Diagnosing and treating health ailments

Methods and systems for diagnosis and treatment of health conditions

[Related application]

This patent application claims priority to U.S. Provisional Application No. 62/133,870, filed March 16, 2015 and entitled "METHODS AND SYSTEM FOR DIAGNOSING AND TREATING HEALTH AILMENTS." U.S. Patent Application No. 14/555,585 entitled "VIRTUAL AND AUGMENTED REALITY SYSTEMS AND METHODS" and United States Patent Application No. 14/555,585 entitled "METHODS AND SYSTEM FOR CREATING FOCAL PLANES IN VIRTUAL AND AUGMENTED REALITY" Patent Application No. 62/005,834 is incorporated herein by reference.

The present application relates to various methods and systems for diagnosing, monitoring, and treating health conditions and diseases, including conditions and diseases of the eye and other organs.

Clinicians routinely use ophthalmic devices and technologies to diagnose and treat eye-related diseases. An example of a traditional ophthalmic device is shown in FIG. 1 . As shown, the patient may be positioned in a specific sitting position for the entire course of treatment, which may last for any time between seconds and minutes. Such positioning has been believed to be necessary to properly align the patient's eye with the ophthalmic instrument to perform measurement and/or therapeutic procedures on the patient's eye.

Undesirably, ophthalmic devices tend to be large, bulky and expensive devices and are generally used only in a physician's office. Therefore, patients may be required to make an appointment with an optometrist and visit a doctor for any diagnosis or treatment. This can be a factor that makes many patients reluctant to undergo the test, which can delay the patient's visit to the doctor for a long time, or until the condition worsens. Even if the patient could have been easily relieved if diagnosed or treated in a timely manner, more intense treatment or treatment may be required in a worsening condition. In addition, since most ophthalmic instruments are large and bulky, the patient is forced to remain in an uncomfortable position for a considerable amount of time, which can actually increase the risk of misdiagnosis and patient error.

Therefore, there is a need for a health system that addresses one or more of the above problems.

The exemplary embodiments described herein have innovative or groundbreaking technical features, none of which are essential to or solely responsible for their desirable attributes. Without limiting the scope of the claims, some advantageous features will be summarized below.

An innovative aspect of the subject matter described herein includes a frame, an augmented reality display attached to the frame, a light detector attached to the frame, and a processor configured to perform a health analysis of a user based on light detected by the light detector. It can be implemented as a user-wearable diagnostic health system that includes. The frame is configured to be mounted on a user. The augmented reality display device is configured to guide the image to the user's eyes. The photo detector is configured to detect light reflected from the user's eye.

Another innovative aspect of the subject matter described herein is a frame, an augmented reality display attached to the frame, a sound emitter configured to emit sound waves to a user, and a sound emitter attached to the frame and configured to detect sound waves reflected from the user. It can be implemented as a user wearable diagnostic health system comprising: a configured sound detector; and a processor configured to perform health analysis of the user based on the information detected by the sound detector. The frame is configured to be mounted on a user. The augmented reality display device is configured to guide the image to the user's eyes.

Another innovative aspect of the subject matter described herein is a user wear comprising a frame configured to be mounted on a user, an augmented reality display attached to the frame, and a processor configured to cause the augmented reality display to perform a health treatment protocol on the user. It can be implemented as a possible health treatment system. The augmented reality display device is further configured to guide the image to the user's eyes.

Innovative aspects of the subject matter described herein include a frame configured to be mounted on a clinician, an augmented reality display attached to the frame and configured to direct an image to the eye of the clinician, and an outward image capture device configured to image the eye of a patient. -facing image capture device); and a processor configured to perform health analysis of the patient based on the image of the eye captured by the image capturing device.

Further exemplary embodiments are provided below. It should be recognized that structures for different health analyzes and/or treatments may co-exist in the same health system. Also, as disclosed herein, the same features may be applied to facilitate multiple health analyzes and/or treatments. For example, structures used for drug administration can also be used for a variety of diagnostics as disclosed herein. Consequently, health systems according to some embodiments may include various combinations of features for the structures disclosed herein, including combinations of features disclosed under different headings. In addition, the health systems, including those disclosed under other headings, may be configured to perform various combinations of health analyzes and treatments disclosed herein. Accordingly, various exemplary embodiments are disclosed below.

<u>Myopia / Farsightedness / Astigmatism</u>

One. A wearable ophthalmic device comprising:

head-mounted display systems;

a light source configured to guide light to a human eye to form an image in the eye; and

a waveguide stack comprising one or more waveguides;

each of the one or more waveguides is configured to project the light to one of one or more focal planes,

wherein the image is modified by wavefront correction based on an optical prescription for the eye.

2. The apparatus of embodiment 1, wherein the waveguide stack further comprises one or more lenses.

3. The first embodiment, wherein the head-mounted display system is configured to pass light originating from the outside world to the eye of the person wearing the head-mounted system. A device comprising a configured augmented reality head-mounted ophthalmic system.

4. The apparatus of embodiment 1, wherein the optical prescription comprises a prescription for myopia.

5. The apparatus of embodiment 1, wherein the optical prescription comprises a prescription for hyperopia.

6. The apparatus of embodiment 1, wherein the optical prescription includes a prescription for astigmatism.

7. A wearable ophthalmic device comprising:

an augmented reality head-mounted display system configured to pass light from the outside world into the eyes of a person wearing the head-mounted system;

a light source configured to guide light to the human eye to form an image in the eye; and

an adaptive optical element configured to apply wavefront correction to the image based on an optical prescription for the eye;

Wearable ophthalmic devices.

8. The apparatus according to embodiment 7, wherein the adaptive optical element comprises a variable focus element.

9. The apparatus according to embodiment 8, wherein the variable focus element comprises a membrane mirror.

10. The apparatus of Embodiment 9, wherein the device comprises:

one or more electrodes coupled to the thin-film mirror; and a control system configured to selectively control the one or more electrodes to modify a shape of the thin-film mirror based on a shape of the cornea of the eye.

11. The apparatus of embodiment 7, wherein the optical prescription includes a prescription for myopia.

12. The apparatus of embodiment 7, wherein the optical prescription comprises a prescription for hyperopia.

13. The apparatus of Example 7, wherein the optical prescription comprises a prescription for astigmatism.

14. A wearable ophthalmic device comprising:

head-mounted ophthalmic systems;

a light source configured to guide light to a human eye to form an image in the eye; and

an adaptive optical element configured to apply wavefront correction to the image based on the optical prescription for the eye;

wherein the adaptive optics comprises a thin-film mirror.

15. The apparatus of embodiment 14, wherein the apparatus comprises:

one or more electrodes coupled to the thin-film mirror; and a control system configured to selectively control the one or more electrodes to modify a shape of the thin-film mirror based on a shape of the cornea of the eye.

16. The apparatus of embodiment 14, wherein the optical prescription comprises a prescription for myopia.

17. The apparatus of embodiment 14, wherein the optical prescription comprises a prescription for hyperopia.

18. The apparatus of embodiment 14, wherein the optical prescription comprises a prescription for astigmatism.

19. A wearable ophthalmic device comprising:

head-worn display system; and

a light source configured to guide light to the human eye to form an image in the eye; and

The light source comprises a fiber optic scanning projector,

The image is modified by wavefront correction based on an optical prescription for the eye.

Wearable ophthalmic devices.

20. The apparatus of embodiment 19, wherein the optical prescription comprises a prescription for myopia.

21. The apparatus of embodiment 19, wherein the optical prescription comprises a prescription for hyperopia.

22. The apparatus of embodiment 19, wherein the optical prescription comprises a prescription for astigmatism.

23. A wearable augmented reality ophthalmic device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light from the outside world into the eye of a person wearing the head-mounted system; and

a light source configured to guide light to the human eye to form an image in the eye;

The image is modified by wavefront correction based on an optical prescription for the eye.

Wearable augmented reality ophthalmic device.

24. The apparatus of embodiment 23, wherein the optical prescription comprises a prescription for myopia.

25. The apparatus of embodiment 23, wherein the optical prescription comprises a prescription for hyperopia.

26. The apparatus of embodiment 23, wherein the optical prescription comprises a prescription for astigmatism.

27. A method for addressing a visual defect in a person wearing a head mounted display system, the method comprising:

identifying the person's optical prescription;

generating an image using a display device in the head mounted display system;

applying wavefront correction to the image based on the optical prescription to yield a corrected image; and

Displaying the corrected image to a person wearing a display device system mounted on the head,

A method for addressing a vision defect in a person wearing a head mounted display system.

28. The method of embodiment 27, wherein identifying the person's optical prescription comprises receiving input from the person specifying the prescription.

29. The method of embodiment 27, wherein identifying the optical prescription of the person comprises presenting a different wavefront correction to the person.

30. The method as recited in embodiment 29, wherein the method for resolving a vision deficiency problem in a person wearing the head mounted display system further comprises receiving an input from a person specifying the desired correction.

31. The method according to embodiment 27, wherein the wavefront correction is implemented by adjusting an adaptive optical element in the head-mounted display device.

32. The method according to embodiment 31, wherein the adaptive optical element comprises a variable focus element.

33. The method of embodiment 31, wherein the adaptive optics comprise deformable optics.

34. The method of embodiment 38, wherein the deformable optics comprise a deformable mirror.

35. The method of embodiment 27, wherein the wavefront correction is implemented by using a waveguide stack comprising a plurality of waveguides configured to provide different focal planes.

36. The method of embodiment 35, wherein the wavefront correction is implemented by directing the image through a combination of waveguides that provide a desired optical power to provide the wavefront correction.

37. The method according to Embodiment 27, wherein the method for resolving a visual defect of a person wearing the head mounted display system further comprises providing different image content in different depth planes.

38. The method of embodiment 37, wherein providing different image content in different depth planes comprises providing different image content through different waveguides in a waveguide stack, thereby providing different optical power to different image content. Including method.

39. The method of embodiment 38, wherein different image content provides different optical power to different image content by propagating through different numbers of waveguides.

40. The method of embodiment 39, wherein the waveguide comprises static optics having optical power.

41. The method of embodiment 27, wherein the wavefront correction is implemented by directing the image through at least one waveguide.

42. The method of embodiment 41, wherein the at least one waveguide comprises dynamic optics with variable optical power.

43. The method of embodiment 27, wherein the optical correction is configured to correct myopia.

44. The method of embodiment 27, wherein the optical correction is configured to correct hyperopia.

45. The method of embodiment 27, wherein the optical correction is configured to correct astigmatism.

46. The method of embodiment 27, wherein applying wavefront correction comprises accessing processing electronics.

47. The method according to embodiment 27, wherein the wavefront correction is applied to a virtual reality image.

48. The method according to Embodiment 27, wherein the wavefront correction is applied to an augmented reality image.

49. The method according to the 27th embodiment, wherein the wavefront correction is applied to the image from the display device, and the image object in front of the head mounted display device and a person wearing the head mounted display device.

50. A wearable ophthalmic device comprising:

A wearable optical device comprising a light source and a wearable optical device configured to induce light into the eye of a person wearing the wearable optical device to form an image in the eye,

wherein the wearable optics device is configured to provide a refractive correction prescription for the image based on the optical prescription for the human eye.

Wearable ophthalmic devices.

51. The device of embodiment 50, wherein the wearable ophthalmic device further comprises a user interface controller configured to receive input from a person specifying an optical prescription for the person.

52. The device of embodiment 50, wherein the wearable ophthalmic device is configured to present different wavefront corrections to the person to identify the person's optical prescription.

53. The device of embodiment 52, wherein the wearable ophthalmic device further comprises a user interface configured to receive input from a person specifying a preferred correction.

54. The apparatus of embodiment 50, wherein the wearable optics include adaptable optics within the wearable optics adapted to effectuate the correction.

55. The apparatus of embodiment 54, wherein the adaptive optics comprises a variable focus element.

56. The apparatus of embodiment 54, wherein the adaptive optics include deformable optics.

57. The apparatus of embodiment 56, wherein the deformable optics comprise a deformable mirror.

58. The device of embodiment 50, wherein the wearable optics comprises a waveguide stack comprising a plurality of waveguides configured to provide different focal planes, the waveguide stack configured to provide the prescription correction.

59. The method of embodiment 58, wherein the waveguide stack comprises a combination of waveguides that provide the desired optical power to provide the prescription correction, the prescription correction directing the light through the combination of waveguides. to be implemented by the device.

60. The apparatus of embodiment 50, wherein the wearable optics comprise different depth planes, and wherein the wearable optics are configured to provide different image content in the different depth planes.

61. The wearable optics device of embodiment 60, wherein the wearable optics comprises a waveguide stack comprising a plurality of waveguides, wherein providing different imaging content in the different depth planes provides different optical power for different imaging thereby providing different image content via different waveguides in different waveguide stacks.

62. The apparatus of embodiment 61, wherein the apparatus provides different optical power to different image content by propagating through different number of waveguides.

63. The apparatus of embodiment 58, wherein the waveguide comprises static optics having optical power.

64. The apparatus of embodiment 50, wherein the wearable optics comprises at least one waveguide, and wherein the prescription correction is implemented by directing the light through the at least one waveguide.

65. The apparatus of embodiment 64, wherein the one or more waveguides comprise dynamic optics with variable optical power.

66. The apparatus of embodiment 50, wherein the prescription correction is configured to correct myopia.

67. The apparatus of embodiment 50, wherein the prescription correction is configured to correct hyperopia.

68. The method of embodiment 50, wherein the prescription correction is configured to correct astigmatism.

69. The method of embodiment 50, wherein the wearable ophthalmic device further comprises processing electronics configured to access to provide the prescription correction.

70. The device of embodiment 69, wherein the wearable ophthalmic device further comprises a sensor to determine the orientation of the person's head.

71. The apparatus of embodiment 70, wherein the sensor comprises a gyroscope sensor.

72. The apparatus of embodiment 70, wherein the wearable optics are configured to change focus of the image based on the head position.

73. The apparatus of embodiment 69, wherein the wearable optics comprises a variable focus element configured to change focus of the image to provide the correction.

74. The apparatus of embodiment 69, further comprising an eye tracking system configured to determine a convergence point of the person.

75. The apparatus of embodiment 74, wherein the wearable optics are configured to change focus of the image based on the determined convergence point.

76. The apparatus of embodiment 50, wherein the apparatus comprises a virtual reality device configured to provide the prescription correction to virtual reality image content.

77. The apparatus of embodiment 50, wherein the apparatus comprises an augmented reality system configured to provide the prescription correction to augmented reality image content.

78. The wearable optics device of embodiment 77, wherein the wearable optics are configured such that the prescription correction is applied to an image formed from light from the light source, and an image formed from an object in front of the device and a person wearing the wearable optics. Consisting of a device.

79. The method of embodiment 27, wherein identifying the optical prescription of the person comprises identifying a plurality of optical prescriptions at a plurality of intervals, each optical prescription corresponding to an interval.

80. The method of embodiment 79, wherein the wavefront correction is dynamically adjusted based on the respective optical prescription.

81. The wearable ophthalmic device of embodiment 52, wherein the wearable ophthalmic device is configured to identify a plurality of optical prescriptions at a plurality of intervals, each optical prescription corresponding to the interval, and the refractive correction is dynamically based on each optical prescription. Adjusted gear.

82. The augmented reality head-mounted display system of embodiment 7, wherein the augmented reality head-mounted display system comprises a display lens configured to pass light originating from the outside world to the eye of a person wearing the head-mounted system, wherein the adaptive A possible optic is positioned between the display lens and a light source originating from the outside world.

83. The augmented reality head-mounted display system of embodiment 7, wherein the augmented reality head-mounted display system comprises a display lens configured to pass light originating from the outside world to the eye of a person wearing the head-mounted system, wherein the adaptive A possible optic is positioned between a display lens and the eye of the user.

84. The apparatus of embodiment 7, wherein the adaptive optics are positioned between the light source and the eye of the user.

85. The apparatus of embodiment 7, wherein the adaptive optics are integrated into the light source.

86. The device of embodiment 50, wherein the device comprises an augmented reality system configured to pass ambient light from a front of the person to be provided to the eyes of the person, the device comprising: A device further configured to provide calibration.

87. The apparatus of embodiment 58, wherein the wearable optics comprises optics adaptable in the wearable optics configured to control performance of the correction.

88. The method of embodiment 87, wherein the adaptive optical element comprises:

between the light source and the waveguide stack; between at least one of the plurality of waveguides and another one of the plurality of waveguides; between the waveguide stack and the eye of the person; and between the waveguide stack and an ambient light source from the front of the device.

89. The apparatus of embodiment 87, wherein the adaptive optics are integrated into at least one of the waveguide stack and the light source.

90. The method of embodiment 27 further comprising: passing ambient light originating from the outside world in front of the person and in front of the head mounted display; applying wavefront correction to the ambient light based on the prescription; and displaying the corrected ambient light to the person, wherein the corrected ambient light is displayed along with the corrected image.

The numbered additional examples described herein below in the section entitled "Additional Numbered Examples", as described immediately after the numbered list of examples described herein, are Numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to the numbered list of embodiments herein.

<u>presbyopia</u>

One. A wearable ophthalmic device for treating presbyopia comprising:

head mounted ophthalmic systems;

a sensor configured to determine a gaze direction of the person;

a light source that is implemented to induce a light shape to the human eye and forms an image in the eye; and

an adaptable optical element through which a light shape is projected;

wherein the adaptive optics are configured to modify the focus of the image based on the gaze direction of the person;

A wearable ophthalmic device for treating presbyopia.

2. The apparatus according to the first embodiment, wherein the gaze direction of the person is based on a position of the head of the person.

3. The apparatus according to embodiment 1, wherein the apparatus further comprises a gyroscope sensor for determining the position of the head of the person.

4. The apparatus according to the first embodiment, wherein the gaze direction of the person is determined by tracking the position of the eye.

5. A wearable ophthalmic device comprising:

A wearable optical device comprising a light source and a wearable optical device configured to induce light into the eye of a person wearing the wearable optical device to form an image in the eye,

wherein the wearable optics device is configured to correct presbyopia based on an optical prescription for the human eye.

Wearable ophthalmic devices.

6. The apparatus of embodiment 5, wherein the apparatus further comprises a user interface controller configured to receive input from a person specifying an optical prescription for the person.

7. The apparatus of embodiment 5, wherein different wavefront corrections are presented to the person to identify the person's optical prescription.

8. The apparatus of embodiment 7, wherein the apparatus further comprises a user interface configured to receive input from a person specifying the desired calibration.

9. The apparatus of embodiment 5, wherein the wearable optics comprises an adaptable optic within the wearable optics configured to control performance of the correction.

10. The apparatus according to embodiment 9, wherein the adaptive optical element comprises a variable focus element.

11. The apparatus of embodiment 9, wherein the adaptive optics include deformable optics.

12. The apparatus of embodiment 11, wherein the deformable optics comprise a deformable mirror.

13. The apparatus of embodiment 5, wherein the wearable optics comprises a waveguide stack comprising a plurality of waveguides configured to provide different focal planes, the waveguide stack configured to provide prescription correction.

14. The method of embodiment 13, wherein the waveguide stack comprises a combination of waveguides that provide a desired optical power to provide the prescription calibration, wherein the prescription calibration is performed by directing the light through the combination of waveguides. implemented, the device.

15. The apparatus of embodiment 5, wherein the wearable optics provide different depth planes, and the wearable optics are configured to provide different image content in the different depth planes.

16. The wearable optics device of embodiment 15, wherein the wearable optics comprises a waveguide stack comprising a plurality of waveguides, wherein providing different imaging content in the different depth planes comprises providing different imaging content via different waveguides in the waveguide stack. providing different optical power to different image content by doing so.

17. The apparatus of embodiment 16, wherein the apparatus provides different optical power to different image content by propagating through different numbered waveguides.

18. The apparatus of embodiment 13, wherein the waveguide comprises static optics having optical power.

19. The apparatus of embodiment 5, wherein the wearable optics comprises at least one waveguide, and wherein the prescription correction is implemented by directing the light through the at least one waveguide.

20. The apparatus of embodiment 19, wherein the at least one waveguide comprises dynamic optics with variable optical power.

21. The apparatus of embodiment 5, wherein the apparatus further comprises processing electronics configured to access to provide the prescription correction.

22. The apparatus of embodiment 21, further comprising a sensor for determining the orientation of the person's head. Device.

23. The apparatus of embodiment 22, wherein the sensor comprises a gyroscope sensor.

24. The apparatus of embodiment 22, wherein the wearable optics are configured to change focus of the image based on the position of the head.

25. The apparatus of embodiment 21, wherein the wearable optics comprises a variable focus element configured to change focus of the image to provide the correction.

26. The apparatus of embodiment 21, wherein the apparatus further comprises an eye tracking system configured to determine a convergence point of the person.

27. The apparatus of embodiment 26, wherein the wearable optics are configured to change focus of the image based on the determined convergence point.

28. The apparatus of embodiment 5, wherein the apparatus comprises a virtual reality device configured to provide the prescription correction to virtual reality image content.

29. The apparatus of embodiment 5, wherein the apparatus comprises an augmented reality system configured to provide the prescription correction to augmented reality image content.

30. The wearable optics device of embodiment 29, wherein the wearable optics device is configured such that the prescription correction is applied to an image formed from light from the light source, and an image formed from an object in front of the device and the person wearing the wearable optics device. Consisting of a device.

31. The apparatus of embodiment 5, wherein the apparatus further comprises an electronic device configured to determine the gaze of the person based on one or more movements of the human eye.

32. The apparatus of embodiment 31, wherein the wearable optics are configured to change focus of the image based on the determined gaze.

33. The apparatus of embodiment 31, wherein downward movement of one or more of the eyes of the person indicates that the person is focusing on a near depth of focus.

34. The apparatus of embodiment 33, wherein the wearable optics are configured to increase some optical power of the wearable optics based on the optical prescription of the human eye.

35. The apparatus of embodiment 16, wherein the apparatus further comprises electronics configured to determine the gaze of the person based on one or more movements of the human eye.

