WO2008013907A2 - Dynamic stimuli for visual field testing and therapy - Google Patents

Dynamic stimuli for visual field testing and therapy Download PDF

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Publication number
WO2008013907A2
WO2008013907A2 PCT/US2007/016840 US2007016840W WO2008013907A2 WO 2008013907 A2 WO2008013907 A2 WO 2008013907A2 US 2007016840 W US2007016840 W US 2007016840W WO 2008013907 A2 WO2008013907 A2 WO 2008013907A2
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WIPO (PCT)
Prior art keywords
subject
stimulus
fixation
accordance
computer
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PCT/US2007/016840
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French (fr)
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WO2008013907A3 (en
Inventor
David P. Todd
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Novavision, Inc.
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Publication date
Application filed by Novavision, Inc. filed Critical Novavision, Inc.
Priority to EP07810821A priority Critical patent/EP2076230A2/en
Priority to CA2657762A priority patent/CA2657762C/en
Priority to AU2007277139A priority patent/AU2007277139B2/en
Priority to JP2009521841A priority patent/JP2010501204A/en
Publication of WO2008013907A2 publication Critical patent/WO2008013907A2/en
Publication of WO2008013907A3 publication Critical patent/WO2008013907A3/en

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61HPHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H5/00Exercisers for the eyes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/0091Fixation targets for viewing direction
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/02Subjective types, i.e. testing apparatus requiring the active assistance of the patient
    • A61B3/024Subjective types, i.e. testing apparatus requiring the active assistance of the patient for determining the visual field, e.g. perimeter types

