 includes a flat-panel display 2 configured to be viewed by the subject P. The device 1 further includes another flat-panel display 3 configured to be viewed by an examiner U, and optionally a fixing unit 4 configured to fix the position of the subject P's head relative to the flat-panel display 2. The device 1 further includes a processing unit 5 (e.g., in the form of a computer) configured to display and move a test spot 6 on the subject P's flat-panel display 2 along a predetermined path 7 on the flat-panel display 2. The device 1 further includes an interactive device 8 configured to be activated by the subject P when the displayed test spot 6 becomes invisible to the subject P or becomes visible again while moving along the path 7 at an instantaneous position 9, wherein the processing unit 5 is configured to store each instantaneous position 9 and relevant information that can be used to deduce whether the test spot 6 became invisible to the subject P or became visible again at the instantaneous position 9 when the interactive device 8 is activated (see Figure 4). The processing unit 5 is further configured to display a region 90 of the subject P's field of view on an additional planar display 3, where the instantaneous position 9 forms an edge point of the region 90.

[0090] The fixing unit 4 may have, for example, a jaw and forehead support on which the patient P can rest their jaw. A holder for eyeglass lenses may be provided in front of this, if necessary.

[0091] Preferably, the flat display 2 is designed in the form of a screen and is positioned at a certain distance A from the patient P's uncovered eye. The interaction device 8 can be operated by the patient, for example, by text / sound.

[0092] Furthermore, a fixation control unit can be provided to ensure that patient P fixates on the central object 10 (e.g., a cross) with the eye being examined. Preferably, the fixation of this central fixation cross 10 is controlled by the examiner U and precisely adjusted at the start of the examination (e.g., by corneal reflex or pupillary image). In case of deviation from central fixation 10, the fixation control unit preferably automatically stops the movement of the test spot.

[0093] The flat-panel display 2 or screen 2 is preferably completely different from any ordinary perimeter and campimetry. It preferably has the following characteristics: - Flat display 2 will darken, for example, to a dark blue hue, but other dark colors are also possible. - The distance between the patient's eye P and the flat display or screen 2 is set to, for example, 40 cm. As a result, campimetry according to the present invention is performed in a range from a grid size of 14.1 cm (vertical) in the central 10° range to a grid size of 21.4 cm (horizontal) in the 15° range. All early cases of glaucoma are within this range, and the blind spot F (see Figure 3) is also within this range, which allows us to show the patient that the test spot has disappeared.

[0094] Figure 3 schematically shows the path of nerve fibers N at the back of the eyeball. This square corresponds to the central 10° field of view G. Furthermore, it also shows the position S of the sharpest field of view. The circle BS exemplifies the path of an arcuate scotoma.

[0095] In an example of the present invention, the test spot 6 is bright white. Unlike the periphery of a hemisphere, there is no addition of luminance (environment + test spot). Instead of a dark background, there is a bright test spot.

[0096] The central object 10 (e.g., the central cross) functions as a fixation point, as described above. Therefore, it is preferable that it be clearly visible so that it can be easily fixed upon, but at the same time, it should not be too bright to dazzle the patient P's eyes. Therefore, it is preferable that it be weaker than the light of the test spot 6 and may have a light blue hue, for example (other colors are also possible).

[0097] The size or diameter of the test spot 6 is preferably variably adjustable and can be adapted as needed for the patient being examined. For example, the diameter of the test spot may be 2 mm, corresponding to a 0.3° range of the visual field. In certain applications, where visual acuity decreases towards the periphery, a test spot of 2.5 mm (a range of 0.4° within the visual field) may be required in a test area exceeding 10° from the center. It must also be possible to examine patients with poor visual acuity. Smaller test spots, such as 1 mm or 1.5 mm, would allow for more precise examinations, provided they are easily recognizable. However, the tester may be larger. Preferably, the device 1 is designed so that the test spot 6 increases as the distance from the center 10 increases.

[0098] One of the key differences between this method and all prior art visual field testing methods is the speed at which the test spot 6 travels. This is because it moves relatively quickly within the patient's visual field. Therefore, the perception of the test spot 6 can be measured at a very large number of locations in a short time. According to an embodiment of the present invention, for example, it is possible to test 3750 locations within a 10° range in 30 seconds. Modern computer perimeters, depending on the program, test 16 to 25 locations within a 10° range. On the other hand, the testing speed of the present invention can be, for example, 125 frames per second. The speed at which the test spot 6 travels can be adjusted in the method or apparatus 1 according to the present invention based on the individual requirements of the patient being tested.

