Prism lenses that reduce dynamic alignment differences

Abstract

A method for determining binocular dynamic alignment may include the following steps: having the patient fixate on a starting target with their left and right eyes using a display; shifting the target in a first direction by a first target shift angle over a first target shift time using a display; measuring a first dynamic alignment difference between the left and right eyes capturing the first shifted target using an eye tracker; shifting the first shifted target in a second direction over a second target shift time using a display; measuring a second dynamic alignment difference between the left and right eyes capturing the second shifted target using an eye tracker; determining the average dynamic alignment difference from the first and second dynamic alignment differences using a computer; and determining a prescription prism to reduce the average dynamic alignment difference.

Description

[Background technology]

[0001] Misalignment or displacement of the eyeballs can cause serious medical symptoms, including headaches and migraines. Some of these can be treated by performing diagnostic measurements developed to identify static misalignment and prescribing corresponding eyeglasses with prisms or contour prisms. Known symptoms of static misalignment include many types of headaches, dry eyes, neck stiffness, and eye strain. These symptoms can escalate to nausea and / or dizziness and are involved in the cause of migraines. However, a significant percentage of patients exhibiting these symptoms either 1) do not show significant static misalignment, or 2) obtain best relief with a prism prescription different from that indicated by static misalignment measurements. Therefore, for the purposes of medical research and medical practice, there is a need to discover and identify additional modes of eye misalignment and to create reproducible and reliable means to detect and quantify these modes. [Overview of the project]

[0002] To address the above needs, a method for determining binocular dynamic alignment may include the following steps: having the patient fixate on a starting target with their left and right eyes using a display; shifting the target in a first direction by a first target shift angle in a first target shift time using a display; measuring a first dynamic alignment difference between the left and right eyes capturing the first shifted target using an eye tracker; shifting the first shifted target in a second direction in a second target shift time using a display; measuring a second dynamic alignment difference between the left and right eyes capturing the second shifted target using an eye tracker; optionally using a computer to determine the average dynamic alignment difference from the first and second dynamic alignment differences; and determining a prescription prism to reduce the average dynamic alignment difference.

[0003] In some embodiments, a method for determining binocular dynamic alignment may include: having a patient fixate on a starting target with their left and right eyes using a display; dynamically changing the characteristics of the target using a display; measuring the left-eye dynamic characteristics of the left eye tracking the changing target and the right-eye dynamic characteristics of the right eye tracking the changing target using an eye tracker; optionally using a computer to determine the mean dynamic alignment difference between the left-eye dynamic characteristics and the right-eye dynamic characteristics while tracking the changing target; and determining a prescription prism to reduce the mean dynamic alignment difference. In some embodiments, the dynamically changing characteristics of the target are the target position scanned along a one-dimensional or two-dimensional path.

[0004] In some embodiments, a method for determining binocular dynamic alignment may include the steps of: having a patient fixate on a starting target with their left and right eyes using a display; shifting the target in a direction by a target shift angle over a target shift time using the display; measuring the difference in dynamic alignment between the left and right eyes capturing the shifted target using an eye tracker and a computer; and determining a prescription prism to reduce the difference in dynamic alignment.

[0005] In some embodiments, a method for determining ocular dynamic alignment may include the following steps: presenting a first target to the eyeball at a first angle and for a first time using a display; measuring a first dynamic response of the eyeball to acquire the first target using an eye tracker; presenting a second target at a second angle and for a second time using a display; measuring a second dynamic response of the eyeball to acquire the second target using an eye tracker; and optionally using a computer to determine a dynamic response difference from the difference between the first and second dynamic responses. [Brief explanation of the drawing]

[0006] [Figure 1A] This is a diagram illustrating the nature of the human visual system. [Figure 1B] This is a diagram illustrating the nature of the human visual system. [Figure 2] This diagram shows a system for determining binocular dynamic alignment. [Figure 3A] This diagram shows a method for determining binocular dynamic alignment. [Figure 3B] This diagram shows a method for determining binocular dynamic alignment. [Figure 4A] This is a diagram showing the target shift protocol. [Figure 4B] This is a diagram showing the target shift protocol. [Figure 5A] This figure shows the responses of the left and right eyes to target shift. [Figure 5B] This figure shows the responses of the left and right eyes to target shift. [Figure 5C] This figure shows the responses of the left and right eyes to target shift. [Figure 6A] This figure shows the responses of the left and right eyes to target shift. [Figure 6B] This figure shows the responses of the left and right eyes to target shift. [Figure 7] This is a timing diagram for the left and right eyes. [Figure 8A] The timing diagram taken with the patient is shown. [Figure 8B] The timing diagram taken with the patient is shown. [Figure 9A] This figure shows the additional types of mean dynamic alignment differences. [Figure 9B] This figure shows the additional types of mean dynamic alignment differences. [Figure 10A] This diagram shows the types of dynamic target additions. [Figure 10B] This diagram shows the types of dynamic target additions. [Figure 11]A diagram showing a method for determining binocular dynamic alignment. [Figure 12A] A diagram showing an additional type of dynamic target. [Figure 12B] A diagram showing an additional type of dynamic target. [Figure 13] A diagram showing a method for determining binocular dynamic alignment. [Figure 14] A timing diagram showing a method for determining oculomotor alignment. [Figure 15] A diagram showing a method for determining oculomotor alignment.

Embodiments for Carrying Out the Invention

[0007] The need to identify additional causes of symptoms related to eye misalignment is addressed below by examining the dynamic misalignment between the two eyes. Extended experiments have suggested that in a significant proportion of cases, the movement of the eyes does not cooperate sufficiently and the symptoms are caused by a lack of dynamic alignment.

[0008] Of the extraocular muscles, the lateral rectus muscle turns the eye outward and the medial rectus muscle turns the eye inward. In a significant proportion of symptomatic patients, various misalignments and reduced cooperation were found between the lateral and medial rectus muscles of the two eyes, or generally between the yoke(d) muscles. These include rotating the eyes at different speeds or different rates of rotation, not moving the eyes along the same straight path, and not simultaneously capturing a new target at the end of the rotation. Since the stimuli from the two eyes convey information about how much to move the head, when to rotate it, and generally how to change the position of the head, a lack of consistency in the information from the two eyes will result in conflicting signals for the activation and control of the neck muscles. This leads to neck pain and, ultimately, headaches and migraines.