Definitions

  • the present invention relates to systems for maintaining the focus of a subject on a specified region of a display and for stimulating the motion-sensitive visual-pathway of a subject for purposes of testing or improving a subject's vision.
  • the macula is the region of the retina which is used for high acuity vision, as is typically required for reading.
  • a patient may undergo various types of examinations, including automated perimetry or campimetry, in which the patient is positioned in front of a test surface and is asked to maintain focus on a target.
  • a computer then actuates one or more light sources to present visual stimuli at specific points on the test surface.
  • the patient is asked to press a button in response to perceived test stimuli and the examiner or computer records the patient input and associated spatial information. In this way a visual field map is created.
  • the human retina is unable to fixate continuously upon an unmoving, unchanging stimulus. After less than a second of stimulation, the subject's retinal cells will adapt to the stimulus and no longer relay any information to the brain regarding the stimulus. Such adaptation is problematic for devices requiring constant fixation upon a fixed point since the viewer must change fixation in order to continue seeing the object of regard. This changing fixation may reduce the accuracy, precision, and overall effectiveness of testing, therapeutic, or non-therapeutic visual stimulation programs that require continuous unchanging visual fixation.
  • the human visual system includes two simultaneously functioning pathways.
  • the more primitive “M” pathway is dedicated largely to the recognition of moving objects or objects that change in luminosity.
  • the “P” pathway is more evolved and more closely coupled to neural structures associated with conscious thought.
  • the “P” pathway provides recognition of fine detail and color to the brain and is much less committed to motion detection.
  • Static perimetry In static perimetry, the patient fixates upon a specific point while light stimuli (spots) are delivered to various points in the peripheral visual field. Static perimetry can be administered using peripheral stimuli of varying brightness to determine the level of luminance sensitivity throughout the field, or with peripheral stimuli of identical brightness, to screen for the presence or absence of vision at various locations.
  • Kinetic perimetry also requires a patient to fixate a central spot during delivery of peripheral stimuli.
  • the stimuli are luminous spots of varying size and brightness. The spots are moved from an area where there is known to be no vision (e.g. the far periphery or physiologic blind spot) toward areas where vision may exist.
  • the patient is tasked with responding upon detection of a moving light in the periphery.
  • Test points are delivered along radii of the circle (or "horopter") of the patient's field of vision. The points of first detection are recorded on a plot and the circumference of the connected points is considered the border of motion and light sensitivity for the brightness and size of the stimulus used.
  • Frequency doubling technology is used to test the spatial resolution of a subject's visual field.
  • FDT Frequency doubling technology
  • a subject attempts to observe a peripheral square or circular grating comprised of striations of alternating luminosities.
  • the gratings are modulated in a wave pattern involving temporal changes in luminosity of the striations.
  • the luminosity modulation is performed above the critical flicker frequency (CFF), typically about 25 Hz, so that the modulation is not noticeable to the subject.
  • CFF critical flicker frequency
  • the subject's visual field is sufficient, the subject will observe an optical illusion in which the spatial frequency of the striations is doubled, i.e., the space between the striations is halved.
  • the spatial frequency or contrast may be modulated to determine the limits of the subject's spatial resolution.
  • an abnormally low spatial frequency may be required for the subject to observe the frequency doubling illusion.
  • US Patent No. 6,068,377 issued May 30, 2000 to McKinnon, an alternate version of FDT is employed, in which the grating is isoluminous, but with alternating hue.
  • alteration of a fixation stimulus displayed on a computer-driven display allows a human subject to maintain extended visual fixation upon the resulting dynamic stimulus.
  • the fixation is presented upon the display and the stimulus is altered to allow resensitization of the subject's retina, thereby allowing prolonged visual fixation upon the resulting dynamic target.
  • the steps of presenting the stimulus and altering the stimulus may be repeated for a given number of cycles top allow sustained sensitization and prolonged fixation by the subject.
  • the fixation of the subject may be verified by presenting a test cue and recording a subject's input in response to the test cue.
  • the test cue may also be altered to allow resensitization of the subject's retina.
  • successive presentation of the test cue may be performed with varying intervening time intervals.
  • One way to vary the time intervals is to vary the number of cycles of presentation of the fixation stimulus and the altered fixation stimulus.
  • the alteration of the dynamic fixation stimulus is visible only by using a portion of the subject's retina corresponding to about 2 degrees or less of the subject's central visual field.
  • fixation stimulus may have the form of a repetitively translating object, a rotating object, or an intermingled set of cyclically changing objects.
  • the stimulus could include two sets of intermingled striations of opposite and cyclically altering luminosities.
  • the dynamic fixation stimulus is used for purposes of vision testing or training.
  • a method for stimulating a motion-detecting visual pathway of a subject.
  • a subject is tasked with fixating on a central stimulus displayed on a computer-driven display. While the subject is visually fixated, a peripheral stimulus is presented on the display. At least one characteristic of the peripheral stimulus is altered so as to trigger the motion-sensitive visual pathway of the subject.
  • the altered characteristic may be the spatial locus, size, pattern, luminosity or hue of the stimulus.
  • the altered and base stimulus may be alternately displayed in a cyclical manner to sustain the display of a dynamic peripheral stimulus. While alternately displaying the base and altered stimulus, the subject's response, indicative of their detection of the stimulus, may be monitored and recorded.
  • the dynamic peripheral stimulus may be, for example, a repetitively translating object, or a repetitively blinking object.
  • a computer program product for use on a computer system for stimulating motion-sensitive regions of a subject's peripheral vision.
  • the computer program includes a computer usable medium having computer readable program code, which includes program code for providing a dynamic peripheral stimulation displayed upon a computer-driven display and program code for recording the subject's response to the dynamic peripheral stimulation.
  • a method for maintaining fixation for purposes of testing or treating the visual field of a subject; the method may also be implemented in a computer system or computer program product.
  • the method includes the steps of providing a fixation stimulus for the subject to visually fixate upon, repeatedly altering the stimulus to create an optical illusion that is only detectable by use of the subject's central visual field and presenting a peripheral stimulus to the subject while the subject is fixated on the fixation stimulus.
  • the subject's response to the peripheral stimulus may be recorded.
  • the difficulty level of the optical illusion is tuned to match the spatial perception ability of the subject.
  • the optical illusion may be a frequency doubling optical illusion, such as a frequency doubling grating.
  • the difficulty level of the frequency doubling grating may be tuned by altering the spatial frequency of the grating.
  • the tuning process may include increasing the spatial frequency of the grating until the illusion is not properly detected by the subject and then maintaining the spatial frequency at a level that is detectable by the subject, yet near the limit of the spatial resolution of the subject's central visual field.
  • the fixation stimulus may be systematically altered to target different retinal regions, for example, by rotation or translation, thereby preventing desensitization.
  • a fixation test cue may be presented to query the subject's fixation upon the stimulus.
  • Fig. 1 shows a flow chart of a method for presenting a dynamic fixation stimulus in accordance with an embodiment of the invention
  • Fig. 2 shows a flow chart of a method for presenting a base and alternate dynamic fixation stimulus in accordance with an another embodiment of the invention
  • Fig. 3 shows a flow chart of a method for presenting a base and alternate dynamic fixation stimulus in accordance with the embodiment of Fig. 2;
  • Figs. 4-10 show a repetitively translating fixation stimulus in accordance with an embodiment of the invention
  • FIGs. 1 1-17 show a rotating fixation stimulus in accordance with another embodiment of the invention
  • Fig. 18 shows a grating-like dynamic fixation stimulus in accordance with yet another embodiment of the invention, at a first time point
  • Fig. 19 shows a grating-like stimulus in accordance with the embodiment of Fig. 18 at a second time point
  • Fig. 20 is a flow chart of a method for creating a dynamic peripheral stimulus and recording a subject's response to the stimulus.
  • Fig. 21 shows a frequency doubling grating fixation stimulus as displayed on a computerized display
  • Fig. 22 shows the frequency doubling grating fixation stimulus of Fig. 21, as perceived by a subject
  • Fig. 23 is a flow chart for a method of tuning and using the frequency doubling grating fixation stimulus of Figs. 21-22.
  • Visual Restoration Therapy shall mean a process for allocating and targeting light stimuli to particular regions of a patient's visual field.
  • a "subject” shall mean a human receiving light stimuli during a visual restoration therapy session.
  • a dynamic stimulus is presented via a computer-driven display for a human subject (e.g., a patient or trainee) to fixate upon. At least a portion of the dynamic fixation stimulus is periodically altered in appearance, to mitigate the stimulation to corresponding retinal regions and facilitating retinal resensitization. Accordingly, the subject should be able to avoid retinal adaptation and sustain fixation upon the stimulus for longer than would typically be achievable or comfortable with a static stimulus.
  • the dynamic fixation stimulus may help to increase the accuracy, precision, reproducibility, and effectiveness of the procedure.
  • the dynamic changes in the stimulus may only be observed using the central portion of a subject's visual field.
  • Embodiments may be implemented using a computerized display with appropriate software routines according to methods disclosed herein.
  • Computer based systems for implementing visual restoration therapy are commercialized by the assignee, NovaVision Inc. of Boca Raton, Florida.
  • U.S. Patent No, 6,464, 356 andU.S. Patent Application publication nos. 2005- 0213033, 2006-0092377, 2006-0283466, 2007-0038142 all disclose computer based systems for visual restoration therapy and are hereby incorporated by reference herein.
  • a dynamic stimulus is used as a peripheral spot stimulus for purposes of visual field mapping or therapy.
  • the dynamic peripheral stimulus is presented upon a region of a display to target a corresponding peripheral region of the visual field and preferentially activates the motion-detecting cells and/or structures (e.g., the M pathway) in that region of the visual field.
  • the dynamic peripheral stimulus allows measurement and/or therapeutic stimulation of motion-detection pathway function.
  • dyamic peripheral stimuli of the present invention are confined to subregions of the visual field in a manner that makes them compatible with targeted stimulation of the M pathway in small regions that may be defined or located with respect to a fixation stimulus.
  • Embodiments include using dynamic peripheral stimuli that are "animations" within narrowly bounded zones that are of a size comparable to traditional spot stimuli and moving the bounds of the animation to a second location. Patient responses to the animated stimuli may be recorded upon presentation of each dynamic peripheral stimulus.
  • Fig. 1 shows a flow chart, which summarizes a method in accordance with an embodiment of the invention.
  • a base fixation stimulus is presented on a computer display (step 100). Although usually presented in the center of the display, the stimulus could also be presented off-center to better target a particular region of the visual field for testing or training.
  • all or part of the stimulus is altered (step 110) in a manner that should allow resensitization of the subject's retina.
  • the altered stimulus may be presented on a location of the display that is superimposed upon the base stimulus, or slightly offset, so that fixation may be readily maintained on the same area of the display.
  • the area of fixation is typically small, relative to the size of the display (e.g, less than 5% or 1% of the display area). Resensitization may be accomplished by reducing the overall luminosity (brightness), or spectral distribution of luminosity (i.e., color) of all or part of the stimuli, which may advantageously lower stimulation of corresponding retinal regions. After presenting the altered stimulus for a time, one or more additional altered stimuli may be presented, or the base stimulus may presented again by repeating step 100. The resulting loop may be repeated for a number of iterations, until a condition is fulfilled (e.g., completion of testing, or adequate subject performance) or an interrupt is encountered.
  • a condition e.g., completion of testing, or adequate subject performance
  • the timing of the presentation of the base and altered stimuli may be adjusted to minimize retinal desensitization; for example, stimuli may be switched on a sub-second basis.
  • that part of the subject's visual field that detects the fixation stimulus should be in a condition of sustained sensitization, thereby allowing for prolonged fixation upon the stimulus.
  • the repetition between the base and alternate stimuli may cycle, for example, at a frequency between 0.5 and 100 Hz, and more particularly may be between 1 Hz and 10 Hz.
  • the cycle may have a frequency of about 3 Hz, with stimuli presented for period of about 150 ms.
  • the cycles need not be regular; the delay between changes in the stimulus may vary from cycle to cycle, but the majority of such delays are typically consistent with the above ranges to allow for sustained sensitization.
  • the delays could increase with time, decrease with time, follow a pseudo-random sequence, or other pattern.
  • the sequence of delays could be 210 ms, 240 ms, 275 ms, 255 ms, etc.
  • Figs. 2-3 show flow charts corresponding to embodiments for presenting a dynamic fixation stimulus to a subject and testing the subject for fixation.
  • a loop is employed; a base stimulus is displayed for a time period (step 100), an altered stimulus (step 110) is displayed for a time period, and the process is repeated.
  • a fixation test cue is presented (step 200).
  • the test cue may consist of changing the shape, color, pattern or other visually detectable feature of the dynamic fixation stimulus.
  • the subject may be instructed to respond to the test cue through a computer-input device, such as a keyboard, mouse, touchscreen, joystick, microphone, etc.
  • Varying n between cycles of alternately presenting the fixation stimulus and test cue may advantageously cause the test cue to be presented at times that are not readily predictable by the subject, further ensuring subject compliance with regard to fixation.