36. The apparatus of embodiment 1, wherein the sensor comprises an eye tracking system configured to determine the point of convergence of the human eye.

37. The apparatus according to embodiment 4, wherein an angle of convergence is determined based on the position of the eye, and the focus is modified based on the angle of convergence.

38. The method of embodiment 31, wherein the one or more downward movements of the human eye indicates an increase in the angle of convergence of the eye, and wherein an increase in the angle of convergence of the eye indicates that the person focuses on a near depth of focus. indicating, device.

39. The apparatus of embodiment 5, further comprising a biofeedback system configured to determine a wavefront correction based on monitoring one or more characteristics of the eye while viewing an image.

40. The apparatus of embodiment 40, wherein the biofeedback system receives input from at least one of a phoropter, an autorefractor, and an eye tracking system.

41. The apparatus according to embodiment 40, wherein the property of the eye is at least one of a change in a convergence point of the eye, a change in the position of the person's head, and a change in the pupil size of the eye.

42. The apparatus of embodiment 5, wherein the apparatus further comprises an electronic device configured to determine the gaze of the person based on detection of a glare.

The numbered additional examples described herein below in the section entitled "Additional Numbered Examples", as described immediately after the numbered list of examples described herein, are Numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to the numbered list of embodiments herein.

<u>strabismus / amblyopia</u>

One. A wearable augmented reality device configured for use by a wearer with eyes that cannot align at a single convergence point, said device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light from the outside world to the eye of a wearer wearing the head-mounted system, the augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform;

a light source configured to project light into the eye of the wearer to form an image in the eye; and

an eye tracking system configured to determine the gaze of the eye;

the image is modified to add to complement the prism correction that brings the convergence points of both eyes together.

A wearable augmented reality device configured for use by a wearer with eyes that cannot align at a single point of convergence.

2. A wearable virtual reality device configured for use by a wearer with eyes that cannot align at a single point of convergence, said device comprising:

a virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform including a display that provides an image to the wearer's eyes;

a light source configured to project light into the eye of the wearer to form an image in the eye; and

an eye tracking system configured to determine the gaze of the eye;

the image is modified to add to complement the prism correction bringing together the convergence points of both eyes;

A wearable virtual reality device configured for use by a wearer with eyes that cannot align at a single point of convergence.

3. A wearable augmented reality device configured for use by a wearer having eyes that cannot align at a single point of convergence, said device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light from the outside world to the eye of a wearer wearing the head-mounted system, comprising a wearable augmented reality display platform;

a light source configured to project light into the eye of the wearer to form an image in the eye;

an eye tracking system configured to determine the gaze of the eye; and

adaptive optics configured to add complementary prism corrections bringing together the convergence points of both eyes;

A wearable augmented reality device configured for use by a wearer with eyes that cannot align at a single point of convergence.

4. The apparatus according to embodiment 3, wherein the adaptive optical element comprises a variable focus element.

5. The apparatus according to Embodiment 4, wherein the variable focus element comprises a thin-film mirror.

6. According to the above embodiment 5, the device comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror based on the shape of the cornea of the eye.

7. A wearable virtual reality device configured for use by a wearer with eyes that cannot align at a single point of convergence, said device comprising:

a virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform including a display that provides an image to the wearer's eye;

a light source configured to project light into the eye of the wearer to form an image in the eye;

an eye tracking system configured to determine the gaze of the eye; and

adaptive optics configured to add correcting for prism correction bringing together the convergence point of both eyes;

A wearable virtual reality device configured for use by a wearer with eyes that cannot align at a single point of convergence.

8. The apparatus according to embodiment 7, wherein the adaptive optical element comprises a variable focus element.

9. The apparatus according to Embodiment 8, wherein the variable focus element comprises a thin-film mirror.

10. The apparatus of Embodiment 9, wherein the device comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to change a shape of the thin-film mirror based on a shape of the cornea of the eye.

11. A wearable display configured for use by a wearer having eyes that cannot align at a single point of convergence, said display comprising:

wearable head-mounted ophthalmic systems;

a light source configured to direct light to the eye of the wearer to form an image in the eye, the light source including a fiber optic scanning projector; and

an eye tracking system configured to determine the gaze of the eye;

wherein the light source is configured to add complementary prism correction to bring the convergence points of both eyes together.

A wearable display configured for use by a wearer with eyes that cannot align at a single point of convergence.

12. A wearable display configured for use by a wearer having eyes that cannot align at a single point of convergence, said display comprising:

wearable head-mounted ophthalmic systems;

a light source configured to direct light to the eye of the wearer to form an image in the eye;

a waveguide stack comprising a plurality of waveguides comprised of different waveguides configured to project light from different depth planes; and

an eye tracking system configured to determine the gaze of the eye;

the image is modified to add to complement the prism correction bringing the convergence points of both eyes together.

A wearable display configured for use by a wearer with eyes that cannot align at a single point of convergence.

13. The display device of embodiment 12, wherein the waveguide stack further comprises one or more lenses.

14. In Example 12,

The head-mounted ophthalmic system includes an augmented reality display platform,

and the head-mounted ophthalmic system is configured to pass light originating from the outside world into the eye of the wearer wearing the head-mounted display system.

15. A wearable augmented reality device configured for use by a wearer with eyes that cannot align at a single point of convergence, said device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light originating from the outside world to an eye of a wearer wearing the head-mounted system, comprising an augmented reality display platform;

a light source configured to direct light to the eye of the wearer to form an image in the eye; and

an eye tracking system configured to determine the gaze of the eye;

The wearable augmented reality device is configured to retrain to gradually align the convergence points of both eyes,

A wearable augmented reality device configured for use by a wearer with eyes that cannot align at a single point of convergence.

16. In Example 15,

The wearable augmented reality device is configured to cover one eye and retrain.

17. In Example 15,

wherein the wearable augmented reality device is configured to retrain by reducing the intensity of light directed to one eye.

18. In Example 15,

wherein the wearable augmented reality device is configured to retrain by defocusing light directed to one eye.

19. A wearable virtual reality device configured for use by a wearer with eyes that cannot align at a single point of convergence, said device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display device that provides an image to the eye of the wearer;

a light source configured to direct light to the eye of the wearer to form an image in the eye; and

an eye tracking system configured to determine the gaze of the eye;

The wearable virtual reality device is configured to retrain by gradually aligning the convergence points of both eyes.

A wearable virtual reality device configured for use by a wearer with eyes that cannot align at a single point of convergence.

20. The apparatus of embodiment 19, wherein the wearable virtual reality device is configured to retrain with one eye closed.

21. The apparatus of embodiment 19, wherein the wearable virtual reality device is configured to retrain by reducing the intensity of light directed to one eye.

22. The apparatus of embodiment 19, wherein the wearable virtual reality device is configured to defocus and retrain light directed to one eye.

23. A wearable display configured for use by a wearer having eyes that cannot align at a single point of convergence, said display comprising:

an augmented reality head-mounted ophthalmic system configured to pass light from the outside world to the eye of a wearer wearing the head-mounted ophthalmic system, the augmented reality head-mounted ophthalmic system comprising an augmented reality display platform;

a light source configured to direct light to the eye of the wearer to form an image in the eye;

adaptive optics configured to correct the image; and

an eye tracking system configured to determine the gaze of the eye;

wherein the wearable display is configured to retrain by gradually aligning the convergence points of both eyes.

A wearable display configured for use by a wearer with eyes that cannot align at a single point of convergence.

24. The display device according to embodiment 23, wherein the adaptive optical element comprises a variable focus element.

25. The display device according to Embodiment 24, wherein the variable focus element includes a thin-film mirror.

26. In the 25th embodiment, the display device comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to change a shape of the thin-film mirror based on a shape of the cornea of the eye.

27. A wearable display configured for use by a wearer having eyes that cannot align at a single point of convergence, said display comprising:

head-mounted ophthalmic systems;

a light source configured to direct light to the eye of the wearer to form an image in the eye;

adaptive optics configured to modify the image; and

an eye tracking system configured to determine the gaze of the eye;

wherein the wearable display is configured to retrain by gradually aligning the convergence points of both eyes.

A wearable display configured for use by a wearer with eyes that cannot align at a single point of convergence.

28. The display device according to embodiment 27, wherein the adaptive optical element comprises a variable focus element.

29. The display device according to Embodiment 28, wherein the variable focus element includes a thin-film mirror.

30. In the 29th embodiment, the display device comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror based on the shape of the cornea of the eye.

31. A wearable display configured for use by a wearer having eyes that cannot align at a single point of convergence, said display comprising:

head-mounted ophthalmic systems;

a light source configured to direct light to the eye of the wearer to form an image in the eye, the light source including a fiber optic scanning projector; and

an eye tracking system configured to determine the gaze of the eye;

wherein the wearable display is configured to retrain by gradually aligning the convergence points of both eyes.

A wearable display configured for use by a wearer with eyes that cannot align at a single point of convergence.

32. A wearable display configured for use by a wearer with eyes that cannot align at a single point of convergence, said device comprising:

head-mounted ophthalmic systems;

a light source configured to direct light to the eye of the wearer to form an image in the eye;

a waveguide stack comprising a plurality of waveguides comprised of different waveguides configured to project light from different depth planes; and

an eye tracking system configured to determine the gaze of the eye;

wherein the wearable display is configured to retrain by gradually aligning the convergence points of both eyes.

A wearable display configured for use by a wearer with eyes that cannot align at a single point of convergence.

33. The display device of embodiment 32, wherein the waveguide stack further comprises one or more lenses.

34. The embodiment 32, wherein the head-mounted ophthalmic system comprises an augmented reality display platform;

and the head-mounted ophthalmic system is configured to pass light originating from the outside world into the eye of the wearer wearing the head-mounted display system.

The numbered additional examples described herein below in the section entitled "Additional Numbered Examples", as described immediately after the numbered list of examples described herein, are Numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to the numbered list of embodiments herein.

<u>Higher Order Aberrations</u>

One. A wearable augmented reality device configured for use by a person, the device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light originating from the outside world to the eye of the person wearing the head-mounted system, the augmented reality head-mounted ophthalmic system comprising an augmented reality display platform; and

at least one light source and wearable optics configured to project light into the eye of the person to form an image in the eye;

wherein the at least one light source and the wearable optics are configured to provide refractive correction for higher order refractive errors;

A wearable augmented reality device configured for use by a person.

2. The apparatus of embodiment 1, wherein the at least one light source comprises a fiber optic scanning display.

3. The apparatus of embodiment 1, wherein the apparatus further comprises a user interface controller configured to receive an input specifying an optical prescription of the person.

4. The apparatus of embodiment 1, wherein the wearable optics include adaptable optics within the wearable optics adapted to perform the refractive correction.

5. The apparatus according to embodiment 4, wherein the adaptive optical element comprises a variable focus element.

6. The apparatus of embodiment 4, wherein the adaptive optics include deformable optics.

7. The apparatus of embodiment 6, wherein the deformable optics comprise a deformable mirror.

8. The apparatus of embodiment 1, wherein the wearable optics comprises a waveguide stack comprised of a plurality of waveguides configured to provide different focal planes.

9. The wearable optics device of embodiment 1 comprises different depth planes;

and the wearable optics are configured to provide different imaging content in the different depth planes.

10. The wearable optics device of embodiment 9, wherein the wearable optics comprises a waveguide stack comprising a plurality of waveguides;

wherein providing the different image content in the different depth plane comprises providing different optical power to the different image content by providing the different image content through the different waveguides in the waveguide stack.

11. The apparatus according to embodiment 10, wherein different image content provides different optical power to different image content by propagating through different numbered waveguides.

12. The apparatus of embodiment 8, wherein the waveguide comprises static optics having optical power.

13. The apparatus of embodiment 1, wherein the wearable optics comprises at least one waveguide.

14. The apparatus of embodiment 13, wherein the at least one waveguide comprises dynamic optics with variable optical power.

15. The apparatus of embodiment 1, wherein the apparatus further comprises processing electronics configured to access to provide the refractive correction.

16. The wearable optics device according to embodiment 1, wherein the refractive correction is applied to an image formed from light originating from the light source, and an image formed from an object in front of the device and a person wearing the wearable optics device A device configured to be

17. A wearable virtual reality device configured for human use, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display for providing an image to the eye of the person; and

at least one light source and wearable optics configured to project light into the eye of the person to form an image in the eye;

wherein the at least one light source and the wearable optics are configured to provide refractive correction for higher order refractive errors.

A wearable virtual reality device configured for human use.

18. The apparatus of embodiment 1, wherein the apparatus further comprises receiver circuitry configured to receive input from a remote source specifying an optical prescription of the person.

19. In the first embodiment, the device,

a receiver configured to receive an optical prescription stored on the memory circuitry from a memory circuitry outside the wearable augmented reality device;

wherein the wearable augmented reality device provides refractive correction based on the received optical prescription.

20. In the 17th embodiment, the device comprises:

further comprising an outward facing camera configured to obtain an image of light formed from an object in front of the device;

and the image provided to the eye of the person comprises the acquired image.

21. The apparatus of embodiment 3, wherein the user interface controller is configured to receive input from at least one of the person, a third party, and a physician.

22. The apparatus of embodiment 15, wherein the wearable optics are configured to provide refractive correction in real time when the light forming an image is projected onto the eye of the person.

The numbered additional examples described herein below in the section entitled "Additional Numbered Examples", as described immediately after the numbered list of examples described herein, are Numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to the numbered list of embodiments herein.

<u>chromatic aberration</u>

One. A wearable augmented reality device configured for use by a person, the device comprising:

an augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system receives light from the external world to wear the head-mounted system; configured to pass through the human eye, the augmented reality display platform includes an optical device for projecting an image to the eye,

The augmented reality display device includes a first color component of the image in the first depth plane different from the first depth plane and a second color component of the image in the second depth plane to correct longitudinal chromatic aberration of the human eye. configured to project a color component,

A wearable augmented reality device configured for use by a person.

2. In the first embodiment, the augmented reality display device is configured to output a third color component of the image in a third depth plane different from the first and second depth planes in order to correct longitudinal chromatic aberration of the human eye. becoming a device.

3. The apparatus of embodiment 1, wherein the first color component is red.

4. The apparatus of embodiment 1, wherein the second color component is green.

5. The apparatus of embodiment 2, wherein the third color component is blue.

6. The apparatus of embodiment 1, wherein the apparatus further comprises a user interface for receiving a prescription for the longitudinal chromatic aberration.

7. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to perform an eye examination by automatically changing the focus of the image to provide incremental changes in optical prescription.

8. The augmented reality head-mounted ophthalmic system of embodiment 7, wherein the augmented reality head-mounted ophthalmic system is configured to perform an eye examination by automatically changing the focus of the first color component of the image to provide incremental changes in optical prescription. Device.

9. The augmented reality head-mounted ophthalmic system of embodiment 8, wherein the augmented reality head-mounted ophthalmic system is configured to perform an eye examination by automatically changing the focus of a monochromatic image of the second color component to provide incremental changes in optical prescription. Device.

10. The ophthalmic system of embodiment 9, wherein the augmented reality head-mounted ophthalmic system is configured to perform an eye examination by automatically changing the focus of a monochromatic image of a third color component of the image to provide incremental changes in optical prescription. becoming a device.

11. The apparatus of embodiment 10, wherein the image includes text.

12. The apparatus according to embodiment 10, wherein the image comprises a graphic symbol, a picture or a drawing.

13. The device of embodiment 7, wherein the device further comprises a user interface configured to receive input from a wearer regarding the image.

14. The apparatus of embodiment 7, wherein the augmented reality head-mounted ophthalmic system evaluates whether the person is comfortable viewing the image, and if not, progressively increases positive or negative prescriptions by changing focus.

15. The apparatus of any of the preceding embodiments, wherein the augmented reality head-mounted ophthalmic system is configured to evaluate whether the person is comfortable viewing images and, if so, determine the person's prescription.

16. The apparatus of embodiment 1, wherein the wearable augmented reality display platform comprises a fiber optic scanning device.

17. The apparatus according to the first embodiment, wherein the wearable augmented reality device system is configured such that an angle at which light of different colors is projected can be changed based on lateral chromatic aberration.

18. The apparatus of embodiment 1, wherein the optics include adaptive optics configured to project the light.

19. The apparatus of embodiment 18, wherein the adaptive optical element comprises a variable focus element.

20. Any embodiments of embodiment 1, wherein the apparatus further comprises a waveguide stack comprising a plurality of waveguides;

and the different waveguides are configured to project light from different depth planes.

21. The apparatus of embodiment 20, wherein the waveguide stack further comprises one or more lenses.

22. A wearable augmented reality device configured for use by a person, the device comprising:

an augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system receives light from the external world to wear the head-mounted system; configured to pass through the human eye, the augmented reality display platform includes an optical device for projecting an image to the eye,

The augmented reality display device includes a first color component of the image at the first angle different from the first angle and the second color of the image at the second angle to correct lateral chromatic aberration (magnification chromatic aberration) of the human eye. configured to project two color components,

A wearable augmented reality device configured for use by a person.

23. The apparatus of embodiment 22, wherein the apparatus further comprises a user interface for receiving a prescription for the transverse chromatic aberration (magnification chromatic aberration).

24. The apparatus of embodiment 22, wherein the augmented reality head-mounted ophthalmic system is configured to perform an eye exam by automatically changing the angle of the image to provide incremental changes in optical prescription.

25. A wearable virtual reality device configured for use by a person, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform, wherein the virtual reality display platform includes optics for projecting an image into the human eye;

The virtual reality display device is configured to project a first color image in the first depth plane different from the first depth plane and a second color image in the second depth plane to correct longitudinal chromatic aberration of the human eye. felled,

A wearable virtual reality device configured for use by a human.

26. A wearable virtual reality device configured for use by a person, the device comprising:

A virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform, the virtual reality platform comprising an optics for projecting an image into the human eye;

The virtual reality display device is configured to project a first color image at the first angle different from the first angle and a second color image at the second angle to correct lateral chromatic aberration (magnification chromatic aberration) of the human eye. composed,

A wearable virtual reality device configured for use by a human.

27. Any embodiments of embodiment 1, wherein the device further comprises one or more outward-facing cameras configured to acquire images;

wherein the image projected onto the eye comprises an acquired image.

28. The apparatus of embodiment 17, wherein varying the angle at which light of a different color is projected changes an image formed by the light of a different color along a focal plane of the optic.

29. The apparatus of embodiment 17, wherein the optical device comprises an adaptive optical element configured to receive an input and change an angle at which light of the first color component is projected based on transverse chromatic aberration (magnification chromatic aberration).

30. A wearable device configured for use by a person, the device comprising:

A head-mounted ophthalmic system comprising:

The head-mounted ophthalmic system comprises: a display platform including optics configured to project an image into the eye; and

a processor circuit configured to drive the optics based on an image correction program;

wherein the image correction program is configured to correct for chromatic aberration imparted to the image by an optical surface;

A wearable device configured for use by a person.

31. The apparatus of embodiment 30, wherein the head-mounted ophthalmic system further comprises a memory circuit operatively coupled to the processor circuit and configured to store the image correction program.

32. The apparatus of embodiment 30, wherein the image correction program is based on an optical prescription of the person, and wherein the optical surface comprises a surface of the eye.

33. The apparatus of embodiment 30, wherein the image correction program is based on chromatic aberration imparted to the image by the optics, and wherein the optical surface comprises a surface of the optics.

34. The apparatus according to embodiment 30, wherein the optical device comprises a variable focus element, and the image correction program is configured to drive the variable focus element by selectively projecting a first color component of the image in a first depth plane, and rotating about a central axis of the image in a second depth plane different from the first depth plane.

35. A wearable device configured for use by a person, the device comprising:

A head-mounted ophthalmic system comprising:

The head-mounted ophthalmic system comprises:

a memory circuit configured to store an image;

a display platform including optics configured to project the image to the human eye; and

a processor circuit operatively coupled to the memory circuit and configured to correct the image to correct for chromatic aberration of the human eye;

A wearable device configured for use by a person.

36. The apparatus of embodiment 35, wherein the processor is configured to apply an image correction program based on an optical prescription of the person.

37. A wearable device configured for use by a person, the device comprising:

a head-mounted ophthalmic system comprising a display platform, the display platform comprising an optical device configured to project an image into the human eye;

The display platform projects a first color component of the image with a first intensity to correct chromatic aberration of the human eye, and projects a second color component of the image with a second intensity different from the first intensity configured to

A wearable device configured for use by a person.

38. The apparatus of embodiment 37, wherein the chromatic aberration of the human eye causes focusing of the first color component in front of the retina of the eye, wherein the first intensity is greater than the second intensity.

39. The apparatus of embodiment 37, wherein the chromatic aberration of the human eye causes focusing of the first color component behind the retina of the eye, wherein the first intensity is less than the second intensity.

40. The apparatus of embodiment 7, wherein the apparatus further comprises a biofeedback system configured to provide an input to the augmented reality head-mounted ophthalmic system, wherein the incremental change of the optical prescription is based on the input.

41. The apparatus of embodiment 7, further comprising a biofeedback system configured to objectively monitor one or more characteristics of the eye, wherein the optical prescription is based on the monitored one or more characteristics.

42. The apparatus of embodiment 41, wherein the biofeedback system receives input from at least one of a phoropter, an automatic refractor, and an eye tracking system.

43. The one or more characteristics of the eye of embodiment 41 are:

at least one of a change in the convergence point of the eye, a change in the position of the person's head, and a change in the pupil size of the eye.

44. The apparatus of embodiment 24, further comprising a biofeedback system configured to objectively monitor one or more characteristics of the eye, and wherein the prescription is based on the monitored one or more characteristics of the eye.

45. The apparatus of embodiment 32, further comprising a biofeedback system configured to objectively monitor one or more characteristics of the eye, wherein the optical prescription is based on the monitored one or more characteristics of the eye.

The numbered additional examples described herein below in the section entitled "Additional Numbered Examples", as described immediately after the numbered list of examples described herein, are Numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to the numbered list of embodiments herein.

