Note: Descriptions are shown in the official language in which they were submitted.
WO 2022/011006
PCT/US2021/040677
HOLOGRAPHIC REAL SPACE
REFRACTIVE SYSTEM
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application claims priority benefit to U.S. Patent Application
Serial
No. 16/923,672, filed on July 8, 2020. The prior application is incorporated
herein by
reference in its entirety.
BACKGROUND
I. Technical Field
[0002] Systems and methods for providing a visual examination using
holographic
projection in real space and time are provided.
2. Background Art
[0003] For over one hundred years, doctors have provided eye examinations
including
refraction by using lenses and prisms to determine the refractive state and
binocularity of the
patient. Refraction means to bend light. A person with myopia
(nearsightedness), hyperopia
(farsightedness), and/or astigmatism (two different power curves) may utilize
refraction to
correct the refractive state and blurred vision of the person by using
physical lenses and
prisms. While in the 19th century, refraction was mostly conducted with a
trial frame by
holding up individual lenses before each eye to make the image more clear, in
the 20th
century, the phoropter (meaning "many lenses") was developed. This instrument
was
extended on an arm of a physical stand and the instrument was positioned
before a patient's
face. A clinician would then turn the dial to move different lenses in front
of the patient's
eyes to find the best subjective refraction to improve distance vision. The
instrument was
later advanced to include prisms that could be used to disassociate images or
change the
position of the image, enabling the clinician the ability to evaluate muscle
ranges and
maintain eye alignment and binocularity. It also permitted assessment of the
patient's ability
to accommodate or focus at a near range. This was for the purpose of designing
glasses to
improve eyesight and visual acuity for both distance and near ranges as well
as to prescribe
prisms to correct for imbalance in eye alignment affecting binocularity.
1
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
[0004] Visual acuity and refraction are necessary for assessing vision and the
prescription of
corrective lenses for myopia (nearsightedness), hyperopia (farsightedness) and
astigmatism.
The standards for testing are to provide a visual acuity chart at a specified
distance from the
subject to measure the smallest resolution of detail that can be seen by each
eye for a distance
range. The Snellen Acuity chart was developed by an ophthalmologist, Herman
Snellen MD,
in 1862. The Snellen Acuity Chart is still used today in addition to other
charts.
SUMMARY OF THE INVENTION
[0005] A method for providing a visual examination is provided. A diagnostic
module
configured to execute on a first computing device communicatively coupled to a
head
mounted holographic display device worn by a user renders a virtual
arrangement displayed
within the head mounted holographic display device at an initial simulated
distance away
from the user. The virtual arrangement comprises a background grid orientated
in a first
orientation and an imbedded pattern located within the background grid. The
imbedded
pattern is orientated in a second orientation that is different from the first
orientation. The
diagnostic module updates the rendering of the virtual arrangement within the
head mounted
holographic display device. The update comprises a virtual movement of the
virtual
arrangement. A second computing device receives, from leads attached to the
user, brain
waves of the user. The second computing device displays a visual evoked
potential within
the brain waves. The visual evoked potential comprises an indication that the
user visually
identifies the imbedded pattern at a second simulated distance away from the
user. The
visual evoked potential occurs at a focal length of a myopic correction of the
user.
[0006] The virtual arrangement includes a background grid orientated in a
first orientation
and an imbedded pattern located within the background grid. The imbedded
pattern is
orientated in a second orientation that is different from the first
orientation. For example, the
background grid and the imbedded pattern are patterns of lines that subtend a
specific minute
of arc separation between the lines. In an exemplary embodiment, the
background grid is a
pattern of lines of a minute of arc and the imbedded pattern is a geometric
shape imbedded
within the background grid, where the imbedded pattern is a pattern of lines
of the same
minute of arc as the virtual arrangement but in an opposing direction to
create the geometric
2
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
shape. Some of the lines of the imbedded pattern may be positioned at an
opposite angle to
the lines in the background grid.
[0007] A system for providing a visual examination is provided. The system
includes a head
mounted holographic display device, a first computing device communicatively
coupled to
the head mounted holographic display device worn by a user and a diagnostic
module
configured to execute on the first computing device. The diagnostic module
when executed
renders a virtual arrangement displayed within the head mounted holographic
display device
at an initial simulated distance away from the user, wherein the virtual
arrangement
comprises a background grid orientated in a first orientation and an imbedded
pattern located
within the background grid orientated in a second orientation that is
different from the first
orientation. The diagnostic module when executed further updates the rendering
of the
virtual arrangement within the head mounted holographic display device,
wherein the update
comprises a virtual movement of the virtual arrangement. The system further
includes a
second computing device coupled to leads attached to the user. The second
computing
device when executed receives, from the leads attached to the user, brain
waves of the user,
and displays a visual evoked potential within the brain waves. The visual
evoked potential
comprises an indication that the user visually identified the imbedded pattern
within the
virtual arrangement at a second simulated distance away from the user. The
visual evoked
potential occurs at a focal length of a myopic correction of the user.