  • the timing of test cue presentation may be varied in other ways, including by altering the duration of base or alternate stimulus presentation.
  • the test cue may be altered (step 210) as well, to facilitate continued fixation upon the test cue. Responses may be received from the subject during periods in which either the test cue or altered test cue are displayed.
  • the test cue and altered test cue may be alternately displayed in a loop (steps 200-210) which may repeat a number of times, designated by the variable q.
  • q may be determined in a number of ways and may be either fixed or varied.
  • the test cue and alternate test cue may be iteratively displayed (steps 200-210) until a response is received from the subject or may simply be displayed for a given number of cycles, or for a given elapsed time.
  • the base and altered fixation stimulus may again be displayed (steps 100 -110).
  • Figs. 4-10 schematically show, in time-sequence, an embodiment of a dynamic fixation stimulus and fixation test cue that utilizes a repetitively translating fixation stimulus presented on a computerized display.
  • the translating stimulus 300 is a green oval which horizontally translates between a first position (position A, shown in Figs. 4, 6, 7, and 10), and a second position (position B, shown in Figs. 5, 8 and 9).
  • position A shown in Figs. 4, 6, 7, and 10
  • position B shown in Figs. 5, 8 and 9
  • the translating stimulus may also be darker than the background.
  • the translating stimulus should contrast sufficiently with the background so that it is detectable by the subject (though the level of contrast may also be varied during a procedure or course of therapy).
  • the translating stimulus 300 need not be an oval, but could be a any of a variety of shapes and may translate horizontally, diagonally, or alternately in various directions or patterns.
  • the stimulus 300 may have any of a variety of colors and patterns.
  • a fixation test cue 400 may be presented at various times. The subject may be instructed to respond to the appearance of the fixation test cue 400 via a computer input device. In this way, maintenance of visual fixation upon the stimulus 300 may be tracked and/or measured.
  • the fixation test cue 400 is a change in color of the translating oval from green to yellow, but could be any change in visually detectable characteristics, including a change in shape or movement-pattern of the stimulus.
  • the fixation test cue may also be translated; Fig. 7 shows the fixation test cue in a left (base) position and Fig. 8 shows the fixation test cue in a right (alternate) position. In this way, the fixation test cue may remain visible for a longer period of time.
  • the timing of the translational movement may be performed at a variety of regular, or irregular timings; by way of example, the timing is based on a regular cycle of 2 Hz.
  • the stimulus 300 is translated about every 250 ms.
  • the following table lists the position, time and color of the stimulus, and corresponding figures:
  • FIGs. 11-17 show, in time sequence, a rotating fixation stimulus 500, in accordance with another embodiment of the invention.
  • a subject may visually fixate upon a spiked corona 510, which rotates around a central core 520.
  • the corona 510 may have a greater or fewer number of spikes 530.
  • the spikes may be arranged in either a regular or irregular manner around the core 520. While a subject's vision may saturate with regard to the unchanging parts of the rotating stimulus 500, the alternating positions of the rotating spikes 530 will render at least the spikes 530 continuously visible.
  • a rotating fixation stimulus 500 of altered color may be used as a test cue 600, and is shown in a base configuration in Fig. 15 and in a rotated, altered, configuration in Fig. 16.
  • the corona may rotate in regular or irregular increments; in Figs. 11-17, each increment of rotation is about 28°.
  • the following table summarizes the illustrative embodiment shown in Figs. 11-17.
  • the test cue stimulus 600 is closely matched to the fixation stimulus in terms of luminosity .
  • the patient's fixation may be more precisely ascertained, and consequently, the patient may be forced to fixate more precisely upon the stimulus 500.
  • test cue 600 may vary from the luminance of the base stimulus 500 by a value that is 10%, 5% or less of the base pattern luminance.
  • a test cue stimulus 600 may cycle between colors that are distinguishable when substantially isoluminous; e.g., a yellow test cue stimulus stimulus 600 having a luminance of 200 millicandela per square meter and a green fixation stimulus 500 pattern of 190 millicandela per square meter.
  • Figs. 18 and 19 show yet another embodiment in which a striated dynamic fixation stimulus 700 alternates with time between a positive (Fig. 18) and negative (Fig. 19) form.
  • Low-luminosity areas 710 of the stimulus 700 in Fig. 18 have a high luminosity in Fig. 19.
  • high-luminosity areas 720 of the stimulus 700 in Fig 18 have a low luminosity in Fig 19.
  • the stimulus 700 may repeatedly alternate between these positive and negative forms. If plotted versus time, the displayed luminosity of a given point or area within the stimulus 700 may vary in a square wave, sine wave (which would necessitate the use of intermediate shades of gray), or other repetitive pattern to allow alternate resensitization of saturated retinal regions.
  • the cycle frequency can vary, but may be optimal when above 0.5 Hz since retinal desensitization may occur after less than one second of stimulation.
  • the striations may alternate between bright and dark every 250 ms (2 Hz).
  • the striations may also continuously or discontinuously rotate around a given point.
  • a subject should only be able to resolve the striations by using the central 1-2° of their visual field. As a result, loss of fixation will alter the striated appearance of the stimulus 700. Thus, the subject will be alerted very quickly if his or her fixation has wandered off target. Additionally, such high resolution features may be used with various embodiments of the invention as highly accurate test cues since such test cues should not be detectable using peripheral vision. Use of these test cues may result in increased accuracy in testing subject fixation, and may yield corresponding improvements in testing and training results.
  • the stimulus 700 may be employed. For example, varying colors, patterns or other visually detectable properties may be used, including alternating between more than two such properties (e.g., changing points or regions from red to yellow, or green). While the use of sine waves and square waves described above implies alteration between two fixed levels, the levels may change with time in a pre-defined or semi-random manner.
  • dynamic stimuli like the dynamic fixation stimuli of Figs. 1-18 may be used as peripheral spot stimuli for static or kinetic campimetry or perimetry, or as a component of visual restoration therapy (e.g., NovaVision VRTTM; NovaVision, Inc, Boca Raton, FL).
  • visual restoration therapy e.g., NovaVision VRTTM; NovaVision, Inc, Boca Raton, FL.
  • a subject is tasked with fixating on a central fixation stimulus (static or dynamic) and responding to the appearance of a peripheral spot stimulus.
  • the peripheral spot stimulus has a movement element to the presentation to cause preferential detection by the motion sensitive portion of the visual pathway (a "dynamic peripheral stimulus").
  • the peripheral spot stimulus is still a "spot" in the sense that is presented within bounds that define a fraction of the visual field comparable to the fraction of a visual field that might be stimulated by a static spot stimulus.
  • the stimulus may be an animation within narrowly defined bounds, i.e., bounds that are substantially less than the visual field of the subject.
  • the bounds may correspond to 5%, 3%, or 1% or the patient's visual filed.
  • the dynamic peripheral stimulus may be a single spot or coherent group of spots or objects.
  • the stimulus may be adjustable in size, brightness, hue, frequency or other parameter.
  • the dynamic peripheral stimulus may be used to map the visual field through perimetry or campimetry, to stimulate visual field region in a visual restoration therapy session, or both. Accordingly, user input may be collected to indicate perception of the dynamic peripheral spot stimuli.
  • Fig, 20 is a flow diagram for a presentation of the dynamic peripheral spot stimulus.
  • a peripheral location in which the dynamic peripheral spot stimulus is to be applied is selected (step 800). The location may be based on a previous perimetry or campimetry. For example, the border of the motion-sensitive visual field may be determined using kinetic perimetry.
  • Motion sensitive visual-field regions on, near or within this border may then be tested or stimulated for therapeutic purposes using the dynamic peripheral spot stimulus.
  • the overall size of the stimulus may occupy a relatively small fraction of the visual field to increase campimetry resolution or therapeutic specificity.
  • the boundary of the stimulus may consist of 10-20 pixels on a computerized display.
  • a base peripheral stimulus is presented at the selected location (step 810). Like the above-described fixation stimuli, the stimulus is then altered to target a different retinal region (step 820). The subject's motion-sensitive visual pathway may detect this alteration. Steps 810 and 820 may be repeated a given number of times while awaiting a response from the subject (step 830). Optionally, if there is no response from the subject an additional characteristic (e.g., luminosity, contrast, motion frequency, or hue) of the dynamic peripheral stimulus may be altered; when used for campimetry, a multidimensional motion-sensitive visual-field map may be thereby created.
  • a new location is chosen (step 800). This process (steps 800-830) is repeated until a visual-field map of sufficient detail is created, or until therapy is complete.
  • dynamic peripheral stimuli may be useful for testing and treating subjects that have not optimally responded to other stimuli, and for use with patients having extremely poor vision (e.g., end stage glaucoma, optic atrophy, or retinitis pigmentosa).
  • Dynamic peripheral stimulus may be incorporated as a feature into existing perimeters.
  • Example One An isoluminous circular spot of small angular subtense (e.g. 11 pixels on an LCD monitor) is programmed to appear at pre-determined locations within the testing or therapy area of the applicable device.
  • the circular spot of light "blinks" on and off at a pre-determined frequency but does not deviate from its original location.
  • Example Two Two small (e.g. 5 pixels on an LCD screen), vertically elongated ellipses of light (paired side-by side) appear at a pre-determined location within the testing or therapy area and alternate illumination at a pre-determined frequency (e.g., right-left-right- left).
  • the stimulus is modulated in appearance to trigger the percept of motion but the stimulus remains fixed in its location until detection or a pre-determined length of time.
  • a frequency doubling grating may be used as a fixation stimulus in a way that creates an optical illusion.
  • Fig. 21 shows a frequency doubling grating 850 as displayed upon a computer display in a brief moment of time. Like the frequency doubling gratings used for FDT, the spatial luminosity phase of the frequency doubling grating 850 is cycled above the critical flicker frequency, e.g., 25 Hz, to create a frequency doubling optical illusion.
  • Fig. 22 shows how such an optical illusion might appear to a healthy subject. Unlike prior art gratings, however, the grating 850 of Figs. 21-22 is used as a fixation stimulus, rather than a peripheral test stimulus.
  • Peripheral stimuli used in connection with the grating 850 may be any of those described herein, among others.
  • the frequency doubling optical illusion will only be visible to a subject if it illuminates the very central portion of the subject's retina.
  • very small deviations in fixation will be noticeable to the subject and testable via an appropriate test cue (e.g., a change in the orientation, or other detectable change in the grating 850).
  • an appropriate test cue e.g., a change in the orientation, or other detectable change in the grating 850.
  • movement of the patient's fixation be as little as 2° will result in about a 50% decrease in spatial resolution.
  • the standard deviation in eye position over the course of therapy may be improved by a factor of about 1-2°.
  • the precision and effectiveness of peripheral testing or stimulatory treatment may be improved.
  • a greater fraction of the peripheral stimuli may thereby be correctly allocated to appropriate visual field regions.
  • Fig 23 shows a flow chart for a tuning process in accordance with an embodiment of the invention.
  • a spatial frequency parameter controls the spatial frequency of the grating 850 presented on a computerized display. This parameter is initialized to a low frequency starting point, e.g., one that can be detected as frequency doubling illusion by a majority, e.g. 90%, of patients or greater (step 910).
  • the grating 850 is then presented as a frequency doubling fixation stimulus (step 920). If the subject detects the illusion (decision step 930), the spatial frequency parameter is increased and the higher frequency grating 850 is presented again at step 920.
  • the spatial frequency parameter is then decreased to one that is just below the threshold frequency. Accordingly, the spatial frequency adjusted stimulus is then detectable by the subject only with use of the most spatially sensitive region of the subject's visual field.
  • the frequency parameter may be set to be between 2% and 15% lower than the threshold frequency.
  • the subject's retina may be desensitized to the striatums.
  • the grating 850 may be systematically perturbed to alternately stimulate different retinal regions; e.g., rotated or translated, as in the embodiments described with reference to Figs. 1-19.
  • the grating 850 may also be alternated with a fixation test cue, also described above.
  • the disclosed methods for vision fixation, testing and training may be implemented as a computer program product for use with a computer system.
  • Such implementations may include a series of computer instructions fixed either on a tangible medium, such as a computer readable medium (e.g., a diskette, CD-ROM, ROM, or fixed disk) or transmittable to a computer system, via a modem or other interface device, such as a communications adapter connected to a network over a medium.
  • the medium may be either a tangible medium (e.g., optical or analog communications lines) or a medium implemented with wireless techniques (e.g., microwave, infrared, laser or other transmission techniques).
  • the series of computer instructions embodies all or part of the functionality previously described herein with respect to the system. Those skilled in the art should appreciate that such computer instructions can be written in a number of programming languages for use with many computer architectures or operating systems.
  • Such instructions may be stored in any memory device, such as semiconductor, magnetic, optical or other memory devices, and may be transmitted using any communications technology, such as optical, infrared, microwave, laser or other transmission technologies.
  • a computer program product may be distributed as a removable medium with accompanying printed or electronic documentation (e.g., shrink wrapped software), preloaded with a computer system (e.g., on system ROM or fixed disk), or distributed from a server or electronic bulletin board over the network (e.g., the Internet or World Wide Web).
  • some embodiments of the invention may be implemented as a combination of both software (e.g., a computer program product) and hardware. Still other embodiments of the invention are implemented as entirely hardware, or entirely software (e.g., a computer program product).