<u>refractometer (</u><u>phoropter</u><u>)</u>

One. A wearable augmented reality device configured for use by a wearer with a left eye and a right eye, the device comprising:

an augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system originates from the outside world in the eye of a wearer wearing the head-mounted system. configured to pass light, the augmented reality display platform optical device is configured to project an image to the eye,

wherein the augmented reality head-mounted ophthalmic system is configured to perform an eye examination by automatically changing the focus of the image to provide a gradual change in optical prescription.

A wearable augmented reality device configured for use by wearers with left and right eyes.

2. The apparatus of embodiment 1, wherein the wearable augmented reality display platform comprises a fiber optic scanning display.

3. The apparatus according to any one of embodiments 1 to 2, wherein the optics comprise adaptive optics configured to project the light.

4. The apparatus according to embodiment 3, wherein the adaptive optical element comprises a variable focus element.

5. The apparatus of any one of embodiments 1-4, further comprising a waveguide stack comprising a plurality of waveguides, wherein different waveguides are configured to project light originating from different depth planes.

6. The apparatus of embodiment 5, wherein the waveguide stack further comprises one or more lenses.

7. The apparatus of any of embodiments 1-6, wherein the augmented reality head-mounted ophthalmic system is configured to project different images of different sizes and/or intensities.

8. The apparatus according to embodiment 7, wherein the image includes text.

9. The device of any one of embodiments 1-8, wherein the device further comprises a user interface configured to receive an input from a wearer regarding the image.

10. The augmented reality head-mounted ophthalmic system according to any one of embodiments 1 to 9 above, wherein the augmented reality head-mounted ophthalmic system evaluates whether the patient can see the image with normal vision and administers the prescription by changing focus based on the evaluation. A device configured to make a gradual change, either positively or negatively.

11. The augmented reality head-mounted ophthalmic system according to any one of embodiments 1 to 10, wherein the augmented reality head-mounted ophthalmic system evaluates whether the patient can see the image with normal vision and determines the prescription of the wearer based on the evaluation an apparatus configured to do so.

12. The apparatus of any one of embodiments 1-11, wherein the augmented reality head-mounted ophthalmic system is configured to automatically make adjustments to the prescription based on physical changes in the eye.

13. The apparatus of embodiment 12, wherein the augmented reality head-mounted ophthalmic system is configured to track ocular behavior such that the manipulation is made automatically by the ophthalmic system.

14. The apparatus of any one of embodiments 1-12, wherein the apparatus further comprises a fiber optic light source, and wherein the augmented reality head-mounted ophthalmic system changes the focus of the image by changing the length or position of the optical fiber.

15. The device according to any one of embodiments 1 to 12, wherein the device further comprises a micro electro mechanical systems (MEMS) device, wherein the augmented reality head-mounted ophthalmic system changes the focus of the image by changing the MEMS device. changing device.

16. The apparatus according to any one of embodiments 1 to 15, wherein the eye exam comprises an eye exam, a brightness test and/or a glare test.

17. The apparatus of any one of embodiments 1-16, wherein the augmented reality head-mounted ophthalmic system is configured to automatically determine a focus quality of the projected image.

18. The apparatus according to embodiment 17, wherein the focus quality of the projected image is determined through analysis of accommodation, vergence and/or pupil size of the eye of the wearer.

19. The augmented reality head-mounted ophthalmic system according to any one of the preceding embodiments, wherein the augmented reality head-mounted ophthalmic system is configured to measure accommodation reflex by measuring accommodation, vergence and/or pupil size. becoming a device.

20. A wearable virtual reality device configured for use by a wearer with a left eye and a right eye, the device comprising:

A virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform, the virtual reality display platform optics comprising:

A wearable augmented reality display platform configured to project an image to the eye comprises a fiber optic scanning display,

wherein the virtual reality head-mounted ophthalmic system is configured to perform an eye examination by automatically changing the focus of the image to provide a gradual change in optical prescription.

A wearable virtual reality device configured for use by wearers with left and right eyes.

21. A wearable virtual reality device configured for use by a wearer with a left eye and a right eye, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform, wherein the virtual reality display platform optics are configured to project an image to the eye, the wearable augmented reality display platform comprising: a waveguide stack comprising a plurality of waveguides, wherein different waveguides are configured to project light from different depth planes;

wherein the virtual reality head-mounted ophthalmic system is configured to perform an eye examination by automatically changing the focus of the image to provide a gradual change in optical prescription.

A wearable virtual reality device configured for use by wearers with left and right eyes.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>red reflection</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

An augmented reality head-mounted ophthalmology comprising an augmented reality display platform and configured to pass light originating from the outside world to an eye of a wearer wearing the head-mounted system, wherein the eye comprises a retina and a cornea. dragon system;

a light source configured to project light to the eye of the wearer, wherein at least a portion of the light is reflected from at least a portion of the eye to produce a reflection; and

a camera configured to capture the reflected image, the device configured to perform a diagnostic test of the wearer's eye to detect an abnormality of the eye;

A wearable augmented reality device configured to be used by the wearer.

2. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform comprising a display for providing an image to the eye of the wearer comprising a retina and a cornea;

a light source configured to project light to the eye of the wearer, wherein at least a portion of the light reflects from at least a portion of the eye to produce a reflection; and

a camera configured to capture the reflected image, wherein the device is configured to perform a diagnostic test of the eye of the wearer to detect an abnormality in the eye.

A wearable virtual reality device configured for use by the wearer.

3. The apparatus of embodiments 1 or 2, wherein the light source is configured to direct the light to the eye along a normal of the eye's field of view.

4. The apparatus of embodiments 1 or 2, wherein the light source is configured to direct the light to the eye at a first angle at a first time and at a different second angle at the second time.

5. The light source according to embodiment 1 or 2, wherein the light source is configured to project the light to a first portion of the wearer's eye at a first time, and to project the light to another second portion of the wearer's eye at a second time Consisting of a device.

6. The device of embodiment 1 or 2, wherein the light source is configured to project light into both eyes of the wearer, each of the eyes comprising a retina and a cornea.

7. The device of any of the above embodiments 1 or 2, further comprising a second light source configured to project light to a second eye of the wearer, the second eye comprising a second retina and a second cornea, wherein at least a portion of the light a portion reflects from at least a portion of the second eye to create a reflection.

8. The apparatus of any one of embodiments 1-6, wherein the light source comprises a display device.

9. The apparatus of embodiment 8, wherein the display comprises a fiber optic scanning display.

10. The apparatus of embodiment 1 or 2, wherein the camera comprises an eye tracking camera.

11. The apparatus of any of the above embodiments 1 or 2, wherein the apparatus further comprises an eye tracking camera.

12. The apparatus of embodiment 1 or 2, wherein the abnormality of the eye comprises glaucoma, cataract, eye cancer, retinoblastoma, retinal detachment, ocular aberration, or corneal scar.

13. The device of any one of embodiments 1-12, wherein the light source is configured to project light into the wearer's left and right eyes.

14. The device of any one of embodiments 1-13, wherein the camera is configured to capture images of reflections and perform red reflection tests of the wearer's left and right eyes.

15. The apparatus of embodiment 13 or 14, wherein the abnormality of the eye comprises an eye misalignment, strabismus, or asymmetry.

16. The apparatus according to embodiment 1 or 2, wherein the apparatus further comprises an adaptive optics element.

17. The apparatus of embodiment 16, wherein the adaptive optical element comprises a variable focus element.

18. The apparatus of embodiments 16 or 17, wherein the adaptive optics are configured to direct the light to the eye at a first angle at a first time and at a different second angle at a second time.

19. The adaptive optics according to embodiment 16 or 17, wherein the adaptive optics project the light to a first portion of the wearer's eye at a first time and project the light to a second, different portion of the wearer's eye at a second time A device configured to project on.

20. The apparatus of any one of embodiments 1-19, wherein the apparatus further comprises a waveguide stack comprising a plurality of waveguides, wherein different waveguides are configured to project light from different depth planes.

21. The apparatus of embodiment 20, wherein the waveguide stack further comprises one or more lenses.

22. The apparatus of any of embodiments 20 or 21, wherein the waveguide stack is configured to provide a fixation target for the wearer in different depth planes.

23. The apparatus of any one of embodiments 19-21, wherein the waveguide stack accommodates the eye of the wearer by changing the depth plane of the fixation target.

24. The device according to any one of embodiments 19-23, wherein the fixation target is located away from the center of the wearer's field of view.

25. The apparatus of embodiments 1 or 2, wherein at least one of the waveguides is configured to capture the reflected image.

26. The apparatus of embodiment 25, wherein the plurality of waveguides are configured to capture a plurality of images of the reflection in different depth planes.

27. The apparatus of embodiment 26, wherein at least one of the waveguides comprises an optical element having an optical output, the optical output corresponding to a depth plane of 8 inches to 4 feet from the eye.

28. The display platform according to embodiment 1 or 2, wherein the display platform provides a first fixation target at a first location at a first time, and a second fixation target at a different second location at a second time to move the eye an apparatus configured to do so.

29. The apparatus according to any one of embodiments 1-28, wherein the camera comprises a light pipe.

30. The apparatus of any one of embodiments 1-29, wherein the light source comprises a light pipe.

31. The apparatus of any one of embodiments 1-30, wherein the light comprises visible light.

32. The apparatus of embodiment 31, wherein the light comprises white light.

33. The apparatus of embodiment 32, further comprising at least one mechanical filter configured to limit the spectrum of reflected light detected by the camera.

34. The apparatus of embodiment 32, wherein the apparatus is configured to digitally filter images captured by the camera to remove light in at least one wavelength range from the images.

35. The apparatus of any one of embodiments 1-32, wherein the light comprises infrared light.

36. The apparatus of any one of embodiments 1-33, wherein at least a portion of the light is reflected from the retina and the diagnostic test comprises a red reflection test.

37. The apparatus of any of embodiments 1-33, wherein at least a portion of the light is reflected from the cornea, and wherein the diagnostic test comprises a Hirschberg corneal reflex test.

38. The apparatus according to any one of embodiments 1-35, wherein the apparatus is further configured to compare the result of the diagnostic test with a database of normal or abnormal results.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>intraocular pressure</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

a wearable augmented reality display platform, configured to pass light originating from the outside world to an eye of a wearer wearing a head-mounted system, the eye comprising a cornea, the augmented reality head-mounted system comprising: An ophthalmic system comprising: an augmented reality head-mounted ophthalmic system configured to apply a force to the cornea of the eye; and

a sensor configured to determine applanation of the cornea for determining intraocular pressure of the eye;

A wearable augmented reality device configured for use by a wearer.

2. A wearable virtual reality device configured for use by a wearer, the device comprising:

and a wearable virtual reality display platform comprising a display device for providing an image to the eye of the wearer, wherein the eye comprises a cornea, and wherein the virtual reality head-mounted ophthalmic system comprises the cornea of the eye. a wearable virtual reality display platform configured to apply a force to the and

a sensor configured to determine applanation of the cornea for determining intraocular pressure of the eye;

A wearable virtual reality device configured for use by the wearer.

3. The device of embodiments 1 or 2, wherein the head-mounted ophthalmic system is configured to apply a pulse of air to flatten the cornea.

4. The device of embodiments 1 or 2, wherein the head-mounted ophthalmic system is configured to apply a mechanical force to the cornea of the eye through the eyelids of the wearer.

5. The device of embodiment 4, wherein the head-mounted ophthalmic system comprises a transducer.

6. The apparatus of any one of embodiments 1-4, wherein the sensor utilizes ultrasonic range imaging.

7. The apparatus of any one of embodiments 1-4, wherein the sensor utilizes photoacoustic imaging.

8. The apparatus according to any one of embodiments 1-4, wherein the sensor comprises an imaging head.

9. The apparatus of embodiment 8, wherein the imaging head comprises an interferometric 3D imaging head.

10. The device of any one of embodiments 1-9, wherein the device further comprises a light source configured to project the beam of light onto the eye of the wearer.

11. The device of any one of embodiments 1-9, further comprising a fiber optic scanning display configured to project a beam of light onto the eye of the wearer.

12. The apparatus of embodiment 10, wherein the apparatus further comprises adaptive optics.

13. The apparatus of embodiment 12, wherein the adaptive optics are configured to project the light.

14. The apparatus according to embodiment 13, wherein the adaptive optical element comprises a variable focus element.

15. The apparatus of any one of embodiments 1-14, wherein the apparatus further comprises a waveguide stack comprising a plurality of waveguides, wherein different waveguides are configured to project light originating from different depth planes.

16. The apparatus of embodiment 15, wherein the waveguide stack further comprises one or more lenses.

17. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-worn ophthalmic system comprising a wearable augmented reality display platform, wherein the augmented reality head-worn ophthalmic system is configured to pass light originating from the outside world to an eye of a wearer wearing the head-worn system;

a light source configured to project light to the eye of the wearer; and

a light-monitoring device configured to measure reflected light;

wherein the augmented reality head-mounted ophthalmic system is configured to determine intraocular pressure from the measured reflected light;

A wearable augmented reality device configured for use by a wearer.

18. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-worn ophthalmic system comprising a wearable virtual reality display platform having a display for supplying an image to the eye of the wearer;

a light source configured to project light to the eye of the wearer; and

a light-monitoring device configured to measure reflected light;

wherein the virtual reality head-worn ophthalmic system is configured to determine intraocular pressure from the measured reflected light;

A wearable virtual reality device configured for use by the wearer.

19. The apparatus of embodiments 17 or 18, wherein the light source comprises a fiber optic scanning display configured to project a beam of light into the eye of the wearer.

20. The apparatus of embodiment 19, wherein the fiber length of the optical fiber scanning display can be varied.

21. The apparatus of embodiment 19, wherein the light-monitoring device comprises the optical fiber scanning display.

22. The apparatus according to embodiment 17 or 17, wherein the photo-monitoring device comprises a fiber optic scanning indicator or a photo-detector.

23. The apparatus of any of embodiments 17 or 18, wherein the wavelength of the light projected to the eye may be varied.

24. The device of any of embodiments 17 or 18, wherein the device further comprises an adaptable optic configured to project the light to the eye of the wearer.

25. The apparatus of embodiment 24, wherein the adaptive optical element comprises a variable focus element.

26. The apparatus of embodiments 17 or 18, wherein the apparatus further comprises a waveguide stack comprising a plurality of waveguides, wherein different waveguides are configured to project light originating from different depth planes.

27. The apparatus of embodiment 26, wherein the waveguide stack further comprises one or more lenses.

28. The apparatus according to any one of embodiments 17 to 27, wherein the light-monitoring device is configured to measure backscattered light.

29. The apparatus of any of embodiments 17-27, wherein the light-monitoring device is configured to detect a number of Purkinje images of the wearer's eye.

30. The apparatus of embodiment 29, wherein the head-mounted ophthalmic system is configured to determine intraocular pressure based at least in part on a shape or location of the one or more Purkinier images.

31. The apparatus of embodiments 29 or 30, wherein the one or more Purkinier images comprise flashing.

32. The device of any one of embodiments 1-31, wherein the ophthalmic system is further configured to detect the presence of ocular hypertension based at least in part on the determined intraocular pressure.

33. The device of any one of embodiments 1-31, wherein the ophthalmic system is further configured to determine an ocular pulse rate based at least in part on comparing a plurality of intraocular pressures determined from measurements taken at regular time intervals.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below are those described immediately after the numbered list of examples described herein, as well as those The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>pinhole</u><u> Breaker (Pinhole) </u><u>Occluder</u><u>)</u>

One. A wearable augmented reality device configured for human use, the display device comprising:

an augmented reality head-mounted ophthalmic system comprising an augmented reality display platform and configured to pass light originating from the outside world to at least one eye of a person wearing the head-mounted system;

a light source configured to project light into the eye of the person to form an image in the eye; and

a user interface configured to receive input from a human;

wherein the wearable augmented reality device is configured to block a specific portion of the person's eye and to receive, via the user interface, an input originating from the person regarding the wearer's eyesight;

A wearable augmented reality device configured for human use.

2. The device of embodiment 1, wherein the wearable augmented reality device is configured to block a central region.

3. The apparatus of Embodiment 1, wherein the wearable augmented reality device is configured to block a surrounding area.

4. The apparatus of embodiment 1, wherein the wearable augmented reality device is configured to digitally block the specific portion of the human eye.

5. The apparatus of embodiment 1, wherein the wearable augmented reality device is configured to manually block the specific portion of the human eye.

6. A wearable virtual reality device configured for human use, the display device comprising:

a head-mounted display device comprising a virtual reality display platform;

a light source configured to project light into the eye of the person to form an image in the eye; and

a user interface configured to receive input from a human;

wherein the wearable virtual reality device is configured to block a specific portion of the person's eye and to receive an input from the person regarding the wearer's field of view via the user interface;

A wearable virtual reality device configured for human use.

7. The device of embodiment 6, wherein the wearable augmented reality device is configured to block a central region.

8. The device of embodiment 6, wherein the wearable augmented reality device is configured to block a surrounding area.

9. The apparatus according to embodiment 6, wherein an image is presented to a person, and the wearable virtual reality device is configured to receive an input from the person regarding the image via the user interface.

10. A wearable display device configured for human use, the display device comprising:

head-mounted ophthalmic systems;

a light source configured to guide light to the human eye to form an image in the eye;

a user interface configured to receive input from a person; and

an adaptable optical element configured to project the image onto a specific portion of the human eye;

wherein the wearable display is configured to block a particular portion of the eye of the person and to receive an input from the person relating to the wearer's eyesight via the user interface;

A wearable device configured for human use.

11. The apparatus according to embodiment 10, wherein the adaptive optical element comprises a variable focus element.

12. The apparatus according to embodiment 11, wherein the variable focus element comprises a membrane mirror.

13. In the 12th embodiment, the display device comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to change a shape of the thin-film mirror based on a shape of the cornea of the eye.

14. A wearable display device configured for human use, the display device comprising:

head-mounted display system;

a light source configured to guide light to a human eye to form an image in the eye, the light source including a fiber optic scanning projector; and

a user interface configured to receive input from a human;

wherein the wearable display is configured to block a particular portion of the person's eye and to receive an input from the person relating to the wearer's vision through the user interface;

A wearable display device configured for human use.

15. A wearable display device configured for human use, the display device comprising:

head-mounted display system;

a light source configured to guide light to one eye of the person to form an image in the eye;

a waveguide stack comprising a plurality of waveguides wherein different waveguides are configured to project the light at different focal planes; and

a user interface configured to receive input from a human;

wherein the wearable display is configured to block a particular portion of the eye of the person and to receive an input from the person relating to the wearer's eyesight via the user interface;

A wearable display device configured for human use.

16. The apparatus of embodiment 15, wherein the waveguide stack further comprises one or more lenses.

17. The 15th embodiment, wherein the head-mounted display system comprises an augmented reality head-mounted ophthalmic system configured to pass light originating from the outside world to the eye of a person wearing the head-mounted system. Including device.

18. A wearable augmented reality device configured for use by a person, the device comprising:

an augmented reality head-mounted ophthalmic system comprising an augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system is configured to pass light originating from the outside world to an eye of a person wearing the head-mounted system; and

a light source configured to project light into the eye of the person to form an image in the eye;

The wearable augmented reality device is configured to block a specific part of the human eye,

A wearable augmented reality device configured for use by a person.

19. The apparatus of embodiment 18, wherein the wearable augmented reality device is configured to block a central region.

20. The apparatus of embodiment 18, wherein the wearable augmented reality device is configured to block a surrounding area.

21. The apparatus of embodiment 18, wherein the wearable augmented reality device is configured to digitally block the specific portion of the human eye.

22. The apparatus of embodiment 18, wherein the wearable augmented reality device is configured to manually block the specific portion of the human eye.

23. The apparatus according to the first embodiment, wherein the augmented reality device is configured to block a part of the light corresponding to the specific part of the human eye.

24. The apparatus of embodiment 2, wherein blocking the central region improves visual acuity of the person in the image representing a visual defect of the eye of the person.

25. The apparatus of embodiment 18, wherein the wearable augmented reality device is configured to block a specific portion of the person's eye based on the person's optical prescription.

26. The apparatus according to embodiment 18, wherein the wearable augmented reality device is configured to block a specific portion of the human eye by stopping a periphery of the light forming the image.

27. The apparatus of embodiment 18, wherein the wearable augmented reality device is configured to adjust an intensity of ambient light originating from the external world surrounding the person.

28. The apparatus of embodiment 18, wherein the wearable augmented reality device is configured to block the specific portion of the eye based on input originating from the external world surrounding the person.

29. The apparatus of embodiment 28, wherein the input from the surroundings comprises at least one of gaze orientation, ambient light from the surroundings, and adjustment.

30. The apparatus of embodiment 21, further comprising a waveguide stack comprising a plurality of waveguides, wherein different waveguides are configured to project the light at different focal planes, digitally blocking the particular portion of the eye wherein selectively projecting light to different focal planes, wherein said particular portion of said eye corresponds to a selected focal plane.

31. The apparatus according to embodiment 18, wherein the wearable augmented reality device is configured to correct a color of a portion of the image corresponding to the specific portion of the eye.

32. The apparatus according to embodiment 18, wherein the wearable augmented reality device is configured to change the intensity of a portion of the image corresponding to the specific portion of the eye.

33. The apparatus of embodiment 9, further comprising a camera configured to receive a reflected image based on an image presented to the person passing through the particular portion of the human eye and reflected by the retina of the eye. wherein the received input is based on a comparison of the reflected image with an expected reflected image, wherein the expected reflected image is based on a healthy eye.

34. The apparatus of embodiment 14, wherein an image is presented to the person, and the wearable virtual reality device is configured to receive an input originating from the person regarding the image via the user interface.

35. The apparatus of embodiment 34, further comprising a camera configured to receive a reflected image based on an image presented to the person passing through the specified portion of the human eye and reflected by the retina of the eye. wherein the received input is based on a comparison of the reflected image with an expected reflected image, wherein the expected reflected image is based on a healthy eye.

36. The apparatus according to embodiment 21, wherein the wearable augmented reality device is configured to correct a focus of a portion of the image corresponding to the specific portion of the eye.