[0099] Figure 2 shows the possible paths 7 that the test spot 6 may traverse during measurement, depending on the corresponding configuration or design of the device 1.

[0100] According to one embodiment of the present invention, the apparatus 1 is designed to move the test spot 6 along a path 7, first from right to left along six vertical sections 70, and particularly from top to bottom and bottom to top alternately, and then along four horizontal sections 71. The length of the path 7 can be, for example, about 130 cm on the flat display 2. Using a test spot speed of 3 cm / s, the inspection time in this example is less than 1 minute.

[0101] Figure 5 shows an alternative configuration of path 7. Here, the test spot 6 is first guided along four vertical sections 70 from right to left, and especially from top to bottom and bottom to top, alternately. Subsequently, the test spot 6 is guided along four sections 72 that are inclined with respect to the vertical, thereby crossing, for example, 5° and / or 10° circles, especially perpendicular to each circle. This is advantageous because the nerve fibers N of the optic nerve (see Figure 3) are cut as vertically as possible.

[0102] The examiner U's additional planar display 3 or additional screen 3 also preferably has a central object / cross 10 corresponding to the patient's fixation point 10 on screen 2. Furthermore, circles of 5°, 10°, and 15° in size of the field of view are preferably displayed.

[0103] The two planar displays / screens 2 and 3 are particularly linked and cooperate with each other, so that the test spot 6 also visibly moves across the additional screen 3 to the examiner U. When patient P signals the disappearance or reappearance of the test spot 6, these spots or momentary positions 9 (see Figure 4) are marked on this screen 3 for the examiner U.

[0104] At the end of the test, all locations or points 9 where the test spot 6 is no longer visible (off-point) or becomes visible again (on-point) are connected to each other by the processing unit 5 of the device 1 via preliminary connections, as shown in Figure 4 as an example, so that forms of likely visual field defects can be recognized. The pre-drawn potential for visual field defects can be verified, if necessary, by moving the test spot (a cursor like a test mark) from an invisible area to a visible area, similar to dynamic perimetry. This movement of the test spot, controlled by the examiner U, is controlled by the examiner U, for example, via input means 11, particularly the directional keys of the computer or processing unit 5. The device 1 or processing unit 5 may also be further designed to automatically visualize the area 90 or areas suspected of having visual field defects at the end of the test, as shown in Figure 5.

[0105] During the measurement, patient P can notify the patient in various ways, for example, by pressing a button or speaking, that the visibility of the test spot 6 has changed. The dialogue device 8 is provided with corresponding input means for this purpose.

[0106] The location 9 of the visual field defect, signaled by patient P, is stored in the device 1. After the first measurement run, the area signaled by patient P can be manually specified by the examiner. Such specification of the estimated visual field defect 90 is done, for example, by slowly approaching the approximate location of the visual field change after the first measurement run and focusing on the defect area signaled by patient P. In principle, the method according to the present invention is also suitable for use as a telemedicine method. For example, the measurement run or examination can be performed via the internet. Patient P can undergo the examination as long as they have a computer at home, and the examiner U can perform the measurement run remotely if necessary. Particularly experienced patients, such as glaucoma patients who have already undergone examinations several times, know the examination procedure and can autonomously repeat the examination procedure as needed (covering one eye, maintaining a distance of, for example, 40 cm, fixing the central object 10, pressing a button when the test spot disappears, for example). No auxiliary staff would be necessary. For example, the patient can collect results regularly and send them to their doctor (examiner U). In other parts of the world where perimeters are unavailable, caregivers trained in testing techniques can collect and transmit Campimetry results via the internet.

[0107] Figure 1 shows a further embodiment of the apparatus 1 for measuring the visual field of a subject P, which is suitable for carrying out the method according to the present invention and further eliminates the need for the examiner U to be present at the subject P's location.

[0108] In this case, the device 1 includes a flat-panel display 2 configured to allow the subject P to view it. The flat-panel display (particularly a screen) 2 is connected to a local processing unit (e.g., in the form of a computer) 5, which is then connected to an interactive device 8, which may be, for example, a computer keyboard or microphone. The local processing unit 5 is connected to a further processing unit 55, which may be, for example, a server, via a data transmission connection V (e.g., an internet connection). The server side may be provided with a further flat-panel display 3 and a keyboard 11 for the examiner U. Measurement execution can be implemented by a computer program running on the local processing unit 5. On the local processing unit 5, measurement data (instantaneous position and related information) can be stored, evaluated, and a result dataset can be generated. The result dataset can be transmitted to the server 55 or the examiner U via the data transmission connection V. Alternatively, it is also possible to generate a result dataset by sending the measurement data to the server 55, where it can be evaluated.