[0009] An illustrative example is reading. According to eye-tracking experiments, when patients (except those undergoing speed-reading training) read, their eyes are shown to capture the starting point of a word, then quickly scan the word, and then rest at the end of the word, probably to give the brain time to judge the meaning of the word. Subsequently, this process is repeated for subsequent words. The entire cycle of capture-scan-rest typically takes about 200 milliseconds per word, of which the time taken for the scan itself is very short. In the case of patients, often a difference of a few milliseconds is observed between the left and right eyes when capturing the starting point of the next word or stopping at the end of the scan. This difference corresponds to a few percent of the total scan time and can cause conflicts and orientation disorders regarding how much the eyeballs and the entire head rotate or move during the reading process. Since these conflicts and orientation disorders are repeated 200 - 300 times per minute during reading, it is not very surprising that ultimately the visual and muscular systems react and cause symptoms of fatigue and migraine. <00000 ninety-six><00000 ninety-seven><00000 ninety-eight>Figure 1A shows the anatomical reasons why the tolerance for such dynamic misalignments in the visual system is very limited. The cones responsible for color vision are concentrated in the foveal region. The radial angle of this foveal region is only about 2 degrees. When the line connecting the eyeball and the new target deviates from the optical axis of the eyeball by more than this 2 degrees, visual acuity drops sharply. Therefore, each time a deviation is recognized, corrective rotations and adjustments of the eyeball, head, or both are caused to recenter the alignment of the eyeball and restore foveal vision. <00000 ninety-nine>

[0011] Surprisingly, our eyes perform rapid rotational adjustments even when no obvious stimulus is required, such as reading. Saccades, or saccadic movements, can last from 20 to 200 milliseconds and involve very rapid rotations of the eyeball, with angular velocities of up to 100 to 500 degrees per second. There are several theories as to why the eyeball performs such high-speed saccadic movements. One theory is that because there are no rods in the center and the density of cones is very low in the periphery, the eyeball is constantly making small rotations so that a target nominally in the center of the eye can be seen with both cones and rods. Another theory concerns edge recognition. An efficient process for recognizing the edges of an object is to rock the eyeball back and forth a few times, and this rocking motion identifies the edge that causes the sharpest change.

[0012] Besides reading, driving is another activity that requires frequent acquisition of new targets. Our peripheral vision constantly recognizes newly appearing targets as the car moves forward at high speed, sending stimuli to the brain to rotate the eyes or head to determine if the newly appearing target requires a response. This is a special case of the general "passing" of a newly acquired target from peripheral vision to central vision, requiring the coordination of perceptual and muscular functions in any form. This "target passing" is further complicated by the amount of light, which affects pupil size. Generally, as the lighting dilates, the pupils dilate and the depth of focus changes. A change in depth of focus alters the eye's ability to calculate the distance from the orbit to peripheral targets. Therefore, pupil size is important in determining the difference in binocular alignment.

[0013] All of the functions mentioned above require the body to acquire new, off-center targets several times per second. However, when the two eyes are applying opposing stimuli to different areas of the eyeball, and the entire head needs to rotate to acquire these new targets, this conflict can cause neck tension, fatigue, headaches, and eventually escalate into migraines.

[0014] In medical terms, the eyeball acquires a new target by performing peripheral visual saccades followed by tracking. From an engineering perspective, the eye / brain system is essentially solving a control theory problem that can be expressed with established mathematics and algorithms. Viewing observed eye problems as performance issues of a suboptimal control system can help find clues for medical corrective measures.

[0015] In control theory, a visually guided saccade is a high-speed open-loop operation involving multiple actuators (muscles), with parameters estimated from peripheral vision and learned responses. What happens in numerical calculations in machines is a parallel selection from many associative responses activated by the nervous system. Both approaches may or may not work. In either case, one indicator of performance is the error vector, which represents the difference between the optimal ending angle of eye for initiating the next operation (following) and the actual ending angle of eye.

[0016] Following the saccade, tracking is achieved more slowly and through a closed-loop (feedback) system. This operation requires visual data processing and is computationally intensive in both mechanical and biological systems. The amount of final tracking correction required for each eye to achieve the target depends primarily on the performance of the preceding saccade. Mechanical or biological systems are expected to experience the same control difficulties due to poor saccade performance. However, in humans, the magnitude of the saccade error vector, the angular mismatch between the subsequent tracking vectors, and the timing mismatch between the onset and completion of tracking correlate with symptoms of eye misalignment in patients.

[0017] Figure 1B illustrates another relevant detail: the retina has sub-regions supplied by different optic nerves, which have complex connections along the way between the retina and the visual cortex. In each eyeball, the temporal and nasal retinas are innervated by different optic nerves. Furthermore, mechanical differences can exist between the equatorial and subequential portions of the retina. Finally, as indicated by the seven numbered regions, damage or dysfunction in specific areas along the optic nerve can lead to visual field defects in specific small regions, as will be discussed later. Reduced coordination between these sub-regions of the retina can lead to further dynamic misalignment.

[0018] Further experiments motivated by the above considerations revealed that prescribing prism glasses can reduce the dynamic interocular displacement described above, and therefore reduce the confusion and conflict in response to stimuli, such as how much the eyeballs need to rotate by the connected eye muscles and how much the neck muscles need to rotate the head to capture a new target that is off-center.

[0019] The following describes a system and method for determining such binocular dynamic alignment. The output of this system and method can be used to determine the prescription of prism lenses, reduce the difference in dynamic alignment, and thereby optimize binocular dynamic alignment.

[0020] Figure 2 shows a system 10 for determining binocular dynamic alignment differences. The system 10 for determining binocular dynamic alignment may include a left optical unit 20_L containing a left display 30_L and a left eye tracker 40_L; and a right optical unit 20_R containing a right display 30_R and a right eye tracker 40_R. The left / right displays 30_L / R can be longitudinally adjustable along the optical axis or z-axis 5 of the left eye 1_L and right eye 1_R. This adjustability can be used to simulate target distances, as well as existing patient prescriptions. Furthermore, the optical units 20_L / R can be laterally adjustable. This adjustability ensures proper alignment of the system for patients with different pupillary distances from the center 11. Proper alignment allows for the use of smaller eye-tracking optics, thereby reducing the overall size of the system 10. The eye tracker 40_L / R may include infrared (IR) illumination and / or IR LEDs, the IR light of which is reflected from the eyeball and captured and recorded by an IR camera. More broadly, the eye tracker 40_L / R may include one or more of the following: an infrared imaging eye tracker, a visible video imaging eye tracker, a pupil size tracker, and a Purkinje reflection-based eye tracker.

[0021] For simplicity, the system 10 for determining binocular dynamic alignment can also be interchangeably referred to simply as "system 10." Furthermore, for simplicity, the "left element xx_L and right element xx_R" may collectively be simply called "elements xx_L / R" or "elements xx."

[0022] The eye trackers 40_L / R can partially share the optical path of system 10, and these IR beams are redirected from the main optical path in the x or y direction by a beam splitter. In other embodiments, the eye trackers 40_L / R can be individually oriented from acute angles to both eyes 1_L / R without sharing the main optical path. Such designs are used, for example, in some virtual reality goggles.

[0023] In some other embodiments, the positions of the displays 30_L / R and the eye trackers 40_L / R can be swapped, the eye trackers 40_L / R can be positioned along the z-axis, and the displays 30_L / R can be easily positioned laterally apart in the x-direction or y-direction by a beam splitter. Finally, the operation of the system 10 for determining binocular dynamic alignment can be controlled by the computer 50.

[0024] The displays 30_L / R can be a wide variety of display systems capable of displaying dynamic targets in 3D. Embodiments include LCD displays, OLED displays, mechanically movable light sources such as LEDs, a number of appropriately arranged discrete LEDs, or LED arrays. As mentioned above, the term "display 30" will also be used to refer collectively to the left display 30_L and the right display 30_R. The displays 30 may be a pair of displays such as displays 30_L and 30_R, or a single centrally located display 30, and the two halves of the display 30 can be used to display dedicated images for the left eye 1_L and the right eye 1_R.