[0008] A non-transitory computer readable medium storing instructions
executable by a
processing device is provided. Execution of the instructions causes the
processing device to
implement a method for providing a visual examination. The method comprises
rendering,
via a diagnostic module configured to execute on a first computing device
communicatively
coupled to a head mounted holographic display device worn by a user, a virtual
arrangement
displayed within the head mounted holographic display device at an initial
simulated distance
away from the user. The virtual arrangement comprises a background grid
orientated in a
first orientation and an imbedded pattern located within the background grid
orientated in a
second orientation that is different from the first orientation. The method
further comprises
updating, via the diagnostic module, the rendering of the virtual arrangement
within the head
mounted holographic display device, wherein the update comprises a virtual
movement of the
virtual arrangement. The method also comprises receiving, by a second
computing device
3
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
from leads attached to the user, brain waves of the user. The method further
comprises
displaying, via the second computing device, a visual evoked potential within
the brain
waves. The visual evoked potential comprises an indication that the user
visually identified
the imbedded pattern within the virtual arrangement at a second simulated
distance away
from the user. The visual evoked potential occurs at a focal length of a
myopic correction of
the user.
[0009] Additional features, functions and benefits of the disclosed systems
and methods will
be apparent from the detailed description which follows, particularly when
read in
conjunction with the accompanying figures.
BRIEF DESCRIPTION OF DRAWINGS
[0010] Illustrative embodiments are shown by way of example in the
accompanying
drawings and should not be considered as a limitation of the present
disclosure:
[0011] FIG. 1 is a block diagram illustrating a system for the holographic
vision testing
device according to an exemplary embodiment.
[0012] FIGs. 2 and 3 are diagrams illustrating a test for assessing visual
acuity and
performing refraction with a holographic vision testing device according to an
exemplary
embodiment.
[0013] FIGs. 4A and 4B illustrate sample virtual arrangements in accordance
with an
exemplary embodiment.
[0014] FIGs. 5A and 5B illustrate additional sample virtual arrangements in
accordance with
an exemplary embodiment.
[0015] FIG. 6 illustrates a method for providing a visual examination in
accordance with an
exemplary embodiment.
[0016] FIG. 7 depicts a diagram for evaluating the electrical activity in the
brain of a user for
monitoring a Visual Evoked Potential P-100 pattern response for a right (OD)
eye and a left
(OS) eye of the user using a virtual arrangement as a stimulus for fixation.
4
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
[0017] FIG. 8 illustrates exemplary electrical activity in the brain of a user
in response to an
imbedded pattern for a right (OD) eye and a left (OS) eye of a user using a
virtual
arrangement as described herein as a stimulus for fixation.
[0018] FIG. 9 depicts a block diagram an exemplary computing device in
accordance with an
exemplary embodiment.
DETAILED DESCRIPTION
[0019] Systems, methods, apparatus, and non-transitory computer readable
medium are
described for holographic eye testing to assess visual acuity and perform a
refraction test.
Example embodiments provide a device for utilizing virtual and/or augmentative
holographic
projections to perform eye testing and diagnosis, and provide a prescriptive
remedy. In some
embodiments, the systems, methods, apparatus, and non-transitory computer
readable
medium includes and/or is in communication with a disclosed holographic vision
testing
device. In an exemplary embodiment, the holographic vision testing device is a
head mounted
holographic display device that renders at least one two-dimensional (2D) or
three-
dimensional (3D) virtual arrangement within the holographic display device.
The rendering
of the virtual arrangement corresponds to a virtual level of depth viewable by
a user wearing
the head mounted device.
[0020] In an exemplary embodiment, the virtual arrangement includes a
background grid
comprising a series of lines in a same or similar orientation. The series of
lines of the
background grid subtends x minutes of arc with a spacing of y minute of arc,
where x and y
are predefined numbers of minutes of arc. In an exemplary embodiment, the
series of lines
subtend 5 minutes of arc with a spacing of 1 minute of arc. Different minutes
of arc may be
used in other embodiments. Within the background grid is an imbedded pattern
that is in a
different orientation from the background grid. For example, the imbedded
pattern may be a
series of lines of the same minute of arc as the background grid but that are
in a different
orientation from the background grid to create a geometric shape or form. The
imbedded
pattern forms the geometric shape, such as, but not limited to, a
checkerboard, a circle, or a
diamond. Any universal geometric shape can be used as well, such as imbedded
letters,
numbers, shapes, and pictures that will be universal for different cultures
and languages and
that will not discriminate against age or literacy.
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
[0021] The holographic display device updates the rendering of the virtual
arrangement. The
update includes a virtual movement of the virtual arrangement within the
virtual level of
depth, typically closer or farther from the user.
[0022] A computing device coupled to a computing display and/or coupled to
leads attached
to the user receives brain waves of the user via the leads. For example, the
computing device
coupled to the leads may utilize an electroencephalogram (EEG) to detect
and/or display the
electrical activity in the brain of the user for monitoring for a visual
evoked potential. Of
primary interest is the latency of the positive wave at a midline occipital
EEG electrode,
usually at approximately 100 ms after stimulation, called the Visual Evoked
Potential P100.
The computing device coupled to the leads displays waveforms on the computing
display,
including waveforms of a visual evoked potential. The visual evoked potential
comprises an
indication that the user visually identified the imbedded pattern within the
background grid.