[0109] Furthermore, the measurement can also be performed by a computer program, such as a browser-based application, running on an additional processing unit 55 (e.g., a server). The patient can access this application via data transmission or an internet connection V, and the measurement data collected during the measurement is stored on the server 55, where it is evaluated and a resulting dataset is generated.

[0110] In the modified process described above, the resulting dataset may have graphically representable data that corresponds to or encodes the region 90 of the subject's field of view (see Figures 4 and 5). This region 90 can be displayed, for example, to the patient via a flat-panel display 2, or to a remote examiner U via a further flat-panel display 3.

[0111] The examiner U can communicate with the patient P, particularly during the measurement. Such (e.g., audiovisual) communication between the patient and the examiner (e.g., in the form of video chat) can also be achieved via a data transmission connection V between the two processing units 5, 55, or by other means.

[0112] Various designs of the embodiment shown in Figure 5 allow patients to perform measurements on a local flat-screen display at home. If necessary, patients can receive real-time guidance or assistance from the examiner.

[0113] Furthermore, according to one embodiment of the method or corresponding apparatus of the present invention, if a visual field defect is detected after a first measurement run along the defined path described above (i.e., an event in which a momentary position 9 in which the test spot becomes invisible and then becomes visible again is detected), it is provided that an optionally detailed inspection or further measurement run can be performed to more accurately scan any detected visual field defects. This can be done in the manner described above (for example, for smaller areas 92), particularly with the assistance of a (partially) automated (see Figures 9-11) and further artificial intelligence (AI) based method (see Figure 12). Furthermore, manual area inspection (see Figure 13) or even further manual free inspection (see Figure 14) can also be performed.

[0114] More specifically, for example, a section 91 along the path 7 detected during a first measurement run or standard run is a section extending between two consecutive instantaneous positions 9 where the test spot 6 becomes invisible or becomes visible again to the subject P, and can be further detailed and identified in an automated manner by an area inspection around the section 91 (potential scotoma area) by applying the following process steps, for example.

[0115] Region 92 is defined around the section 91 (potential scotoma or defect region) detected during the first measurement run (see Figure 8), through which the test spot is guided along a further path 70, thereby detecting again the instantaneous position 9 in which the test spot 6 becomes invisible or becomes visible again (see Figure 9). After further measurement runs along the further path 70 in the region 92, in each case, the section 91 (new potential defect region) located at the edge of region 92 is used as the center of the further region 92, and these regions 92 are traversed again until they overlap with the further section 91 (potential scotoma region) detected in the first measurement run or the further measurement run. This section 91 is also selected as the center of the region 92 traversed according to the same principle (see Figures 9 to 11).

[0116] As an alternative to this procedure, each section 91 (or potential scotoma or missing area) identified during the first measurement run (see Figure 8) can be used in each case as the center of an area 92 to which the test spot 6 is guided along a further path 70, thereby storing in each case the instantaneous position 9 in which the test spot 6 becomes invisible or visible to the subject P (see Figures 9 and 11).

[0117] In particular, region 92 has a smaller area than the area through which path 7 passes during the first measurement run. Specifically, each region 92 can cover an area around its respective center (section 91) corresponding to viewing angles of 5°, 2.5° in particular, and 1° in particular, so that the distance between adjacent parallel sections 70a of further path 70 is 2.5° in each case, 1° in each case, and 0.5° in each case.

[0118] For further measurement execution, patient data from additional subjects can be used, for example, to train the AI ​​algorithm. In this way, potential missing areas or intervals 91 that were not found by previous examination methods can be identified. For this purpose, two basic AI methods can be applied, in particular: one is statistical analysis based on the stored instantaneous position 9 in the coordinate system of the examination area (e.g., (x,y) coordinates in the coordinate system of a planar display or further planar display); the other is image analysis of the visualized examination results, i.e., image analysis of the area 90 where an edge is formed by the position 9. Based on the results of the AI ​​analysis of other subjects and the probability of potential missing areas / scotomas compared to other subjects, further areas 92 can be automatically examined, where potentially further intervals 91 that have not yet been recognized can be located. For this purpose, as described above, further measurement execution can be performed in the area 92 determined by the AI ​​(see Figure 12).

[0119] Furthermore, each region 92 can be determined by the inspector, and then (automatic) further measurements can be performed along the further path 70 in the manner described above (see Figure 13).