[0025] In other alternative embodiments, the system 10 for determining the binocular dynamic alignment difference can be formed by a single stereo-capable display 30. Stereo capability can be achieved by several known single-display technologies, some of which are listed below. (1) Active shutter technology: The display sequentially shows images for both eyes in an alternating manner, while the active shutter obstructs the view of both eyes in an alternating synchronous manner in synchronization with the display. The most widely used shutters currently utilize a liquid crystal layer that becomes opaque when a voltage is applied to it. The timing signal can be relayed to a voltage generator via wired or wireless means. (2) Polarization technology: The display sequentially displays images for both eyes. An active, switchable polarizing filter is positioned in front of the display and filters the images to be displayed alternately in an alternating synchronous manner along two perpendicular polarization planes. The stereo experience is achieved by having passive polarizers oriented along the two polarization planes of the active polarizing filter in front of both eyes. (3) Image splitting glass technology: Stereoscopic vision is achieved by splitting the displayed image for both eyes using a properly functioning glass splitter. (4) Headset technology: The single display implemented in the headset displays separate images for the left and right eyes in two halves of the display. The separate visual experience for each eye is ensured by a visual splitting / separation device positioned perpendicular to the display by a line separating the two halves. From this point forward, the term "display" will be used in a broad sense, and can be implemented using either the single-display / monitor / screen or double-display / monitor / screen technologies described above.

[0026] In all of the stereo display designs described above, even though the physical distance between the displays remains fixed, various optical techniques can create the illusion of different viewing distances.

[0027] Figure 3A shows a method 100 for determining binocular dynamic alignment using this binocular dynamic alignment determination system 10, which involves the following steps: Using a display, the patient is instructed to fixate on the starting target with both their left and right eyes (110), Using a display, the target is shifted in the first direction by a first target shift angle during the first target shift time (120), Using an eye tracker, the first dynamic alignment difference between the left and right eyes that capture the first shifted target is measured (130), Using a display, the first target is shifted in the second direction during the second target shift time (140), Using an eye tracker, measure the second dynamic alignment difference between the left and right eyes that capture the second shifted target (150), Using a computer, the average dynamic alignment difference is determined from the first dynamic alignment difference and the second alignment difference (160), This demonstrates that it can be included. These steps are explained in detail below.

[0028] After determining the mean dynamic alignment difference (160), the next step may be to determine the prescription prism to reduce the mean dynamic alignment difference (170). This final step can be performed by the system (10), the system's computer system (50), or by a qualified medical professional such as an optician or optometrist.

[0029] Figure 4A shows the triggering step 110. The target 32 ​​can be presented centrally to the left eye 1_L and the right eye 1_R. Here, an embodiment having a single display 30 is shown. In other embodiments, separate displays 30_L and 30_R may be employed, which together produce the perception of a single target 32. For clarity, the displays 30 are removed in the following Figures 4-6. The optical axes 60_L / R of the left and right eyes can be defined in several different ways. One of these is a straight line passing through the centers of the left and right eyeballs and the centers of the lenses. The angles that these optical axes 60_L / R make with the z-axis 5 (blind spot) of the left and right eyes will be called the left optical axis angle 62_L and the right optical axis angle 62_R. In step 110, the starting target 32 ​​can be presented centrally as shown, or at the starting offset angle. In some displays, this can be achieved by presenting a single LED source visible to both eyes 1_L / R. In other embodiments, each eye can view only its own LCD display, as shown in Figure 2. The left and right displays 30_L / R can each display a starting target 32, such as a glossy dot or a cross, and are arranged to create the impression of a single target 32 ​​positioned at a certain distance, so that the left and right eyes 1_L / R fuse these images to perceive a single target 32. The target 32 ​​can have additional properties, such as being an expandable object whose size, brightness, and / or color can be changed.

[0030] Figure 4B shows the shift step 120. Method 100 includes using displays 30_L / R to shift target 32 ​​in a first direction by a first target shift angle TSA64_1 at a first target shift time TST_1. As previously stated, “display” can refer to a single source display such as a single LED, or a pair of displays such as LCD displays 30_L / R, or any of the above display embodiments. The target shift angle TSA64_1 is defined, as shown in the figure, by the target z-axis (“directly in front”) and the target code connecting the center 11 and the first shifted target 32_1. The shift of the first shifted target 32_1 can equivalently be characterized not only by the target shift angle TSA64_1, but also by the target shift distance, or by any other suitable measure. Figure 4B shows the moment t=TST_1 when the first shifted target 32_1 has shifted, but eyes 1_L / R have not yet reacted to this shift.

[0031] Figure 5A shows the time immediately after t=TST_1 when at least one of the two eyes begins to respond to the shift of the first shifted target 32_1. This is called the right eye target reaction time TRT_R. In some patients, the right eye 1_R responds first, while in others, the left eye 1_L responds first. Even in the same patient, if the targets are shifted in different directions, the left eye 1_L may respond before the right eye 1_R. To avoid specificity and complex language, the measurement will be described for the case where the right eye 1_R responds first. However, this should not be interpreted as limiting, and if the left eye 1_L responds first, the explanatory wording should be adapted with obvious modifications.

[0032] Figure 5A shows that at time t=TRT_R, the right eye 1_R and its right optical axis 60_R responded to the shift 110 of the first shifted target 32 ​​by rotating away from the starting direction toward the first shifted target 32_1. Figure 5B shows the moment at time t=TRT_L when the left eye 1_L also responded to the target shift and began rotating toward the first shifted target 32_1.

[0033] Figure 5A-B shows, as explained in detail at the beginning, that the left eye 1_L and the right eye 1_R typically do not respond similarly to dynamic target shifts. Responses can vary considerably. In some cases, target reaction times may also differ.

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[0034] Figure 5C shows the eye tracker 40_L / R recording the patient's time-dependent optical axis angle 62_L / R after the first target shift time t=TST_1. In this patient, the target reaction time was the same, TRT_L=TRT_R. However, the target acquisition rate, which is directly related to the slope of the eye-tracking curve, was different.

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[0035] As described above, Figures 6A-B show the target acquisition time TAT_L / R, which is the time when the ocular optical axis 60_L / R acquires the direction of the first shifted target 32_1. Figure 6A shows the time t=TAT_R when the right eye 1_R has acquired the first shifted target 32_1, but the left eye 1_L has not yet acquired it. This acquisition angle is called the right eye target acquisition optical axis angle TA-62_R. Figure 6B shows the subsequent time t=TAT_L when the left eye 1_L has also acquired the first shifted target 32_1 with the left eye target acquisition optical axis angle TA-62_L. Figure 5C shows the eye-tracking results of an actual patient's eyes, showing that these two times can differ.

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[0036] Figure 7 combines these concepts into a single timing diagram. The upper part is the timing diagram of the target shift angle TSA 64_1 related to the first shift at TST_1. At the first target shift time TST_1, the starting target angle is shifted to the first target shift angle TSA 64_1. This shift can be abrupt or gradual, as will be explained later. The starting target shift angle TSA_0 is typically zero because, at the start of method 100, target 32 ​​is typically centered (on the target z-axis). However, various considerations may motivate a trained professional to start with a non-zero starting target shift angle TSA_0. For example, as discussed in relation to Figures 8A-B, the starting target shift angle TSA_0 can be the same as, or close to, the second target shift angle TSA 64_2.