Abstract

Alteration of a fixation or peripheral stimulus displayed on a computer-driven display allows a human subject to maintain extended visual fixation upon the resulting dynamic stimulus. The fixation is presented upon the display and the stimulus is altered to allow resensitization of the subject's retina, thereby allowing prolonged visual fixation upon the resulting dynamic target. A dynamic stimulus may utilize a frequency doubling illusion.

Description

Dynamic Stimuli for Visual Field Testing and Therapy
Cross Reference To Related Applications
[0001] This patent application claims priority from U.S. Provisional Application Serial No. 60/833,199 filed on July 25, 2006 and U.S. Provisional Application Serial No. 60/867,499 filed on November 28, 2006, which are hereby incorporated by reference herein in their entirety.
Technical Field
[0002] The present invention relates to systems for maintaining the focus of a subject on a specified region of a display and for stimulating the motion-sensitive visual-pathway of a subject for purposes of testing or improving a subject's vision.
Background [0003] The macula is the region of the retina which is used for high acuity vision, as is typically required for reading. To diagnose macular damage, a patient may undergo various types of examinations, including automated perimetry or campimetry, in which the patient is positioned in front of a test surface and is asked to maintain focus on a target. A computer then actuates one or more light sources to present visual stimuli at specific points on the test surface. The patient is asked to press a button in response to perceived test stimuli and the examiner or computer records the patient input and associated spatial information. In this way a visual field map is created.
[0004] The human retina is unable to fixate continuously upon an unmoving, unchanging stimulus. After less than a second of stimulation, the subject's retinal cells will adapt to the stimulus and no longer relay any information to the brain regarding the stimulus. Such adaptation is problematic for devices requiring constant fixation upon a fixed point since the viewer must change fixation in order to continue seeing the object of regard. This changing fixation may reduce the accuracy, precision, and overall effectiveness of testing, therapeutic, or non-therapeutic visual stimulation programs that require continuous unchanging visual fixation.
[0005] The human visual system includes two simultaneously functioning pathways. The more primitive "M" pathway is dedicated largely to the recognition of moving objects or objects that change in luminosity. The "P" pathway is more evolved and more closely coupled to neural structures associated with conscious thought. The "P" pathway provides recognition of fine detail and color to the brain and is much less committed to motion detection.
[0006] In persons who have suffered damage to the visual system (which includes the brain itself), these two pathways frequently are affected to different degrees. Moreover, the two systems usually recover function at different rates. This disparity of functional loss and recovery can cause significant disharmony of the innately matched systems and resulting disturbances to the overall sensory function of the subject.
[0007] The ability to accurately detect the different types of visual processing disturbance and to properly treat the affected pathways is of vital importance to the treating practitioner and ultimately, the patient. Increased diagnostic testing sensitivity and visual therapy specificity result in better prognosis for recovery of the individual's function. Current diagnostic testing modalities are limited in their ability to detect specific types of visual function damage. [0008] Most field-of- vision testing falls into one of two categories: Static perimetry and kinetic perimetry. Static perimetry is valuable in establishing a depiction of fine light sensitivity or detail within the central 30 to 60 degrees of visual field ("P" cell function), while kinetic perimetry is valuable in identifying the borders of motion vision function ("M" cell function). However, neither technique is able to identify efficiently the amount or level of motion sensitivity at all the points within the borders.
[0009] In static perimetry, the patient fixates upon a specific point while light stimuli (spots) are delivered to various points in the peripheral visual field. Static perimetry can be administered using peripheral stimuli of varying brightness to determine the level of luminance sensitivity throughout the field, or with peripheral stimuli of identical brightness, to screen for the presence or absence of vision at various locations.
[0010] Kinetic perimetry also requires a patient to fixate a central spot during delivery of peripheral stimuli. In kinetic perimetry, the stimuli are luminous spots of varying size and brightness. The spots are moved from an area where there is known to be no vision (e.g. the far periphery or physiologic blind spot) toward areas where vision may exist. The patient is tasked with responding upon detection of a moving light in the periphery. Test points are delivered along radii of the circle (or "horopter") of the patient's field of vision. The points of first detection are recorded on a plot and the circumference of the connected points is considered the border of motion and light sensitivity for the brightness and size of the stimulus used.
[0011] Frequency doubling technology (FDT) is used to test the spatial resolution of a subject's visual field. In FDT, a subject attempts to observe a peripheral square or circular grating comprised of striations of alternating luminosities. The gratings are modulated in a wave pattern involving temporal changes in luminosity of the striations. The luminosity modulation is performed above the critical flicker frequency (CFF), typically about 25 Hz, so that the modulation is not noticeable to the subject. If the subject's visual field is sufficient, the subject will observe an optical illusion in which the spatial frequency of the striations is doubled, i.e., the space between the striations is halved. The spatial frequency or contrast may be modulated to determine the limits of the subject's spatial resolution. In a patient with visual field damage, e.g., one suffering from glaucoma, an abnormally low spatial frequency may be required for the subject to observe the frequency doubling illusion. In US Patent No. 6,068,377, issued May 30, 2000 to McKinnon, an alternate version of FDT is employed, in which the grating is isoluminous, but with alternating hue.
[0012] Work in the laboratory of Krystel R. Huxlin at the University of Rochester has utilized a series of spot stimuli for visual field therapy. In the poster presentation, "Training- induced perceptual recovery after visual cortical stroke" Eric Kelts, Jennifer M. Williams, Brad Feldman, Mary Hayhoe and Krystel R. Huxlin, 30th Annual NANOS meeting, Orlando, Fl, 2004, stimuli move with respect to the entire visual field. Such as approach is not consistent with visual restoration therapy approaches that individually target small regions of the visual field. Additionally, movement of a stimulus across a large region will tend to cause distraction of a patient, and is thus inconsistent with visual therapy approaches that utilize a fixation stimulus. If patient feedback were collected with such a system, it would be difficult or even impossible to precisely locate the visual filed region that caused the patient's perception to be triggered.
Summary of the Invention
[0013] In accordance with an embodiment of the invention, alteration of a fixation stimulus displayed on a computer-driven display allows a human subject to maintain extended visual fixation upon the resulting dynamic stimulus. The fixation is presented upon the display and the stimulus is altered to allow resensitization of the subject's retina, thereby allowing prolonged visual fixation upon the resulting dynamic target.
[0014] In accordance with various embodiments, the steps of presenting the stimulus and altering the stimulus may be repeated for a given number of cycles top allow sustained sensitization and prolonged fixation by the subject. The fixation of the subject may be verified by presenting a test cue and recording a subject's input in response to the test cue. Like the dynamic fixation stimulus, the test cue may also be altered to allow resensitization of the subject's retina.
[0015] In order to prevent the subject from predicting the time at which a test cue is presented, successive presentation of the test cue may be performed with varying intervening time intervals. One way to vary the time intervals is to vary the number of cycles of presentation of the fixation stimulus and the altered fixation stimulus.
[0016] In accordance with particular embodiments, the alteration of the dynamic fixation stimulus is visible only by using a portion of the subject's retina corresponding to about 2 degrees or less of the subject's central visual field.
[0017] There are many suitable fixation stimulus geometries and dynamic transformations. For example, the fixation stimulus may have the form of a repetitively translating object, a rotating object, or an intermingled set of cyclically changing objects. The stimulus could include two sets of intermingled striations of opposite and cyclically altering luminosities.
[0018] In embodiments of the invention, the dynamic fixation stimulus is used for purposes of vision testing or training.
[0019] In related embodiments, a method is provided for stimulating a motion-detecting visual pathway of a subject. A subject is tasked with fixating on a central stimulus displayed on a computer-driven display. While the subject is visually fixated, a peripheral stimulus is presented on the display. At least one characteristic of the peripheral stimulus is altered so as to trigger the motion-sensitive visual pathway of the subject.
[0020] In other related embodiments, the altered characteristic may be the spatial locus, size, pattern, luminosity or hue of the stimulus. The altered and base stimulus may be alternately displayed in a cyclical manner to sustain the display of a dynamic peripheral stimulus. While alternately displaying the base and altered stimulus, the subject's response, indicative of their detection of the stimulus, may be monitored and recorded. The dynamic peripheral stimulus may be, for example, a repetitively translating object, or a repetitively blinking object. By first determining the bounds of a subject's visual field, testing or therapy can be concentrated within those bounds.
[0021] In further related embodiments, a computer program product for use on a computer system is provided for stimulating motion-sensitive regions of a subject's peripheral vision. The computer program includes a computer usable medium having computer readable program code, which includes program code for providing a dynamic peripheral stimulation displayed upon a computer-driven display and program code for recording the subject's response to the dynamic peripheral stimulation.
[0022] In accordance with another embodiment of the invention, a method is provided for maintaining fixation for purposes of testing or treating the visual field of a subject; the method may also be implemented in a computer system or computer program product. The method includes the steps of providing a fixation stimulus for the subject to visually fixate upon, repeatedly altering the stimulus to create an optical illusion that is only detectable by use of the subject's central visual field and presenting a peripheral stimulus to the subject while the subject is fixated on the fixation stimulus. The subject's response to the peripheral stimulus may be recorded.
[0023] In related embodiments, the difficulty level of the optical illusion is tuned to match the spatial perception ability of the subject. The optical illusion may be a frequency doubling optical illusion, such as a frequency doubling grating. The difficulty level of the frequency doubling grating may be tuned by altering the spatial frequency of the grating. For example, the tuning process may include increasing the spatial frequency of the grating until the illusion is not properly detected by the subject and then maintaining the spatial frequency at a level that is detectable by the subject, yet near the limit of the spatial resolution of the subject's central visual field. The fixation stimulus may be systematically altered to target different retinal regions, for example, by rotation or translation, thereby preventing desensitization. A fixation test cue may be presented to query the subject's fixation upon the stimulus. Brief Description of the Drawings
[0024] The foregoing features of the invention will be more readily understood by reference to the following detailed description, taken with reference to the accompanying drawings, in which:
Fig. 1 shows a flow chart of a method for presenting a dynamic fixation stimulus in accordance with an embodiment of the invention;
Fig. 2 shows a flow chart of a method for presenting a base and alternate dynamic fixation stimulus in accordance with an another embodiment of the invention; Fig. 3 shows a flow chart of a method for presenting a base and alternate dynamic fixation stimulus in accordance with the embodiment of Fig. 2;
Figs. 4-10 show a repetitively translating fixation stimulus in accordance with an embodiment of the invention;
Figs. 1 1-17 show a rotating fixation stimulus in accordance with another embodiment of the invention;
Fig. 18 shows a grating-like dynamic fixation stimulus in accordance with yet another embodiment of the invention, at a first time point;
Fig. 19 shows a grating-like stimulus in accordance with the embodiment of Fig. 18 at a second time point; Fig. 20 is a flow chart of a method for creating a dynamic peripheral stimulus and recording a subject's response to the stimulus.
Fig. 21 shows a frequency doubling grating fixation stimulus as displayed on a computerized display;
Fig. 22 shows the frequency doubling grating fixation stimulus of Fig. 21, as perceived by a subject;
Fig. 23 is a flow chart for a method of tuning and using the frequency doubling grating fixation stimulus of Figs. 21-22.
Detailed Description of Specific Embodiments [0025] Definitions. As used in this description and the accompanying claims, the following terms shall have the meanings indicated, unless the context otherwise requires:
"Visual Restoration Therapy" shall mean a process for allocating and targeting light stimuli to particular regions of a patient's visual field.
A "subject" shall mean a human receiving light stimuli during a visual restoration therapy session.
[0026] In illustrative embodiments of the invention, a dynamic stimulus is presented via a computer-driven display for a human subject (e.g., a patient or trainee) to fixate upon. At least a portion of the dynamic fixation stimulus is periodically altered in appearance, to mitigate the stimulation to corresponding retinal regions and facilitating retinal resensitization. Accordingly, the subject should be able to avoid retinal adaptation and sustain fixation upon the stimulus for longer than would typically be achievable or comfortable with a static stimulus. When used as a central target in perimetry, campimetry, or vision enhancing training (e.g. vision restoration therapy targeting peripheral regions), the dynamic fixation stimulus may help to increase the accuracy, precision, reproducibility, and effectiveness of the procedure. In some embodiments, the dynamic changes in the stimulus may only be observed using the central portion of a subject's visual field. Embodiments may be implemented using a computerized display with appropriate software routines according to methods disclosed herein. Computer based systems for implementing visual restoration therapy are commercialized by the assignee, NovaVision Inc. of Boca Raton, Florida. U.S. Patent No, 6,464, 356 andU.S. Patent Application publication nos. 2005- 0213033, 2006-0092377, 2006-0283466, 2007-0038142 all disclose computer based systems for visual restoration therapy and are hereby incorporated by reference herein.
[0027] In related embodiments of the invention, a dynamic stimulus is used as a peripheral spot stimulus for purposes of visual field mapping or therapy. The dynamic peripheral stimulus is presented upon a region of a display to target a corresponding peripheral region of the visual field and preferentially activates the motion-detecting cells and/or structures (e.g., the M pathway) in that region of the visual field. When used with visual restoration therapy, perimetry, or campimetry, the dynamic peripheral stimulus allows measurement and/or therapeutic stimulation of motion-detection pathway function. Unlike stimuli of the prior art that move in a pattern across all or large portions of the visual field, dyamic peripheral stimuli of the present invention are confined to subregions of the visual field in a manner that makes them compatible with targeted stimulation of the M pathway in small regions that may be defined or located with respect to a fixation stimulus. Embodiments include using dynamic peripheral stimuli that are "animations" within narrowly bounded zones that are of a size comparable to traditional spot stimuli and moving the bounds of the animation to a second location. Patient responses to the animated stimuli may be recorded upon presentation of each dynamic peripheral stimulus.
[0028] Fig. 1 shows a flow chart, which summarizes a method in accordance with an embodiment of the invention. A base fixation stimulus is presented on a computer display (step 100). Although usually presented in the center of the display, the stimulus could also be presented off-center to better target a particular region of the visual field for testing or training. After presenting the base stimulus for a period of time, all or part of the stimulus is altered (step 110) in a manner that should allow resensitization of the subject's retina. The altered stimulus may be presented on a location of the display that is superimposed upon the base stimulus, or slightly offset, so that fixation may be readily maintained on the same area of the display. The area of fixation is typically small, relative to the size of the display (e.g, less than 5% or 1% of the display area). Resensitization may be accomplished by reducing the overall luminosity (brightness), or spectral distribution of luminosity (i.e., color) of all or part of the stimuli, which may advantageously lower stimulation of corresponding retinal regions. After presenting the altered stimulus for a time, one or more additional altered stimuli may be presented, or the base stimulus may presented again by repeating step 100. The resulting loop may be repeated for a number of iterations, until a condition is fulfilled (e.g., completion of testing, or adequate subject performance) or an interrupt is encountered. The timing of the presentation of the base and altered stimuli may be adjusted to minimize retinal desensitization; for example, stimuli may be switched on a sub-second basis. As a result of the repeated resensitizations, that part of the subject's visual field that detects the fixation stimulus should be in a condition of sustained sensitization, thereby allowing for prolonged fixation upon the stimulus.
[0029] The repetition between the base and alternate stimuli may cycle, for example, at a frequency between 0.5 and 100 Hz, and more particularly may be between 1 Hz and 10 Hz. For example, the cycle may have a frequency of about 3 Hz, with stimuli presented for period of about 150 ms. However, the cycles need not be regular; the delay between changes in the stimulus may vary from cycle to cycle, but the majority of such delays are typically consistent with the above ranges to allow for sustained sensitization. The delays could increase with time, decrease with time, follow a pseudo-random sequence, or other pattern. For example, the sequence of delays could be 210 ms, 240 ms, 275 ms, 255 ms, etc.