[0120] Finally, the inspector can also determine or control additional paths 70 for further measurement execution in real time (see Figure 14).

[0121] In all of the above testing methods or further measurement procedures, the tester may, at their discretion, affect or adjust the test parameters, namely, the following test parameters in particular: - The size or diameter of test spot 6 (e.g., the starting and ending sizes of test spot 6, and possibly changes in size or speed), - Speed ​​of moving test spot 6, - The direction of the paths 7 and 70 to be traversed (e.g., horizontal, vertical, diagonal, etc.) - The number of sections 70a of the paths 7, 70 to be traversed within area 92, or on a flat-panel display or further flat-panel display.

Claims

1. A method for measuring the visual field of a subject (P) using a device (1), comprising the following steps: - A step of displaying a visually detectable test spot (6) on the planar display (2) of the device (1) as seen by the subject (P) with the subject (P)'s eyes, wherein the spatial position of the subject (P)'s head with respect to the planar display (2) remains unchanged, and - A step in which, during measurement execution, the device (1) moves the test spot (6) on the flat display (2) along a path (7), and when the displayed test spot (6) becomes invisible to the subject (P) or becomes visible again while it is moving along the path (7) at an instantaneous position (9), the subject (P) activates the dialogue device (8) of the device (1), wherein the activation of the dialogue device (8) causes the device (1) to store relevant information that allows it to deduce each of the instantaneous positions and whether the test spot (6) became invisible to the subject (P) or became visible again at each instantaneous position. The method comprising the above.

2. The above method further involves the following steps: A step of displaying information and / or a region (90) of the subject (P) on the planar display (2) and / or a further planar display (3), wherein the instantaneous position forms an edge point of the region (90), The method according to claim 1, including the method described in claim 1.

3. The test spot (6) has a speed S / f in cm / s when moving on the flat display (2), where S is the distance covered by the test spot in cm, f is a number in the range of 2 to 7, particularly a number in the range of 3 to 6, particularly a number in the range of 4 to 5, and f is particularly 4.

7. The method according to claim 1 or 2.

4. The method according to any one of claims 1 to 3, wherein when the test spot (6) is moved along the path (7), the eyes of the subject (P) are at a distance (A) from the planar display (2) in the range of 10 cm to 400 cm, particularly in the range of 20 cm to 200 cm, particularly in the range of 30 cm to 100 cm, particularly in the range of 30 cm to 50 cm, particularly in the range of 35 cm to 45 cm, and the distance is particularly 40 cm.

5. The method according to any one of claims 1 to 4, wherein during the measurement execution for a period of one minute, pixels at at least 500 to 50,000 different locations on a flat-panel display within the field of view are tested by the test spot (6), in particular at least 1,000 to 25,000 different locations, in particular at least 1,500 to 10,000 different locations, in particular at least 2,500 different locations, and / or the path (7) has a total length of at least 17.625 cm to 705 cm, and / or the path (7) has a total length of at least 35.25 cm to 352.5 cm, and / or the path (7) has a total length of at least 52.875 cm to 176.25 cm, and / or the path (7) has a total length of at least 70.5 cm, and the test spot (6) moves along the entire path (7) during the measurement process for a period of one minute or less.

6. The method according to any one of claims 1 to 5, wherein the path (7) includes a plurality of parallel first sections (70), and / or the path (7) includes a plurality of parallel second sections (71).

7. The method according to claim 6, wherein the first section (70) crosses the second section (71) in particular, such that the first section and the second section define a grid.

8. The method according to claim 6 or 7, wherein the test spot (6) first moves along each of the first sections (70), and then moves along each of the second sections (71).

9. The method according to any one of claims 6 to 8, wherein the first section (70) extends vertically in the planar display (2), and the second section (71) extends horizontally in the planar display (2); or the first section extends horizontally in the planar display, and the second section extends vertically in the planar display.

10. The method according to any one of claims 1 to 9, characterized in that the path (7) has at least one section (72) that runs vertically or inclined with respect to the vertical; and / or the path (7) has at least one section that runs in an arc shape, particularly a semicircular shape; and / or the path (7) has at least one section (72) that crosses a nerve fiber (N) and particularly perpendicular to the nerve fiber (N).

