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EP-4736740-A2 - APPARATUS, SYSTEMS, AND METHODS FOR OBJECTIVELY ASSESSING ACCOMMODATION IN AN EYE

EP4736740A2EP 4736740 A2EP4736740 A2EP 4736740A2EP-4736740-A2

Abstract

Disclosed are apparatus, systems, and methods for objectively assessing accommodation in an eye. For example, a method for objectively assessing accommodation can comprise displaying, at a far display, a stimulus target for a first duration and displaying, at a near display, the stimulus target for a second duration. The stimulus target displayed at the near display can be projected onto a first beam splitter positioned at an oblique angle with respect to the near display. The stimulus target displayed on the far display can be axially aligned with the stimulus target projected onto the first beam splitter. The method can also comprise obtaining, at a controller, measurements concerning refractive states of the eye during the first duration and the second duration from a refractor device in communication with the controller and determining, using the controller, an accommodative response of the eye based in part on the respective refractive states.

Inventors

  • SREENIVASAN, Vidhyapriya
  • McGough, Madison
  • SMILEY, TERAH WHITING
  • ANGELOPOULOS, Robert Demitri
  • SOLTAN ZADI, Armin
  • HERNANDEZ, Victor Manuel

Assignees

  • Alcon Inc.

Dates

Publication Date
20260506
Application Date
20220321

Claims (15)