37. In the 21st embodiment, the wearable augmented reality device contrasts a part of the image corresponding to the specific part of the eye related to another part of the image that does not correspond to the specific part of the eye. A device configured to calibrate

38. A wearable virtual reality device configured for human use, the display device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform; and

a light source configured to project light into the eye of the person to form an image in the eye;

The wearable virtual reality device is configured to block a specific part of the human eye,

A wearable virtual reality device configured for human use.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>Early </u><u>W4LT</u><u> test</u>

One. A wearable augmented reality device configured for use by a wearer with a left eye and a right eye, the device comprising:

an augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system is configured to pass light originating from the outside world to an eye of a wearer wearing the head-mounted system; and

and first and second displays included in the augmented reality display platform for each of the left and right eyes,

wherein the augmented reality head-mounted ophthalmic system is configured to project independent first and second images into the left and right eyes, respectively, and to identify visual defects;

A wearable augmented reality device configured for use by wearers with left and right eyes.

2. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to evaluate angles of binocular vision and binocular monovision of the wearer.

3. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to administer a Worth Four Light Test or a Worth Four Dot Test.

4. The apparatus of embodiment 1, wherein the image includes a colored small dot.

5. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to detect inhibition of either the right eye or the left eye.

6. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to receive input from the wearer, analyze the received input, and identify a visual defect of the wearer.

7. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to project the independent first and second images from different depth planes.

8. The device of any one of embodiments 1-7, further comprising a fiber optic scanning display configured to project light onto the eye of the wearer.

9. The apparatus according to any one of embodiments 1 to 8, wherein the apparatus further comprises adaptive optics configured to project the independent first image and second image.

10. The apparatus according to embodiment 9, wherein the adaptive optical element comprises a variable focus element.

11. The apparatus of any one of embodiments 1-10, further comprising a waveguide stack comprising a plurality of waveguides, wherein different waveguides are configured to project light originating from different depth planes.

12. The apparatus of embodiment 11, wherein the waveguide stack further comprises one or more lenses.

13. The augmented reality head-mounted ophthalmic system according to any one of embodiments 1 to 12, wherein the augmented reality head-mounted ophthalmic system allows the wearer's vision defect through analysis of the independent first and second images imaged corresponding to the wearer's retina. A device, configured to automatically determine

14. A wearable virtual reality device configured for use by a wearer with a left eye and a right eye, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform including a display that provides an image to the wearer's eye; and

and first and second display devices included in the virtual reality display platform for each of the left and right eyes,

wherein the virtual reality head-mounted ophthalmic system is configured to project, respectively, independent first and second images into the left and right eyes and to identify visual defects;

A wearable virtual reality device configured for use by wearers with left and right eyes.

15. The apparatus of embodiment 14, wherein the virtual reality head-mounted ophthalmic system is configured to evaluate a rating of the wearer's binocular vision and a single visual acuity in both eyes.

16. The apparatus of embodiment 14, wherein the virtual reality head-mounted ophthalmic system is configured to administer a Worth Four Light Test or a Worth Four Dot Test.

17. The apparatus of embodiment 14, wherein the image includes colored dots.

18. The apparatus of embodiment 14, wherein the virtual reality head-mounted ophthalmic system is configured to detect inhibition of either the right eye or the left eye.

19. The apparatus of embodiment 14, wherein the virtual reality head-mounted ophthalmic system is configured to receive input from the wearer, analyze the received input, and identify a visual defect of the wearer.

20. The apparatus of embodiment 14, wherein the virtual reality head-mounted ophthalmic system is configured to project the independent first and second images from different depth planes.

21. The apparatus of any one of embodiments 14-20, further comprising a fiber optic scanning display configured to project light onto the eye of the wearer.

22. The apparatus according to any one of embodiments 14 to 21, wherein the apparatus further comprises adaptive optics configured to project the independent first image and second image.

23. The apparatus of embodiment 22, wherein the adaptive optical element comprises a variable focus element.

24. The apparatus of any one of embodiments 14-23, wherein the apparatus further comprises a waveguide stack comprising a plurality of waveguides, wherein different waveguides are configured to project light originating from different depth planes.

25. The apparatus of embodiment 24, wherein the waveguide stack further comprises one or more lenses.

26. The virtual reality head-mounted ophthalmic system according to any one of embodiments 14-25, wherein the virtual reality head-mounted ophthalmic system enables the wearer through analysis of the independent first and second images imaged corresponding to the wearer's retina. A device, configured to automatically determine the visual impairment of

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>retinal examination</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

An augmented reality head-mounted ophthalmic system comprising an augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system is configured to pass light originating from the outside world to an eye of a wearer wearing the head-mounted system, the eye having a retina. ;

at least one light source configured to project light into the eye of the wearer to form an image in the eye, the light source configured to sweep light across a retina of the eye of the wearer to produce a reflection of the retina; and

and a sensor configured to measure the retina's response to the sweeping light, such that the augmented reality head-mounted ophthalmic system can perform a retinoscopy examination to measure refractive errors of the eye.

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1, wherein the image can be dynamically altered to provide a dynamic retinoscopy examination.

3. The apparatus of any one of embodiments 1-2, wherein the at least one light source comprises a fiber optic scanning display.

4. The apparatus of any one of embodiments 1-3, wherein the at least one light source comprises a fiber scanning display and a light source.

5. The device of any one of embodiments 1-4, wherein the device further comprises an adaptive optic configured to project the image onto a target portion of the wearer's eye.

6. The apparatus according to embodiment 5, wherein the adaptive optical element comprises a variable focus element.

7. The apparatus according to Embodiment 6, wherein the variable focus element comprises a thin-film mirror.

8. In the above embodiment 7, the device comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror based on the shape of the cornea of the eye.

9. The apparatus of any one of embodiments 1-8, wherein the apparatus further comprises a waveguide stack comprising a plurality of waveguides, wherein different waveguides are configured to project light originating from different depth planes.

10. The apparatus of embodiment 9, wherein the waveguide stack further comprises one or more lenses.

11. The apparatus of any one of embodiments 1-10, wherein the wearable augmented reality device is configured to determine whether the measured refractive error has improved in response to a change in light output.

12. The apparatus of embodiment 11, wherein the wearable augmented reality device is configured to modify an applied light magnification to reduce the measured refractive error.

13. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system comprising an augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system transmits light originating from the external world to the wearer of the head-mounted system. configured to pass through the eye,

wherein the augmented reality head-mounted ophthalmic system is configured to perform a retinal examination to measure refractive errors of the eye.

A wearable augmented reality device configured for use by a wearer.

14. A wearable virtual reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system comprising a virtual reality display platform including a display device providing the image to the wearer's eyes, wherein the eyes have a retina;

at least one light source configured to project light into the eye of the wearer to form an image in the eye, the light source configured to sweep light across a retina of the eye of the wearer to produce a reflection of the retina; and

and a sensor configured to measure the retina's response to the sweeping light, such that the virtual reality head-mounted ophthalmic system can perform a retinal examination to measure refractive error of the eye.

A wearable virtual reality device configured for use by a wearer.

15. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform comprising a display device for providing an image to the eye of the wearer, wherein the eye has a retina;

wherein the virtual reality head-mounted ophthalmic system is configured to perform a retinoscopy examination to measure refractive errors of the eye.

A wearable virtual reality device configured for use by the wearer.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>slit lamp</u><u> Slit Lamp</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system comprising the augmented reality display platform and configured to pass light originating from the outside world to the eyes of a wearer wearing the head-mounted system;

and project an illumination beam of light to the eye of the wearer to illuminate an anterior or posterior portion of the eye, wherein a cross-sectional beam shape of the illumination beam is such that the size of the cross-sectional beam shape along an up-down direction of the eye is the a light source configured to be greater than a size of a cross-sectional beam shape along a nose-temporal direction of the eye; and

an imaging system configured to capture an image of the illuminated portion of the wearer's eye to perform a slit lamp lamp examination to determine the health of the eye;

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1, wherein the illumination beam originating from the light source is incident on the location on the surface of the eye at an angle perpendicular to the location on the surface of the eye.

3. The method of embodiment 2 wherein the illumination beam originating from the light source is incident at the location on the surface of the eye at an angle between about ±10 degrees and about ±90 degrees with respect to a direction perpendicular to the location on the surface of the eye. , Device.

4. The apparatus of embodiment 2, wherein the illumination beam originating from the light source is incident along an axis that crosses the eye and passes through the pupil.

5. The device of embodiment 1, wherein the illumination beam originating from the light source has a width along the temple-nose axis of the wearer, the width being between about 25 micrometers and about 1.0 mm.

6. The apparatus of embodiment 1, wherein the imaging system comprises a camera configured to track the wearer's eye.

7. The apparatus of embodiment 1, wherein the apparatus is further configured to determine the health of the eye by matching an image captured by the imaging system with a known pattern.

8. The apparatus of embodiment 1, wherein the apparatus is further configured to compare the image captured by the imaging system with an image of the eye previously acquired.

9. The apparatus of embodiment 1, wherein the light source comprises a fiber optic scanning device.

10. The apparatus of embodiment 1, wherein the apparatus further comprises an adaptive optics configured to project the illumination beam onto a particular portion of the wearer's eye.

11. The apparatus according to embodiment 10, wherein the adaptive optical element comprises a variable focus element.

12. The apparatus according to embodiment 11, wherein the variable focus element comprises a thin-film mirror.

13. The apparatus of embodiment 12, wherein the apparatus comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to change the shape of the membrane mirror.

14. The apparatus of embodiment 10, wherein the adaptive optics are configured to change the angle of incidence of the illumination beam at the particular portion of the wearer's eye.

15. The apparatus of embodiment 10, wherein the adaptive optics are configured to vary the width of the illumination beam.

16. The apparatus of embodiment 10, wherein the adaptive optics are configured to vary the depth of the wearer's eye into which the illumination beam is focused.

17. The apparatus of any one of embodiments 1-17, further comprising a waveguide stack comprising a plurality of waveguides, wherein different waveguides are configured to project light from different focal planes.

18. The apparatus of embodiment 17, wherein the waveguide stack further comprises one or more lenses.

19. The apparatus of embodiment 1, wherein the illumination beam comprises a thin sheet of light.

20. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system comprising the augmented reality display platform and configured to pass light originating from the outside world to the eye of a wearer wearing the head-mounted system;

a scanning optical fiber device configured to project light into the eye of the wearer to illuminate the eye for performing a slit lamp lamp examination of the eye; and

a camera configured to capture an image of the illuminated portion of the wearer's eye to determine the health of the eye;

A wearable augmented reality device configured for use by a wearer.

21. The apparatus of embodiment 20, wherein the optical fiber scanning device is configured to project an illumination beam onto the eye of the wearer.

22. The device of embodiment 20, wherein the illumination beam has a width along the temple-nose direction of the wearer, the width being between about 25 micrometers and about 1.0 mm.

23. The apparatus according to embodiment 20, wherein the illumination beam has a rectangular cross-sectional shape.

24. The apparatus of embodiment 23, wherein the dimension of the rectangular cross-sectional shape along the up-down direction of the eye is greater than the dimension of the rectangular cross-sectional beam shape along the nose-temporal direction of the eye.

25. The apparatus of embodiment 20, wherein the scanning fiber optic device is configured to project light into the eye of the wearer at an angle that is not perpendicular to the surface of the eye at the incident position.

26. The apparatus of embodiment 20, wherein the apparatus is further configured to determine eye health by matching the image captured by the camera with a known pattern.

27. The apparatus of embodiment 20, wherein the apparatus is further configured to compare the image captured by the imaging system with a previously acquired image of the eye.

28. The device according to any of the preceding embodiments, wherein the device is configured to detect a change in the eye of the wearer at least twice a year.

29. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display for providing an image to the eye of the wearer;

and project an illumination beam of light to the eye of the wearer to illuminate an anterior or posterior portion of the eye, wherein a cross-sectional beam shape of the illumination beam is configured to illuminate the eye according to a superior-inferior direction of the eye. a light source configured to have a cross-sectional beam shape dimension larger than a cross-sectional beam direction dimension along a nasal-temporal direction of the eye; and

an imaging system configured to capture an image of the illuminated portion of the wearer's eye to perform a slit lamp lamp examination to determine the health of the eye;

A wearable virtual reality device configured for use by the wearer.

30. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display for providing an image to the eye of the wearer;

a scanning optical fiber device configured to project light into the eye of the wearer to illuminate the eye for performing a slit lamp lamp examination of the eye; and

a camera configured to acquire an image of the illuminated portion of the wearer's eye to determine the health of the eye;

A wearable virtual reality device configured for use by the wearer.

31. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system comprising the augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system is configured to pass light originating from the outside world to the eye of a wearer wearing the head-mounted system;

a light source configured to project a thin sheet of light into the eye of the wearer to illuminate an anterior or posterior portion of the eye; and

a camera configured to capture an image of the illuminated portion of the wearer's eye to perform a slit lamp lamp examination to determine the health of the eye;

A wearable augmented reality device configured for use by a wearer.

32. The apparatus of embodiment 21, wherein light from a sheet originating from the light source is incident on the location on the surface of the eye at an angle perpendicular to the location on the surface of the eye.

33. The device of embodiment 21, wherein the light of the sheet originating from the light source has a width along the nose-temporal axis of the wearer's eye, the width being between about 25 micrometers and about 1.0 mm.

34. The apparatus of embodiment 21, wherein the camera is further configured to track the wearer's eye.

35. The apparatus of embodiment 31, wherein the apparatus is further configured to determine the health of the eye by matching the image captured by the imaging system with a known pattern.

36. The apparatus of embodiment 31, wherein the apparatus is further configured to compare the image captured by the imaging system with a previously acquired image of the eye.

37. The apparatus of embodiment 31, wherein the light source comprises a fiber optic scanning device.

38. The device of embodiment 31, wherein the device further comprises an adaptive optic configured to project the thin sheet of light to a specific portion of the wearer's eye.

39. The apparatus of embodiment 38, wherein the adaptive optical element comprises a variable focus element.

40. The apparatus of embodiment 39, wherein the variable focus element comprises a membrane mirror.

41. The apparatus of embodiment 31, wherein the apparatus comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to change the shape of the thin film mirror.

42. The apparatus of any of the preceding embodiments, wherein the camera comprises a visible camera.

43. The apparatus of any one of the preceding embodiments, wherein the camera comprises an infrared camera.

44. The device of any of the preceding embodiments, wherein the device is configured to detect a change in the wearer's eye at least twice a year.

45. The apparatus of any one of the preceding embodiments, wherein the display device further comprises a frame supported by the frame.

46. The apparatus of embodiment 45, wherein the light source is disposed on the frame.

47. The apparatus according to any one of embodiments 45 and 46, wherein the imaging system is disposed on the frame.

48. The device of any one of embodiments 45-47, wherein the frame comprises one or more ear stems.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>color blindness</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

CLAIMS 1. An augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform comprising a display device, wherein the augmented reality head-mounted ophthalmic system is the head-mounted system with light originating from the outside world. is configured to pass through the eyes of the wearer wearing the

wherein the wearable augmented reality device is configured to perform a color test to examine the wearer's imperfections when detecting a particular color.

A wearable augmented reality device configured for use by a wearer.

2. A wearable virtual reality device configured for use by a wearer, the device comprising:

A virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform comprising a display device, the wearable virtual reality display platform comprising a display device comprising at least one light source;

wherein the wearable virtual reality device is configured to perform a color test to examine the wearer's imperfections when detecting a specific color.

A wearable virtual reality device configured for use by a wearer.

3. The device of embodiments 1 or 2, wherein the head-mounted ophthalmic system is configured such that the display device provides images of Ishihara color plates.

4. The apparatus of embodiment 1 or 2, wherein the head-mounted ophthalmic system is configured such that the display device provides a virtual image of the Ishihara color vision test table.

5. The apparatus of any one of embodiments 1-4, wherein the head-mounted ophthalmic system is configured to receive user input regarding the color vision test table or color image.

6. The apparatus of any one of embodiments 1-5, wherein the head-mounted ophthalmic system is configured to determine whether a wearer has a defect based on the color test.

7. The head-mounted ophthalmic system of embodiments 1 or 2, wherein the head-mounted ophthalmic system is configured to perform an anomaloscope examination, and wherein the head-mounted ophthalmic system transmits light of a control color to the first portion of the retina. and project light of a variable color onto the second portion of the retina, wherein the variable color is controllable by a wearer.

8. The apparatus of any one of embodiments 1-7, wherein the at least one light source comprises a fiber optic scanning display configured to project light into an eye of the wearer.

9. The apparatus of any one of embodiments 1-7, wherein the at least one light source comprises a multi-fiber scanning display configured to project different colored lights to the eye of the wearer.

10. The device of any one of the preceding embodiments, wherein the head-mounted ophthalmic system is configured to provide a background for enhancing visibility of the color test.

11. The apparatus of embodiment 10, wherein the background is provided using one or more spatial light modulators configured to selectively attenuate light.

12. The apparatus of any one of the preceding embodiments, wherein the apparatus further comprises adaptive optics.

13. The apparatus of embodiment 12, wherein the adaptive optical element comprises a variable focus element.

14. The apparatus of any of the preceding embodiments, wherein the display comprises a waveguide stack comprising a plurality of waveguides, the waveguide stack configured to project light from different depth planes.

15. The apparatus according to embodiment 14, wherein the display is configured to project an Ishihara color vision test table in a plurality of depth planes.

16. The apparatus of embodiment 14, wherein the display is configured to project a chromoscopic image in a plurality of depth planes.

17. The apparatus of embodiment 14, wherein the waveguide stack further comprises one or more lenses.

18. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform and at least one outward looking camera configured to image light originating from the outside world;

wherein the augmented reality head-mounted ophthalmic system is configured to pass the light originating from the outside world into the eyes of a wearer wearing the head-mounted system, wherein the wearable augmented reality display platform comprises at least one A display device comprising a light source, wherein the eye comprises a retina,

wherein the wearable augmented reality device is configured to selectively alter light originating from the outside world based on a color detection defect of the wearer;

A wearable augmented reality device configured for use by a wearer.

19. A wearable augmented reality device configured for use by a wearer, the device comprising:

A wearable virtual reality display platform comprising a wearable virtual reality display platform and at least one outwardly looking camera configured to image light originating from an external world and project light originating from the external world onto the eye of a wearer wearing the head-mounted system. , a virtual reality head-mounted ophthalmic system,

the virtual reality head-mounted virtual reality display platform comprises a display comprising at least one light source, the eye comprises a retina;

wherein the wearable virtual reality device is configured to selectively alter light originating from the external world projected to the eye based on a color detection defect of the wearer;

A wearable virtual reality device configured for use by a wearer.

20. The apparatus of any of embodiments 18 or 19, wherein the outward looking camera is configured to detect the presence of the light originating from the outside world of a color for which the wearer has a detection defect.

21. The apparatus of embodiment 20, wherein the selectively altering comprises projecting light from the light source to increase an amplitude of the light in an area of the display that includes a color for which the wearer has a detection defect.

22. The apparatus of embodiment 20, wherein said selectively changing comprises changing a color of said light in an area of said display device.

23. The apparatus of embodiment 22, wherein changing the color of the light in an area of the display comprises using an optical filter to remove spectral overlap between a plurality of light-curable materials.

24. A wearable augmented reality device configured for use by a wearer, the device comprising:

An augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform,

The augmented reality head-mounted ophthalmic system is configured to pass the light originating from the outside world into the eyes of a wearer wearing the head-mounted system, and the wearable augmented reality display platform includes at least one light source. A display device comprising:

wherein the wearable augmented reality device is configured to selectively change the light projected from the display device based on a color detection defect of the wearer.

25. A wearable virtual reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system comprising a wearable virtual reality display platform system;

The virtual reality head-mounted virtual reality display platform includes a display device including at least one light source,

and the wearable virtual reality device is configured to selectively change the light projected from the display device to the eye based on a color detection defect of the wearer.

26. The apparatus of any of embodiments 24 or 25, wherein the selectively altering comprises projecting light from the light source to increase the amplitude of the light in an area of the display comprising a color for which the wearer has a detection defect. .

27. The apparatus of any of embodiments 24 or 25, wherein the selectively altering comprises changing a color of the light in an area of the display device.

28. The apparatus of any of embodiments 24 or 25, wherein the selectively altering comprises enhancing a color of the light projected from at least a portion of the display device.

29. The apparatus of embodiment 24, wherein the selectively altering comprises reducing visibility of at least a portion of the light originating from the outside world through destructive interference.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>ophthalmoscope / </u><u>fundus ophthalmoscope</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

a wearer wearing an augmented reality head-mounted ophthalmic system comprising an augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system receives light from the outside world is configured to pass through the eyes of

wherein the augmented reality head-mounted ophthalmic system is configured to monitor the health of the eye of the wearer and capture an image of an illuminated portion of the eye of the wearer for analysis to detect abnormalities or other health problems of the eye. ,

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1, further comprising a fiber optic scanning display configured to project a beam of specially focused light onto at least a portion of the wearer's eye.

3. The device of embodiment 1, further comprising an eye tracking camera for capturing an image of the illuminated portion of the wearer's eye.

4. The apparatus of embodiment 2, wherein the optical fiber scanning display is configured to capture the image of the illuminated portion of the wearer's eye.

5. The device of embodiment 1, wherein the device further comprises a specialized camera for capturing the image of the illuminated portion of the wearer's eye.

6. The apparatus according to any one of embodiments 1 to 5, wherein the apparatus further comprises an electronic hardware processor configured to analyze the captured image to detect an abnormality or health problem of the eye.

7. The apparatus of embodiment 6, wherein the electronic processor is configured to detect the abnormality of the eye by matching a known pattern with the image.

8. The apparatus of embodiment 6, wherein the electronic processor is preloaded with a pattern indicative of a health problem.

9. The apparatus of any one of embodiments 1-8, wherein the electronic hardware processor is remote from the augmented reality head-mounted ophthalmic system.