The visual evoked potential occurs at a focal length of a myopic correction of
the user. More
specifically, at the focal length of a refractive error, pattern receptors
respond causing the
user to identify the imbedded pattern.
[0023] In some embodiments, the computing device coupled to the leads or a
separate
computing device identifies the Visual Evoked Potential P-100 (for example,
using artificial
intelligence or other appropriate software to identify the Visual Evoked
Potential P-100
within the waveforms). In other embodiments, a human reviews the waveforms and
identifies the Visual Evoked Potential P-100.
[0024] The disclosed systems, methods, apparatus, and non-transitory computer
readable
medium utilizes the virtual arrangement to assess refractive power or error of
the eye by
causing a response of pattern receptors at the focal length of the refractive
error of the eye.
This is accomplished by projecting the virtual arrangement via virtual or
augmentative reality
using the head mounted device. The formula for calculation of the refractive
power of the eye
is diopters = 100 cm. / focal length (cm.).
[0025] The user recognizes the imbedded pattern based on pattern receptors
organizing and
establishing visual imagery though the support of a hi-modal visual process.
The pattern
receptors in the visual cortex function by processing information delivered by
responding to
groups of cells in the retina that are stimulated by patterns and lines. The
imbedded pattern
6
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
stimulates pattern receptors of the user using the holographic vision testing
device to trigger a
response to the imbedded pattern to assess visual acuity and refraction. The
imbedded pattern
is only seen if the user can resolve the minutes of arc (in an example
embodiment, 5 minutes
of arc), thereby enabling the user to recognize the imbedded figure. If the
virtual
arrangement is rendered to appear too far from the user or is moved away from
the user more
than the pattern receptors of the user can resolve the dimensional change in
the lines then the
imbedded pattern is not seen. The farthest distance that the pattern receptors
respond is
related to the focal length of the refractive error. The imbedded pattern
causes pattern
receptors to respond when the resolution of the imbedded pattern is at the
focal length of the
refractive correction.
[0026] In an exemplary embodiment, the disclosed systems, methods, apparatus,
and non-
transitory computer readable medium can non-verbally assess visual acuity
and/or the
refractive state of an eye by assessing visual evoked potentials using brain
wave testing, for
example, using an EEG to detect, evaluate, and/or display the electrical
activity in the brain
of the user. This is especially useful for non-verbal persons (infants through
adult). This
assessment is accomplished by placing leads (typically, three leads) attached
to a computing
device onto a scalp of the user wearing the holographic vision testing device.
A reference
electrode is usually placed on the earlobe, the midline top of the head, or on
the forehead. A
ground electrode can be placed at any location. The virtual arrangement is
rendered to slowly
move toward the person as the person fixates on the virtual arrangement. When
the imbedded
pattern is appreciated, a Visual Evoked Potential P100 response is produced.
In other words,
when the pattern receptors are triggered, a brain wave called the Visual
Evoked Potential P-
100 (or P-100) is released and this can be captured as a visual evoked
potential (VEP). The
distance from the person's eyes at the time the P-100 response is appreciated
marks the focal
length of the spherical refractive power of the eye. By determining the
minutes of arc
subtended by the lines on the chart producing the geometric form, an acuity
measurement for
this eye can be determined using the following formula: 1 minute of arc
separation of a 5
minute subtented dimensional target = 20/20 (feet) or 6/6 (meters) of
resolution.
[0027] A minute of arc, arcminute (arcmin), arc minute, or minute arc is a
unit of angular
measurement equal to 160 of one degree. Since one degree is 1360 of a turn (or
complete
rotation), one minute of arc is 121600 of a turn. An angle subtended from the
macula to the
7
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
size and distance to the target viewed represents the minutes of arc. The best
resolution for
the normal eye is 20/20 or 6/6. This represents a 1 minute of arc subtended
angle from the
eye.
[0028] The disclosed systems, methods, apparatus, and non-transitory computer
readable
medium can be designed to utilize different sized virtual arraignments (e.g.,
different sized
backgrounds grid and/or different sized imbedded patterns) that will assess
varying acuity at
specified distances by stimulating pattern receptor response. The virtual
arrangement can be
designed for distance, intermediate, and near ranges.
[0029] In some embodiments, the virtual arraignments can he rendered and
updated in
computing devices other than the head mounted holographic display device
described herein.
For example, the virtual arraignments can be rendered and updated on a non-
head mounted
computing display (for example, a desktop computer display, a wall-mounted
computer
display, a tablet, etc.). In some embodiments, the virtual arraignments can be
rendered and
updated in an internet browser on, for example, a tablet, a desktop display,
and/or a laptop
display.
[0030] In other embodiments, the virtual arraignments can be rendered and
updated in a
vision testing kiosk in which a user places the user's head within the kiosk
to view a display
configured to render and update a virtual arraignment (for example, the head
mounted
holographic display device is mounted and/or installed within the kiosk).
These
embodiments can be used to test for visual acuity and/or developing an
internet refraction
system, but are not limited to these tests.
[0031] In other embodiments, the virtual arraignments can be printed on charts
(e.g., an eye
chart).
[0032] In all the above embodiments, leads may be attached to the user to
receives brain
waves of the user, as described within this disclosure.