[0037] The lower panel of Figure 7 shows that the response of each eye can be characterized by at least three properties: left eye target reaction time TRT_L, left eye target capture rate TAR_L, and left eye target capture time TAT_L, and that the same three properties can be characterized by the right eye: TRT_R, TAR_R, and TAT_R. In Figure 7, all three of these properties are different for the left eye 1_L and the right eye 1_R.

[0038] At the start, the optical axis angle 62_L / R is the angle corresponding to when both eyes have acquired the start target 32. Using the notation mentioned earlier, this is the target acquisition optical axis angle, or TA-62_L / R. In the case of a simple centrally located start target 32, these two angles are symmetrical around zero, and TA-62_L = -(TA-62_R). This example is shown in Figure 7. Of course, the start target can also be shown in a non-centered position. Also, the patient may have static binocular misalignment. In each of these cases, the two start angles TA-62_L and TA-62_R can be asymmetrical. Furthermore, considerably after the first target shift time TST_1, both eyes again acquire the first shifted target 32_1. Thus, the end angle can again be expressed as TA-62_L / R_1, as shown, but this time it refers to when eye 1_L / R acquired the first shifted target 32_1.

[0039] Based on these considerations, in some embodiments, the first dynamic alignment difference measurement 130 may include measuring the first dynamic alignment difference as a first target reaction time difference ΔTRT_1 related to the difference between the right eye target reaction time TRT_R and the left eye target reaction time TRT_L. In the formula, ΔTRT_1 = TRT_R - TRT_L (1) That is the case.

[0040] This first target reaction time difference is an indicator of the dynamic discrepancy between the right eye 1_R and the left eye 1_L in shifting target 32 ​​in the first direction.

[0041] Figure 3B shows the corresponding substeps of measurement step 130 as follows: Before or around the first target shift time TST_1, the left eye optical axis angle 62_L and the right eye optical axis angle 62_R are determined (132). The left eye target reaction time TRT_L is measured as the time representing the left eye optical axis angle 62_L in response to the shift of the first shifted target 32_1 (134). The right eye target reaction time TRT_R is measured as the time representing the right eye optical axis angle 62_R in response to the shift of the first shifted target 32_1 (136). The first target reaction time difference ΔTRT_1 is determined as the difference between the target reaction time of the right eye and the target reaction time of the left eye (138) (ΔTRT_1 = TRT_R - TRT_L). This indicates.

[0042] Figure 7 also shows a second shift step 140. Once the first target reaction time difference ΔTRT_1 is determined, the first shifted target 32_1 can be second time-shifted relative to the second shifted target 32_2 by a second target shift angle TSA64_2 with a second target shift time TST_2 in order to determine the dynamic misalignment of the two eyes in the second direction. In a typical embodiment, the first direction can be a positive x-direction or a positive angular rotation, and the second direction can be a negative x-direction or a negative angular rotation. In some embodiments, the first shift 120 and the second shift 140 may be symmetrical. For example, the first target shift angle TSA64_1 may be +α, while the second target shift angle TSA64_2 may be -α, with both rotations aligned with the x, or horizontal axis, and α may be in the range of α = 5 to 50 degrees, and in some embodiments, α may be in the range of α = 10 to 30 degrees. Many other embodiments are possible, such as asymmetric shifts, shifts in which at least one of the shifts has a y component, and shifts in which the directions of the first and second shifts are not aligned with each other.

[0043] Next, measurement step 150 may include repeating steps 132-138 related to the second shift 140 of target 32 ​​in the second direction in order to determine the second target reaction time difference ΔTRT_2 = TRT_R - TRT_L. The timing diagram for the second shift 140 is essentially similar to the timing diagram for the first shift 120 in Figure 7, with the index naturally changing from "1" to "2" as appropriate. For this reason, showing the timing diagram for this second shift here is iterative and cumulative.

[0044] The determination step 160 includes determining the average dynamic alignment difference ΔTRT, which is related to the average of the first target reaction time difference ΔTRT_1 (determined in step 130) and the second target reaction time difference ΔTRT_2 (determined in step 150). In some embodiments, this average dynamic alignment difference ΔTRT can be a simple average or sum of the first target reaction time difference ΔTRT_1 and the second target reaction time difference ΔTRT_2: ΔTRT=(ΔTRT_1+ΔTRT_2) / 2 (2) That is

[0045] It should be noted that equation (2) is sensitive to the signs of ΔTRT_1 and ΔTRT_2. ΔTRT = 0 when the first target reaction time difference ΔTRT_1 is positive (i.e., the right eye reacts later, TRT_R > TRT_L) and the second target reaction time difference ΔTRT_2 is of equal magnitude but opposite sign (i.e., negative, the left eye reacts later). Dynamic misalignment with a mean dynamic alignment difference ΔTRT of zero is difficult to correct with static prism prescriptions. However, if ΔTRT is not zero, there is an overall bias between the dynamic characteristics of the two eyes. Such an overall bias can result, for example, from weakness in at least one of the linked muscles involved in the coordination of both eyes 1_L / R. Such weakness may be called oculoparalysis and can be affected by various diseases such as myasthenia gravis. For example, if the right eye tracks a target shifted to the right more quickly than the left eye, while both eyes track a target shifted to the left at approximately the same speed, prescribing glasses with prisms that at least partially correct the difference for right-shifted targets would reduce the dynamic misalignment between the two eyes. Determining and prescribing glasses with such prisms is one embodiment of determination step 170.

[0046] Figures 8A-B demonstrate that such asymmetry in the dynamic alignment of the eyeball is extremely common. The upper panel of Figure 8A shows a timing diagram of the optical axis angle 62_L / R in response to target 32 ​​being shifted from TSA64_0 = -15 degrees to TSA64_1 = +15 degrees. This timing diagram was obtained by determining the patient's mean target reaction times ΔTRT_1 and ΔTRT_2 by repeating the target shift back and forth between -15 degrees and +15 degrees five times to determine a statistically reliable target reaction time difference ΔTRT = (ΔTRT_1 + ΔTRT_2) / 2. Clearly, on average, the left eye 1_L responded to the target shift 1.2 ms later than the right eye 1_R. Using the above coding convention of subtracting the left eye target reaction time TRT_L from the right eye target reaction time TRT_R, this means a first target reaction time difference ΔTRT_1 = -1.2 ms. The lower panel shows the same angle 62_L / R when the target is moved in the opposite direction from TSA64_1 = +15 degrees to TSA64_2 = -15 degrees. Here, the left eye reacts faster and asymmetrically larger: the second target reaction time difference ΔTRT_2 = +4.5 ms. Therefore, the average target reaction time difference is given by the following equation: ΔTRT=(ΔTRT_1+ΔTRT_2) / 2=(4.5ms-1.2ms) / 2=+1.6ms It is given by.

[0047] Due to the asymmetry between the response to a right-shifted target and the response to a left-shifted target, eyeglasses that correct this mean dynamic alignment difference (at least partially) with prism prescriptions can improve a patient's overall dynamic binocular visual acuity.