10. The apparatus according to any one of embodiments 1 to 9, wherein the apparatus further comprises an adaptive optics element.

11. The apparatus of embodiment 10, wherein the adaptive optics are configured to project the beam of light onto a particular portion of the wearer's eye.

12. The apparatus of embodiment 11, wherein the adaptive optical element comprises a variable focus element.

13. The apparatus of any one of embodiments 1-12, further comprising a waveguide stack comprising a plurality of waveguides, wherein the other waveguides are configured to project light as if originating from different focal planes.

14. The apparatus of embodiment 13, wherein the waveguide stack further comprises one or more lenses.

15. The apparatus of embodiment 1, wherein the optical fiber scanning is configured to project the beam of light to the bottom of the wearer's eye.

16. The apparatus of embodiment 1, wherein the projected beam of light comprises white light.

17. The apparatus of embodiment 1, wherein the projected beam of light comprises colored light.

18. The apparatus of embodiment 17, wherein the projected beam of light has a wavelength in the red, green, or blue spectral region of the visible light spectrum.

19. The apparatus of embodiment 1, wherein the projected beam of light is within a wavelength range of the infrared spectrum.

20. The apparatus of embodiment 1, wherein the projected beam of light is configured to be focused at different depths of the wearer's eye.

21. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to capture images of at least a portion of a fundus of the eye of the wearer.

22. The apparatus of embodiment 21, wherein the augmented reality head-mounted ophthalmic system is configured to capture images of at least a portion of the wearer's retina.

23. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to capture images from different depths of the wearer's eye.

24. A wearable augmented reality device configured for use by a wearer, the device comprising:

An augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system receives light from the outside world in the eyes of a wearer wearing the head-mounted system. a system configured to pass through;

a light source configured to project a beam of light onto at least a portion of the wearer's eye; and

a camera configured to capture an image of an illuminated portion of the wearer's eye for analysis to monitor the health of the wearer's eye and detect abnormalities or other health problems in the eye;

A wearable augmented reality device configured for use by a wearer

25. The apparatus of embodiment 24, wherein the light source comprises a fiber optic scanning device.

26. The apparatus of embodiment 24, wherein the camera comprises an eye tracking camera.

27. The apparatus of embodiment 24, wherein the camera comprises the optical fiber scanning device.

28. The apparatus of embodiment 24, wherein the apparatus further comprises an electronic hardware processor configured to analyze the captured image to monitor health of the eye of the wearer or to detect an abnormality of the eye.

29. The apparatus of embodiment 28, wherein the electronic hardware processor is configured to analyze the captured image by matching a known pattern, color, shape or size with the captured image.

30. The apparatus of embodiment 29, wherein the electronic hardware processor is preloaded with a pattern indicative of a health problem.

31. The apparatus of embodiment 28, wherein the electronic hardware processor is configured to compare the captured image to one or more images stored in an information store accessible by the electronic hardware processor.

32. The apparatus of embodiment 24, further comprising adaptive optics.

33. The apparatus of embodiment 32, wherein the adaptive optics are configured to project the beam of light onto a particular portion of the wearer's eye.

34. The apparatus of embodiment 32, wherein the adaptive optical element comprises a variable focus element.

35. The apparatus of any one of embodiments 24-34, further comprising a waveguide stack comprising a plurality of waveguides, wherein the other waveguides are configured to project light as if originating from different focal planes.

36. The apparatus of embodiment 35, wherein the waveguide stack further comprises one or more lenses.

37. The apparatus of embodiment 24, wherein the light source is configured to project the light beam onto a fundus of the eye of the wearer.

38. The apparatus of embodiment 24, wherein the projected beam of light comprises white light.

39. The apparatus of embodiment 24, wherein the projected beam of light comprises colored light.

40. The apparatus of embodiment 39, wherein the projected beam of light has a wavelength in the red, green, or blue spectral region of the visible light spectrum.

41. The apparatus of embodiment 24, wherein the projected beam of light is within a wavelength range of the infrared spectrum.

42. The apparatus of embodiment 24, wherein the projected beam of light is configured to be focused at different depths of the wearer's eye.

43. The apparatus of embodiment 24, wherein the camera is configured to capture an image of at least a portion of a fundus of the eye of the wearer.

44. The apparatus of embodiment 24, wherein the camera is configured to capture images from different depths of the wearer's eye.

45. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display that provides an image to the wearer's eye; and

a fiber optic scanning display configured to project a beam of light of a particular focus onto at least a portion of the wearer's eye;

The virtual reality head-mounted ophthalmic system includes a camera configured to monitor the health of the wearer's eye and capture an image of an illuminated portion of the wearer's eye for analysis to detect abnormalities or other health problems of the eye. to do, device.

46. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display that provides an image to the wearer's eye;

a light source configured to project a beam of specially focused light onto at least a portion of the wearer's eye; and

an imaging system configured to monitor health of the wearer's eye and capture an image of an illuminated portion of the wearer's eye for analysis to detect abnormalities or other health problems of the eye.

47. The apparatus of any one of the preceding embodiments, wherein the portion of the eye from which the image is captured by the apparatus comprises the fundus.

48. The apparatus of any one of the preceding embodiments, wherein the portion of the eye from which an image is captured by the apparatus comprises a retina.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>confocal</u><u> microscope /</u><u>SLO</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

An augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform,

The augmented reality head-mounted ophthalmic system is configured to pass light originating from the outside world into the eyes of a wearer wearing the head-mounted system, wherein the augmented reality head-mounted ophthalmic system images the eyes. An apparatus comprising a confocal microscope configured to:

2. The apparatus of embodiment 1, wherein the confocal microscope comprises a light source.

3. The apparatus of embodiment 2, wherein the light source comprises a point light source.

4. The apparatus of embodiment 3, wherein the light source further comprises an aperture for forming a point light source.

5. The apparatus according to any one of embodiments 2 to 4, wherein the light source is configured to project beams of light of different wavelengths at different times.

6. The apparatus of embodiment 5, wherein the wavelength comprises a visible light wavelength.

7. The apparatus of embodiment 5, wherein the wavelength comprises an infrared wavelength.

8. The apparatus according to any one of embodiments 1 to 7, wherein the confocal microscope is configured such that the angle at which light is projected by a light source into the eye can be changed based on the portion of the eye space to be imaged.

9. The apparatus of any one of embodiments 1-8, wherein the confocal microscope comprises at least one pinhole stop configured to pass light reflected from the eye.

10. The apparatus of embodiment 9, wherein the confocal microscope comprises at least one imaging optics having an optical power to focus light reflected from the eye.

11. The apparatus of embodiment 10, wherein the pinhole stop is disposed in an optical path between the imaging optics and the optical detector.

12. The apparatus according to any one of embodiments 9 to 11, wherein the pinhole stop is disposed at the focal point of the light reflected from the eye.

13. The apparatus according to any one of embodiments 9 to 11, wherein the pinhole stop is disposed at a focal point of the imaging optics.

14. The apparatus of any one of embodiments 1-13, wherein the confocal microscope comprises an optical detector.

15. The apparatus according to any one of embodiments 1 to 14, wherein the confocal microscope comprises a fiber optic scanning device.

16. The apparatus of embodiment 15, wherein the optical fiber scanning device is configured to project a light beam.

17. The apparatus of any one of embodiments 15-16, wherein the optical fiber scanning device is configured to receive light reflected from the eye.

18. The apparatus of embodiment 17, wherein the optical fiber scanning device comprises a photodetector.

19. The apparatus of any one of embodiments 1-18, wherein the optics comprise adaptive optics configured to project light.

20. The apparatus of embodiment 19, wherein the adaptive term optics comprises a variable focus element.

21. The apparatus of any one of embodiments 1-20, wherein the apparatus further comprises a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light from different depth planes.

22. The apparatus of embodiment 21, wherein the waveguide stack further comprises one or more lenses.

23. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform;

wherein the virtual reality display platform is configured to project an image into the eye of the wearer, and the virtual reality head-mounted ophthalmic system comprises a confocal microscope configured to image the eye.

24. The apparatus of any one of embodiments 1 and 3 to 23, wherein the confocal microscope comprises a scanning laser ophthalmoscope comprising a light source comprising a laser.

25. The device of any one of the preceding embodiments, wherein the device further comprises a fluid delivery system configured to deliver a fluorescent dye.

26. The apparatus of any one of the preceding embodiments, wherein the apparatus is configured to visualize in real time an image projected onto a retina of an eye.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>2 photons</u><u> Two-Photon Microscopy</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

An augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform,

The augmented reality head-mounted ophthalmic system is configured to pass light from the outside world into the eyes of a wearer wearing the head-mounted system, wherein the augmented reality head-mounted ophthalmic system is configured to emit fluorescence. a two-photon absorption microscope configured to generate two-photon absorption to image the eye;

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1, wherein the two-photon absorption microscope comprises a light source.

3. The apparatus of embodiment 2, wherein the light source comprises a laser.

4. The apparatus of embodiment 3, wherein the laser comprises a pico-second laser configured to output a picosecond pulse.

5. The apparatus of embodiment 3, wherein the laser comprises a femto-second laser configured to output a femto-second pulse.

6. The apparatus of embodiment 3, wherein the laser comprises a mode-locked laser.

7. The apparatus of embodiment 3, wherein the laser comprises a fiber laser.

8. The apparatus of embodiment 2, wherein the light source is configured to output an infrared wavelength.

9. The apparatus according to embodiment 8, wherein the light source is configured to output infrared rays having a wavelength between 700-1000 nm.

10. The apparatus of any one of embodiments 1-9, further comprising an optical element having an optical power configured to focus the light to the eye.

11. The apparatus of any one of embodiments 1-10, wherein the two-photon absorption microscope is configured such that the angle at which light is projected by a light source into the eye can be varied based on the portion of the eye space to be imaged.

12. The apparatus of any one of embodiments 1-11, further comprising a scanner configured to scan a beam of light over the eye.

13. The apparatus of any one of embodiments 1-12, wherein the two-photon absorption microscope comprises an optical detector.

14. The apparatus of any one of embodiments 1-13, wherein the two-photon absorption microscope comprises a fiber optic scanning device.

15. The apparatus of embodiment 14, wherein the optical fiber scanning device is configured to project a light beam.

16. The apparatus of any one of embodiments 14-15, wherein the optical fiber scanning device is configured to receive light reflected from the eye.

17. The apparatus of embodiment 16, wherein the optical fiber scanning device comprises a photodetector.

18. The apparatus of any one of embodiments 1-17, wherein the apparatus comprises an adaptive optic configured to project light.

19. The apparatus of embodiment 18, wherein the adaptive optical element comprises a variable focus element.

20. The apparatus of any one of embodiments 1-19, wherein the apparatus further comprises a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light from different depth planes.

21. The apparatus of embodiment 20, wherein the waveguide stack further comprises one or more lenses.

22. A wearable augmented reality device configured for use by a wearer, the device comprising:

An augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform,

The augmented reality head-mounted ophthalmic system is configured to pass light originating from the outside world into the eyes of a wearer wearing the head-mounted system, wherein the augmented reality head-mounted ophthalmic system is configured to emit fluorescence. a multi-photon absorption microscope configured to generate multi-photon absorption to image the eye;

A wearable augmented reality device configured for use by a wearer.

23. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform;

wherein the virtual reality display platform is configured to project an image into the eye of the wearer, and wherein the virtual reality head-mounted ophthalmic system comprises a two-photon absorption microscope configured to image the eye.

A wearable virtual reality device configured for use by a wearer.

24. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform;

wherein the virtual reality display platform is configured to project an image to the eye of the wearer, and the virtual reality head-mounted ophthalmic system comprises a multi-photon absorption microscope configured to image the eye.

A wearable virtual reality device configured for use by a wearer.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>automatic refractometer (</u><u>Autorefractor</u><u>)</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

An augmented reality head-mounted ophthalmic system comprising an augmented reality display platform,

wherein the augmented reality head-mounted ophthalmic system is configured to pass light originating from the outside world into an eye of a wearer wearing the head-mounted ophthalmic system, the eye having a retina;

wherein the augmented reality head-mounted ophthalmic system is configured to capture an image of the retina, and to determine when one or more images formed by the fiber optic scanning display to determine an optical prescription of the wearer are on the retina. ,

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1, further comprising a fiber optic scanning display configured to provide one or more images at various depths.

3. The apparatus of embodiment 2, wherein the apparatus further comprises adaptive optics configured to provide one or more images at various depths.

4. The apparatus of embodiment 3, wherein the adaptive optical element comprises a variable focus element.

5. The apparatus according to Embodiment 4, wherein the variable focus element comprises a membrane mirror.

6. According to the above embodiment 5, the device comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror.

7. The apparatus of any one of embodiments 1-6, wherein the apparatus further comprises a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light from different focal planes.

8. The apparatus of embodiment 7, wherein the waveguide stack further comprises one or more lenses.

9. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display device for providing an image to the eye of the wearer, wherein the eye has a retina; and

a fiber optic scanning display configured to provide one or more images at various depths;

wherein the virtual reality head-mounted ophthalmic system is configured to capture an image of the retina, and to determine when one or more images formed by the fiber optic scanning display to determine an optical prescription of the wearer are on the retina. ,

A wearable virtual reality device configured for use by a wearer.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>OCT</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

An augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform,

The augmented reality head-mounted ophthalmic system is configured to pass the light originating from the outside world into the eye of a wearer wearing the head-mounted system, and the augmented reality display is configured to image the eye. an interference tomography system, comprising:

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1, wherein the optical coherence tomography system is configured to project light beams of various wavelengths.

3. The apparatus of embodiment 2, wherein the wavelength comprises a visible light wavelength.

4. The apparatus of embodiment 2, wherein the wavelength comprises an infrared wavelength.

5. The device of any one of embodiments 1-4, wherein the wearable augmented reality display platform comprises a 3D scanning head comprising a fiber optic scanning device.

6. The apparatus of embodiment 5, wherein the optical fiber scanning device is configured to project a beam of light onto the eye.

7. The apparatus of embodiment 5, wherein the optical fiber scanning device is configured to receive light reflected from the eye.

8. The apparatus according to any one of embodiments 1 to 7, wherein the apparatus further comprises an eye tracking system configured to measure eye movement to denoise the optical coherence tomography image.

9. The apparatus according to any one of embodiments 1 to 7, wherein the apparatus further comprises an ERG.

10. The apparatus according to any one of embodiments 1 to 9, wherein the optical coherence tomography system is configured such that the angle at which light is projected into the eye can be changed based on the portion of the eye space to be imaged.

11. The apparatus of any one of embodiments 1-10, further comprising one or more inward facing cameras configured to receive light from the eye.

12. The apparatus of embodiment 11, wherein the one or more inward facing cameras comprise at least one CMOS sensor.

13. The apparatus of any one of embodiments 1-10, wherein the apparatus further comprises a plurality of photodetectors disposed in different portions of the system.

14. The device of embodiment 12, wherein the photodetector can be positioned around a rim of the head-mounted ophthalmic system.

15. The apparatus of embodiment 12, wherein the photodetector can be positioned around a perimeter of a frame of the head-mounted ophthalmic system.

16. The apparatus according to any one of embodiments 1 to 14, wherein the optics further comprise adaptive optics configured to project light.

17. The apparatus of embodiment 15, wherein the adaptive optical element comprises a variable focus element.

18. The apparatus of any one of embodiments 1-16, further comprising a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light from different depth planes.

19. The apparatus of embodiment 17, wherein the waveguide stack further comprises one or more lenses.

20. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform;

wherein the virtual reality display platform is configured to project an image to the eye of the wearer, and the virtual reality display platform comprises an optical coherence tomography system configured to image the eye.

A wearable virtual reality device configured for use by a wearer.

21. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a wearable virtual reality display platform;

the virtual reality display platform is configured to project an image to the eye of the wearer, the virtual reality display platform comprises an optical coherence tomography system configured to image the eye,

wherein the wearable virtual reality display platform further comprises a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light from different depth planes;

A wearable virtual reality device configured for use by a wearer.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>aberration analyzer (</u><u>Aberrometer</u><u>)</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality display platform, wherein light from the outside world is configured to pass through an eye of a wearer wearing the head-mounted ophthalmic system, the eye having a cornea, a lens and a retina; realistic head-mounted ophthalmic system;

at least one light source and wearable optics configured to create a wavefront and project the wavefront to the eye of the wearer such that it passes through the cornea and lens of the eye and is reflected back by the retina of the eye );

an aberrometer configured to measure a wavefront passing through the eye to determine an abnormality in the eye;

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1, wherein the at least one light source comprises a fiber optic scanning display.

3. The apparatus of embodiment 1, wherein the at least one light source is configured to generate a desired wavefront.

4. The apparatus of embodiment 1, wherein the at least one light source is configured to generate wavefronts of different wavelengths.

5. The apparatus of embodiment 4, wherein the at least one light source is configured to generate a visible wavefront projected to the eye.

6. The apparatus of embodiment 4, wherein the at least one light source is configured to create an invisible wavefront projected to the eye.

7. The apparatus of embodiment 1, wherein the wearable optics include adaptable optics configured to adjust to effect correction.

8. The apparatus of embodiment 7, wherein the adaptive optical element comprises a variable focus element.

9. The apparatus of embodiment 7, wherein the adaptive optics include deformable optics.

10. The apparatus of embodiment 9, wherein the deformable optics comprise a deformable mirror.

11. The apparatus of embodiment 1, wherein the wearable optics comprises a waveguide stack comprising a plurality of waveguides configured to provide different focal planes.

12. The apparatus of embodiment 11, wherein the waveguide stack is configured to create a desired wavefront.

13. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform comprising a display device for providing an image to the eye of the wearer, the eye having a cornea, a lens and a retina;

at least one light source and wearable optics configured to create a wavefront and projecting the wavefront into the eye of the wearer to pass through the cornea and lens of the eye and reflected back by the retina of the eye optics; and

an aberrometer configured to measure a wavefront passing through the eye to determine an abnormality in the eye;

A wearable virtual reality device configured for use by a wearer.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>ultrasonic wave</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality display platform comprising a display configured to form an image viewable by the wearer, wherein light from the outside world is configured to pass into the eyes of a wearer wearing the head-mounted system; head-mounted ophthalmic systems; and

an ultrasound producing component comprising an ultrasound transducer, comprising the augmented reality head-mounted optical system for delivering ultrasound to the user's eye to produce an ultrasound image;

A wearable augmented reality device configured for use by a wearer.

2. The apparatus according to the first embodiment, wherein the wearable augmented reality system is configured to detect an abnormality of the eye from a generated ultrasound image or to monitor the health of the user's eye.

3. The apparatus according to embodiment 2, wherein the apparatus further comprises a processor configured with a pattern matching algorithm for detecting an abnormality of the eye.

4. The apparatus of embodiment 1, wherein the ultrasound generating component is configured to deliver ultrasound based on a protocol for the user.

5. The apparatus of embodiment 1, wherein the apparatus further comprises an adaptive optics configured to project the image onto a particular portion of the wearer's eye.

6. The apparatus according to embodiment 5, wherein the adaptive optical element comprises a variable focus element.

7. The apparatus according to Embodiment 6, wherein the variable focus element comprises a membrane mirror.

8. The apparatus according to embodiment 7, wherein:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror.

9. The apparatus of embodiment 1, wherein the apparatus further comprises a light source for forming the image on the wearer's eye, the light source comprising a fiber optic scanning projector.

10. The apparatus of embodiment 1, wherein the display comprises a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light at different focal planes.

11. The apparatus of embodiment 10, wherein the waveguide stack further comprises one or more lenses.

12. The apparatus of any one of embodiments 1-11, wherein the ultrasound generating component comprises a probe configured to deliver ultrasound energy to and receive ultrasound energy from the eye.

13. A wearable augmented reality device configured for use by a wearer, the device comprising:

augmented reality comprising an augmented reality display platform comprising a display configured to form an image viewable by the wearer, wherein light originating from the outside world is configured to pass into the eye of a wearer wearing the head-mounted system; head-mounted ophthalmic systems; and

It is coupled to the augmented reality head-mounted ophthalmic system, and transmits ultrasound to the user's eye to generate the ultrasound image to detect an abnormality of the eye, including an ultrasound generator including an ultrasound transducer,

The wearable augmented reality device is configured to measure the reaction of the user's eye to the ultrasound to detect an abnormality in the eye.

A wearable augmented reality device configured for use by a wearer.

14. The apparatus of embodiment 13, wherein the abnormality comprises a detached retina.

15. The device of embodiment 13, wherein the device further comprises an adaptive optic configured to project the image onto a particular portion of the wearer's eye.

16. The apparatus according to embodiment 13, wherein the adaptive optical element comprises a variable focus element.

17. The apparatus according to embodiment 16, wherein the variable focus element comprises a membrane mirror.

18. The method of embodiment 17, wherein the device comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror.

19. The apparatus of embodiment 13, further comprising a light source for forming the image in the eye of the wearer, the light source comprising a fiber optic scanning projector.

20. The apparatus of embodiment 13, wherein the display comprises a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light at different focal planes.

21. The apparatus of embodiment 20, wherein the waveguide stack further comprises one or more lenses.

22. The apparatus of embodiments 13-21, wherein the ultrasound generating component comprises a probe configured to deliver ultrasound energy to and receive ultrasound energy from the eye.

23. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display for providing an image to the eye of the wearer; and

An ultrasound generator coupled to the virtual reality head-mounted ophthalmic system and including an ultrasound transducer configured to generate an ultrasound image by transmitting ultrasound to the user's eye;

A wearable virtual reality device configured for use by a wearer.

24. The apparatus according to embodiment 21, wherein the apparatus is configured to detect an abnormality of the eye from a generated ultrasound image.

25. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display for providing an image to the eye of the wearer; and

and an ultrasound generator coupled to the virtual reality head-mounted ophthalmic system and transmitting ultrasound to the user's eye to generate an ultrasound image and including an ultrasound transducer capable of detecting abnormalities in the eye,

wherein the wearable virtual reality device is configured to measure a response of the user's eye to the ultrasound,

A wearable virtual reality device configured for use by a wearer.