[0033] The disclosed systems, methods, apparatus, and non-transitory computer
readable
medium are useful for assessing visual acuity and/or refraction in non-verbal
persons. The
testing is independent of different cultures, languages, or ages. The
disclosed systems,
methods, apparatus, and non-transitory computer readable medium enables both
subjective
8
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
testing by the subject as well as objective response directly from brain waves
associated with
the visual response. The implication is that objective testing can be
performed for refraction
on non-verbal patients potentially from infancy to the end stages of life. In
addition, the
disclosed systems, methods, apparatus, and non-transitory computer readable
medium can be
adapted for use with visual habilitation and rehabilitation for providing
therapy to improve
binocular function and visual skills. The disclosed systems, methods,
apparatus, and non-
transitory computer readable medium can further have beneficial use for sports
visual
enhancement to improve visual skills as well as reaction time. Military and
police may
benefit for training advanced visual skills with recognition danger for
reaction time and
decision-making. In addition, compromise to the bi-modal visual process can
occur following
concussion, traumatic brain injury, or other neurological events that affect
the spatial visual
process. Thus, the disclosed systems, methods, apparatus, and non-transitory
computer
readable medium serve as a means to assess visual processing dysfunction
following a
concussion or neurological event affecting the bi-modal visual process.
[0034] In some embodiments, the disclosed systems, methods, apparatus, and non-
transitory
computer readable medium can perform the refraction by using lenses within a
phoropter, a
trial frame, or any method employing optics to improve the resolution of
detail for correcting
myopia, hyperopia, and astigmatism.
[0035] In one embodiment, the disclosed systems, methods, apparatus, and non-
transitory
computer readable medium tests for astigmatism using a virtual arrangement
(typically in a
spherical shape) presented to the user. An imbedded pattern of a straight line
is located
within the virtual arrangement. The user performs a cross cylinder test to
determine the axis
of the cylinder. In particular, the virtual arrangement is rotated about an
axis. The refraction
in the augmentative reality device uses the near to far axis from the eye(s)
or 'z' axis to move
the arrangement until it is at the focal length of the eye causing the pattern
receptors to
respond and simultaneously causing the user to see the imbedded pattern such
as a circle. A
second arrangement is introduced and an imbedded pattern is rotated until the
lines are the
clearest. This is the astigmatic axis. The arrangement is move away from the
user and the
lines are rotated 90 degrees. The arrangement is then brought toward the user
until the lines
appear clear. The delta between the lines at the greater distance that were
first seen (focal
length of the spherical power and the focal length of the 90 degree rotated
lines) represents
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
the cylindrical power of the astigmatism. The spherical power, cylindrical
power, and axis are
determined to complete the refraction. This test is described in detail in
U.S. Patent
No. 10,441,161, which is incorporated herein by reference in its entirety.
[0036] In some embodiments, the disclosed systems, methods, apparatus, and non-
transitory
computer readable medium is used to treat amblyopia. Amblyopia is a lack of
acuity in one
eye caused either by the eye being deviated from birth due to strabismus or if
the child has an
uncorrected amount of astigmatism or hyperopia (an uncorrected refractive
state) causing the
light to not be able to focus accurately either in one meridian on the retina
(as is the case of a
high amount of astigmatism) or generally out of focus (due to a high amount of
uncorrected
hyperopia (farsightedness). In such an embodiment, a corrective refractive
prescription is
utilized and the virtual arrangement is virtually moved towards the user until
the user first
sees and/or identifies the imbedded pattern (e.g., a geometric figure), which
causes the
pattern receptors in the user's visual cortex to become actuated. The virtual
arrangement is
virtually moved away/farther from the user until the user can no longer see
and/or identify the
imbedded pattern. In an exemplary embodiment, this process is repeated for 5-
10 minutes per
day. It has been found that over two weeks, this has resulted in improved
acuity in the
amblyopic eye.
[0037] FIG. 1 is a block diagram illustrating a system 100 for the holographic
vision testing
device according to an exemplary embodiment. In one embodiment, the
holographic vision
testing device can include a head mounted display (HMD) 102. The HMD 102 can
include a
pair of combiner lenses 104A, 104B for rendering a virtual arrangement within
a user's field
of view (FOY). The combiner lenses 104A, 104B can be calibrated to the
interpupillary
distance from the user's eyes 106A, 106B. A computing system 108 can be
connected to the
combiner lenses 104A, 104B. The holographic vision testing device can be
repositioned in
any of the nine primary gaze positions as needed. These tests are built to run
on technical
platforms that can project 2D and/or 3D holographic images within a field of
view provided
by a wired or wireless headset. The HMD 102 can be connected to an adjustable,
cushioned
inner headband, which can tilt the combiner lenses 104A, 104B up and down, as
well as
forward and backward. To wear the unit, the user fits the HMD 102 on their
head, using an
adjustment wheel at the back of the headband to secure it around the crown,
supporting and
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
distributing the weight of the unit equally for comfort, before tilting the
visor and combiner
lenses 104A, 104B towards the front of the eyes.