[0030] Figs. 2-3 show flow charts corresponding to embodiments for presenting a dynamic fixation stimulus to a subject and testing the subject for fixation. As in the embodiment of Fig. 1, a loop is employed; a base stimulus is displayed for a time period (step 100), an altered stimulus (step 110) is displayed for a time period, and the process is repeated. After a given number (designated by the variable n) of loop cycles, a fixation test cue is presented (step 200). The test cue may consist of changing the shape, color, pattern or other visually detectable feature of the dynamic fixation stimulus. The subject may be instructed to respond to the test cue through a computer-input device, such as a keyboard, mouse, touchscreen, joystick, microphone, etc. Varying n between cycles of alternately presenting the fixation stimulus and test cue may advantageously cause the test cue to be presented at times that are not readily predictable by the subject, further ensuring subject compliance with regard to fixation. However, the timing of test cue presentation may be varied in other ways, including by altering the duration of base or alternate stimulus presentation. As shown in the flow chart of Fig. 3, the test cue may be altered (step 210) as well, to facilitate continued fixation upon the test cue. Responses may be received from the subject during periods in which either the test cue or altered test cue are displayed. The test cue and altered test cue may be alternately displayed in a loop (steps 200-210) which may repeat a number of times, designated by the variable q. As is true for determining n, q may be determined in a number of ways and may be either fixed or varied. For example, the test cue and alternate test cue may be iteratively displayed (steps 200-210) until a response is received from the subject or may simply be displayed for a given number of cycles, or for a given elapsed time. In any case, after the test cue presentation phase is complete, the base and altered fixation stimulus may again be displayed (steps 100 -110).
[0031] Figs. 4-10 schematically show, in time-sequence, an embodiment of a dynamic fixation stimulus and fixation test cue that utilizes a repetitively translating fixation stimulus presented on a computerized display. As shown, the translating stimulus 300 is a green oval which horizontally translates between a first position (position A, shown in Figs. 4, 6, 7, and 10), and a second position (position B, shown in Figs. 5, 8 and 9). Although shown as having a higher luminosity than its background 310, the translating stimulus may also be darker than the background. Generally, the translating stimulus should contrast sufficiently with the background so that it is detectable by the subject (though the level of contrast may also be varied during a procedure or course of therapy). Of course, the translating stimulus 300 need not be an oval, but could be a any of a variety of shapes and may translate horizontally, diagonally, or alternately in various directions or patterns. The stimulus 300 may have any of a variety of colors and patterns.
[0032] As shown in Figs. 7 and 8, a fixation test cue 400 may be presented at various times. The subject may be instructed to respond to the appearance of the fixation test cue 400 via a computer input device. In this way, maintenance of visual fixation upon the stimulus 300 may be tracked and/or measured. As shown by way of example, the fixation test cue 400 is a change in color of the translating oval from green to yellow, but could be any change in visually detectable characteristics, including a change in shape or movement-pattern of the stimulus. Optionally, the fixation test cue may also be translated; Fig. 7 shows the fixation test cue in a left (base) position and Fig. 8 shows the fixation test cue in a right (alternate) position. In this way, the fixation test cue may remain visible for a longer period of time.
[0033] In accordance with an embodiment of the invention, the timing of the translational movement may be performed at a variety of regular, or irregular timings; by way of example, the timing is based on a regular cycle of 2 Hz. In other words, the stimulus 300 is translated about every 250 ms. The following table lists the position, time and color of the stimulus, and corresponding figures:
Time Translational Color Corresponding Comment
(ms) Position Figure
0 Left Green 4 Base stimulus
250 Right Green 5 Altered stimulus
500 Left Green 6
750 Right Green Not shown
1000 Left Green Not shown
1250 Right Green Not shown
1500 Left Green Not shown
1750 Right Green Not shown
2000 Left Green Not shown
2250 Right Green Not shown
2500 Left Green Not shown
2750 Right Green Not shown
3000 Left Green Not shown
3250 Right Green Not shown
3500 Left Green Not shown
3750 Right Green Not shown
4000 Left Yellow 7 Fixation Test Cue
4250 Right Yellow 8 Fixation Test Cue
4500 Left Green 9
4750 Right Green 10
[0034] Figs. 11-17 show, in time sequence, a rotating fixation stimulus 500, in accordance with another embodiment of the invention. A subject may visually fixate upon a spiked corona 510, which rotates around a central core 520. Although shown with eight regularly arranged spikes 530, the corona 510, may have a greater or fewer number of spikes 530. The spikes may be arranged in either a regular or irregular manner around the core 520. While a subject's vision may saturate with regard to the unchanging parts of the rotating stimulus 500, the alternating positions of the rotating spikes 530 will render at least the spikes 530 continuously visible. A rotating fixation stimulus 500 of altered color (orange corona 210 with a green core 220), may be used as a test cue 600, and is shown in a base configuration in Fig. 15 and in a rotated, altered, configuration in Fig. 16. The corona may rotate in regular or irregular increments; in Figs. 11-17, each increment of rotation is about 28°. The following table summarizes the illustrative embodiment shown in Figs. 11-17.
[0035] In a specific embodiment, the test cue stimulus 600 is closely matched to the fixation stimulus in terms of luminosity . By closely matching the luminance of the test cue 600 and a fixation stimulus 500, the patient's fixation may be more precisely ascertained, and consequently, the patient may be forced to fixate more precisely upon the stimulus 500.
Experimental data show that isoluminous test cues are visible only within about 2 degrees of visual angle. Conversely, if the test cue 600 varied greatly in luminance from the fixation stimulus 500, then a patient could detect the fixation change at greater angles, e.g., 6°, 10°, or even 15° off the line of proper fixation. The luminance of the test cue 600 may vary from the luminance of the base stimulus 500 by a value that is 10%, 5% or less of the base pattern luminance. For example, a test cue stimulus 600 may cycle between colors that are distinguishable when substantially isoluminous; e.g., a yellow test cue stimulus stimulus 600 having a luminance of 200 millicandela per square meter and a green fixation stimulus 500 pattern of 190 millicandela per square meter.
Time Rotation Core 520 Corona 510 Corresponding Comment
(ms) Position Color Color Figure
0 Base Green Yellow 11
250 Altered Green Yellow 12
500 Base Green Yellow 13 760 Altered Green Yellow 14
1000 Base Green Yellow Not shown
1250 Altered Green Yellow Not shown
1510 Base Green Yellow Not shown
1750 Altered Green Yellow Not shown
2000 Base Orange Green 15 Fixation Cue
2250 Altered Orange Green 16 Fixation Cue
2500 Base Green Yellow 17 Return to Standard Fixation Stimulus
[0036] Figs. 18 and 19 show yet another embodiment in which a striated dynamic fixation stimulus 700 alternates with time between a positive (Fig. 18) and negative (Fig. 19) form. Low-luminosity areas 710 of the stimulus 700 in Fig. 18 have a high luminosity in Fig. 19. Conversely, high-luminosity areas 720 of the stimulus 700 in Fig 18 have a low luminosity in Fig 19. The stimulus 700 may repeatedly alternate between these positive and negative forms. If plotted versus time, the displayed luminosity of a given point or area within the stimulus 700 may vary in a square wave, sine wave (which would necessitate the use of intermediate shades of gray), or other repetitive pattern to allow alternate resensitization of saturated retinal regions. As in the preceding examples of Figs 4-17, the cycle frequency can vary, but may be optimal when above 0.5 Hz since retinal desensitization may occur after less than one second of stimulation. For example, the striations may alternate between bright and dark every 250 ms (2 Hz). The striations may also continuously or discontinuously rotate around a given point.
[0037] If the striations are sufficiently narrow in width, a subject should only be able to resolve the striations by using the central 1-2° of their visual field. As a result, loss of fixation will alter the striated appearance of the stimulus 700. Thus, the subject will be alerted very quickly if his or her fixation has wandered off target. Additionally, such high resolution features may be used with various embodiments of the invention as highly accurate test cues since such test cues should not be detectable using peripheral vision. Use of these test cues may result in increased accuracy in testing subject fixation, and may yield corresponding improvements in testing and training results.
[0038] Many variations of the stimulus 700 may be employed. For example, varying colors, patterns or other visually detectable properties may be used, including alternating between more than two such properties (e.g., changing points or regions from red to yellow, or green). While the use of sine waves and square waves described above implies alteration between two fixed levels, the levels may change with time in a pre-defined or semi-random manner.
[0039] In related embodiments of the present invention, dynamic stimuli like the dynamic fixation stimuli of Figs. 1-18 may be used as peripheral spot stimuli for static or kinetic campimetry or perimetry, or as a component of visual restoration therapy (e.g., NovaVision VRT™; NovaVision, Inc, Boca Raton, FL).
[0040] In embodiments, a subject is tasked with fixating on a central fixation stimulus (static or dynamic) and responding to the appearance of a peripheral spot stimulus. The peripheral spot stimulus has a movement element to the presentation to cause preferential detection by the motion sensitive portion of the visual pathway (a "dynamic peripheral stimulus"). However, the peripheral spot stimulus is still a "spot" in the sense that is presented within bounds that define a fraction of the visual field comparable to the fraction of a visual field that might be stimulated by a static spot stimulus. Thus, the stimulus may be an animation within narrowly defined bounds, i.e., bounds that are substantially less than the visual field of the subject. For example, the bounds may correspond to 5%, 3%, or 1% or the patient's visual filed. The dynamic peripheral stimulus may be a single spot or coherent group of spots or objects. The stimulus may be adjustable in size, brightness, hue, frequency or other parameter. The dynamic peripheral stimulus may be used to map the visual field through perimetry or campimetry, to stimulate visual field region in a visual restoration therapy session, or both. Accordingly, user input may be collected to indicate perception of the dynamic peripheral spot stimuli. [0041] Fig, 20 is a flow diagram for a presentation of the dynamic peripheral spot stimulus. A peripheral location in which the dynamic peripheral spot stimulus is to be applied is selected (step 800). The location may be based on a previous perimetry or campimetry. For example, the border of the motion-sensitive visual field may be determined using kinetic perimetry. Motion sensitive visual-field regions on, near or within this border may then be tested or stimulated for therapeutic purposes using the dynamic peripheral spot stimulus. The overall size of the stimulus may occupy a relatively small fraction of the visual field to increase campimetry resolution or therapeutic specificity. For example, the boundary of the stimulus may consist of 10-20 pixels on a computerized display.
[0042] A base peripheral stimulus is presented at the selected location (step 810). Like the above-described fixation stimuli, the stimulus is then altered to target a different retinal region (step 820). The subject's motion-sensitive visual pathway may detect this alteration. Steps 810 and 820 may be repeated a given number of times while awaiting a response from the subject (step 830). Optionally, if there is no response from the subject an additional characteristic (e.g., luminosity, contrast, motion frequency, or hue) of the dynamic peripheral stimulus may be altered; when used for campimetry, a multidimensional motion-sensitive visual-field map may be thereby created. Upon receiving a response from the subject or reaching a time-out or other termination condition, a new location is chosen (step 800). This process (steps 800-830) is repeated until a visual-field map of sufficient detail is created, or until therapy is complete.
[0043] By stimulating visual-field regions that do not respond to static stimuli, dynamic peripheral stimuli may be useful for testing and treating subjects that have not optimally responded to other stimuli, and for use with patients having extremely poor vision (e.g., end stage glaucoma, optic atrophy, or retinitis pigmentosa). Dynamic peripheral stimulus may be incorporated as a feature into existing perimeters.
[0044] Example One: An isoluminous circular spot of small angular subtense (e.g. 11 pixels on an LCD monitor) is programmed to appear at pre-determined locations within the testing or therapy area of the applicable device. The circular spot of light "blinks" on and off at a pre-determined frequency but does not deviate from its original location.
[0045] Example Two: Two small (e.g. 5 pixels on an LCD screen), vertically elongated ellipses of light (paired side-by side) appear at a pre-determined location within the testing or therapy area and alternate illumination at a pre-determined frequency (e.g., right-left-right- left...). The stimulus is modulated in appearance to trigger the percept of motion but the stimulus remains fixed in its location until detection or a pre-determined length of time.
[0046] In another embodiment of the invention, a frequency doubling grating may be used as a fixation stimulus in a way that creates an optical illusion. Fig. 21 shows a frequency doubling grating 850 as displayed upon a computer display in a brief moment of time. Like the frequency doubling gratings used for FDT, the spatial luminosity phase of the frequency doubling grating 850 is cycled above the critical flicker frequency, e.g., 25 Hz, to create a frequency doubling optical illusion. Fig. 22 shows how such an optical illusion might appear to a healthy subject. Unlike prior art gratings, however, the grating 850 of Figs. 21-22 is used as a fixation stimulus, rather than a peripheral test stimulus. Peripheral stimuli used in connection with the grating 850 may be any of those described herein, among others. By appropriately tuning the frequency doubling grating 850, the frequency doubling optical illusion will only be visible to a subject if it illuminates the very central portion of the subject's retina. As a result, very small deviations in fixation will be noticeable to the subject and testable via an appropriate test cue (e.g., a change in the orientation, or other detectable change in the grating 850). For example, due to the structure of the human visual system, movement of the patient's fixation be as little as 2° will result in about a 50% decrease in spatial resolution. With an appropriately configured frequency doubling grating 850, the standard deviation in eye position over the course of therapy may be improved by a factor of about 1-2°. By increasing the mean accuracy of fixation in this manner, the precision and effectiveness of peripheral testing or stimulatory treatment may be improved. When such a dynamic stimulus is used in visual restoration therapy, a greater fraction of the peripheral stimuli may thereby be correctly allocated to appropriate visual field regions. [0047] Due to disease, injury, genetic or other source of variation, different subjects vary in terms of their spatial resolution ability. Therefore, an individualized spatial frequency tuning may be beneficial before beginning testing or training. By tuning the spatial frequency of the grating 850, the subject will be forced to maintain a tighter fixation. Fig 23 shows a flow chart for a tuning process in accordance with an embodiment of the invention. A spatial frequency parameter controls the spatial frequency of the grating 850 presented on a computerized display. This parameter is initialized to a low frequency starting point, e.g., one that can be detected as frequency doubling illusion by a majority, e.g. 90%, of patients or greater (step 910). The grating 850 is then presented as a frequency doubling fixation stimulus (step 920). If the subject detects the illusion (decision step 930), the spatial frequency parameter is increased and the higher frequency grating 850 is presented again at step 920. This process is repeated until a threshold frequency is reached at which the individual sanations of the grating 850 are no longer detectable (decision step 930). The spatial frequency parameter is then decreased to one that is just below the threshold frequency. Accordingly, the spatial frequency adjusted stimulus is then detectable by the subject only with use of the most spatially sensitive region of the subject's visual field. For example, the frequency parameter may be set to be between 2% and 15% lower than the threshold frequency.
[0048] Since the grating 850 is presented at a high flicker rate, the subject's retina may be desensitized to the striatums. To avoid desensitization, the grating 850 may be systematically perturbed to alternately stimulate different retinal regions; e.g., rotated or translated, as in the embodiments described with reference to Figs. 1-19. The grating 850 may also be alternated with a fixation test cue, also described above.
[0049] In alternative embodiments, the disclosed methods for vision fixation, testing and training may be implemented as a computer program product for use with a computer system. Such implementations may include a series of computer instructions fixed either on a tangible medium, such as a computer readable medium (e.g., a diskette, CD-ROM, ROM, or fixed disk) or transmittable to a computer system, via a modem or other interface device, such as a communications adapter connected to a network over a medium. The medium may be either a tangible medium (e.g., optical or analog communications lines) or a medium implemented with wireless techniques (e.g., microwave, infrared, laser or other transmission techniques). The series of computer instructions embodies all or part of the functionality previously described herein with respect to the system. Those skilled in the art should appreciate that such computer instructions can be written in a number of programming languages for use with many computer architectures or operating systems.
[0050] Furthermore, such instructions may be stored in any memory device, such as semiconductor, magnetic, optical or other memory devices, and may be transmitted using any communications technology, such as optical, infrared, microwave, laser or other transmission technologies. It is expected that such a computer program product may be distributed as a removable medium with accompanying printed or electronic documentation (e.g., shrink wrapped software), preloaded with a computer system (e.g., on system ROM or fixed disk), or distributed from a server or electronic bulletin board over the network (e.g., the Internet or World Wide Web). Of course, some embodiments of the invention may be implemented as a combination of both software (e.g., a computer program product) and hardware. Still other embodiments of the invention are implemented as entirely hardware, or entirely software (e.g., a computer program product).
[0051] The described embodiments of the invention are intended to be merely exemplary and numerous variations and modifications will be apparent to those skilled in the art. All such variations and modifications are intended to be within the scope of the present invention as defined in the appended claims.