26. The apparatus of embodiment 22, wherein the apparatus is configured to detect an abnormality of the eye from the measured response.

27. The device of any one of the preceding embodiments, wherein the device is configured to auscultate.

28. The apparatus of any one of the preceding embodiments, wherein the apparatus is configured to transmit or receive ultrasonic energy to or from the eye in an audible frequency range.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>electric ophthalmology record</u><u>(</u><u>EOG</u><u>), </u><u>EEG recording test</u><u>(EEG), </u><u>electroretinography test</u><u>(ERG)</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system comprising an augmented reality display platform comprising a display, wherein light originating from the outside world is configured to pass into the eyes of a wearer wearing the head-mounted system; and

a plurality of electrodes configured to be disposed around the eye;

wherein the wearable augmented reality device is configured to measure and compare the resting potential of the retina,

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1 comprising the electrooculography (EOG) sensor.

3. The apparatus of embodiment 2, wherein the apparatus further comprises an electroencephalogram (EEG) sensor.

4. The apparatus of embodiment 1, further comprising a camera configured to optically image the eye.

5. The device of embodiment 1, wherein the device further comprises an adaptive optic configured to project the image onto a particular portion of the wearer's eye.

6. The apparatus according to embodiment 6, wherein the adaptive optical element comprises a variable focus element.

7. The apparatus according to Embodiment 7, wherein the variable focus element comprises a membrane mirror.

8. According to the 8th embodiment, the device comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror based on the shape of the cornea of the eye.

9. The apparatus of embodiment 1, wherein the light source of the apparatus comprises a fiber optic scanning projector.

10. The apparatus of embodiment 1, further comprising a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light at different focal planes.

11. The apparatus of embodiment 11, wherein the waveguide stack further comprises one or more lenses.

12. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted optical system comprising an augmented reality display platform comprising a display device, the augmented reality head-mounted optical system configured to pass light originating from the outside world to the eyes of a wearer wearing the head-mounted system; and

a plurality of electroencephalography (EEG) sensors configured to map brain activity;

wherein the wearable augmented reality device is configured to detect an abnormal activity or pattern in the brain of the wearer;

A wearable augmented reality device configured for use by a wearer.

13. The device of embodiment 12, wherein the device further comprises an adaptive optic configured to project the image onto a specific portion of the wearer's eye.

14. The apparatus according to embodiment 13, wherein the adaptive optical element comprises a variable focus element.

15. The apparatus according to embodiment 14, wherein the variable focus element comprises a membrane mirror.

16. The apparatus of embodiment 15, wherein the apparatus comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes based on a shape of the cornea of the eye to modify a shape of the thin-film mirror.

17. The apparatus of embodiment 12, wherein the light source comprises a fiber optic scanning projector.

18. The apparatus of embodiment 12, further comprising a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light at different focal planes.

19. The apparatus of embodiment 18, wherein the waveguide stack further comprises one or more lenses.

20. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display for providing an image to the eye of the wearer; and

a plurality of electrodes configured to be disposed around the eye;

wherein the wearable augmented reality device is configured to measure and compare the resting potential of the retina,

A wearable virtual reality device configured for use by a wearer.

21. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display for providing an image to the eye of the wearer; and

a plurality of electroencephalography (EEG) sensors configured to map brain activity;

wherein the wearable virtual reality device is configured to detect an abnormal activity or pattern in the brain of the wearer;

A wearable virtual reality device configured for use by a wearer.

22. In Example 1,

wherein the electrode is disposed on the augmented reality head-mounted ophthalmic system around the wearer's eye.

23. The apparatus of any of embodiments 1 or 20, wherein the electrode comprises an electroretinography (ERG) sensor.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>Light Therapy</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light originating from the outside world into the eyes of a wearer wearing the head-mounted ophthalmic system, the augmented reality head-mounted ophthalmic system comprising an augmented reality display platform; and

a light source configured to project light into the eye of the wearer to form an image in the eye;

wherein the wearable augmented reality device is configured to detect an amount of light of one or more wavelengths directed to the eye, and modify an amount of light of one or more wavelengths that reaches the eye based on the detected amount,

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1, wherein the head-mounted system is configured to actively reduce the amount of light of one or more wavelengths reaching the eye.

3. The apparatus of embodiment 2, wherein the head-mounted system is configured to actively reduce the amount of light at one or more wavelengths by reducing the amount of light at one or more wavelengths projected by the light source to the eye.

4. The system of embodiment 3 wherein the head-mounted system comprises:

providing an indication of an amount of light of the one or more wavelengths to be output by the light source; and

and subsequently modifying the indication to reduce light output of the one or more wavelengths by the light source.

5. The system of embodiment 2 wherein the head-mounted system comprises:

configured to block at least a portion of the wearer's view of the outside world, thereby reducing the amount of light of one or more wavelengths reaching the eye from the outside world;

wherein the size and location of the portion of the obstructed wearer's external world field of view is determined based on detected amounts of one or more wavelengths of light.

6. The apparatus of embodiment 1, wherein the apparatus further comprises one or more sensors configured to detect an amount of light of the one or more wavelengths incident on the head-mounted system.

7. The apparatus of embodiment 6, wherein the one or more sensors are cameras attached to the head-mounted system.

8. The apparatus of embodiment 6, wherein the one or more sensors are configured to detect overexposure of a particular color of light, and wherein the head-mounted system is configured to reduce the amount of light of the particular color reaching the eye.

9. The apparatus of embodiment 1, wherein the wearable augmented reality device is configured to selectively reduce blue light reaching the eye.

10. The apparatus of embodiment 1, wherein the wearable augmented reality device is configured to modify an amount of one or more wavelengths of light reaching the eye based on a detected amount and time.

11. The apparatus of embodiment 1, wherein the wearable augmented reality device is configured to modify the amount of the one or more wavelengths reaching the eye based on the detected amount and a calendar date.

12. The apparatus of embodiment 1, wherein the wearable augmented reality device is configured to modify the amount of the one or more wavelengths reaching the eye based on the detected amount and a current season and location of the wearer.

13. The device of embodiment 1, wherein the device further comprises an adaptive optics element configured to project the image to a specific portion of the wearer's eye.

14. The apparatus of embodiment 13, wherein the adaptive optical element comprises a variable focus element.

15. The apparatus according to embodiment 14, wherein the variable focus element comprises a thin-film mirror.

16. In the above embodiment 15, the apparatus comprises;

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror.

17. The apparatus of embodiment 14, wherein the light source comprises a fiber optic scanning projector.

18. The apparatus of embodiment 1, further comprising a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light at different focal planes.

19. The apparatus of embodiment 18, wherein the waveguide stack further comprises one or more lenses.

20. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light originating from the outside world into the eyes of a wearer wearing the head-mounted system and comprising an augmented reality display platform; and

a light source configured to project light into the eye of the wearer to form an image in the eye;

wherein the wearable augmented reality device is configured to selectively administer light of a portion of a light spectrum to the eye of the wearer;

A wearable augmented reality device configured for use by a wearer.

21. The device of embodiment 20, further comprising one or more sensors configured to detect underexposure of light in the portion of the light spectrum, wherein the wearable augmented reality device selects the light based on the detected underexposure. A device configured to augment with.

22. The apparatus of embodiment 20, further comprising one or more sensors configured to detect underexposure of blue light.

23. The apparatus of embodiment 22, wherein the wearable augmented reality device is configured to selectively manage blue light.

24. The apparatus of embodiment 20, wherein the light comprises a range of wavelengths corresponding to daylight.

25. The apparatus of embodiment 20, wherein the light comprises a range of wavelengths corresponding to full spectrum light.

26. The device of embodiment 20, further comprising a second light source configured to provide light to be selectively administered to an eye of the wearer.

27. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light originating from the outside world into the eyes of a wearer wearing the head-mounted system and comprising an augmented reality display platform; and

a light source configured to project light into the eye of the wearer to form an image in the eye;

wherein the wearable augmented reality device is configured to selectively administer light of a predetermined range of wavelengths to the eyes of the wearer based on a treatment protocol;

A wearable augmented reality device configured for use by a wearer.

28. The apparatus of embodiment 27, wherein the treatment protocol administers a predetermined amount of light periodically.

29 The apparatus of embodiment 27, wherein the treatment protocol administers a predetermined amount of light continuously.

30. The apparatus of embodiment 27, wherein the wearable augmented reality device is configured to modify the wavelength in the predetermined range based on time.

31. The apparatus of embodiment 27, wherein the wearable augmented reality device is configured to modify the wavelength in the predetermined range based on a calendar date.

32. The apparatus of embodiment 27, wherein the wearable augmented reality device is configured to modify the predetermined range of wavelengths based on a current season and/or location of the wearer.

33. The apparatus of embodiment 27, wherein the wearable augmented reality device is configured to determine a treatment protocol for selectively administering light in a particular portion of the spectrum to the eye of the wearer.

34. The apparatus of embodiment 33, wherein the wearable augmented reality device is configured to determine a treatment protocol based on one or more of a physiological state of the wearer, an atmosphere of the wearer, and a surrounding environment around the wearer.

35. The apparatus of embodiment 33, wherein the wearable augmented reality device is configured to determine a treatment protocol based on input originating from the wearer.

36. The apparatus of embodiment 33, wherein the wearable augmented reality device is configured to determine a treatment protocol based on a symptom of depression or other condition of the wearer.

37. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform; and

a light source configured to project light into the eye of the wearer to form an image in the eye;

wherein the wearable virtual reality device is configured to selectively remove light of a specific color;

A wearable virtual reality device configured for use by a wearer.

38. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform; and

a light source configured to project light into the eye of the wearer to form an image in the eye;

wherein the wearable virtual reality device is configured to detect underexposure of light within a particular portion of the spectrum and selectively administer light in the particular portion of the spectrum to the eye of the wearer;

A wearable virtual reality device configured for use by a wearer.

39. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform; and

a light source configured to project light into the eye of the wearer to form an image in the eye;

wherein the wearable virtual reality device is configured to selectively administer light of a particular portion of the spectrum to the eye of the wearer based on a treatment protocol;

A wearable virtual reality device configured for use by a wearer.

The numbered additional examples described herein below in the section entitled "Additional Numbered Examples" are the same as those set forth immediately after the numbered list of examples set forth herein that the "numbered examples hereinbelow" The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>Macular Degeneration</u>

One. A wearable augmented reality device configured for use by a wearer, the display device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light originating from the outside world into the eyes of the wearer wearing the head-mounted system, the augmented reality head-mounted ophthalmic system comprising the augmented reality display platform;

a light source configured to project light into the eye of the wearer to form an image in the eye; and

a user interface configured to receive input from a user;

wherein the wearable augmented reality device is configured to project the image onto a particular portion of the wearer's eye and detect a response to the image to determine a health of the portion with respect to the eye;

A wearable augmented reality device configured for use by a wearer.

2. A wearable virtual reality device configured for use by a wearer, the device comprising:

a head-mounted display device comprising a virtual reality display platform; and

a light source configured to project light into the eye of the wearer to form an image in the eye; and

a user interface configured to receive input from a user;

wherein the wearable virtual reality device is configured to project the image onto a particular portion of the wearer's eye and detect a response to the image to determine a health of the portion with respect to the eye.

A wearable virtual reality device configured for use by a wearer.

3. A wearable display device configured for use by a wearer, the display device comprising:

head-mounted ophthalmic systems;

a light source configured to direct light to the eye of the wearer to form an image in the eye;

a user interface configured to receive input from a user; and

an adaptive optical element configured to receive light directed to the eye from the light source;

wherein the wearable augmented reality device is configured to detect a response to the image to determine the health of the part of the eye.

A wearable display configured for use by a wearer.

4. The apparatus of embodiment 3, wherein the adaptive optical element comprises a variable focus element.

5. The apparatus according to Embodiment 4, wherein the variable focus element comprises a membrane mirror.

6. According to the above embodiment 5, the device comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror.

7. A wearable display device configured for use by a wearer, the display device comprising:

head-mounted display system;

a light source comprising a fiber optic scanning projector configured to direct light to an eye of a wearer to form an image in the eye; and

a user interface configured to receive input from a user;

wherein the wearable display is configured to project the image onto a particular portion of the wearer's eye and detect a response to the image to determine a health of the portion with respect to the eye.

A wearable display configured for use by a wearer.

8. A wearable display device configured for use by a wearer, the display device comprising:

head-mounted display system;

a light source configured to direct light to one eye of the wearer to form an image in the eye;

a waveguide stack comprising a plurality of waveguides; and

a user interface configured to receive input from a user;

wherein the wearable display is configured to project the image onto a particular portion of the wearer's eye and detect a response to the image to determine a health of the portion with respect to the eye.

A wearable display configured for use by a wearer.

9. The apparatus of embodiment 8, wherein the waveguide stack further comprises one or more lenses.

10. The head-mounted display system of embodiment 8 above, wherein the head-mounted display system comprises an augmented reality head-mounted ophthalmic system configured to pass light from the outside world into the eyes of a wearer wearing the head-mounted system. to do, device.

11. The wearable device according to any one of embodiments 1-10, wherein the wearable device is configured to project the image onto another part of the eye of the wearer and detect a response to the image to determine the health of the part of the eye. Device.

12. The wearable device according to any one of embodiments 1 to 10, wherein the wearable device projects a first image and a second image on the same part of the eye of the wearer, detects a response for each image, and and compare a response to the second response to determine the health of the portion.

13. The apparatus according to Embodiment 12, wherein the at least one color present in the first image is different from the at least one color present in the second image.

14. The apparatus of embodiment 13, wherein the wearable augmented reality device is configured to identify an area with reduced sensitivity based on the inspected portion of the eye.

15. The apparatus of embodiment 11, wherein the wearable augmented reality device is configured to determine a location of macular degeneration based on the examined portion of the eye.

16. The apparatus of embodiment 15, wherein determining the location of the macular degeneration is further based on imaging of a retina of the wearer's eye.

17. The apparatus of embodiment 11, wherein the wearable augmented reality device is configured to identify an anomaly in the wearer's eye based on the inspected portion of the eye.

18. The apparatus according to embodiment 11, wherein determining the health of the part of the eye is performed in real time.

19. The method according to the eleventh embodiment, wherein the wearable augmented reality device is further configured to store data relating to a projected image and a detected response, wherein determining the health of the part of the eye comprises:

device, which is performed later based on the stored data.

20. The apparatus according to embodiment 19, wherein the wearable augmented reality device is further configured to transmit the stored data, and wherein determining the health of the part of the eye is performed remotely based on the transmitted data.

21. The apparatus of any one of embodiments 1-10, wherein detecting a response comprises receiving input from the user via the user interface.

22. The apparatus of any one of embodiments 1-10, wherein detecting the response detects movement of the eye of the wearer.

23. The apparatus of embodiment 22, wherein movement of the eye of the wearer is a voluntary response to the image.

24. The apparatus of embodiment 23, wherein the movement of the eye of the wearer is an involuntary response to the image.

25. The device according to any one of embodiments 1 to 10, wherein the device further comprises a display device for forming an image in the eye of the wearer.

26. The apparatus of embodiment 25, wherein the display comprises a fiber optic scanning display.

27. The apparatus of embodiments 25 or 26, wherein the display further comprises a waveguide stack.

28. The apparatus of any one of embodiments 25, 26 or 27, wherein the display is configured to generate an image in multiple depth planes.

29. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light originating from the outside world into the eyes of a wearer wearing the head-mounted ophthalmic system, the augmented reality head-mounted ophthalmic system comprising an augmented reality display platform; and

a light source configured to project light into the eye of the wearer to form an image in the eye;

wherein the wearable device is configured to selectively project pixels of an image onto healthy cells;

A wearable augmented reality device configured for use by a wearer .

30. A wearable display device configured for use by a wearer, the display device comprising:

head-mounted display system; and

a light source comprising a fiber optic scanning projector configured to direct light to an eye of a wearer to form an image in the eye;

wherein the light source is configured to selectively project pixels of an image onto healthy cells;

A wearable display configured for use by a wearer.

31. A wearable display device configured for use by a wearer, the display device comprising:

head-mounted display system;

a light source configured to direct light to one eye of the wearer to form an image in the eye; and

a waveguide stack comprising a plurality of waveguides;

wherein the wearable display is configured to selectively project pixels of an image onto healthy cells;

A wearable display configured for use by a wearer.

32. The apparatus of embodiment 31, wherein the waveguide stack further comprises one or more lenses.

33. The head-mounted display system of embodiment 31 above, wherein the head-mounted display system comprises an augmented reality head-mounted ophthalmic system configured to pass light from the outside world into the eyes of a wearer wearing the head-mounted system. to do, device.

34. The device of any one of embodiments 29-33, wherein the wearable device is configured to selectively project pixels of an image onto healthy cells in the periphery of the retina.

35. The device of any one of embodiments 29-33, wherein the wearable device is configured to selectively project pixels of the image onto healthy cells.

36. The device of any one of embodiments 29-33, wherein the wearable device is configured to modify light projected to the eye.

37. The device of embodiment 36, wherein the wearable device is configured to magnify or brighten pixels of the image projected to the damaged area of the eye.

38. A wearable virtual reality device configured for use by a wearer, the display device comprising:

a head-mounted display device comprising a virtual reality display platform; and

a light source configured to project light into the eye of the wearer to form an image in the eye;

wherein the wearable device is configured to selectively project pixels of the image onto healthy cells;

A wearable virtual reality device configured for use by a wearer.

39. The device of embodiment 38, wherein the wearable device is configured to selectively project pixels of an image onto healthy cells in a periphery of the retina.

40. The device of embodiment 38, wherein the wearable device is configured to selectively project a portion of the image onto healthy cells.

41. A wearable virtual reality device configured for use by a wearer, the display device comprising:

a head-mounted display device comprising a virtual reality display platform; and

a light source configured to project light into the eye of the wearer to form an image in the eye;

wherein the wearable device is configured to alter light projected to the damaged area of the eye;

A wearable virtual reality device configured for use by a wearer.

42. The apparatus of embodiment 41, wherein the wearable device is configured to magnify pixels of the image projected to the damaged area of the eye.

43. The device of embodiment 41, wherein the wearable device is configured to increase or decrease the intensity of a pixel of the image projected to the damaged area of the eye.

44. The apparatus of embodiment 41, wherein the wearable is configured to increase or decrease a contrast of a pixel of the image projected to the damaged area of the eye.

45. The device of embodiment 41, wherein the wearable device is configured to change the hue of a pixel of the image projected to the damaged area of the eye.

46. The apparatus of embodiment 41, wherein the wearable device is configured to modify the projected light for the determined specific wavelength to have reduced sensitivity when projected onto the damaged area of the eye.

47. The apparatus of embodiment 46, wherein the wearable device is configured to magnify pixels of the image projected to the damaged area of the eye.

48. The apparatus of embodiment 46, wherein the wearable device is configured to increase the intensity of a pixel of the image projected to the damaged area of the eye.

49. The apparatus of embodiment 46, wherein the wearable device is configured to increase the contrast of pixels of the image projected to the damaged area of the eye.

50. A wearable display device configured for use by a wearer, the display device comprising:

head-mounted ophthalmic systems;

a light source configured to direct light to the eye of the wearer to form an image in the eye; and

an adaptive optical element configured to receive light from the light source;

wherein the wearable device is configured to selectively project pixels of an image onto healthy cells;

A wearable display configured for use by a wearer.

51. The apparatus of embodiment 50, wherein the adaptive optical element comprises a variable focus element.

52. The apparatus of embodiment 50, wherein the variable focus element comprises a membrane mirror.

53. The apparatus of embodiment 52, wherein the apparatus comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror.

54. The device of any one of embodiments 1-28, wherein the wearable device is configured to selectively project pixels of an image onto healthy cells.

55. The device of embodiment 53, wherein the wearable device is configured to selectively project pixels of an image onto healthy cells in the periphery of the retina.

56. The apparatus of embodiment 53, wherein the light source is configured to selectively project a portion of the image onto healthy cells.

57. The device of any one of embodiments 1-23, wherein the wearable device is configured to modify light projected onto the eye.

58. The apparatus of embodiment 56, wherein the wearable device is configured to magnify pixels of the image projected to the damaged area of the eye.

59. The apparatus of embodiment 56, wherein the wearable device is configured to increase the contrast of pixels of the image projected to the damaged area of the eye.

60. The apparatus of embodiment 56, wherein the wearable device is configured to modify the projected light for a particular wavelength determined to have reduced sensitivity when projected onto the damaged area of the eye.

61. The apparatus of embodiment 59, wherein the wearable device is configured to magnify pixels of the image projected to the damaged area of the eye.

62. The apparatus of embodiment 59, wherein the wearable device is configured to increase the intensity of a pixel of the image projected to the damaged area of the eye.

63. The apparatus of embodiment 59, wherein the wearable device is configured to increase the contrast of pixels of the image projected to the damaged area of the eye.

64. The apparatus of embodiment 28, wherein the multiple depth planes are separated by at least 10 centimeters.

65. The apparatus of embodiments 28 or 63, wherein the multiple depth planes comprise at least three depth planes.

66. The apparatus of embodiment 37, wherein the wearable device is configured to increase or decrease the spatial frequency of a periodic image projected on the damaged area of the eye.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>Contrast Testing</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light originating from the outside world into the eyes of a wearer wearing the head-mounted system, the system comprising an augmented reality display platform;

a light source configured to project light into the eye of the wearer to form an image in the eye; and

a user interface configured to receive input from a user;

wherein the wearable augmented reality device is configured to project an image of the wearer and detect a response to the image to determine a contrast sensitivity of the wearer;

A wearable augmented reality device configured for use by a wearer.

2. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted display device comprising a virtual reality display platform;

a light source configured to project light into the eye of the wearer to form an image in the eye; and

a user interface configured to receive input from a user;

wherein the wearable augmented reality device is configured to project an image of the wearer and detect a response to the image to determine a contrast sensitivity of the wearer;

A wearable virtual reality device configured for use by a wearer.