[0038] The computing system 108 can be inclusive to the HMD 102, where the
holographic
vision testing device is a self-contained apparatus. The computing system 108
in the self
contained apparatus can include additional power circuitry to provide
electrical current to the
parts of the computing system 108. Alternatively, the computing system 108 can
be external
to the HMD 102 and communicatively coupled either through wired or wireless
communication channels to the HMD 102. Wired communication channels can
include
digital video transmission formats including High Definition Multimedia
Interface (HDMI),
DisplayPortTM (DisplayPort is a trademark of VESA of San Jose CA, U.S.A.), or
any other
transmission format capable of propagating a video signal from the computing
system 108 to
the combiner lenses 104A, 104B. Additionally, the HMD 102 can include speakers
or
headphones for the presentation of instructional audio to the user during the
holographic eye
tests. In a wireless communication embodiment, the HMD 102 can include a
wireless adapter
capable of low latency high bandwidth applications, including but not limited
to IEEE
802.11ad. The wireless adapter can interface with the computing system 108 for
the
transmission of low latency video to be displayed upon the combiner lenses
104, 104B.
[0039] Additionally the computing system 108 can include software for the
manipulation and
rendering of 2D and/or 3D virtual arrangements within a virtual space. The
software can
include both platform software to support any fundamental functionality of the
HMD 102,
such as motion tracking, input functionality, and eye tracking. Platform
software can be
implemented in a virtual reality (VR) framework, augmented reality (AR)
framework, or
mixed reality (MR) framework. Platform software to support the fundamental
functionality
can include but are not limited to SteamVRO (SteamVR is a registered trademark
of the
Valve Corporation, Seattle WA, U.S.A) software development kit (SDK), Oculus
VR SDK
(Oculus is a registered trademark of Oculus VR LLC, Irvine CA, U.S.A.), OSVR
(Open
source VR) (OSVR is a registered trademark of Razer Asia Pacific Pte. Ltd.
Singapore)
SDK, and Microsoft Windows Mixed Reality Computing Platform. Application
software
executing on the computing system 108 with the underlying platform software
can be a
customized rendering engine, or an off-the-shelf 2D and/or 3D rendering
framework, such as
Unity Software (Unity Software is a registered trademark of Unity
Technologies of San
11
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
Francisco CA, U.S.A). The rendering framework can provide the basic building
blocks of the
virtualized environment for the holographic refractive eye test, including 3D
objects and
manipulation techniques to change the appearance of the 2D and/or 3D virtual
arrangements.
The rendering framework can provide application programming interfaces (APIs)
for the
instantiation of 2D and/or 3D virtual arrangements and well-defined interfaces
for the
manipulation of the 2D and/or 3D virtual arrangements within the framework.
Common
software programming language bindings for rendering frameworks include but
are not
limited to C++, Java, and Olt Additionally, the application software can
provide settings to
allow a test administrator to adjust actions within the test, such as
holographic virtual
arrangements speed and virtual arrangements orientations.
[0040] FIGs. 2 and 3 are diagrams illustrating a test for assessing visual
acuity and
performing refraction with a holographic vision testing device according to an
exemplary
embodiment. FIG. 2 is a side view of the holographic vision testing device and
FIG. 3 is a
top down view of the holographic vision testing device. In one embodiment, a
virtual 2D or
3D virtual arrangement 202 can be manipulated in a user's field of view (FOV)
204A, 204B.
The virtual arrangement 202 can have a starting point within the user's FOV
204A, 204B.
Utilizing application software, the virtual arrangement 202 is translated and
projected on the
combiner lenses 104A, 104B to give the appearance that the virtual arrangement
202 is a set
distance from the view of the user's eyes 106A, 106B. For example, in some
embodiments,
the presentation of the virtual arrangement 202 can correspond to projection
of the virtual
arrangement 202 at distances of 16 inches to 20 feet in front of the user's
eyes 106A, 106B.
The range of distances allows visual acuity to be measured at different
intervals of depth for
better confidence in results.
[0041] The virtual arrangement 202 is rendered moving towards or moving away
from the
user in the user's FOV 204A, 204B.
A computing device may utilize an
electroencephalogram (EEG) to detect, evaluate, and display the electrical
activity in the
brain of the user. For example, responses are recorded from electrodes that
are placed on the
back of the user's head and are observed as a reading on the EEG. A visual
evoked
potential is an evoked potential caused by a visual stimulus, such as the
imbedded pattern
206. In the exemplary embodiment, the visual evoked potential comprises an
indication that
the user visually identified an imbedded pattern 206 within the virtual
arrangement 202. The
12
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
visual evoked potential occurs at a focal length of a myopic correction of the
user. The
power of any lens system that corrects myopia can be expressed in units called
diopters (D),
the reciprocal of its focal length in meters_ The lens powers on an eyeglass
prescription for
myopia always begin with a minus sign. The higher the power number of the
lens, the more
myopia it corrects.
[0042] In some embodiments, the user can provide input to the application
software or
platform software. The input can take the form of voice commands, gestures, or
input from a
"clicker." For example, at the point in which the imbedded pattern 206 becomes
clear to the
user, the user can provide input to stop any motion or translation of the
virtual arrangement
202. The application software evaluates a delta (or change) between the
midpoint of the
user's FOV 204A, 204B and the point at which the virtual arrangement 202 were
located
when the user provided input to stop the motion or translation. The delta can
be represented
as a deviation relative to the virtual distance of the virtual arrangement 202
from the patient.