11. To visualize the region (90), the instantaneous position (9) at which the test spot (6) disappears from view is connected to a line displayed on the further planar display (3) as an edge line of the region (90), and / or the instantaneous position (9) at which the test spot (6) becomes visible again is connected to a line displayed on the further planar display (3) as an edge line of the region (90), wherein, in particular, the region (90) enclosed by the edge line is optically raised from the background of the further planar display (3) and displayed on the further planar display (3), according to claim 2, or, as far as claim 2 is concerned, the method according to any one of claims 3 to 11.

12. The method according to claim 2, or, insofar as it relates to claim 2, or the method according to any one of claims 3 to 11, wherein the detected region (90) is inspected by repeatedly guiding the test spot (6) from the detected region (90) to the surrounding region visible to the subject, under observation by a subject (P) controlled by an examiner (U) on the flat-panel display (2).

13. The method according to any one of claims 1 to 12, wherein during the measurement, the central object (10) is displayed on the planar display (2), in particular with a light weaker than the test spot (6) and in the shape of a cross as seen by the subject (P) in order to fix the subject's (P) line of sight, wherein the device (1) detects during the measurement whether the subject's (P) line of sight deviates from the central object (10), and stops the movement of the test spot (6) if a deviation is detected, in particular the diameter of the test spot (6) decreases as the distance from the central object (10) decreases.

14. The method according to claim 3, or, as far as claim 3 is concerned, according to any one of claims 4 to 13, wherein, if necessary, the inspector may temporarily slow down the speed of the test spot (6), particularly by interacting with the user interface of the device (1), in order to specify the instantaneous position in which the test spot (6) becomes invisible or becomes visible again.

15. The method comprises the following steps: performing further measurement runs on each section (91) of the path (7) of the measurement run extending between two adjacent stored instantaneous positions (9), wherein in each case the test spot (6) on the flat-panel display (2) is moved by the device (1) along the further path (7) in a region (92) on the flat-panel display that includes the respective section (91), and in each case the displayed test spot (6) is in the further path (70) in the region (92) at the instantaneous position (9) The method according to any one of claims 1 to 14, further comprising the step of having the subject (P) activate the dialogue device (8) of the apparatus (1) when the subject (P) becomes invisible to the subject (P) or becomes visible again while moving along the area, wherein the activation by the dialogue device (8) causes the apparatus (1) to store relevant information that allows the subject (P) to deduce the respective instantaneous position (9) of the test spot (6) in the area (92), and whether the test spot (6) became invisible to the subject (P) or became visible again at the instantaneous position (9).

16. The method according to claim 15, wherein, in each case, after each further measurement run on each section (91) of the further path (70) found in each of the regions, which extends between two adjacent stored instantaneous positions (9) of the further path (70) and is located at the edge of the region (92), further measurement runs are performed until a previously found section (91) is detected in the process during the measurement run or during the further measurement run, where further measurement runs are performed again on this section (91).

17. The method according to any one of claims 1 to 14, wherein at least one region (92) is automatically selected by an AI algorithm trained on multiple datasets of various subjects, where further measurements are performed, and in each case, the test spot (6) on the flat-panel display (2) is moved by the device (1) along a further path (70) within the region (92) on the flat-panel display, and in each case, when the displayed test spot (6) moves along the further path (70) within the region and becomes invisible to the subject (P) at an instantaneous position (9), the interaction device (8) of the device (1) is activated by the subject (P), and the activation by the interaction device (8) causes the device (1) to store relevant information that allows the user to deduce the respective instantaneous position (9) of the test spot (6) within the region (92), and whether the test spot (6) became invisible to the subject (P) at the instantaneous position.

18. The method according to claim 17, wherein the AI ​​algorithm is adapted to select at least one region (92) based on a dataset of various subjects, where each of the subject's datasets includes the subject's stored instantaneous location (9), and / or the AI ​​algorithm is adapted to select at least one region (92) based on a dataset of various subjects, where each of the datasets corresponds to the subject's visualization region (90).

19. The method according to any one of claims 1 to 18, further comprising the steps of: performing at least one further measurement on an area selected by an inspector, wherein the test spot (6) on the flat-panel display (2) is moved by the device (1) along a further path (7) within the area on the flat-panel display, and in each case, when the displayed test spot (6) becomes invisible to the subject (P) or becomes visible again at an instantaneous position (9) while moving along the further path (7) within the area, the subject (P) activates the dialogue device (8) of the device (1), wherein the activation of the dialogue device (8) causes the device (1) to store relevant information that can be used to derive each instantaneous position of the test spot within the area and whether the test spot (6) became invisible to the subject (P) or became visible again at the instantaneous position.