Claims

What is claimed is:
1. A method for creating a dynamic fixation stimulus for maintaining visual fixation of a human subject, the method comprising:
(a) providing, for the subject to visually fixate upon, a fixation stimulus displayed upon a computer-driven display; and
(b) altering at least one characteristic of the fixation stimulus to allow resensitization of a retina of the subject; so as to allow prolonged visual fixation.
2. A method in accordance with claim 1 , wherein the at least one characteristic is selected from the group consisting of spatial locus, size, luminosity, and color.
3. A method in accordance with claim 1, further comprising: (c) repeating steps (a) and (b) for a given number of cycles.
4. A method in accordance with claim 3, further comprising:
(d) presenting a fixation test cue; and (e) recording the subject's input in response to the test cue.
5. A method in accordance with claim 4 comprising performing steps (a)-(e) and repeating step (c) with irregular timing, thereby preventing the subject from reliably predicting the time at which the fixation test cue is presented.
6. A method in accordance with claim 4 further comprising altering the fixation test cue to allow resensitization of the patient's retina.
7. A method in accordance with claim 1 wherein the alteration of the fixation stimulus is detectable only by an area of the subject's retina corresponding to less than 2 degrees of the subject's central visual field.
8. A method in accordance with claim 1 , wherein the dynamic fixation stimulus comprises a repetitively translating object.
9. A method in accordance with claim 1 , wherein the fixation stimulus comprises a rotating object.
10. A method in accordance with claim 1, wherein the fixation stimulus comprises at least first set and a second set of objects, the objects of the first and second sets being intermingled and contrasting, wherein at least a subset of the objects change appearance over time.
11. A method in accordance with claim 10, wherein the subset of objects change appearance over time in a cyclical manner.
12. A method in accordance with claim 10, wherein the change in appearance is a change in luminosity.
13. A method in accordance with claim 10, wherein the first and second set of objects include sets of sanations.
14. A method in accordance with claim 1 , further comprising presenting peripheral stimuli for purposes of testing or treatment.
15. A computer system for visual fixation, the system comprising:
(a) means for providing, for the subject to visually fixate upon, a fixation stimulus displayed upon a computer-driven display; and
(b) means for altering the fixation stimulus to allow resensitization of the subject's retina; thereby allowing prolonged visual fixation upon the resulting dynamic fixation stimulus.
16. A computer system according to claim 15, further comprising:
(c) means for repeating steps (a) and (b) for a given number of cycles.
17. A computer system according to claim 16, further comprising:
(d) means for presenting a fixation test cue; and
(e) means for recording the subject's input in response to the test cue.
18. A computer system in accordance with claim 17, comprising means for performing steps (a)-(e) and repeating step (c) with irregular timing, thereby preventing the subject from reliably predicting the time at which the fixation test cue is presented.
19. A computer system in accordance with claim 18 further comprising means for altering the fixation test cue to allow resensitization of the subject's retina.
20. A computer program product for use on a computer system for allowing a subject to extendedly fixate upon on computer-based fixation target, the computer program product comprising a computer usable medium having computer readable program code thereon, the computer readable program code including:
(a) program code for providing, for the subject to visually fixate upon, a target focal stimulation displayed upon a computer-driven display; and
(b) program code for altering the focal stimulation to allow resensitization of the subject's retina; thereby allowing prolonged visual fixation.
21. A method for stimulating the motion-detecting visual pathway of a subject, the method comprising: (a) instructing the subject to fixate upon a central fixation stimulus;
(b) providing a peripheral stimulus displayed upon a computer-driven display;
(c) altering at least one characteristic of the peripheral stimulus; and
(d) iterating steps (b) and (c) in a manner that displays a first dynamic peripheral stimulus within a first narrowly bounded region that targets a corresponding visual field region that is substantially smaller than the entire visual field and that triggers recognition by the motion-sensitive visual pathway.
22. A method in accordance with claim 21, further comprising repeating steps (a)-(d) in a second narrowly bounded region so as to create a second dynamic peripheral stimulus.
23. A method in accordance with claim 22, further comprising: recording the subject's input in response to one of the the first and second dynamic peripheral stimuli.
24. A method in accordance with claim 21, wherein the at least one characteristic is selected from the group consisting of spatial locus, size, pattern, luminosity, and hue.
25. A method in accordance with claim 21, wherein the dynamic peripheral stimulus is selected from the group consisting of a repetitively translating object and a repetitively blinking object.
26. A method according to claim 21, further comprising determining the bounds of a subject's motion-sensitive visual field and presenting the peripheral stimulus within the determined motion-sensitive visual field.
27. A computer system for stimulating the motion-detecting visual pathway of a subject, the system comprising:
(a) means for tasking the subject to fixate upon central fixation stimulus;
(b) means for providing a peripheral stimulus displayed upon a computer-driven display; and (c) means for altering at least one characteristic of the peripheral stimulus so as to trigger recognition by the motion-sensitive visual pathway; and
(d) means for iterating steps (b) and (c) in a manner that displays a dynamic peripheral stimulus within a first narrowly bounded region that targets a corresponding visual field region that is substantially smaller than the entire visual field and that triggers recognition by the motion-sensitive visual pathway.
28. A system in accordance with claim 27, further comprising means for repeating steps (a)- (d) in a second narrowly bounded region.
29. A system in accordance with claim 27, wherein the at least one characteristic is selected from the group consisting of spatial locus, size, pattern, luminosity, and hue.
30. A system in accordance with claim 27, further comprising: means for recording the subject's input in response to one of the first and second dynamic peripheral stimulus.
31. A system in accordance with claim 27, wherein the peripheral stimulus is selected from the group consisting of a repetitively translating object and a repetitively blinking object.
32. A system in accordance with claim 27, further comprising means for determining the bounds of a subject's motion-sensitive visual field and means for presenting the peripheral stimulus within the determined motion-sensitive visual field.
33. A computer program product for use on a computer system for stimulating motion- sensitive regions of a subject's peripheral vision, the computer program product comprising a computer usable medium having computer readable program code thereon, the computer readable program code including:
(a) program code for providing, a first dynamic peripheral stimulus displayed upon a computer-driven display; and
(b) program code for recording the subject's response to the first dynamic peripheral stimulus.
34. A computer program product in accordance with claim 33, further comprising program code for presenting a second dynamic peripheral stimulus at a second visual field location.
35. A computer program product in accordance with claim 34, further comprising program code for recording the subject's response to the second dynamic peripheral stimulus.
36. A method for maintaining visual fixation for testing or treating the vision of a subject comprising: providing, for the subject to visually fixate upon, a fixation stimulus; and repeatedly altering the stimulus to create an optical illusion that is only detectable by use of the subject's central visual field; and while the subject is fixated upon the optical illusion, presenting a peripheral stimulus to the subject.
37. A method in accordance with claim 36, further comprising tuning the difficulty level of the optical illusion to match the spatial perception ability of the subject.
38. A method in accordance with claim 36, wherein the optical illusion is a frequency doubling illusion.
39. A method in accordance with claim 38, wherein the illusion comprises a frequency doubling grating.
40. A method in accordance with claim 39, wherein the tuning of the difficulty level includes varying the spatial frequency of the grating.
41. A method in accordance with claim 39, wherein the tuning includes increasing the spatial frequency of the grating until the illusion is not properly detected by the subject and then maintaining the spatial frequency at a level that is detectable by the subject, yet near the limit of the spatial resolution of the subject's central visual field.
42. A method according to claim 39, further comprising recording the patient's response to the peripheral stimulus.
43. A computer system for visual fixation, the system comprising: means for providing, for the subject to visually fixate upon, a fixation stimulus; and means for repeatedly altering the stimulus to create an optical illusion that is only detectable by use of the subject's central visual field; and means for presenting to the subject, while the subject is fixated upon the optical illusion, a peripheral stimulus.
44. A computer system according claim 43, further comprising means for tuning the difficulty level of the optical illusion to match the spatial perception ability of the subject.
45. A computer system according to claim 43, wherein the optical illusion is a frequency doubling illusion.
46. A computer system according to claim 45, wherein the illusion comprises a frequency doubling grating.
47. A computer system according to any of claim 44, wherein the tuning of the difficulty level includes varying the spatial frequency of the grating.
48. A computer system according to claim 47, wherein the tuning includes increasing the spatial frequency of the grating until the illusion is not properly detected by the subject and then the maintaining the spatial frequency at a level that is detectable by the subject, yet near the limit of the spatial resolution of the subject's central visual field
49. A computer system according to claim 43, further comprising means for recording the patient's response to the peripheral stimulus.
50. A computer system according to any of claim 43 , further comprising means for systematically perturbing the fixation stimulus to alternately target different retinal regions.
51. A computer system according to claim 50, wherein the perturbation is selected from the group consisting of rotation and translation.
52. A computer system according to claim 43 further comprising means for presenting a fixation test cue to query the subject's fixation.
53. A computer program product for use on a computer system for allowing a subject to extendedly fixate upon on computer-based fixation target, the computer program product comprising a computer usable medium having computer readable program code thereon, the computer readable program code including: program code for providing, for the subject to visually fixate upon, a target focal stimulation displayed upon a computer-driven display; and program code for repeatedly altering the stimulus to create an optical illusion that is only detectable by use ofthe subject's central visual field; and program code for presenting a peripheral stimulus to the subject while the subject is fixated upon the optical illusion.
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Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2012511344A (en) * 2008-12-12 2012-05-24 カール ツァイス メディテック アクチエンゲゼルシャフト High precision contrast ratio display for visual stimulation
US8702233B2 (en) 2005-06-30 2014-04-22 Novavision, Inc. Vision exercising apparatus
EP2934285A4 (en) * 2012-12-20 2016-08-17 Newsouth Innovations Pty Ltd Methods and systems for diagnosis of ocular disease
WO2017208227A1 (en) 2016-05-29 2017-12-07 Nova-Sight Ltd. Display system and method
US9940844B2 (en) 2010-11-11 2018-04-10 The Regents Of The University Of California Enhancing cognition in the presence of distraction and/or interruption
US10672292B2 (en) 2010-06-28 2020-06-02 The Regents Of The University Of California Method of suppressing of irrelevant stimuli
US20210312613A1 (en) * 2020-04-03 2021-10-07 Wisconsin Alumni Research Foundation Apparatus for Detection of Early-Stage Glaucoma and Other Optic Nerve Diseases