A diopter is measured by the deviation of the image at a specific virtual
distance (1 prism
diopter = 1 virtual cm deviation of the image at a 1 virtual meter distance).
[0043] In one embodiment, the user can start the test by providing input to
the computing
system 108. The input can take the form of voice commands, including saying
key words
indicative of beginning the test, gestures or providing input from a "clicker.-
The user states
the word "start" to begin the test. As the test begins, the virtual
arrangement 202 is translated
toward the combiner lenses 104A, 104B to give the user the appearance that the
virtual
arrangement 202 is coming directly at the user's eyes 106A, 106B.
[0044] In some embodiment, when the user can see the imbedded pattern 206
clearly, the
user can provide input to stop the test in the form of a voice command of
"stop." The
computing system 108 ceases translation of the virtual arrangement 202 and
calculates a delta
distance from the starting point of the virtual arrangement 202 to the point
where the virtual
arrangement 202 resides at the end of the test. A constant point of reference
on the virtual
arrangement 202 can be utilized to determine a consistent location to
determine the delta
distance.
[0045] In some embodiments, the virtual arrangement 202 can be moved forward
or
backwards. Control of the test can take the form voice commands including
"forward" and
13
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
"backward." A voice command of "forward" translates the plane 608, and
associated virtual
arrangement 202 toward the combiner lenses 104A, 104B. A voice command of
"backward"
translates the plane 608, and associated virtual arrangement 202 away from the
combiner
lenses 104A, 104B. Utilizing the voice commands and associated translations, a
user can
manipulated the virtual arrangement 202 until the user can identify the
imbedded pattern 206.
The user can provide a voice command to the computing system 108, such as
stating the
word "stop" to complete the manipulation portion of the test. Upon the receipt
of the "stop"
command, the computing system 108 disallows subsequent input commands, such as
"forward" and "backward," and determines a final distance of the virtual
arrangement 202.
[0046] FIG. 4A illustrates a sample virtual arrangement 402 in accordance with
an
exemplary embodiment. In an exemplary embodiment, the virtual arrangement 402
includes
a background grid 404 of a series of lines that subtend 5 minutes of arc with
a spacing of 1
minute of arc. The virtual arrangement 402 further includes an imbedded
pattern 406 of lines
that are not in the same orientation as the background grid 404. In this
embodiment, the
imbedded pattern 406 forms a diamond, although in different embodiments
different patterns
may be formed. The imbedded pattern 406 stimulates a certain group(s) of
pattern receptors
to trigger a response to the imbedded pattern 406 (here, a diamond). The
imbedded pattern
406 is only seen if the person can resolve the 5 minutes of arc thereby
enabling the person to
recognize the imbedded pattern 406 of the diamond. If the virtual arrangement
402 is located
and/or moved a greater distance from the user more than the pattern receptors
can resolve the
dimensional change in the lines then the imbedded pattern 406 of the diamond
is not seen.
Any universal geometric form can be used as an imbedded pattern, such as
letters, numbers,
shapes, and pictures that will be universal for different cultures and
languages and that will
not discriminate against age or literacy.
[0047] FIG. 4B illustrates another sample virtual arrangement 408 in
accordance with an
exemplary embodiment. In an exemplary embodiment, the virtual arrangement 408
includes
with a background grid 410 of a series of lines that subtend 5 minutes of arc
with a spacing of
1 minute of arc. The virtual arrangement 408 further includes an imbedded
pattern 412 of
lines (here, forming a cross) that are not in the same orientation as the
background grid 410.
14
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
[0048] FIGs. 5A and 5B illustrate additional sample virtual arrangements in
accordance with
an exemplary embodiment.
[0049] In some embodiments, the virtual arraignments illustrated in FIGs. 4A,
4B, 5A, and
5B can be rendered and updated in computing devices other than the head
mounted
holographic display device described herein. For example, the virtual
arraignments can be
rendered and updated on non-head mounted computer displays, such as on desktop
displays
and/or laptop displays. In other embodiments, the virtual arraignments can be
rendered and
updated in a vision-testing kiosk in which a user places the user's head
within the kiosk to
view a virtual arraignment (for example, the described head mounted
holographic display
device is mounted and/or installed within the kiosk). These embodiments can be
used to test,
for example, but not limited to, visual acuity and/or developing an internet
refraction system.
[0050] FIG. 6 illustrates a method for providing a visual examination in
accordance with an
exemplary embodiment.
[0051] At step 602, a diagnostic module configured to execute on a first
computing device
communicatively coupled to a head mounted holographic display device renders a
virtual
arrangement displayed within the head mounted holographic display device. The
virtual
arrangement comprises a background grid orientated in a first orientation and
an imbedded
pattern located within the background grid orientated in a second orientation
that is different
from the first orientation.
[0052] At step 604, the diagnostic module updates the rendering of the virtual
arrangement
within the head mounted holographic display device, wherein the update
comprises a virtual
movement of the virtual arrangement.
[0053] At step 606, a second computing device receives brain waves from leads
attached to a
user.
[0054] At step 608, the second computing device displays a visual evoked
potential. The
visual evoked potential comprises an indication that the user visually
identifies the imbedded
pattern. The visual evoked potential occurs at a focal length of a myopic
correction of the
user.