[0048] There can be various considerations when setting the specific details of a prescribed prism. If there is a dynamic alignment difference between the left and right eyes, for example, if the left eye responds to a shifted target slower than the right eye, this dynamic alignment difference can be at least partially compensated by prescribing a prism to alter the direction of the ocular optical axis 60_L / R in one or both eyes, thereby altering the dynamic movement and timing between the coupled muscles. The prescribed prism encourages the slower left eye to track the shifted target in a different way. Embodiments of the prescribed prism can include training glasses, vision therapy, eyeglasses, light stimulation, or virtual reality goggles that influence the oculiar rotator cuff muscles to rotate simultaneously. Over time, treatments and therapies using prescribed prisms in the above embodiments have been able to improve ocular dynamic alignment. When none of these treatments or therapies were effective, prescribing prism glasses has been proven to provide symptom relief.

[0049] In some embodiments, measurement 130 is given by the following formula: ΔTAR_1 = TAR_R - TAR_L (3) This may include measuring a first dynamic alignment difference as a first target acquisition rate difference ΔTAR_1, which is related to the difference between the right eye target acquisition rate TAR_R and the left eye target acquisition rate TAR_L.

[0050] As already mentioned, after measurement 130 is performed on target 32 ​​shifted in the first direction, in shift step 140, in order to determine the dynamic misalignment of both eyes in the second direction, the first shift target 32_1 can be shifted to the second shifted target 32_2 by a second time and a second target shift angle TSA64_2 during the second target shift time TST_2. After this, measurement step 150 may follow, and measurement step 130 is repeated, but the second shift of target 32_2 is performed. The result of measurement step 150 is, ΔTAR_2 = TAR_R - TAR_L This is the second target acquisition rate difference ΔTAR_2, which is related to the difference between the right eye target acquisition rate TAR_R and the left eye target acquisition rate TAR_L. Finally, in the determination step 160, the average of the first and second target acquisition rate differences can be taken to determine the average target acquisition rate difference ΔTAR: ΔTAR=(ΔTAR_1+ΔTAR_2) / 2 (4) That is the case.

[0051] In decision step 170, ΔTAR is used as the mean dynamic alignment difference, similar to ΔTRT in the previous explanation, and prism lenses can be prescribed to reduce this ΔTAR target reaction time difference.

[0052] Figure 5C shows the patient's eye-tracking chart, where the left and right eyeball target acquisition rates TAR_L / R, measured by the slope of the left and right eye-tracking curves, are visibly different for the left and right eyeballs TAR_L / R. A similar case can be seen in the eye-tracking timing diagram in Figures 8A-B. The duration of the intermediate target tracking interval TTI_L / R between the target reaction time TRT_L / R and the target acquisition time TAT_L / R is: TTI_L / R = |TAT_L / R - TRT_L / R| It is given by . The target acquisition rate TAR is given by the reciprocal of this TTI_L / R, TAR_L / R = Target Shift Angle * (TTI_L / R) -1 That is the case. The longer the target tracking interval TTI_L / R, the smaller the target acquisition rate TAR_L / R. As visible in Figure 8A, when the target shift angle changes from -15.5 degrees to +15.5 degrees, i.e., TSA64_1 = 31 degrees, TAR_R = 31 degrees * (30.3 ms) -1 =31 degrees*0.033ms -1 , TAR_L=31 degrees*(20.6ms) -1 =31 degrees * 0.048 ms -1Therefore, ΔTAR_1 = TAR_R - TAR_L = -31deg * 0.015ms -1 = -0.46deg / ms. In the case of the left shift target, ΔTAR_2 = TAR_R - TAR_L = 31deg * (18.2ms) -1 -31deg * (21.2ms) -1 = 31deg * 0.055ms -1 -31deg * 0.047ms -1 = 31deg * 0.008ms -1 = 0.25deg / ms

[0053] The average target capture rate difference determined in step 160 is ΔTAR = (ΔTAR_1 + ΔTAR_2) / 2 = (-0.46deg / ms + 0.25deg / ms) / 2 = -0.10deg / ms

[0054] Finally, in some embodiments, measuring the first dynamic alignment difference (130) can include measuring the first dynamic alignment difference as a first target capture time difference related to the difference between the left eye target capture time TAT_L and the right eye target capture time TAT_R

[0055] More specifically, in this embodiment, the measurement 130 is similar to sub - steps 132 - 138 in FIG. 3B and includes the following sub - steps[[ID=二十五]] [ [[ID=二十六]]Determining (132') the left eye optical axis angle 62_L and the right eye optical axis angle 62_R before or around the first target shift time TST_1 Measuring (134') the left eye target capture time TAT_L as the time when the left eye optical axis angle 62_L captures the first shifted target 32_1 Measuring (136') the right eye target capture time TAT_R as the time when the right eye optical axis angle 62_R captures the first shifted target 32_1 Determining (138') the first target capture time difference ΔTAT_1 as the difference between the right eye target capture time TAT_R and the left eye target capture time TAT_L, that is ΔTAT_1=TAT_R-TAT_L (5) Being It can include...

[0056] Following these substeps, a second shift (140) of the first shifted target 32_1 is performed by a second target shift angle TSA_2 at a second target shift time TST_2, and the substeps 132' to 138' of measurement step 130 can be repeated as a substep of measurement step 150 for this second shifted target 32_2.

[0057] Finally, in decision step 160, the average of the first and second target acquisition time differences can be taken to determine the average target acquisition time difference ΔTAT: ΔTAT=(ΔTAT_1+ΔTAT_2) / 2 (6) That is the case.

[0058] In decision step 170, ΔTAT can be used as the mean dynamic alignment difference, similar to ΔTRT and ΔTAR described above.

[0059] In the embodiments described above, the average target reaction time difference ΔTRT, the average target capture rate difference ΔTAR, and the average target capture time difference ΔTAT are three embodiments of the average dynamic alignment difference determined in the determination step 160. Each of these embodiments can be used in the determination step 170 to determine a prescription prism for reducing the average dynamic alignment difference. Additional embodiments of the average dynamic alignment difference will now be described.

[0060] Figures 9A and 9B show, (1) Before or around the first target shift time TST_1, determine the left eye optical axis angle 62_L and the right eye optical axis angle 62_R. (2) Measure the left eye target overshoot TOS_L, which is related to the maximum angle at which the left eye optical axis angle 62_L overshoots the first shifted target 32_1. (3) Measure the right eye target overshoot TOS_R, which is related to the maximum angle at which the right eye optical axis angle 62_R overshoots the first shifted target 32_1. (4) Determine the first target overshoot difference ΔTOS_1 as the difference between the right eye target overshoot and the left eye target overshoot, that is, ΔTOS_1 = TOS_R - TOS_L (7) and, An additional embodiment of the first dynamic alignment difference measurement (130), including the above, is shown.