  1. A system (100) for objectively assessing accommodation in an eye of a subject, the system comprising: a near display (116); a far display (108) located further from the eye than the near display (116); and a controller (128) in communication with the near display (116) and the far display (108), the controller comprising one or more processors and a tangible non-transitory machine-readable medium comprising instructions stored thereon, wherein execution of the instructions by the one or more processors causes the controller (128) to: direct appearance of a stimulus target (200) on the far display (108) in a plurality of first rotational orientations for a first duration, direct the appearance of the stimulus target (200) on the near display (116) in a plurality of second rotational orientations for a second duration, receive user inputs from an input device (154) corresponding to the first rotational orientations and the second rotational orientations, obtain measurements concerning refractive states of the eye during the first duration and the second duration from a refractor device (138) in communication with the controller (128), and determine an accommodative response of the eye based in part on the refractive states and the user inputs.
  2. The system of claim 1, further comprising a first beam splitter (118) positioned at an oblique angle with respect to the near display (116), wherein the near display (116) is configured to project the stimulus target (200) onto the first beam splitter (118), wherein the stimulus target (200) displayed on the far display (108) is axially aligned with the stimulus target (200) projected onto the first beam splitter (118).
  3. The system of claim 2, further comprising: a support assembly (124); and a motorized stage (122) coupled to a top of the support assembly, wherein the motorized stage (122) is configured to translate the near display (116) and the first beam splitter (118) in a linear direction, wherein the first beam splitter (118) is configured to be translated to a plurality stimulus positions, and wherein the near display (116) is oriented in a downward direction.
  4. The system of claim 3, wherein the stimulus positions are located at approximately 0.80 meters, 0.37 meters, 0.33 meters, and 0.25 meters from the eye of the subject.
  5. The system of claim 2, further comprising: an angled mirror (146); and a hot mirror (148) positioned above the angled mirror (146) and in between the near display (116) and the subject, wherein the refractor device (138) comprises: a refractor light source (142) configured to generate an illumination beam, wherein the angled mirror (146) and the hot mirror (148) are configured to steer the illumination beam to the eye of the subject; a refractor camera (144) configured to capture or detect light reflected by the eye in response to the illumination beam, wherein the light reflected by the eye is steered back toward the refractor device (138) via the hot mirror (148) and the angled mirror (146); and one or more refractor processors configured to determine a refractive state of the eye based on the light reflected by the eye.
  6. The system of claim 5, further comprising: a second beam splitter (150) positioned in a line-of-sight of the eye at a distal end of a support assembly (124) in between the near display (116) and the far display (108); an alignment camera (202) in communication with the controller (128) and configured to capture real-time images of the eye, wherein the alignment camera (202) is positioned offset from the line-of-sight of the eye, and wherein the second beam splitter (150) is configured to reflect images of the eye of the subject toward the alignment camera (202); and a controller display (136) in communication with the controller and configured to display a graphical user interface, GUI, showing the real-time images of the eye captured by the alignment camera (202), wherein the GUI further shows a fixed reticle graphic overlaid on the real-time images of the eye, wherein the eye of the subject is optically aligned with the refractor device when the GUI shows an anatomical feature of the eye within at least part of the fixed reticle graphic.
  7. The system of claim 6, wherein the one or more processors (130) of the controller (128) are configured to execute further instructions to cause the controller to: obtain, from the refractor device (138), measurements concerning a pupil diameter and a gaze displacement of the eye; and proceed to determine the accommodative response of the eye only when the pupil diameter exceeds a minimum diameter threshold and the gaze displacement is less than a maximum displacement threshold.
  8. The system of claim 7, wherein a line-of-sight of the eye of the subject extends through the hot mirror (148), the first beam splitter (118), and the second beam splitter (150) such that the subject views the stimulus target (200) displayed on the far display (108) through the hot mirror (148), the first beam splitter (118), and the second beam splitter (150).
  9. The system of claim 6, further comprising a far alignment light source (400) positioned at the distal end of the support assembly, wherein the far alignment light source is configured to project a light marker onto the far display via the second beam splitter, and wherein the stimulus target is displayed on the far display within a region encompassing the light marker.
  10. The system of claim 1, wherein the input device (154) is in communication with the controller (128), wherein the input device (154) is configured to receive the user inputs from the subject concerning the first rotational orientations of the stimulus target (200) displayed on the far display (108) and the second rotational orientations of the stimulus target (200) displayed on the near display (116).
  11. The system of claim 10, wherein the input device (154) is a joystick and wherein each of the user inputs is a joystick movement initiated by the subject in a direction associated with a rotational orientation of the stimulus target displayed on either the near display or the far display.
  12. The system of claim 10, wherein the input device (154) is a touchpad and wherein each of the user inputs is a touch input initiated by the subject in a direction associated with a rotational orientation of the stimulus target displayed on either the near display or the far display.
  13. The system of claim 10, wherein the input device (154) is a keyboard and wherein each of the user inputs is a keystroke initiated by the subject in a direction associated with a rotational orientation of the stimulus target displayed on either the near display or the far display.
  14. The system of claim 10, wherein the input device (154) is a computer mouse and wherein each of the user inputs is a mouse click initiated by the subject in a direction associated with a rotational orientation of the stimulus target displayed on either the near display or the far display.
  15. The system of claim 1, wherein the stimulus target (200) is an optotype letter.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application claims the benefit of U.S. Provisional Application No. 63/171,320 filed on April 6, 2021 and U.S. Provisional Application No. 63/261,801 filed on September 29, 2021, the contents of which are incorporated herein by reference in their entireties. TECHNICAL FIELD The present disclosure relates generally to the field of ophthalmic equipment, and, more specifically, to apparatus, systems, and methods for objectively assessing accommodation in an eye. BACKGROUND Accommodation refers to an increase in dioptric power of the eye when a subject attempts to focus on a near object or target. It is one third of the oculomotor near triad, the others being convergence and pupil constriction. Accommodative ability diminishes with increasing age with the onset of presbyopia or farsightedness caused by the loss of elasticity of the lens of the eye. A subject's accommodative ability is traditionally measured in a clinical setting using subjective techniques such as standard push-up tests and questions directed to the patient. However, subjective tests are beset with both patient and clinician bias and often overestimate a patient's accommodative ability. Moreover, while some academic or research institutions have proposed designs for systems that objectively measure accommodation, such systems are difficult to set up and the data obtained from such systems require a large amount of post-processing to obtain a useful result. As such, these systems are not intended for use in clinical settings where ease of use is paramount. Furthermore, some systems for measuring accommodation rely on optically induced accommodative stimuli that are difficult for patients to focus on and may underestimate a patient's accommodative ability. Therefore, a solution is needed which addresses the above challenges. Such a solution should provide an accurate and objective assessment of a subject's accommodative ability without being overly complicated. Such a solution should be designed with clinical considerations in mind and should also present the patient with a compelling real-world target that can sustain the patient's focus. SUMMARY Disclosed herein are apparatus, systems, and methods for objectively assessing accommodation in an eye. In one embodiment, a system for objectively assessing accommodation in an eye of a subject is disclosed. The system can comprise a near display, a first beam splitter, and a far display located further from the eye than the near display and the first beam splitter. The system can also comprise a controller in communication with the near display and the far display. The near display can be oriented in a downward direction. The first beam splitter can be positioned at an oblique angle with respect to the near display such that graphics or images displayed on the near display are projected onto the near display. The controller can comprise one or more processors and a tangible non-transitory machine-readable medium comprising instructions stored thereon. The one or more processors can execute at least some of the instructions to cause the controller to direct appearance of a stimulus target on the far display for a first duration and on the near display for a second duration. The near display can be configured to project the stimulus target onto the first beam splitter. The stimulus target displayed on the far display can be axially aligned with the stimulus target projected on the first beam splitter. The one or more processors can execute further instructions to cause the controller to obtain measurements concerning refractive states of the eye during the first duration and the second duration from a refractor device in communication with the controller and determine an accommodative response of the eye based in part on the refractive states. The system can also comprise a support assembly and a motorized stage coupled to a top of the support assembly. The motorized stage can be configured to translate the near display and the first beam splitter in a linear direction. The first beam splitter can be automatically translated to a plurality stimulus positions located at variable distances from the eye of the subject. For example, the stimulus positions can be located at approximately 0.80 meters, 0.37 meters, 0.33 meters, and 0.25 meters from the eye of the subject. In certain embodiments, the far display can be located between approximately 4 meters and 6 meters from the eye of the subject. In some embodiments, the stimulus target can be an optotype letter. The stimulus target can have a height dimension of between approximately 1.5 cm and 2.0 cm. The system can further comprise an angled mirror and a hot mirror positioned above the angled mirror. The hot mirror can be positioned in between the near display assembly and the subject. The refractor device can comprise a refractor light source configured to generate an illumination beam and a refractor camera con