3. The apparatus according to embodiment 1 or 2, wherein the image comprises a plurality of regions having different contrast levels.

4. The apparatus of embodiment 3, wherein the image comprises a sine-wave grating.

5. The apparatus according to embodiment 3, wherein the image includes a plurality of letters or numbers projected with different different contrast levels.

6. The apparatus of Example 5, wherein the image comprises a Pelli-Robson chart.

7. The device of embodiment 5, wherein the wearable device is configured to detect a response originating from the wearer representing letters, numbers or shapes visible to the wearer.

8. The apparatus according to embodiment 1 or 2, wherein the light source is configured to continuously project a plurality of images to the wearer.

9. The apparatus of embodiment 8, wherein each of the plurality of images is contrasted with at least one other image of the plurality of images.

10. The apparatus of embodiment 9, wherein the wearable device is configured to detect a response originating from the wearer indicative of an ability to detect a contrast feature in an image of the wearer.

11. The apparatus of embodiments 1 or 2, wherein the light source is configured to reduce the contrast of the image over time.

12. The device of embodiment 11, wherein the wearable device is configured to detect a response originating from the wearer indicative of a time when the wearer is unable to discern a contrasting feature of the image.

13. The device according to any one of embodiments 1 to 12, wherein the device further comprises a display device for forming an image in the eye of the wearer.

14. The apparatus of embodiment 13, wherein the display comprises a fiber optic scanning display.

15. The apparatus of any of embodiments 13 or 14, wherein the display further comprises a waveguide stack.

16. The apparatus of any one of embodiments 10-12, wherein the display is configured to generate an image in multiple depth planes.

17. The device of any one of embodiments 1-16, wherein the wearable device is configured to perform a plurality of contrast sensitivity measurements and perform comparative analysis of the results.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>Visual Fields</u>

One. A wearable augmented reality device configured for use by a wearer, the display device comprising:

an augmented reality head-mounted ophthalmic system configured to pass light originating from the outside world into the eyes of the wearer wearing the head-mounted system, the augmented reality head-mounted ophthalmic system comprising the augmented reality display platform;

a light source configured to project light into the eye of the wearer to form a moving image in the eye; and

a user interface configured to receive input from a user;

wherein the wearable augmented reality device is configured to project the image at a particular portion around the wearer's field of view and detect a response to the image to determine a health of the portion to the eye.

A wearable augmented reality device configured for use by a wearer.

2. A wearable virtual reality device configured for use by a wearer, the device comprising:

a head-mounted display device comprising a virtual reality display platform;

a light source configured to project light into the eye of the wearer to form a moving picture in the eye; and

a user interface configured to receive input from a user;

wherein the wearable virtual reality device is configured to project the image at a specific portion around the wearer's field of view and detect a response to the image to determine a health of the portion to the eye.

A wearable virtual reality device configured for use by a wearer.

3. The apparatus according to embodiment 1 or 2, wherein the moving image moves inward from the periphery of the wearer's field of view toward the center of the wearer's field of view.

4. The device of embodiment 3, wherein the wearable device is configured to detect a response originating from the wearer indicative of a time at which the image becomes visible to the wearer.

5. The apparatus of embodiment 3, wherein the wearable device is configured to detect a response originating from the wearer to a monitored characteristic of the image.

6. The apparatus of embodiment 3, wherein the light source is further configured to project an image of an object approaching the eye of the wearer.

7. The device according to any one of embodiments 1 to 6, wherein the device further comprises a display device for forming an image in the eye of the wearer.

8. The apparatus of embodiment 7, wherein the display comprises a fiber optic scanning display.

9. The apparatus of embodiments 7 or 8, wherein the display further comprises a waveguide stack.

10. The apparatus according to any one of embodiments 7 to 9, wherein the display is configured to generate an image in multiple depth planes.

11. The device of any one of embodiments 1-10, wherein the device is configured to provide a visual, audible or tactile notification to the wearer based on detecting a hazard in an unhealthy portion of the wearer's field of vision.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>Laser Therapy</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

an augmented reality head-mounted ophthalmic system comprising an augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system is configured to pass light originating from the outside world to the eyes of a wearer wearing the head-mounted ophthalmic system; and

a laser configured to apply laser treatment to the eye of the wearer;

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1, wherein the apparatus is configured to direct laser light to the eye for intensity, wavelength and duration to alter ocular tissue.

3. The apparatus of embodiment 1, wherein the laser is configured to reduce the growth of abnormal blood vessels or to occlude abnormal blood vessels.

4. The apparatus of embodiment 3, wherein the laser is configured to perform complete laser photocoagulation.

5. The apparatus of embodiment 3, wherein the laser is configured to treat wet age-related macular degeneration.

6. The apparatus of embodiment 1, further comprising a module configured to inject a photosensitizer into the eye, wherein the laser is configured to activate the photosensitizer.

7. The apparatus of embodiment 1, wherein the wearable augmented reality device is configured to determine an area for exposure of light originating from the laser.

8. The apparatus of embodiment 7, wherein the wearable augmented reality device is configured to determine an area for exposure by imaging the retina and surrounding tissue of the eye and determining the presence of choroidal neurovascularization.

9. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to provide instructions to the wearer prior to exposing the wearer to light originating from a laser.

10. The apparatus of embodiment 9, wherein the augmented reality head-mounted ophthalmic system is configured to display an image to the wearer as part of the laser treatment.

11. The apparatus of embodiment 10, wherein the augmented reality head-mounted ophthalmic system is configured to display the instructions to the wearer prior to exposing the wearer to light originating from a laser.

12. The augmented reality head-mounted ophthalmic system of embodiment 9, wherein the augmented reality head-mounted ophthalmic system is configured to orient the wearer's eyes in a desired direction while exposing the wearer to light originating from the laser; wherein the ophthalmic system is configured to orient the eye of the wearer by indicating an object on which the eye of the wearer can focus.

13. The apparatus of embodiment 9, wherein the augmented reality head-mounted ophthalmic system is configured to display a moving object as part of a laser treatment.

14. The apparatus of embodiment 9, wherein the augmented reality head-mounted ophthalmic system is configured to provide instructions to the wearer after exposing the wearer to light originating from a laser.

15. The apparatus of embodiment 14, wherein the instructions include one or more of shutting an eyelid for a set duration and blinking a set number of times.

16. The apparatus of embodiment 1, wherein the laser is mounted to a frame of an ophthalmic system.

17. The device of embodiment 1, wherein the device further comprises an adaptive optics element configured to project the image to a specific portion of the wearer's eye.

18. The apparatus of embodiment 17, wherein the adaptive optical element comprises a variable focus element.

19. The apparatus according to embodiment 18, wherein the variable focus element comprises a membrane mirror.

20. The apparatus of embodiment 19, wherein the apparatus comprises:

one or more electrodes coupled to the thin-film mirror; and

and a control system configured to selectively control the one or more electrodes to modify the shape of the thin-film mirror.

21. The apparatus of embodiment 1, further comprising a fiber optic scanning projector for outputting light to form an image in the eye of the wearer.

22. The apparatus of embodiment 1, further comprising a waveguide stack comprising a plurality of waveguides, the other waveguides configured to project light at different focal planes.

23. The apparatus of embodiment 22, wherein the waveguide stack further comprises one or more lenses.

24. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display platform including a display device that provides an image to the eye of the wearer; and

a laser configured to selectively administer laser treatment to the eye of the wearer;

A wearable virtual reality device configured for use by a wearer.

25. The head-mounted ophthalmic system of embodiment 24, wherein the virtual reality head-mounted ophthalmic system is head-mounted such that light originating from the external world in front of the head-mounted ophthalmic system forms an image of the external world in the eye of the wearer. A device configured to not pass through the eyes of a wearer wearing the system.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>Delivery of Medication</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

a wearer wearing an augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system receives light from the outside world is configured to pass through the eyes of

wherein the augmented reality head-mounted ophthalmic system is configured to deliver a drug to the eye of the wearer;

A wearable augmented reality device configured for use by a wearer.

2. The device of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to deliver the medicament to the eye of the wearer based on a treatment protocol.

3. The device of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to provide an alert to the wearer during drug delivery.

4. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to provide an alert to the wearer to keep the eye open while drug is delivered.

5. The device of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to provide an alert to the wearer to focus on visual cues while drug is delivered.

6. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to deliver a drug as part of a light or laser treatment.

7. The device of Example 6, wherein the drug is photosensitive to light of a wavelength used for light or laser therapy.

8. A wearable augmented reality device configured for use by a wearer, the device comprising:

a wearer wearing an augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system receives light from the outside world is configured to pass through the eyes of

wherein the augmented reality head mounted ophthalmic system is configured to deliver a liquid to the eye of the wearer;

A wearable augmented reality device configured for use by a wearer.

9. The apparatus of embodiment 8, wherein the augmented reality head-mounted ophthalmic system is configured to deliver a spray or mist of liquid to the eye.

10. The apparatus of embodiment 8, wherein the augmented reality head-mounted ophthalmic system is configured to deliver a liquid drop to the eye.

11. The apparatus of embodiment 8, wherein the augmented reality head-mounted ophthalmic system is configured to deliver a stream of the liquid to the eye.

12. The apparatus of embodiment 8, wherein the augmented reality head-mounted ophthalmic system is configured to deliver saline solution to the eye of the wearer.

13. The apparatus of embodiment 12, wherein the augmented reality head-mounted ophthalmic system is configured to detect that the eye is dry and deliver a saline solution when the eye is dry.

14. The apparatus of embodiment 12, wherein the augmented reality head-mounted ophthalmic system is configured to detect a red or congested eye and deliver saline upon detecting the red or congested eye.

15. The device of Example 8, wherein the augmented reality head-mounted ophthalmic system controls at least one of the wearer's temperature, the duration after the immediate supply of liquid or powdered drug, ambient humidity, foreign matter in the eye, or the eye The device further comprising one or more sensors that measure against the eye in the presence of chemical irritants or in the presence of pollen or particulates.

16. The apparatus of embodiment 15, wherein the augmented reality head-mounted ophthalmic system is configured to deliver the liquid to the eye based on one or more measurements of the one or more sensors exceeding a threshold value.

17. The apparatus of embodiment 15, wherein the augmented reality head-mounted ophthalmic system is configured to deliver sufficient liquid to irrigate the eye.

18. A wearable virtual reality device configured for use by a wearer, the device comprising:

and a virtual reality head-mounted ophthalmic system comprising a virtual reality display device platform including a display device for providing an image to the eye of the wearer,

wherein the virtual reality head-mounted ophthalmic system is configured to deliver medication to the eye of the wearer.

19. The virtual reality head-mounted ophthalmic system of embodiment 18, wherein the virtual reality head-mounted ophthalmic system is head-mounted such that light originating from the external world in front of the head-mounted ophthalmic system forms an image of the external world in the eye of the wearer. A device configured to not pass through the eyes of the wearer wearing the system.

20. A wearable virtual reality device configured for use by a wearer, the device comprising:

and a virtual reality head-mounted ophthalmic system comprising a virtual reality display device platform including a display device for providing an image to the eye of the wearer,

wherein the virtual reality head-mounted ophthalmic system is configured to deliver saline solution to the eye of the wearer.

21. The 20th embodiment, wherein the virtual reality head-mounted ophthalmic system is head-mounted such that light originating from the external world in front of the head-mounted ophthalmic system forms an image of the external world in the eye of the wearer. A device configured to not pass through the eyes of the wearer wearing the system.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>Platform for Other Treatments</u>

One. A wearable augmented reality device configured for use by a wearer, the device comprising:

a wearer wearing an augmented reality head-mounted ophthalmic system comprising a wearable augmented reality display platform, wherein the augmented reality head-mounted ophthalmic system receives light from the outside world is configured to pass through the eyes of

wherein the augmented reality head-mounted ophthalmic system is configured to deliver a treatment other than phototherapy to the wearer;

A wearable augmented reality device configured for use by a wearer.

2. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to deliver vibration therapy.

3. The apparatus of embodiment 2, wherein the augmented reality head-mounted ophthalmic system is configured to massage the wearer's face or skull.

4. The apparatus of embodiment 3, wherein the augmented reality head-mounted ophthalmic system further comprises an actuator having a contact surface configured to contact the wearer during massage.

5. The apparatus of embodiment 5, wherein the actuator is selected from the group consisting of a piezoelectric actuator, an eccentric cam, an eccentric rotating mass (ERM) vibration motor, and a linear resonant actuator (LNA).

6. The apparatus of embodiment 2, wherein the augmented reality head-mounted ophthalmic system further comprises a speaker configured to deliver sound therapy.

7. The apparatus of embodiment 6, wherein the augmented reality head-mounted ophthalmic system is configured to output binaural beats.

8. The apparatus of embodiment 6, wherein the augmented reality head-mounted ophthalmic system is configured to direct sound waves to the eye.

9. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to deliver thermal therapy to the wearer.

10. The apparatus of embodiment 9, wherein the augmented reality head-mounted ophthalmic system further comprises a cooler.

11. The apparatus of embodiment 9, wherein the augmented reality head-mounted ophthalmic system is configured to deliver cold air cooled by the cooler to the wearer.

12. The apparatus of embodiment 9, wherein the augmented reality head-mounted ophthalmic system further comprises a heater.

13. The apparatus of embodiment 9, wherein the augmented reality head-mounted ophthalmic system is configured to deliver heated air heated by the heater to the eye.

14. The apparatus of embodiment 1, wherein the device further comprises an EEG sensor, and wherein the augmented reality head-mounted ophthalmic system is configured to deliver treatment based on a physiological state of the wearer measured by the EEG sensor. .

15. The apparatus of embodiment 1, wherein the augmented reality head-mounted ophthalmic system is configured to provide an alert to the wearer while treatment is being delivered.

16. The apparatus of embodiment 15, wherein the augmented reality head-mounted ophthalmic system is configured to provide an alert to the wearer to keep the eye open while treatment is delivered.

17. The apparatus of embodiment 15, wherein the augmented reality head-mounted ophthalmic system is configured to provide an alert to the wearer to focus on visual cues while treatment is delivered.

18. The apparatus of embodiment 15, wherein the augmented reality head-mounted ophthalmic system is configured to direct air into the eye during treatment.

19. A wearable virtual reality device configured for use by a wearer, the device comprising:

a virtual reality head-mounted ophthalmic system comprising a virtual reality display device platform including a display device for providing an image to the eye of the wearer;

wherein the virtual reality head-mounted ophthalmic system is configured to deliver a treatment other than phototherapy to the eye of the wearer;

A wearable virtual reality device configured for use by a wearer.

20. The virtual reality head-mounted ophthalmic system of embodiment 19, wherein the virtual reality head-mounted ophthalmic system is head-mounted such that light originating from the external world in front of the head-mounted ophthalmic system forms an image of the external world in the eye of the wearer. A device configured to not pass through the eyes of the wearer wearing the system.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>Outward Looking Camera</u>

One. A wearable display system comprising:

head-mounted display; and

at least one outward looking camera configured to capture an image of the outside world around the wearer of the head-mounted display device;

wherein the display system is configured to process an image of the external world, re-render an image of the external world, and project the re-rendered image from a head-mounted display to the eye of the wearer;

Wearable display system.

2. The wearable display system of embodiment 1, wherein the display system is configured to re-render an image of the outside world based at least in part on a known ophthalmic eye condition of the wearer.

3. The wearable display system of embodiment 1, wherein the display system is configured to re-render the image of the external world by changing the hue of at least a portion of the image.

4. The wearable display system of embodiment 3, wherein the display system is configured to re-render the image of the external world by shifting a color of at least a portion of the image.

5. The wearable display system of embodiment 1, wherein the display system is configured to re-render the image of the external world by changing the intensity of at least a portion of the image.

6. The wearable display system of embodiment 1, wherein the display system is configured to re-render an image of the outside world by changing a portion of the image based on a distribution of healthy and unhealthy cells in the retina of the wearer. .

7. The wearable display system of embodiment 1, wherein the display system is configured to re-render the image of the external world by modifying a wavefront of at least a portion of the image.

8. The wearable display system of embodiment 1, wherein the display system is configured to re-render an image of the external world by enlarging at least a portion of the image.

9. The wearable display system of embodiment 1, wherein the display system is configured to re-render the image of the external world by changing the saturation of at least a portion of the image.

10. The wearable display system of embodiment 1, wherein the display system is configured to re-render the image of the external world by changing the spatial frequency of at least a portion of the image.

11. The wearable display system of embodiment 1, wherein the head-mounted display comprises a virtual reality display.

12. The wearable display system of embodiment 1, wherein the head-mounted display comprises an augmented reality display configured to allow light originating from the external world to pass through to the eye of the wearer.

13. The wearable display system of any one of embodiments 1-12, wherein the head-mounted display comprises a light field display.

The numbered additional examples described herein in the section entitled "Additional Numbered Examples" below, just as they are immediately after the numbered list of examples set forth herein, are The numbered additional embodiments described in the section entitled "Additional Embodiments Numbered" are repeated, added to, and linked to, the numbered list of embodiments herein.

<u>numbered additions </u><u>Example</u><u></u>

These additional embodiments are in addition to the list of embodiments provided in the different sections above, including but not limited to the sections titled: Myopia/ Farsightedness/ Astigmatism; presbyopia; strabismus/amblyopia; high aberration; chromatic aberration; phoropter; red reflection; intraocular pressure; pinhole breaker; Initial W4LT testing; retinoscopy; slit lamp; color blindness; ophthalmoscope/fundus ophthalmoscope; confocal microscopy/2 photon microscopy/SLO; two-photon microscopy; autorefractometer; optical coherence tomography system; aberration analyzer; ultrasonic wave; safety record (EOG), electroencephalography (EEG), and electroretinography (ERG); phototherapy; macular degeneration; control test; eyesight; laser treatment; drug administration; other therapeutic platforms; and a camera looking outward.

These additional embodiments are repeated and linked to the list of embodiments provided in each other section above, such that the list below is immediately followed by a list of embodiments described in a particular section. Further, it will be understood that additional embodiments, numbered below, will also apply to any of the claims herein, and in determining the subject matter covered by such embodiments, reference to "a device of any of the above embodiments" It should also be understood that reference may be made to any of the claims below.

One. The apparatus of any one of the preceding embodiments, wherein the apparatus comprises a light field display.

2. The device of any one of the preceding embodiments, wherein the device is configured to project an image to the eye of the wearer from a different depth plane.

3. The apparatus of any one of the preceding embodiments, wherein the apparatus comprises a plurality of optical elements having optical outputs for projecting images from different depth planes.

4. The apparatus of any one of the preceding embodiments, wherein the apparatus comprises a plurality of lenses having optical outputs for projecting images from different depth planes.

5. The apparatus of any one of the preceding embodiments, wherein the apparatus is configured to project images from different depth planes onto the eye using temporal multiplexing such that images for different depth planes are projected at different times.

6. The apparatus of any one of the preceding embodiments, wherein the apparatus is configured to project at least one beam of light in a scanning pattern at the eye of the wearer.

7. The device of any one of the preceding embodiments, wherein the device is configured to project at least one beam of light in a scanning pattern onto the eye of the wearer to form an image.

8. The device of any one of the preceding embodiments, wherein the display device is configured to project at least one light beam having a lateral dimension of 1 to 25 microns to the eye of the wearer.

9. The apparatus of any one of the preceding embodiments, wherein the apparatus further comprises a transmissive adaptive optical element.

10. The apparatus of any one of the preceding embodiments, wherein the apparatus further comprises a transmissive adaptive optical element, the transmissive adaptive optical element comprising an adaptive optical lens or spatial light modulator that modulates a phase.

11. The apparatus of any one of the preceding embodiments, further comprising a transmissive adaptive optical element comprising a deformable lens.

12. The apparatus of any of the preceding embodiments, further comprising a transmissive adaptive optical element comprising a deformable lens comprising a deformable elastomeric lens.

13. The apparatus of any one of the preceding embodiments, wherein the apparatus is configured to track data of a user obtained by the apparatus over a period of time.

14. The apparatus of any one of the preceding embodiments, wherein the apparatus is further configured to describe a result of a previous test, inspection or procedure performed by the apparatus when providing an output or controlling light reaching a user.

15. The apparatus of any one of the preceding embodiments, wherein the apparatus is further configured to modify light control or output provisioning reaching the user based at least in part on results of one or more previous tests, inspections or procedures it performs.

16. The any one of the preceding embodiments, wherein the test, inspection, or procedure performed by the device depends at least in part on the results of a previous test, inspection, or procedure performed by the device. A device that is initialized based on

17. The apparatus of any one of the preceding embodiments, wherein the apparatus comprises a gaming system.

18. The apparatus of any one of the preceding embodiments, wherein the apparatus comprises an entertainment system.

19. The apparatus of any one of the preceding embodiments, wherein the apparatus comprises a personal display system.

20. The apparatus of any one of the preceding embodiments, wherein the apparatus comprises an occupation indicator system.

21. The apparatus of any one of the preceding embodiments, wherein the apparatus is configured to perform a test, inspection or procedure while presenting a movie.

22. The device of any one of the preceding embodiments, wherein the device is configured to cause the device to perform a test, inspection or procedure while the wearer plays a video game.

23. The apparatus of any one of the preceding embodiments, wherein the apparatus is configured to obtain a test result based at least in part on measurements of the wearer's eye while presenting a movie.

24. The apparatus of any one of the preceding embodiments, wherein the apparatus is configured to obtain a test result based at least in part on measurements of the wearer's eyes while playing a game.

25. The device according to any one of the above embodiments, wherein the device is a film projected on, a portion of the film projected from various depth planes, and an eye measurement when viewing the portion of the film projected from various depth planes on the eye of the wearer. A device, configured to perform a test, inspection or procedure based on it.

26. The device according to any one of the above embodiments, wherein the device is provided with a video game, the portion of the video game is provided from various depth planes, and the eye of the wearer when viewing the portion of the video game presented from various depth planes A device configured to perform a test, inspection or procedure based on the measurement of

27. The device of any one of the preceding embodiments, wherein the device is configured for use by an optometrist, clinician or physician.