[0061] In this embodiment, the dynamic alignment difference relates not to a difference in characteristic time, but to another characteristic of dynamic target tracking by the eye, namely, the frequent overshoot of the ocular optical axis 60_L / R as it moves to capture the first shifted target 32_1, as shown in Figure 9A. The overshoot is then corrected in a so-called secondary saccade, and finally, the left and right ocular optical axis angles 62_L / R are aligned so that they point to the first shifted target 32_1 at the first target shift angle TSA 64_1. If the overshoot differs between the two eyes, i.e.,

number

[0062] Figure 9B shows yet another embodiment of dynamic drift. Here, instead of overshoot, eyeball 1_L / R “undershoots,” that is, partially tracks the first shifted target 32_1, then stops, then continues tracking, often repeating several times until the first shifted target 32_1 is properly captured. This process can be called target capture jitter, or TAJ. Alternatively, this jitter can also be called target capture drift, or target tracking. As previously stated, if one eye exhibits a different amount of “target capture jitter” than the other eye, this “target capture jitter difference” is another form of dynamic drift, and reducing it improves dynamic visual acuity. Many different embodiments of measuring target capture jitter TAJ (130) can exist, and include calculating the derivative or gradient of the eye tracking the first shifted target 32 ​​from TRT_L / R to TAT_L / R, and characterizing how much the derivative deviates from its mean value during target capture. In other embodiments, the first measurement of the dynamic alignment derivative (130) may include measuring the functional characteristics of the left and right eyes tracking the target, the functional characteristics consisting of at least one of jitter, lag, curvature, S-curvature, and higher-order derivatives.

[0063] As described above, the first target acquisition jitter difference ΔTAJ_1 can be determined as the difference between the right eye target acquisition jitter TAJ_R and the left eye target acquisition jitter TAJ_L, i.e., ΔTAJ_1=TAJ_R-TAJ_L (9) That is the case.

[0064] Finally, as described above, in the decision step (160), the average of the first and second target capture jitter differences can be taken to determine the average target capture jitter difference ΔTAJ, i.e., ΔTAJ=(ΔTAJ_1+ΔTAJ_2) / 2 (10) That is the case.

[0065] In all of the above embodiments of Method 100, determining the average dynamic alignment difference from the first dynamic alignment difference and the second alignment difference (160) may also include assigning a different weight to the first dynamic alignment difference than to the second alignment difference. For example, the above formula calculated in the embodiment of the average dynamic alignment difference can be modified as follows: ΔTRT=α ΔTRT_1+ (1-α) ΔTRT_2 (2') ΔTAR=α ΔTAR_1+(1-α) ΔTAR_2 (4') ΔTAT=α ΔTAT_1+(1-α) ΔTAT_2 (6') ΔTOS=α ΔTOS_1+(1-α) ΔTOS_2 (8') ΔTAJ=α ΔTAJ_1+(1-α) ΔTAJ_2 (10') Herein, α can be in the range [0,1]. These embodiments arise from a consideration of lens design that some patients may have a lifestyle or occupation that causes them to use their eyes to track targets that shift in one or more directions. The most obvious example is a patient for whom reading is important, as reading requires capturing / tracking targets that shift systematically from left to right, as the target shift takes the form of repeatedly targeting the next word to the right of the previously targeted word. For such patients, determining the mean dynamic alignment difference in equations (2'), (4'), (6'), (8'), (10') (160) may involve selecting an α value different from α = 0.5, which focuses on reducing the alignment difference associated with shifting the target from left to right.

[0066] Some of the described embodiments of Method 100 involved a symmetrical shift of the target 32. For example, in Figure 8A, the target 32 ​​was shifted approximately 15 degrees to the left and 15 degrees to the right, and in Figure 8B, approximately 11 degrees to the left and 11 degrees to the right. However, a wide variety of other arrangements can also be implemented within Method 100. For example, initially the target 32 ​​may be positioned at the center, the first shift 120 may be a shift from the center to the periphery, and the second shift 140 may be a shift from the periphery to the center. More broadly, in some embodiments, one of the first and second shifted targets may be positioned more centrally than the other target.

[0067] In yet another embodiment, one of the first and second shifted targets differs from the starting target in characteristics other than the target shift angle, including size, color, light intensity, or shape. For example, when the target undergoes a first shift in the first shift step 120, its color may also change. Alternatively, its shape or size may also change. In a notable embodiment, as described above, the shift of the target 32 ​​may be accompanied by a change in target brightness, since, on the one hand, pupil size responds to the intensity of illumination, and on the other hand, pupil size affects the depth of focus, which can affect the dynamic alignment difference.

[0068] Because pupil size is important, some embodiments of Method 100 may include selecting the light intensity of target 32 ​​so as to affect pupil size and thereby affect the depth of focus of the left and right eyes 1_L / R; optionally measuring pupil size using a pupil size tracker or possibly a separate module which may be part of the eye tracker 40_L / R; recording the measured pupil size along with the mean dynamic alignment difference; and optionally repeating the above steps with different light intensities.

[0069] Different light intensities induce different pupil sizes, and different pupil sizes can lead to different mean dynamic alignment differences. The light intensity-pupil size-dependent dynamic alignment difference can be used in different ways by medical and ophthalmic professionals. In some cases, prism glasses can be prescribed based on the dynamic alignment difference determined under the lighting conditions most relevant to the patient. For example, for a truck driver or night security guard who drives frequently at night, Method 100 can be performed at an appropriately low light intensity most relevant to their work, and the prescribed prisms can be determined accordingly. Conversely, a person who works under bright light conditions can be diagnosed at an appropriately high light intensity using Method 100. Furthermore, for some patients who work under various lighting conditions, Method 100 can be performed at a low light intensity and then repeated at a high light intensity. These two measurements yield two different dynamic alignment differences. From these two values, the optometrist may choose to form an mean dynamic alignment difference using potentially non-uniform weighting factors and prescribe prism glasses based on this mean dynamic alignment difference. In some cases, an optometrist or ophthalmologist may choose to prescribe a patient's visual acuity therapy based on the determined mean dynamic alignment difference, rather than using prism glasses.

[0070] Figure 10A shows that in some embodiments, the shift 120 of the target 32 ​​in a first direction by a first target shift angle TSA64_1 is performed by presenting the target at a first target shift angle TSA64_1 with potentially gradually increasing light intensity during a first target shift time TST_1, while simultaneously gradually decreasing the light intensity of the starting target at the starting target angle STA. In other words, in these embodiments, when the first shifted target is presented on the display 30_L / R at the first target shift angle TSA64_1, the starting target is not terminated in an abrupt, step-like manner, but rather is gradually dimmed over the target overlap time, as shown.

[0071] Figure 10B shows that in some embodiments, the first shift 120 of the target 32 ​​in a first direction by a first target shift angle 64_1 can be performed in the stepwise manner described above, while in other embodiments, the first shift 120 can be performed in a non-stepwise progressive manner, including a scanning manner. For example, the target 32 ​​can be shifted continuously from an initial target angle or position to a final first shift angle or position, as shown in Figure 10B.

[0072] Returning to Figure 1B, the human visual system is highly structured and can be divided into four main quadrants: the superior temporal, inferior temporal, superior nasal, and inferior nasal regions. There are cooperative visual fields between the eyes. For example, the superior temporal lobe of the right eye corresponds to the superior nasal lobe of the left eye. Dynamic movement between the eyes may differ in the associated visual field quadrants. This can affect interocular function because different optic nerves pass through these quadrants. This difference may also be related to usage patterns. For example, patients typically use the lower quadrant for near-distance activities such as navigation while walking or running, and reading. Therefore, in some patients, the dynamic alignment difference may differ because peripheral targets appear in the visual field quadrant (usually the upper) for distant targets, and peripheral targets appear in the lower part of the visual field for near-distance activities. To address or mitigate different dynamic alignment differences at different quadrants and distances, several prism lenses can be designed, including prescription prism determination 170, which involves prescribing different prisms on the upper and lower parts of the lens. Such embodiments of Method 100 may include performing the Method on a target shifted in the upper hemisphere of the patient's visual field / visual cortex to identify the upper mean dynamic alignment difference—typically related to distance vision; performing the Method on a target shifted in the lower hemisphere of the patient's visual field / visual cortex to identify the lower mean dynamic alignment difference—typically related to near vision; and determining the upper and lower prescription prisms. Subsequently, spectacle lenses having contour or progressive prisms that vary from the upper prescription prism to the lower prescription prism can be prescribed. In other embodiments, the prisms may also be prescribed and shaped to compensate for dynamic alignment differences observed between any of the four quadrants.