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
[0055] At step 610, the visual evoked potential is identified by a user or a
computing device
(e.g., the second computing device or a third computing device) using
artificial intelligence.
[0056] FIG. 7 depicts a diagram for evaluating the electrical activity in a
brain of a user 704
for monitoring a Visual Evoked Potential P-100 pattern response for the user
704 provoked
using a virtual arrangement (such as shown in FIGs. 4A-4B or FIGs. 5A-5B) as a
stimulus
for fixation, in accordance with an exemplary embodiment. The exemplary
embodiment can
non-verbally assess visual acuity and/or the refractive state of an eye by
assessing visual
evoked potentials using the brain wave testing, for example using an
electroencephalogram
(EEG) to detect and evaluate the electrical activity in the brain of the user.
This assessment is
accomplished by placing leads (typically, three leads) attached to a computing
device onto a
scalp of the user using the holographic vision testing device. A reference
electrode is usually
placed on the earlobe, the midline top of the head, or on the forehead. A
ground electrode can
be placed at any location.
[0057] As shown, at least three leads 702 (via wires) are attached to the
scalp of the user 704
for recording electrical activity in the brain, including a P-100 visual
evoked potential. The
at least three leads 702 are attached to a computing device 706 with software
to be sensitive
to changes in brain waves of the user 704 produced by visual awareness (visual
evoked
potential) of an imbedded pattern in the virtual arrangement.
[0058] In an exemplary embodiment, the virtual arrangement slowly moves toward
the user
as the user fixates on the virtual arrangement. When the imbedded pattern is
appreciated, a P-
100 response is produced. The distance from the user's eyes at the time the P-
100 response is
appreciated marks the focal length of the spherical refractive power of the
eye. By
determining the minutes of arc subtended by the lines on the chart producing
the geometric
form, an acuity measurement for this eye can also be determined using the
following formula:
1 minute of arc separation of a 5 minute subtented dimensional target = 20/20
(feet) or 6/6
(meters) of resolution.
[0059] FIG. 8 illustrates exemplary electrical activity 802 in a brain of a
user in response to
viewing a virtual arrangement as described herein as a stimulus for fixation.
A visual evoked
potential (VEP) is primarily a relatively large, positive polarity wave
generated in the
occipital cortex in response to visual stimulation. It measures the conduction
time of neuronal
16
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
activity from the retina to the occipital cortex and is used clinically as a
measure of the
integrity and function of that pathway. Of primary interest is the latency of
the positive wave
at a midline occipital EEG electrode, usually at approximately 100 ms after
stimulation,
called the Visual Evoked Potential P-100. As described, the Visual Evoked
Potential P-100
is elicited by an imbedded pattern that occurs at the focal length of the
refractive error.
[0060] The illustrated electrical activity 802 was produced by having leads
attached to the
scalp of the user, as illustrated in FIG. 7. The leads are attached to a
computing device with
software to be sensitive to changes in brain waves of the user produced by
visual awareness
(visual evoked potential) of the user.
[0061] The electrical activity 802 is produced as the user views a virtual
arrangement (for
example, a virtual arrangement with an imbedded pattern of a checkerboard or
circle) at a
predefined virtual distance (for example, here virtually rendered at a six
meters (twenty feet)
distance). As the virtual arrangement with the imbedded pattern is rendered to
move towards
the user, pattern receptors respond in the visual process causing the user to
see or identify the
imbedded pattern at the focal length of the refractive error (in this example
at 100 cm from
the eye) when the pattern has lines that are 1 minute of arc separation. At
this moment, a P-
100 response is produced. This response coincided with it occurring at the
focal length of the
user's myopic correction, which is 100 centimeters. The formula for dioptric
power is
diopters = 100 centimeters divided by focal length (centimeters).
[0062] In the illustration, the first cross 804 represents the beginning of
the response from the
pattern receptors and the second cross 806 represents the end of the response.
Between the
first cross 804 and the second cross 806 is the P-100 response. The x-axis
represents a
temporal period or a time period the response began and when it ended. The y-
axis represents
the amplitude of the response delivered form the bi-modal visual process in
the brain.
[0063] The calculation determines that the subject has a -1.00 diopters of
myopia and this
corresponded to the subject's refractive correction that was determined by a
refraction with a
standard phoropter. The power of any lens system that corrects myopia can be
expressed in
diopters, the reciprocal of its focal length in meters.
17
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
[0064] If the user is myopic and the focal length is at a shorter distance
than 6 meters the
pattern receptors will not be able to see the subtended angle of the imbedded
pattern so there
will be no response until the pattern is moved toward the user or unless the
user moves closer
to the imbedded pattern to move it to the focal length of the refractive
correction. A
hyperopic eye can be given a plus lens to simulate closer focal lengths. When
the subtended
arc minute is resolved and the pattern receptors respond, the focal length is
measured and the
dioptric power is calculated. The testing lens is subtracted from this lens
power to yield the
dioptric power of the hyperopic eye.