20. The method according to any one of claims 1 to 19, further comprising the steps of: performing at least one further measurement, wherein the test spot (6) on the planar display (2) is moved by the device (1) along a further path (70) under the control of an examiner, and in each case, the subject (P) activates the dialogue device (8) of the device (1) when the displayed test spot (6) becomes invisible to the subject (P) or becomes visible again while moving along the further path (70) in the area at an instantaneous position (9), wherein the activation of the dialogue device (8) causes the device (1) to store relevant information that allows the subject (P) to derive each instantaneous position of the test spot in the area, and whether the test spot (6) became invisible to the subject (P) or became visible again at the instantaneous position.

21. The contents of the flat panel display (2) are transmitted to the further flat panel display (3) via a data transmission connection (V), and / or the contents of the further flat panel display (3) are transmitted to the flat panel display (2) via a data transmission connection (V), according to claim 2, or, as far as claim 2 is concerned, the method according to any one of claims 3 to 20.

22. The method according to any one of claims 1 to 21, wherein the apparatus (1) comprises processing units (5, 55), and in particular, processing units (5, 55) for displaying and moving the visually detectable test spot (6) on the flat display (2).

23. The method according to claim 22, wherein the processing unit (5) is a local processing unit (5) located at the location of the subject (P), and the respective instantaneous locations and related information are stored in the local processing unit (5), transmitted to a further processing unit (55) via a data transmission connection (V), and evaluated by the further processing unit (55) to generate a resulting dataset.

24. The method according to claim 22, wherein the processing unit is a local processing unit located at the location of the subject (P), and the respective instantaneous locations and related information are stored in the local processing unit (5), and evaluated in the local processing unit (5) to generate a dataset of results, the dataset of results being optionally transmitted to a further processing unit (55) via a data transmission connection (V).

25. The method according to claim 22, wherein the apparatus (1) further comprises a local processing unit (5) located at the location of the subject (P) and connected to the flat panel display (2), the processing unit (55) causes the display and movement of the visually detectable test spots on the flat panel display (2) via a data transmission connection (V) to the local processing unit (5), where the respective instantaneous positions and related information are stored and evaluated in the processing unit (55) to generate a result dataset.

26. A computer program that, when executed on the processing unit, includes an instruction causing the processing unit to perform a step according to any one of claims 22 to 25.

27. A device (1) for measuring the visual field of a subject (P): A flat-panel display (2) configured to be viewed by the subject (P), Processing units (5, 55) configured to display a test spot (6) on the flat-panel display (2) of the subject (P) and to move the test spot (6) along a predefined path (7) on the flat-panel display (2), A dialogue device (8) is configured to be activated by the subject (P) when the displayed test spot (6) becomes invisible to the subject (P) or becomes visible again while it is moving along the path (7) at an instantaneous position. The device (1) is provided with the processing unit (5) being configured to store relevant information that allows it to determine, when the dialogue device (8) is activated, the respective instantaneous position and whether the test spot (6) became invisible to the subject (P) or became visible again at that instantaneous position.

28. The apparatus (1) according to claim 27, further comprising a planar display (3) configured to be viewed by an inspector (U).

29. The apparatus (1) according to claim 28, wherein the processing unit (5) is further configured to display a region (90) of the subject's (P) field of view on the further planar display (3), where the instantaneous position (9) forms an edge point of the region (90).

30. The apparatus (1) according to any one of claims 27 to 29, comprising a fixing unit (4) configured to fix the position of the subject's (P) head relative to the flat-panel display (2).

31. The apparatus (1) according to any one of claims 27 to 30, wherein the apparatus (1) comprises a further processing unit (55), the processing unit (5) is configured to transmit the instantaneous position and related information to the further processing unit (55) via a data transmission connection (V), and the further processing unit (55) is configured to evaluate the instantaneous position and related information and generate a resulting dataset.

32. The apparatus (1) according to any one of claims 27 to 30, wherein the apparatus (1) comprises a further processing unit (55), the processing unit (5) is configured to evaluate the instantaneous position and related information to generate a resulting dataset, and to transmit the resulting dataset to the further processing unit (55) via a data transmission connection (V).

33. The apparatus (1) further comprises a local processing unit (5) located at the location of the subject (P) and connected to the flat panel display (2), wherein the processing unit (55) causes the display and movement of the visually detectable test spots on the flat panel display (2) via a data transmission connection (V) to the local processing unit (5), and the respective instantaneous positions and related information are stored and evaluated in the processing unit (55) to generate a result dataset, according to any one of claims 27 to 30.

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