[0073] In a typical example, in some patients, Method 100 can be performed first by presenting a target at a distant apparent distance, which ends with determining the “distance-dynamic alignment difference.” Method 100 can then be repeated by presenting a target at an apparent near distance, leading to the determination of the “near-range dynamic alignment difference.” In a significant proportion of patients, the distance-alignment difference and the near-range dynamic alignment difference are different. For such patients, prescribing contour-type or progressive prism lenses, where the prism value changes from the far-vision range to the near-vision range, may be most useful.

[0074] Figure 11 shows a method 200 for determining binocular dynamic alignment, which is: Using a display, the patient is instructed to fixate on the starting target with both their left and right eyes (210). Using a display, the characteristics of the target are dynamically changed (220). Using an eye tracker, measure the left eye dynamic characteristics of the left eye tracking a changing target and the right eye dynamic characteristics of the right eye tracking a changing target (230). Using a computer, determine the average dynamic alignment difference between the left eye dynamic characteristics and the right eye dynamic characteristics while tracking a changing target (240). Includes.

[0075] Subsequently, a prescription prism for reducing the mean dynamic alignment difference can be determined (250). Embodiments of Method 200 are closely related to Method 100 and can therefore be implemented in conjunction with all the details, limitations, and features previously described for Method 100.

[0076] Figures 12A and 12B show that in some embodiments of Method 200, the dynamically changing characteristics of the target can be a target position scanned along a one-dimensional or two-dimensional path. Figure 12A shows an embodiment of Method 200, where the target 32 ​​is moved or shifted in a one-dimensional pattern, but instead of a shift such as a step from a first target shift angle TSA64_1 to a second target shift angle TSA64_2, the target moves smoothly between endpoints oscillatingly.

[0077] Figure 12B shows another embodiment of Method 200 in which the target moves along a two-dimensional pattern, such as circular motion as shown in the inset, rather than along a one-dimensional pattern. This circular motion can be characterized by two vibrating target shift angles TSA_x and TSA_y that are phase-shifted relative to each other by 90 degrees, as shown.

[0078] Figure 13 shows a related method 300 for determining binocular dynamic alignment, which is: Using a display, the patient is instructed to fixate on the starting target with both their left and right eyes (310). Using a display, the target is shifted in one direction by the target shift angle during the target shift time (320). Using an eye tracker and optionally a computer, measure the dynamic alignment difference between the left and right eyes that capture a shifted target (330). Includes.

[0079] This can then be followed by determining a prescription prism to reduce the dynamic alignment difference (340).

[0080] Embodiments of Method 300 can be employed to design prism lenses for a patient when there is reason to believe that dynamic alignment differences can be better captured by measuring the responses of the left and right eyes to a single shift of target 32, instead of the two shifts of Method 100. Embodiments of Method 300 can be carried out in conjunction with all the details, limitations, and features described for Methods 100 and 200.

[0081] For perfection, return to Figure 2 for a description of the system 10 for determining binocular dynamic alignment, which may include: a display 30_L / R for causing the patient to fixate on the starting target 32 ​​with the left eye 1_L and the right eye 1_R, and to shift the target 32 ​​in a first direction by a first target shift angle TSA 64_1 at a first target shift time TST_1; and an eye tracker 40_L / R for measuring the first dynamic alignment difference between the left eye 1_L and the right eye 1_R to capture the first shifted target 32_1; and the display 30_L / R for the second target shift angle TSA at a second target shift time TST_2. 64_2 is configured to shift the first shifted target 32_1 in a second direction, the eye trackers 40_L / R are configured to measure a second dynamic alignment difference between the left eye 1_L and the right eye 1_R that capture the second shifted target 32_2, and optionally the computer 50 determines the average dynamic alignment difference from the first and second dynamic alignment differences.

[0082] Figures 14-15 show yet another method 400 for determining eye dynamic alignment, which is: Using a display, the first target of the eye is presented at a first angle at a first time (410). Using an eye tracker, measure the first dynamic response of the eye to acquire a first target (420). Using a display, a second target for the eye is presented at a second angle and at a second time (430). Using an eye tracker, measure the second dynamic response of the eye to capture a second target (440), and The dynamic response difference is determined by arbitrarily using a computer to obtain the difference between the first dynamic response and the second dynamic response (450). Includes.

[0083] An embodiment of Method 400 differs from embodiments of Methods 100 and 300 in that Method 400 is a monocular method, in which the first and second targets are presented to one eye. The difference in the dynamic response of that eye is then determined, and visual acuity therapy or prism glasses can be prescribed to mitigate this difference. In particular, in simple embodiments, if the eyes respond asymmetrically, with one direction capturing the new target slightly more easily than the other, this asymmetry can be mitigated by prism prescription. In fact, these embodiments of the previously described methods can be summarized in the following brief table. [Table 1]

[0084] Each of these methods 100, 300, and 400 can diagnose various asymmetries, misalignments, and differences in monocular or binocular vision, which in many patients can be mitigated by quantitative measurement followed by the prescription of prism glasses.

[0085] Continuing the description of Method 400, Figure 14 shows a timing diagram in an embodiment of Method 400. This diagram is similar to Figure 7. Figure 14 is simpler in that it shows only the optical axis angle of one eye, but is more expansive in that it shows both the first target presentation time T1 and the second target presentation time T2.

[0086] In some embodiments, the first dynamic response measurement 420 includes the measurement of a first target reaction time TRT1, and the second dynamic response measurement 440 includes the measurement of a second target reaction time TRT2.

[0087] In some embodiments, the first dynamic response measurement 420 includes the measurement of a first target capture rate TAR1, and the second dynamic response measurement 440 includes the measurement of a second target capture rate TAR2.

[0088] In yet another embodiment, the first dynamic response measurement 420 includes the measurement of a first target acquisition time TAT1, and the second dynamic response measurement 440 includes the measurement of a second target acquisition time TAT2.

[0089] In a method reminiscent of method 100, determining the dynamic response difference from the difference between the first dynamic response and the second dynamic response (450) is as follows: ΔTRT = TRT1 - TRT2 (11) ΔTAR=TAR1-TAR2 (12) ΔTAT = TAT1 - TAT2 (13) This may include determining at least one of the following.

[0090] Using any of these differences, the dynamic response difference of the eye to target movement or capture in different directions can be shown, and then the appropriate visual treatment or prescribed prism glass can be calculated or determined.