Families Citing this family (62)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7682021B2 (en) * 2002-02-08 2010-03-23 Novavision, Inc. System and methods for the treatment of retinal diseases
US7753524B2 (en) * 2002-02-08 2010-07-13 Novavision, Inc. Process and device for treating blind regions of the visual field
US20070216865A1 (en) * 2002-02-08 2007-09-20 Novavision, Inc. Process and Device for Apportioning Therapeutic Vision Stimuli
US7642990B2 (en) 2004-06-15 2010-01-05 Novavision, Inc. Method and device for guiding a user's head during vision training
AU2006230433A1 (en) * 2005-03-30 2006-10-05 Novavision, Inc. Method and device for delivering visual stimuli with head mounted display during vision training
EP2040605A2 (en) * 2006-06-30 2009-04-01 Novavision, Inc. Diagnostic and therapeutic system for eccentric viewing
US7753526B2 (en) 2006-07-25 2010-07-13 Novavision, Inc. Frequency doubling fixation stimuli for visual field testing and therapy
US7621639B2 (en) * 2006-10-04 2009-11-24 Syed Khizer Rahim Khaderi Method of developing a visual processing profile based on a retino-geniculo-cortical pathway
WO2008091876A1 (en) * 2007-01-22 2008-07-31 Novavision, Inc. Device for treating human vision using combined optical and electrical stimulation
US20090024049A1 (en) 2007-03-29 2009-01-22 Neurofocus, Inc. Cross-modality synthesis of central nervous system, autonomic nervous system, and effector data
WO2008137581A1 (en) 2007-05-01 2008-11-13 Neurofocus, Inc. Neuro-feedback based stimulus compression device
US8392253B2 (en) 2007-05-16 2013-03-05 The Nielsen Company (Us), Llc Neuro-physiology and neuro-behavioral based stimulus targeting system
US20110205167A1 (en) * 2007-06-13 2011-08-25 Massengill Family Trust Brain concussion screening method & apparatus
US20080309616A1 (en) * 2007-06-13 2008-12-18 Massengill R Kemp Alertness testing method and apparatus
JP5542051B2 (en) 2007-07-30 2014-07-09 ニューロフォーカス・インコーポレーテッド System, method, and apparatus for performing neural response stimulation and stimulation attribute resonance estimation
US8386313B2 (en) 2007-08-28 2013-02-26 The Nielsen Company (Us), Llc Stimulus placement system using subject neuro-response measurements
US8392255B2 (en) 2007-08-29 2013-03-05 The Nielsen Company (Us), Llc Content based selection and meta tagging of advertisement breaks
US20090083129A1 (en) 2007-09-20 2009-03-26 Neurofocus, Inc. Personalized content delivery using neuro-response priming data
US8327395B2 (en) 2007-10-02 2012-12-04 The Nielsen Company (Us), Llc System providing actionable insights based on physiological responses from viewers of media
CN101917898A (en) 2007-10-31 2010-12-15 埃姆申塞公司 Physiological responses from spectators is provided the system and method for distributed collection and centralized processing
JP4524408B2 (en) * 2008-09-10 2010-08-18 独立行政法人産業技術総合研究所 Flicker threshold measurement device and measurement program
US20100156638A1 (en) * 2008-12-22 2010-06-24 Intercept Logic, Inc. Hand directed contraband sensing apparatus and method
US20100250325A1 (en) 2009-03-24 2010-09-30 Neurofocus, Inc. Neurological profiles for market matching and stimulus presentation
EP3138604B1 (en) * 2009-03-27 2020-11-25 Second Sight Medical Products, Inc. Visual prosthesis fitting system
ES2914092T3 (en) * 2009-08-02 2022-06-07 Tel Hashomer Medical Res Infrastructure & Services Ltd System and method for the analysis of objective chromatic perimetry through the use of the pupillometer
US10987015B2 (en) 2009-08-24 2021-04-27 Nielsen Consumer Llc Dry electrodes for electroencephalography
US20110085140A1 (en) * 2009-10-09 2011-04-14 The Ohio State University Research Foundation Apparatus and methods for testing contrast sensitivity
US20110106750A1 (en) 2009-10-29 2011-05-05 Neurofocus, Inc. Generating ratings predictions using neuro-response data
US9560984B2 (en) 2009-10-29 2017-02-07 The Nielsen Company (Us), Llc Analysis of controlled and automatic attention for introduction of stimulus material
WO2011133548A2 (en) 2010-04-19 2011-10-27 Innerscope Research, Inc. Short imagery task (sit) research method
GB201013796D0 (en) * 2010-08-18 2010-09-29 Univ Manchester A method and apparatus for measuring a property of an eye of a subject
WO2012135822A2 (en) * 2011-03-31 2012-10-04 University Of South Florida Device and method for stimulating eye movement
US8616460B2 (en) 2011-07-13 2013-12-31 Eastman Kodak Company Method for providing dynamic optical illusion images
US8616461B2 (en) 2011-07-13 2013-12-31 Eastman Kodak Company Printed dynamic optical illusion images
US8385640B2 (en) 2011-07-13 2013-02-26 Eastman Kodak Company System for controlling dynamic optical illusion images
US9462941B2 (en) 2011-10-17 2016-10-11 The Board Of Trustees Of The Leland Stanford Junior University Metamorphopsia testing and related methods
US9314154B2 (en) 2011-10-17 2016-04-19 The Board Of Trustees Of The Leland Stanford Junior University System and method for providing analysis of visual function using a mobile device with display
KR101245330B1 (en) * 2011-12-20 2013-03-25 경희대학교 산학협력단 Pc-based visual filed self-diagnosis system and gaze fixing method
US20130250246A1 (en) * 2012-02-23 2013-09-26 American University Directional illusions and uses thereof
US10426333B2 (en) 2012-02-23 2019-10-01 American University Directional illusions based on motion pixels and uses thereof
US9101312B2 (en) 2012-04-18 2015-08-11 TBI Diagnostics LLC System for the physiological evaluation of brain function
JP2014059691A (en) * 2012-09-18 2014-04-03 Sony Corp Image processing device, method and program
US8950864B1 (en) 2013-08-30 2015-02-10 Mednovus, Inc. Brain dysfunction testing
JP6731850B2 (en) * 2013-09-02 2020-07-29 オキュスペクト オサケ ユキチュア Threshold inspection and determination
WO2015063598A1 (en) 2013-10-30 2015-05-07 Tel Hashomer Medical Research Infrastructure And Services Ltd. Pupillometers and systems and methods for using a pupillometer
US20150164418A1 (en) * 2013-12-17 2015-06-18 Mayo Foundation For Medical Education And Research Cognitive performance assessment test
US20150231020A1 (en) * 2014-02-18 2015-08-20 David James Battin Automated Variable Zoom Software (AVZS) for Exercising the Eyes
WO2016154066A2 (en) 2015-03-20 2016-09-29 Glaukos Corporation Gonioscopic devices
IL283779B (en) 2015-11-24 2022-09-01 Massachusetts Inst Technology Systems and methods for preventing, mitigating, and/or treating dementia
PL3402388T3 (en) 2016-01-12 2022-02-21 Tel Hashomer Medical Research Infrastructure And Services Ltd. System and method for performing objective perimetry and diagnosis of patients with retinitis pigmentosa and other ocular diseases
WO2017218993A1 (en) 2016-06-17 2017-12-21 Predictive Safety Srp, Inc. Interlock control system and method
US10674906B2 (en) 2017-02-24 2020-06-09 Glaukos Corporation Gonioscopes
USD833008S1 (en) 2017-02-27 2018-11-06 Glaukos Corporation Gonioscope
EP3672478A4 (en) 2017-08-23 2021-05-19 Neurable Inc. Brain-computer interface with high-speed eye tracking features
WO2019074637A1 (en) 2017-10-10 2019-04-18 Massachusetts Institute Of Technology Systems and methods for preventing, mitigating, and/or treating dementia
US10960225B2 (en) * 2017-10-10 2021-03-30 Massachusetts Institute Of Technology Systems and methods for preventing, mitigating, and/or treating dementia via visual stimulation that binds higher order brain regions, reduces neurodegeneration and neuroinflammation, and improves cognitive function
FR3077722B1 (en) * 2018-02-13 2020-03-06 Streetlab VISUAL FIELD TEST DEVICE
JP7117768B2 (en) * 2018-07-18 2022-08-15 株式会社Qdレーザ Visual field visual acuity test device and visual field visual acuity test method
US10664050B2 (en) 2018-09-21 2020-05-26 Neurable Inc. Human-computer interface using high-speed and accurate tracking of user interactions
EP3824797B1 (en) * 2019-11-22 2023-09-27 Hochschule Aalen Method and device for acquiring data relating to perception of colours by a test person
WO2022212259A1 (en) * 2021-03-29 2022-10-06 Burke Neurological Institute System for assessing target visibility and trackability from eye movements
WO2023114744A1 (en) * 2021-12-16 2023-06-22 Musc Foundation For Research Development Televisual field device and method for assessing neurological performance

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4995717A (en) * 1989-08-22 1991-02-26 The University Court Of The University Of Glasgow Device for moving eye campimetry
US5565949A (en) * 1995-07-10 1996-10-15 Kasha, Jr.; John R. Visual field perimetry on a small computer screen
US5883692A (en) * 1997-10-01 1999-03-16 Retsan, Inc. Visual field measurement apparatus
US5912723A (en) * 1994-04-29 1999-06-15 Australian National University Of Acton Method and apparatus for early detection of glaucoma