[0065] FIG. 9 depicts a block diagram an exemplary computing device 900 in
accordance
with an exemplary embodiment. Computing device 900 may include computing
device 108
for implementing the holographic vision testing device and/or computing device
706 for
evaluating the electrical activity in the brain. For example, the computing
device 900 can be
embodied as a portion of the holographic vision testing device, and supporting
computing
devices. The computing device 900 includes one or more non-transitory computer-
readable
media for storing one or more computer-executable instructions or software for
implementing
exemplary embodiments. The non-transitory computer-readable media may include,
but are
not limited to, one or more types of hardware memory, non-transitory tangible
media (for
example, one or more magnetic storage disks, one or more optical disks, one or
more flash
drives, one or more solid state disks), and the like. For example, memory 906
included in the
computing system 900 may store computer-readable and computer-executable
instructions or
software (e.g., applications 930 such as rendering application) for
implementing exemplary
operations of the computing device 900. The computing system 900 also includes
configurable and/or programmable processor 902 and associated core(s) 904, and
optionally,
one or more additional configurable and/or programmable processor(s) 902' and
associated
core(s) 904' (for example, in the case of computer systems having multiple
processors/cores),
for executing computer-readable and computer-executable instructions or
software stored in
the memory 906 and other programs for implementing exemplary embodiments of
the present
disclosure. Processor 902 and processor(s) 902' may each be a single core
processor or
multiple core (904 and 904') processor. Either or both of processor 902 and
processor(s)
902' may be configured to execute one or more of the instructions described in
connection
with computing system 900.
18
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
[0066] Virtualization may be employed in the computing system 900 so that
infrastructure
and resources in the computing system 900 may be shared dynamically. A virtual
machine
912 may be provided to handle a process running on multiple processors so that
the process
appears to be using only one computing resource rather than multiple computing
resources.
Multiple virtual machines may also be used with one processor.
[0067] Memory 906 may include a computer system memory or random access
memory,
such as DRAM, SRAM, EDO RAM, and the like. Memory 906 may include other types
of
memory as well, or combinations thereof. The computing system 900 can receive
data from
input/output devices. A user may interact with the computing system 900
through a visual
display device 914, such as a combiner lenses 916, which may display one or
more virtual
graphical user interfaces, a microphone 920, and one or more cameras 918.
[0068] The computing system 900 may also include one or more storage devices
926, such as
a hard-drive, CD-ROM, or other computer readable media, for storing data and
computer-
readable instructions and/or software that implement exemplary embodiments of
the present
disclosure. For example, exemplary storage device 926 can include storing
information
associated with platform software and the application software.
[0069] The computing system 900 can include a network interface 908 configured
to
interface via one or more network devices 924 with one or more networks, for
example,
Local Area Network (LAN), Wide Area Network (WAN) or the Internet through a
variety of
connections including, but not limited to, standard telephone lines, LAN or
WAN links (for
example, 802A1, Ti, T3, 56kb, X.25), broadband connections (for example, ISDN,
Frame
Relay, ATM), wireless connections, controller area network (CAN), or some
combination of
any or all of the above. In exemplary embodiments, the computing system can
include one or
more antennas 922 to facilitate wireless communication (e.g., via the network
interface)
between the computing system 900 and a network and/or between the computing
system 900
and other computing devices. The network interface 908 may include a built-in
network
adapter, network interface card, PCMC1A network card, card bus network
adapter, wireless
network adapter, USB network adapter, modem or any other device suitable for
interfacing
the computing system 900 to any type of network capable of communication and
performing
the operations described herein.
19
CA 03188913 2023- 2-9
WO 2022/011006
PCT/US2021/040677
[0070] The computing system 900 may run any operating system 910, such as any
of the
versions of the Microsoft Windows operating systems, the different releases
of the Unix
and Linux operating systems, any version of the MacOSO for Macintosh
computers, any
embedded operating system, any real-time operating system, any open source
operating
system, any proprietary operating system, or any other operating system
capable of running
on the computing system 900 and performing the operations described herein. In
exemplary
embodiments, the operating system 910 may be run in native mode or emulated
mode. In an
exemplary embodiment, the operating system 910 may be run on one or more cloud
machine
instances.
[0071] In describing exemplary embodiments, specific terminology is used for
the sake of
clarity. For purposes of description, each specific term is intended to at
least include all
technical and functional equivalents that operate in a similar manner to
accomplish a similar
purpose. Additionally, in some instances where a particular exemplary
embodiment includes
multiple system elements, device components, or method steps, those elements,
components,
or steps can be replaced with a single element, component, or step. Likewise,
a single
element, component, or step can be replaced with multiple elements,
components, or steps
that serve the same purpose. Moreover, while exemplary embodiments have been
shown and
described with references to particular embodiments thereof, those of ordinary
skill in the art
will understand that various substitutions and alterations in form and detail
can be made
therein without departing from the scope of the present disclosure. Further,
still, other
aspects, functions, and advantages are also within the scope of the present
disclosure.
[0072] Exemplary flowcharts are provided herein for illustrative purposes and
are non-
limiting examples of methods. One of ordinary skill in the art will recognize
that exemplary
methods can include more or fewer steps than those illustrated in the
exemplary flowcharts
and that the steps in the exemplary flowcharts can be performed in a different
order than the
order shown in the illustrative flowcharts.
CA 03188913 2023- 2-9