[0091] While this book contains many specific details, these should not be interpreted as limiting the scope of the invention or the claims, but rather as describing features specific to particular embodiments of the invention. Specific features described in this book in the context of separate embodiments may also be implemented in combination in a single embodiment. Conversely, various features described in the context of a single embodiment may also be implemented separately or in any suitable subcombination in multiple embodiments. Furthermore, features are described above as acting in specific combinations, and may even be initially described in the claims as such; however, in some cases, one or more features may be excluded from a combination described in the claims, and the combination described in the claims may be directed towards a partial combination or a variation of a partial combination.

Claims

1. A method for determining binocular dynamic alignment, Using a display, the patient is instructed to fixate on the starting target with both their left and right eyes, Using the display, the target is shifted in a first direction by a first target shift angle within a first target shift time. Using an eye tracker, measure the first dynamic alignment difference between the left eye and the right eye that capture the first shifted target, Using the aforementioned display, during the second target shift time, the first shifted target is shifted in the second direction by the second target shift angle, Using the eye tracker, measure the second dynamic alignment difference between the left eye and the right eye that capture the second shifted target, The average dynamic alignment difference is determined from the first dynamic alignment difference and the second alignment difference using a computer at the discretion of the user. Methods that include...

2. Measuring the first dynamic alignment difference is, The method according to claim 1, comprising measuring the first dynamic alignment difference as a first target reaction time difference related to the difference between the left eye target reaction time and the right eye target reaction time.

3. (1) The left eye optical axis angle and the right eye optical axis angle are determined before or around the first target shift time, (2) The left eye target reaction time is measured as the time representing the left eye optical axis angle in response to the shift of the first shifted target, (3) The right eye target reaction time is measured as the time representing the right eye optical axis angle in response to the shift of the first shifted target, (4) The first target reaction time difference is determined as the difference between the right eye target reaction time and the left eye target reaction time, The method according to claim 2, including the method described in claim 2.

4. To determine the second target reaction time difference, steps (1) to (4) are repeated as part of measuring the second dynamic alignment difference related to the second shift of the target due to the second target shift angle in the second direction, The mean dynamic alignment difference related to the mean of the first target reaction time difference and the second target reaction time difference is determined, The method according to claim 3, further comprising:

5. Measuring the first dynamic alignment difference is, The method according to claim 1, comprising measuring a first target acquisition rate difference relating to the difference between the left eye target acquisition rate and the right eye target acquisition rate.

6. Measuring the first dynamic alignment difference is, The method according to claim 1, comprising measuring the first dynamic alignment difference as a first target acquisition time difference related to the difference between the left eye target acquisition time and the right eye target acquisition time.

7. The above measurement is performed by, The left eye optical axis angle and the right eye optical axis angle are determined before or around the first target shift time, The left eye target acquisition time is measured as the time representing the left eye optical axis angle at which the first shifted target is acquired, The right eye target acquisition time is measured as the time representing the right eye optical axis angle when the first shifted target is acquired, The first target acquisition time difference is determined as the difference between the right eye target acquisition time and the left eye target acquisition time. The method according to claim 6, including the method described in claim 6.

8. Measuring the first dynamic alignment difference is, Before or around the first target shift time, the left eye optical axis angle and the right eye optical axis angle are determined. The left eye target overshoot is measured in relation to the maximum angle at which the left eye optical axis angle overshoots the first shifted target. The measurement of the right eye target overshoot, which is related to the maximum angle at which the right eye optical axis angle overshoots the first shifted target, The first target overshoot difference is determined as the difference between the right eye target overshoot and the left eye target overshoot. The method according to claim 1, including the method described in claim 1.

9. Measuring the first dynamic alignment difference is, This includes measuring the functional characteristics of the left and right eyes that track the target, The method according to claim 1, wherein the functional characteristics consist of at least one of jitter, lag, curvature, S-curvature, and higher-order derivatives.

10. The method according to claim 1, wherein determining the average dynamic alignment difference from the first dynamic alignment difference and the second alignment difference includes assigning a different weight to the first dynamic alignment difference than to the second alignment difference.

11. The method according to claim 1, wherein the eye tracker is at least one of an infrared imaging eye tracker, a visible video imaging eye tracker, and a Purkinje reflection-based eye tracker.

12. The method according to claim 1, wherein one of the first shifted target and the second shifted target is more central than the other target.

13. The method according to claim 1, wherein one of the first shifted target and the second shifted target differs from the start target in one characteristic, including light intensity, size, color, and shape, other than the target shift angle.

14. Select the light intensity of the target so as to affect the pupil size and, consequently, the depth of focus of the left and right eyes. The pupil size is measured using a pupil size tracker in an optional manner, The measured pupil size is recorded along with the average dynamic alignment difference. The above steps are to be arbitrarily repeated with different light intensities, The method according to claim 1, including the method described in claim 1.

15. The method according to claim 1, wherein the shift of the target in the first direction by the first target shift angle is performed in one of step, non-step, gradual, and scan modes.

16. The method according to claim 1, wherein the shift of the target in the first direction by the first target shift angle is performed by presenting the target at the first target shift angle during the first target shift time, and simultaneously gradually reducing the light intensity of the starting target.

17. To identify the upper mean dynamic alignment difference, the method is performed on the target located in the upper hemisphere of the patient's field of vision, To identify the lower mean dynamic alignment difference, the method is performed on the target located in the lower hemisphere of the patient's field of vision, To determine the upper and lower prescription prisms, The method according to claim 1, including the method described in claim 1.

18. The method according to claim 1, comprising determining a prescription prism for reducing the mean dynamic alignment difference.

19. The method according to claim 18, wherein the prescription prism is one of a global prism, a progressive prism, and a contour prism.

20. The method according to claim 1, wherein the display has two displays with adjustable or fixed viewing distances.

21. The method according to claim 1, wherein the display is a single display using at least one of active shutter technology, polarization technology, image splitting glass technology, and headset technology.

22. A method for determining binocular dynamic alignment, Using a display, the patient is instructed to fixate on the starting target with both their left and right eyes, The characteristics of the target are to be dynamically changed using the aforementioned display, Using an eye tracker, the left eye dynamic characteristics of the left eye tracking the changing target and the right eye dynamic characteristics of the right eye tracking the changing target are measured, The process involves optionally using a computer to determine the average dynamic alignment difference between the left eye dynamic characteristics and the right eye dynamic characteristics while tracking the changing target, Methods that include...

23. The method according to claim 22, wherein the dynamically changing characteristics of the target are the target position scanned along a one-dimensional or two-dimensional path.

24. A method for determining the dynamic alignment of the eyeball, Using a display, a first target is presented to the eyeball at a first angle and at a first time, Using an eye tracker, measure the first dynamic response of the eyeball that captures the first target, Using the aforementioned display, the second target is presented at a second angle and at a second time. Using the eye tracker, the second dynamic response of the eyeball that captures the second target is measured, The dynamic response difference is determined by optionally using a computer to obtain the difference between the first dynamic response and the second dynamic response, Methods that include...

25. The method according to claim 24, wherein measuring the first dynamic response includes measuring a first target reaction time, and measuring the second dynamic response includes measuring a second target reaction time.

26. The method according to claim 24, wherein measuring the first dynamic response includes measuring a first target capture rate, and measuring the second dynamic response includes measuring a second target capture rate.

27. The method according to claim 24, wherein measuring the first dynamic response includes measuring the first target acquisition time, and measuring the second dynamic response includes measuring the second target acquisition time.

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