Family Cites Families (105)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US1463847A (en) * 1922-06-12 1923-08-07 Shilling Wade Chin rest
US2213484A (en) 1939-07-22 1940-09-03 Henry H Briggs Apparatus for visual training
US3883234A (en) 1970-07-13 1975-05-13 John R Lynn Computer controlled apparatus for automatic visual field examination
CA1009074A (en) 1973-02-26 1977-04-26 Oculometrics Automatic visual field examination including fixation monitoring and compensation
US4260227A (en) 1977-10-04 1981-04-07 Coherent, Inc. Automated kinetic perimetry apparatus and method
GB2031607B (en) 1978-09-12 1983-05-25 Crick J Apparatus for detecting visual field defects of the eye
US4408846A (en) 1981-02-02 1983-10-11 Andrew M. Clay Method and apparatus for increasing visual acuity
US4429961A (en) 1981-08-14 1984-02-07 Sheingorn Larry A Visual field testing device
EP0115263A1 (en) 1982-12-31 1984-08-08 Andreas Wilde Device for training the external eye muscles
US4660945A (en) 1983-01-25 1987-04-28 Trachtman Joseph N Methods and apparatus for accommodation training
US4533221A (en) 1983-01-25 1985-08-06 Trachtman Joseph N Methods and apparatus for accommodation training
FR2548887B1 (en) 1983-06-14 1985-12-13 Mawas Lucie INSTRUMENT FOR THE EXAMINATION, MEASUREMENT AND TREATMENT OF BINOCULAR VISION ABNORMALITIES
US4679920A (en) 1984-02-24 1987-07-14 Tokyo Kogaku Kikai Kabushiki Kaisha Automatic perimeter
IL82112A0 (en) 1986-04-10 1987-10-30 Techna Vision Inc Optical-mechanical system for an automated perimeter
US5035500A (en) * 1988-08-12 1991-07-30 Rorabaugh Dale A Automated ocular perimetry, particularly kinetic perimetry
US5325136A (en) 1988-12-12 1994-06-28 Prio Corporation Computer display screen simulation for optometric examination
US4998820A (en) 1988-12-12 1991-03-12 Applied Vision Concepts, Inc. Instrument and method for use in optometric examinations
US5088810A (en) 1989-01-23 1992-02-18 Galanter Stephen M Vision training method and apparatus
RU1799577C (en) * 1989-08-17 1993-03-07 Межотраслевой научно-технический комплекс "Микрохирургия глаза" Method for improving vision function affected by ophthalmic nerve and retina disease
US5050982A (en) 1989-10-06 1991-09-24 Meissner Juergen P Method and apparatus for improving visual acuity
US4971434A (en) 1989-11-28 1990-11-20 Visual Resources, Inc. Method for diagnosing deficiencies in and expanding a person's useful field of view
US5139323A (en) 1990-01-10 1992-08-18 Schillo Paula L Hemianopsia rehabilitation training system
US5206671A (en) 1990-06-29 1993-04-27 Eydelman Malvina B Testing and treating of visual dysfunctions
GB9121707D0 (en) 1991-10-12 1991-11-27 British Aerospace Improvements in computer-generated imagery
IT1252873B (en) 1991-11-26 1995-07-03 APPARATUS AND METHOD FOR VISUAL TRAINING ACCORDING TO RETINAL REFLECTION
US5241332A (en) 1991-11-29 1993-08-31 Farrell Joyce M Treatment modality in occupational therapy
US5305027A (en) 1992-01-28 1994-04-19 Patterson Kip E Method and apparatus for enhanced visual training
US5539482A (en) 1992-02-28 1996-07-23 The Australian National University Glaucoma testing using non-linear systems identification techniques
US6062687A (en) 1992-11-09 2000-05-16 Lofgren-Nisser; Gunilla Partially occluded contact lens for treating visual and/or brain disorder
KR940018979U (en) 1993-01-28 1994-08-16 성기호 Vision enhancement and color corrector
DE9305147U1 (en) 1993-04-03 1994-08-04 Schmielau Fritz Prof Dr Dr Dr Training device for the treatment of patients suffering from perceptual disorders
US6359601B1 (en) 1993-09-14 2002-03-19 Francis J. Maguire, Jr. Method and apparatus for eye tracking
GB9319588D0 (en) 1993-09-22 1993-11-10 Univ Glasgow Device for use in oculokinetic perimetry
US5534953A (en) 1994-07-01 1996-07-09 Schmielau; Fritz Training device for the therapy of patients having perception defects
US5550602A (en) 1994-11-09 1996-08-27 Johannes Braeuning Apparatus and method for examining visual functions
US5539481A (en) 1994-12-22 1996-07-23 Vax; Guennadi Acuity therapy apparatus and method thereof
US5991085A (en) 1995-04-21 1999-11-23 I-O Display Systems Llc Head-mounted personal visual display apparatus with image generator and holder
US5946075A (en) 1996-05-21 1999-08-31 Horn; Gerald Vision screening system
US6386706B1 (en) 1996-07-31 2002-05-14 Virtual-Eye.Com Visual function testing with virtual retinal display
US6592222B2 (en) 1996-07-31 2003-07-15 Massengill Family Trust Flicker and frequency doubling in virtual reality
US6016449A (en) 1997-10-27 2000-01-18 Neuropace, Inc. System for treatment of neurological disorders
CA2327249C (en) 1998-04-10 2008-07-08 Visual Resources, Inc. Method and apparatus for training visual attention capabilities of a subject
DE69840710D1 (en) 1998-08-27 2009-05-14 Novavision Inc DEVICE FOR TRAINING HUMAN VISION
US6321338B1 (en) 1998-11-09 2001-11-20 Sri International Network surveillance
US6299632B1 (en) 1998-11-30 2001-10-09 Peter Jaillet Method for changing critical brain activity using light and sound
JP3640830B2 (en) 1999-03-30 2005-04-20 株式会社ニデック Ophthalmic equipment
US6290357B1 (en) * 1999-03-31 2001-09-18 Virtual-Eye.Com, Inc. Kinetic visual field apparatus and method
WO2000072083A1 (en) 1999-05-06 2000-11-30 Stregova Erzsebet Eye-conditioning and eyesight-improving device
US6227668B1 (en) 1999-05-14 2001-05-08 Visionrx Inc. Visual test using counter-phase chromatic and achromatic stimuli
WO2001039659A1 (en) 1999-12-03 2001-06-07 Iouri Malov Field testing using spread spectrum technique
US6540355B1 (en) 1999-12-20 2003-04-01 Paul M. Couture Computerized eye testing and exercises
US6431708B2 (en) 1999-12-21 2002-08-13 Paul A. Krebs Vision therapy system and method
US7004912B2 (en) 1999-12-27 2006-02-28 Neurovision, Inc. Systems and methods for improving visual perception
DE60107409T2 (en) 2000-03-27 2005-12-01 California Institute Of Technology, Pasadena COMPUTER BASED THREE-DIMENSIONAL FACE TESTING SYSTEM AND ANALYSIS
US6769770B2 (en) 2000-03-27 2004-08-03 California Institute Of Technology Computer-based 3D visual field testing with peripheral fixation points
US6519703B1 (en) 2000-04-14 2003-02-11 James B. Joyce Methods and apparatus for heuristic firewall
RU2187237C2 (en) * 2000-04-27 2002-08-20 Туровецкий Владимир Наумович Method for improving sight and/or sight deterioration prophylaxis for video image apparatus users
US7010351B2 (en) 2000-07-13 2006-03-07 Northstar Neuroscience, Inc. Methods and apparatus for effectuating a lasting change in a neural-function of a patient
JP3742288B2 (en) 2000-09-05 2006-02-01 株式会社ニデック Optometry equipment
IL138926A0 (en) 2000-10-06 2001-11-25 Notal Vision Ltd Method and system for detecting eye disease
US6406437B1 (en) 2000-10-11 2002-06-18 Yeda Research And Development Co. Ltd. Method and apparatus for efficient high-resolution visual field mapping
AU2001210650A1 (en) 2000-11-08 2002-05-21 Andrzej Czyzewski Visual screening tests by means of computers
WO2002041768A1 (en) * 2000-11-22 2002-05-30 Carl Zeiss Jena Gmbh Method and arrangement for optically stimulating the visual system
RU2174382C1 (en) 2001-01-05 2001-10-10 Еремеев Александр Павлович Spectral optic reflex therapy device and method for improving vision function
US7444404B2 (en) 2001-02-05 2008-10-28 Arbor Networks, Inc. Network traffic regulation including consistency based detection and filtering of packets with spoof source addresses
DE10207839B4 (en) 2001-02-27 2010-07-15 Constanze Schmidt Method and apparatus for programmable biofeedback snare therapy
DE60124857D1 (en) 2001-03-02 2007-01-11 Luc Ledent Procedures for creating visual or auditory testing or exercises, registration and analysis of results
JP4901009B2 (en) 2001-03-02 2012-03-21 興和株式会社 Perimeter
US6416190B1 (en) 2001-04-27 2002-07-09 University Of Chicago Apparatus for using optical tweezers to manipulate materials
JP4369078B2 (en) 2001-05-11 2009-11-18 オリンパスビジュアルコミュニケーションズ株式会社 VISION RECOVERY DEVICE USING STEREO IMAGE AND METHOD FOR DISPLAYING STEREO IMAGE
US20020186179A1 (en) 2001-06-07 2002-12-12 Knowles Gary R. Optical display device
US20030090439A1 (en) 2001-09-07 2003-05-15 Spitzer Mark B. Light weight, compact, remountable face-supported electronic display
US7682021B2 (en) 2002-02-08 2010-03-23 Novavision, Inc. System and methods for the treatment of retinal diseases
CN100431511C (en) * 2002-02-08 2008-11-12 诺瓦维森公司 Improved process and device for training human vision
US20070216865A1 (en) 2002-02-08 2007-09-20 Novavision, Inc. Process and Device for Apportioning Therapeutic Vision Stimuli
US7753524B2 (en) 2002-02-08 2010-07-13 Novavision, Inc. Process and device for treating blind regions of the visual field
US20040046934A1 (en) 2002-02-14 2004-03-11 Board Of Regents, The University Of Texas System Oculokinetic offset acuity testing
WO2003070089A1 (en) 2002-02-19 2003-08-28 Notal Vision Ltd. Method and system for assessing eye disease
US20040075811A1 (en) 2002-04-16 2004-04-22 Exercise Your Eyes, Inc. Device and method for exercising eyes
US6742892B2 (en) 2002-04-16 2004-06-01 Exercise Your Eyes, Llc Device and method for exercising eyes
JP3494375B1 (en) 2002-04-30 2004-02-09 勝美 永吉 Training eye mask
US7033025B2 (en) * 2002-05-17 2006-04-25 Virtocc, Inc. Interactive occlusion system
US20040012758A1 (en) * 2002-07-19 2004-01-22 Chao-Chyun Lin Prism based dynamic vision training device and method thereof
DE60304631T2 (en) 2002-07-22 2006-11-09 Lin, Chao-Chyun Prism-based device and method for dynamically training human eyesight
US7309128B2 (en) 2002-09-20 2007-12-18 Centrofuse Technologies, Llc Automated stereocampimeter and related method for improved measurement of the visual field
US6943754B2 (en) 2002-09-27 2005-09-13 The Boeing Company Gaze tracking system, eye-tracking assembly and an associated method of calibration
US6660683B1 (en) * 2002-10-21 2003-12-09 W.R. Grace & Co.-Conn. NOx reduction compositions for use in FCC processes
US7153256B2 (en) 2003-03-07 2006-12-26 Neuronetics, Inc. Reducing discomfort caused by electrical stimulation
JP4300844B2 (en) 2003-03-28 2009-07-22 株式会社ニコン Eye function training device
US6990377B2 (en) 2003-04-24 2006-01-24 Northstar Neuroscience, Inc. Systems and methods for facilitating and/or effectuating development, rehabilitation, restoration, and/or recovery of visual function through neural stimulation
WO2004098447A2 (en) 2003-05-05 2004-11-18 Notal Vision Ltd. Eye mapping
US7033026B2 (en) 2003-07-04 2006-04-25 Spector Robert T Method of and apparatus for diagnosing and treating amblyopic conditions in the human visual system
JP2005270451A (en) 2004-03-25 2005-10-06 Konica Minolta Photo Imaging Inc Virtual image display apparatus for strabismus training
US7642990B2 (en) 2004-06-15 2010-01-05 Novavision, Inc. Method and device for guiding a user's head during vision training
WO2006074434A2 (en) * 2005-01-06 2006-07-13 University Of Rochester Systems and methods for improving visual discrimination
AU2006230433A1 (en) 2005-03-30 2006-10-05 Novavision, Inc. Method and device for delivering visual stimuli with head mounted display during vision training
TWI265770B (en) 2005-06-15 2006-11-01 Asustek Comp Inc Portable computer
US7384146B2 (en) 2005-06-28 2008-06-10 Carestream Health, Inc. Health care kiosk having automated diagnostic eye examination and a fulfillment remedy based thereon
GB0513603D0 (en) 2005-06-30 2005-08-10 Univ Aberdeen Vision exercising apparatus
EP1968427A2 (en) 2005-12-16 2008-09-17 Novavision, Inc. Adjustable device for vision testing and therapy
WO2007109724A1 (en) 2006-03-21 2007-09-27 Novavision, Inc. Process and device for apportioning therapeutic vision stimuli
EP2040605A2 (en) 2006-06-30 2009-04-01 Novavision, Inc. Diagnostic and therapeutic system for eccentric viewing
US20080077437A1 (en) 2006-07-25 2008-03-27 Novavision, Inc. Process and Method for Providing Incentives to Increase Vision-Therapy Performance
US7753526B2 (en) 2006-07-25 2010-07-13 Novavision, Inc. Frequency doubling fixation stimuli for visual field testing and therapy
EP2101865B1 (en) 2006-12-22 2016-03-09 EBS Technologies GmbH Apparatus for stimulating a brain of a person

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4995717A (en) * 1989-08-22 1991-02-26 The University Court Of The University Of Glasgow Device for moving eye campimetry
US5912723A (en) * 1994-04-29 1999-06-15 Australian National University Of Acton Method and apparatus for early detection of glaucoma
US5565949A (en) * 1995-07-10 1996-10-15 Kasha, Jr.; John R. Visual field perimetry on a small computer screen
US5883692A (en) * 1997-10-01 1999-03-16 Retsan, Inc. Visual field measurement apparatus

Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8702233B2 (en) 2005-06-30 2014-04-22 Novavision, Inc. Vision exercising apparatus
JP2012511344A (en) * 2008-12-12 2012-05-24 カール ツァイス メディテック アクチエンゲゼルシャフト High precision contrast ratio display for visual stimulation
US11139066B2 (en) 2010-06-28 2021-10-05 The Regents Of The University Of California Method of suppressing of irrelevant stimuli
US10672292B2 (en) 2010-06-28 2020-06-02 The Regents Of The University Of California Method of suppressing of irrelevant stimuli
US9940844B2 (en) 2010-11-11 2018-04-10 The Regents Of The University Of California Enhancing cognition in the presence of distraction and/or interruption
US11830379B2 (en) 2010-11-11 2023-11-28 The Regents Of The University Of California Enhancing cognition in the presence of distraction and/or interruption
US11049408B2 (en) 2010-11-11 2021-06-29 The Regents Of The University Of California Enhancing cognition in the presence of distraction and/or interruption
EP2934285A4 (en) * 2012-12-20 2016-08-17 Newsouth Innovations Pty Ltd Methods and systems for diagnosis of ocular disease
US10390695B2 (en) 2012-12-20 2019-08-27 Newsouth Innovations Pty Limited Methods and systems for diagnosis of ocular disease
EP3463045A4 (en) * 2016-05-29 2019-11-27 Novasight Ltd. Display system and method
US10765314B2 (en) 2016-05-29 2020-09-08 Novasight Ltd. Display system and method
CN109219386B (en) * 2016-05-29 2021-06-22 诺瓦赛特有限公司 Display system and method
WO2017208227A1 (en) 2016-05-29 2017-12-07 Nova-Sight Ltd. Display system and method
CN109219386A (en) * 2016-05-29 2019-01-15 诺瓦赛特有限公司 Display system and method
US20210312613A1 (en) * 2020-04-03 2021-10-07 Wisconsin Alumni Research Foundation Apparatus for Detection of Early-Stage Glaucoma and Other Optic Nerve Diseases
US11651486B2 (en) * 2020-04-03 2023-05-16 Wisconsin Alumni Research Foundation Apparatus for detection of early-stage glaucoma and other optic nerve diseases

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