28. The device of any one of the preceding embodiments, wherein the test, examination or procedure is administered from an optometrist, clinician or physician's office or hospital, clinic or medical facility.

29. The device according to any one of the preceding embodiments, wherein the device consists primarily of an ophthalmic system configured to perform an ophthalmic diagnosis or to perform an ophthalmic treatment.

30. The device of any one of the preceding embodiments, wherein the device is primarily configured as an ophthalmic system configured to determine refractive errors or perform an eye exam.

31. The apparatus of any one of the preceding embodiments, wherein the test, inspection or procedure is performed by the apparatus several times a year.

32. The apparatus of any one of the preceding embodiments, wherein the tests, inspections, procedures are performed by the apparatus several times per week.

33. The apparatus according to any one of the preceding embodiments, wherein the test, inspection, procedure is performed by the apparatus multiple times per day.

34. The device of any one of the preceding embodiments, wherein the test, inspection or procedure is performed by the device at the discretion of the wearer.

35. The apparatus of any one of the preceding embodiments, wherein the test, examination or procedure is dynamically scheduled or suggested based at least in part on results obtained by the apparatus for monitoring the performance of the wearer's eye.

36. The device of any one of the preceding embodiments, wherein the scheduled time for the test, examination or procedure is modified based at least in part on a result of performing device monitoring of the wearer's eye.

37. The device of any of the preceding embodiments, wherein the device is configured to generate an alert that the device will perform a test, inspection or procedure on the wearer.

38. The device of any one of the preceding embodiments, wherein the device is configured to generate an alert that the device has completed a test, inspection or procedure for the wearer.

39. The device of any of the preceding embodiments, wherein the device is configured to generate an alert to the wearer when performance of the wearer's eyes is outside a targeted performance range.

40. The apparatus of any one of the preceding embodiments, wherein the apparatus is configured to generate an alert comprising a suggested test based on a performance characteristic of the eye that is outside a targeted performance range.

41. The apparatus of any one of the preceding embodiments, wherein the apparatus is configured to generate an alert comprising information regarding a performance characteristic of the eye that is outside a targeted performance range.

42. The device of any of the preceding embodiments, wherein the device is configured to generate an alert comprising an audible or visual notification presented to the wearer to indicate a suggested test.

43. The apparatus of any of the preceding embodiments, wherein the apparatus is configured to generate an alert with an audible or visual notification indicating to the wearer which performance characteristic is outside the targeted performance range.

44. Any one of the above embodiments, wherein the device comprises:

obtain information about the surrounding environment of the glasses;

measure the wearer's biological characteristics; and

and determine a relationship between the information and the measured biological property.

45. The method according to embodiment 44, wherein the device is configured to acquire information about the surrounding environment using an outward-facing camera to obtain an image of an object in the environment outside the glasses; and the device is configured to determine a relationship between the objects in the acquired images and the measured biological characteristics.

46. The apparatus according to embodiment 45, wherein the object of the acquired image includes food.

47. The device of any one of embodiments 44-46, wherein the biological characteristic comprises at least one of a trend in heart rate or blood pressure.

48. The apparatus of any one of embodiments 44-47, wherein the relationship is stored to generate a historical record of the determined relationships.

49. The method of any one of embodiments 44-48, wherein the device is configured to obtain information about the surrounding environment by determining a location of the wearer, wherein the information is one or more conditions of the surrounding environment at the location. Device.

50. The apparatus of any one of embodiments 44-49, wherein the apparatus is configured to obtain information about the surrounding environment by accessing a remote data repository.

51. The method of any one of embodiments 44-50 above, wherein the information describes one or more of pollen count, pollution, demographics, environmental toxins, indoor climate and air quality conditions, lifestyle statistics, and proximity to a health care provider. , Device.

The drawings illustrate some examples of embodiments disclosed herein, but do not limit the invention. It should be noted that the drawings are not drawn to scale and elements of similar structure or function are denoted by the same reference numbers throughout the drawings. 1 shows a traditional ophthalmic device used in a clinician's office. 2 shows a cross-section of a human eye. 3A-3D illustrate various configurations of an exemplary ophthalmic instrument. 4A-4D show various eye and head dimensions taken to construct an ophthalmic appliance for a particular user. 5 shows a schematic diagram of various components of an ophthalmic instrument in accordance with some embodiments. 6 is an exemplary process flow for changing the focus of a health system in accordance with some embodiments. 7A and 7B are cross-sectional views schematically illustrating the eyes of a user suffering from myopia. 8A and 8B are cross-sectional views schematically illustrating the eyes of a user suffering from hyperopia. 9A and 9B are cross-sectional views schematically illustrating the eyes of a user suffering from astigmatism. 10A depicts an example process flow for correcting a vision defect in accordance with some embodiments. 10B-10E show examples of structures for correcting an optical prescription in accordance with some embodiments. 11 depicts an example process flow for presbyopia correction in accordance with some embodiments. 12 depicts an exemplary method for treating a convergence deficit, such as caused by strabismus and/or amblyopia, by covering the wearer's eyes. 13 depicts an example process flow for detecting a dead spot in the macula, in accordance with some embodiments. 14 shows an example of a wearable augmented reality device configured to function as a phoropter or refractor. 15 depicts an exemplary method for determining an optical prescription of an augmented or virtual reality device wearer configured for use as a virtual phoropter. 16A schematically depicts an exemplary configuration of a system for determining intraocular pressure of an eye. 16B depicts an example process flow for determining intraocular pressure in accordance with some embodiments. 17A-17C illustrate an embodiment of an exemplary pin hole occluder in accordance with some embodiments. 17D illustrates an example process flow for managing a pinhole occlusion inspection in accordance with some embodiments. 17E illustrates an exemplary pin hole occluder including a plurality of pin holes in accordance with some embodiments. 17F illustrates an exemplary process flow of vision defect correction using a pinhole occluder in accordance with some embodiments. 18 depicts an exemplary method of administering a four-photometric or four-dot test to assess a wearer's degree of binocular vision. 19 illustrates an exemplary method for measuring a refractive error of a wearer of an augmented reality device configured to perform a retinal examination. 20A shows a patient-worn ophthalmic instrument configured with a slit lamp lamp diagnostic instrument. 20B depicts an exemplary process flow for managing slit lamp lamp inspection. 21A shows a schematic diagram of various color plates. 21B schematically depicts an example system for generating a dark background in an augmented reality system. 22A schematically shows augmented reality/virtual reality eyewear composed of an ophthalmoscope/fundus inspector. 22B depicts an example process flow for using a health system as a fundus surveyor in accordance with some embodiments. 22C is a schematic fragmentary view of an embodiment configured to provide illumination to structures at various depths of the eye and to image structures at different depths of the eye. 23A schematically shows a setup for performing an optical coherence tomography (OCT) examination. 23A-1 is a partial schematic diagram of one embodiment of augmented reality/virtual reality eyewear including an optical scanning device and a plurality of waveguides configured to perform an optical coherence tomography (OCT) examination. 23B schematically illustrates augmented reality/virtual reality eyewear including a plurality of light detectors configured to receive reflected/backscattered light from an eye. 23C illustrates an embodiment of a system flow and system configuration using a health system as an OCT system, in accordance with some embodiments. 24A is a schematic diagram of augmented reality/virtual reality eyewear including one or more ultrasound probes and one or more ultrasound transceivers. 24B depicts an exemplary process flow for using ultrasound through an ophthalmic instrument, in accordance with some embodiments. 24C schematically illustrates augmented reality/virtual reality eyewear configured to perform confocal microscopy, scanning laser ophthalmoscopy, or two-photon microscopy. 24D-1 is a partial schematic diagram of an augmented reality/virtual reality eyewear embodiment comprising a plurality of waveguides and fiber optic scanning devices configured to perform confocal microscopy, scanning laser ophthalmoscopy, or two-photon microscopy. 24D-2 is a schematic partial explanatory diagram of one embodiment of eyewear including a light source, one or more imagers, a beam splitter, a lens system, and a scanning mirror; 24E shows an exemplary process flow and system configuration for using augmented reality/virtual reality eyewear with a confocal microscope. 24F is a schematic diagram of augmented reality/virtual reality eyewear including electrodes disposed around a user's eyes. 25 shows a schematic diagram of an example configuration of a health system. 26A-26G show exemplary embodiments of augmented and/or virtual reality systems configured with autorefractors. 27 depicts an exemplary embodiment of an augmented and/or virtual reality system configured with a wavefront aberrometer. 28A schematically illustrates one embodiment of a scanning optical fiber. Fig. 28B schematically shows one embodiment of a display device using a scanning optical fiber. 28C schematically illustrates an exemplary spiral pattern formed by a moving scanning optical fiber of a fiber scanning display. 29A schematically shows an exemplary embodiment of a system having a transmission adaptive optics system. 29B schematically shows an exemplary embodiment of a system with a reflective adaptive optics system.

Various embodiments of the present disclosure relate to methods, systems, and products for implementing a user wearable health system, and may be used to perform health-related diagnosis, monitoring, and treatment for a user. Various objects, features and advantages of the present application are set forth in the detailed description, drawings and claims.

Various embodiments will be described in detail with reference to the drawings provided as exemplary embodiments of the present invention to enable those skilled in the art to practice the present invention. In particular, the following drawings and examples are not intended to limit the scope of the present invention. To the extent that certain components of the present invention can be partially or fully implemented using known components (or methods or processes), only some of those known components (or methods or processes) are necessary for an understanding of the present invention. will be described, and detailed descriptions of other portions of such well-known components (or methods or processes) will be omitted so as not to obscure the present invention. In addition, various embodiments include, by way of illustration, present and future known equivalents to the elements recited herein.

A method and system are disclosed for diagnosing and/or treating a health condition in a patient via a user wearable health system, such as a user wearable ophthalmic device that interacts with the user's eyes. In one or more embodiments herein, the device may be a head mounted system capable of performing one or more diagnostic or therapeutic treatments. In another embodiment of the present application, the device may be stationary (eg, fixed to a doctor's office). In one or more embodiments herein, the device may be an augmented reality system that advantageously combines several augmented reality (AR) and/or virtual reality (VR) technologies for health or ophthalmic purposes. In other embodiments herein, a clinician may wear the device for diagnosis and/or simulation and clinical training. While the various embodiments described below discuss new paradigms of medical systems in the context of AR systems, it should be understood that the techniques disclosed herein may be used independently of any existing and/or known AR systems. Accordingly, the examples discussed below are illustrative only and should not be construed as being limited to an AR system.

As noted above, embodiments herein provide a user-wearable medical examination or health treatment system (generally referred to as a health system), eg, an ophthalmic instrument, worn by a patient, and various health-related, eg, eye It can be programmed with one or more applications specific to the disease involved. In some embodiments herein, diagnosis and/or treatment may be provided by optical, mechanical structures, processing algorithms, or any combination thereof. In other embodiments herein, the patient worn health system may further involve sensing and/or stimulation capabilities for enhanced therapeutic or diagnostic purposes. In one embodiment of the present application, the head-mounted augmented reality system may be used to provide a variety of health related, such as optometry, measurement, evaluation, diagnosis or treatment.

Given that the head-mounted augmented reality display system interacts with the user's eyes, a variety of applications can be envisioned for eye-related diagnosis and therapy. In addition, many other applications in non-ophthalmic diagnosis and therapy are similarly envisioned. Accordingly, the disclosure presented herein is not limited to ophthalmic diagnosis, monitoring and treatment. Embodiments disclosed herein also include, but are not limited to, cardiovascular health and neurological health of a user, and may be applied to diagnose, monitor, and treat other health areas of a user.

Many embodiments of the health system will be discussed in connection with various eye diseases and other conditions. Before looking at various embodiments of the health system, we will briefly discuss the biological mechanisms of the human eye to provide background on common diseases that can affect patients.

Referring to FIG. 2 , cornea 42 , iris 44 , lens or "crystalline lens" 46, sclera 48, choroid layer 50, macula 52, retina 54, and the brain A schematic cross-sectional view of the human eye is shown featuring the optic nerve pathway 56 . The macula is the center of the retina used to see moderate detail; The center of the macula is a portion of the retina called the "fovea" used to see the finest details, and has more photoreceptors (about 120 cones for each degree of vision) than any other part of the retina. The human visual system is not a passive sensor type; It is configured to actively scan its surroundings. Much like using a flat-panel scanner to capture an image or using a finger to read Braille on a piece of paper, the photoreceptors in the eye respond to changes in stimuli rather than constantly responding to a constant state.

Thus, movement is required to provide photoreceptor information to the brain (such as movement of a linear scanner array across a piece of paper in a flatbed scanner, or a finger movement across a Braille word engraved on a piece of paper). Experiments with substances such as cobra venom that actually paralyze the eye muscles have shown that people experience blindness when they see a static scene in a poison-induced paralysis with their eyes open. . In other words, in the absence of a change in stimulus, the photoreceptors do not provide input to the brain, resulting in blindness. It is believed that this is at least one reason why the normal human eye is monitored for back-and-forth movements or tremors called "microsaccades" in side-to-side movements.

As mentioned above, the density of photoreceptors is highest in the fovea of the retina, and although humans generally have a perception that they have high-resolution visualization capabilities across the field of view, they usually only have a small, high-resolution fovea, so that the fovea retains the recently captured high-resolution information. Many parts of the memory are cleaned mechanically. In a somewhat similar manner, the focal length control mechanism of the eye (the ciliary muscle is operatively connected to the lens in such a way that the ciliary connective fibers taut and flatten the lens to a distant focal length; ciliary contraction is the It loosens the ciliary connecting fibers so that the lens takes on a rounded shape with a near focal length) by periodically oscillating back and forth by about ¼ to ½ diopters, resulting in small amounts of so-called "refractive blur" both near and far from the target focal point. (dioptric blur)"; It is used by the brain's accommodation control circuitry as cyclical negative feedback that continuously modifies the path and helps to keep the retinal image of a stationary object approximately in focus.

The visualization center of the brain also acquires valuable perceptual information in the process of moving the two eyes and their components relative to each other. The gaze movement of the two eyes relative to each other (i.e., the rolling motion of the pupils toward or away from each other to converge the gaze of the eyes attempting to fixate on an object) is combined with focusing (or "accommodation") of the lens of the eye. closely related. Under normal conditions, changing the lens focus of the eye or focusing the eye on an object at a different distance while accommodating the eye automatically causes a change in registration to the gaze angle at the same distance, in a relationship known as "accommodation-observatory reflex". causes Similarly, under normal conditions, the gaze change triggers a conformational change in accommodation. As with most prior art stereoscopic AR or VR configurations, working against this reflection is known to cause eye strain, headaches, or other forms of discomfort to the user.

The movement of the head, which holds the eyes, also has an important effect on the visualization of objects. Humans move their heads to visualize the world around them; Often in a distinctly continuous state of rearranging and reorienting the head in relation to the object of interest. Also, most people prefer to move their head when they need to move their gaze more than 20 degrees from the center in order to focus on a particular object (i.e., people generally don't like to see things "in the eye") . Also, humans typically scan or move the head in relation to sound - improving speech signal capture and taking advantage of the spatial structure of the ear relative to the head. The human visual system derives powerful depth cues from what is called "head motion parallax," which relates to the relative motion of objects at different distances as a function of head motion and the gaze distance of the eyes. That is, when a person keeps a fixed gaze on an object while moving his head left and right, the part farther from the object moves in the same direction as the head, and the part in front of the object moves in the opposite direction to the head movement; It becomes a very prominent clue about where you are spatially in your surroundings (perhaps as powerful as stereoscopic images). It is used for head movement as well as for looking around objects.

In addition, head and eye movements are coordinated with what is called the "vestibulo-ocular reflex," which stabilizes image information about the retina during head rotation, keeping the image information of objects about the center of the retina. give. In response to head rotation, the eyes are reflexively rotated proportionally in the opposite direction, maintaining a stable fixation on the object. As a result of this reward relationship, many people can read a book while shaking their head back and forth (interestingly, if the book moves back and forth at the same speed with the head almost stationary, although generally not the same - the person moves unable to read; the vestibular-ocular reflex is one of the coordination of head and eye movements, not generally developed for hand movements). This paradigm may be important in patient-wearing health systems, as a patient's head motion can be relatively directly related to eye motion, and the system will preferably be ready to work with this coupling. Therefore, when designing patient-worn or stationary display-based health systems, considering the characteristics of the human eye and sometimes the limitations of the human eye, rather than emphasizing the natural mechanism of the eye, meaningful VR content that can work with that mechanism. It is desirable to provide Additionally, in the context of health-related applications of augmented reality display systems, this may provide various advantages as disclosed herein. As mentioned above, the display of a health system may be implemented independently of an augmented reality (AR) system, however, many of the embodiments below are described in the context of an AR system for illustrative purposes only.

Referring now to Figures 3A-3D, some general component options are shown. Although the configuration of Figures 3A-3D depicts a head-mounted display, it should be appreciated that in one embodiment the same components may be incorporated into a stationary health system.

As shown in FIG. 3A , the user 60 is shown wearing a patient wearable ophthalmic instrument including a frame 64 structure coupled to a display system 62 positioned in front of the user's eyes. The frame 64 may be coupled to a number of ophthalmological-professional measurement subsystems depending on the application of the health system. Some embodiments herein may be built for one or more ophthalmic applications, and other embodiments may be generic AR systems that may also be capable of ophthalmic applications. In both cases, the possible components of a health system or AR system used for ophthalmic equipment and/or treatment are described below.

In one or more embodiments herein, the health system is for patient or user wear. In some other embodiments, the health system may be worn by another person, such as a physician or clinician, and used to perform a series of diagnostic tests and/or treatment protocols on a patient other than the wearer of the system. It should be understood that any of the applications below may be used in medical systems worn by others to perform diagnostic tests and/or treatment protocols on the patient.

A speaker 66 may be coupled to the frame 64 in the configuration shown and may be positioned adjacent to the user's ear canal (in one embodiment herein, another speaker, not shown, provides acoustic control for stereo/shaping) positioned adjacent to the user's other side of the ear canal). A microphone 55 may also be coupled to the frame to detect sound from the user or surrounding surroundings. In some embodiments herein, another microphone (not shown) may be provided, for example coupled to the user's right frame 64 . In one or more embodiments herein, the health system is a display device 62 operatively coupled to a local processing and data module 70 via a wired or wireless connection, which may be mounted in a variety of configurations so as to be fixed to a frame 64 . 3B, fixedly attached to the helmet or hat 80, as shown in the embodiment of FIG. 3B, or detachably attached to the body 82 of the user 60 in a backpack-type configuration as shown in the embodiment of FIG. 3C. It may be embedded in a possibly attached headphone, or may be removably attached to the hip 84 of the user 60 in a belt-coupled configuration as shown in the embodiment of FIG. 3D .

The local processing and data module 70 is operable on the frame 64, such as a) an imaging device (such as a camera) such as a microphone, inertial meter, accelerometer, compass, GPS unit, radio and/or gyroscope. acquisition and/or processing from a sensor that may be coupled and/or b) acquired and/or processed using a remote processing module 72 and/or a remote datastore 74, and to a display device 62 after such processing or recovery. It may include a high-efficiency processor or controller as well as digital memory, such as flash memory, that may be used to aid in the processing, caching, and storage of data that may be passed through. A local processing and data module 70 is operatively coupled 76, 78 to a remote processing module 72 and a remote datastore 74, via a wired or wireless communication connection, such remote modules 72, 74 are operatively coupled to each other and available as a resource for the local processing and data module 70 .

In some embodiments herein, remote processing module 72 may include one or more relatively powerful processors or controllers configured to analyze and process data and/or image information. In one embodiment of the present disclosure, remote data storage 74 may include a relatively large scale digital data storage facility available via the Internet or other networking configuration in a "cloud" resource configuration. In one embodiment of the present application, all data is stored and all calculations are performed in the local processing and data module, allowing completely free use from any remote module.

Preferably, a health system (or an ophthalmically applied AR system) similar to that described in FIGS. 3A-3D connects to the user's eyes and head in a unique way. The health system interacts with the user's eyes to allow the user to perceive 3D virtual content, and in various embodiments, various biometrics associated with the user's eyes (eg, eye folds, eye movements, retinal structure). , anterior and posterior eye geometry, patterns of eye movements, etc.), the resulting tracked data can be useful for health-related applications as detailed herein. The implementation of various health applications for such users' eyes is an unprecedented approach. Depending on the type of health condition, the health system may be configured to provide imaging, sensing (including measurement) and/or stimulation of the user's eye to diagnose and/or treat the condition.

In one or more embodiments herein, the augmented reality display system may be used as a patient-worn or user-worn ophthalmic instrument. Ophthalmic equipment is used by a clinician to see a patient's eyes and to perform medical procedures and/or examinations on a user's eyes. Traditionally, ophthalmic instruments have been large, bulky fixtures, and often patients have to go to a clinician or physician's office where the physician performs examinations related to the patient's eyes. Typically, the patient is restrained in an ophthalmic device instrument (eg, resting chin on the bib of the ophthalmic instrument, head forward, etc.) until the clinician completes a series of examinations. Therefore, the current approach has many limitations.

In addition to the use of heavy and bulky devices for testing, traditional approaches require physician supervision, and patients may require repeated visits to the clinician's office for further examination/progression evaluation and may be placed in an uncomfortable or restricted position for extended periods of time. there may be Moreover, given the short time a patient is exposed to an ophthalmic device, there is a limit to the amount of data a clinician can collect to diagnose or treat a patient. In addition, traditional approaches do not take into account dynamic changes in user behavior and user orientation. Many tests performed with traditional approaches require the user to be fixed in a specific resting position. However, if the user performs a visual field test and the area of attention is limited, the head and eyes may move, and thus noise may be generated and the test result may be inaccurate.

In one or more embodiments herein, a head-wearing health (eg, ophthalmic) device similar to that illustrated in FIGS. 3A-3D allows a patient to track data, identify, correct, and/or other health conditions related to one or more eyes. It can be used to prevent problems. In one or more embodiments herein, the AR display system may be used as a head-wearing health (eg, ophthalmic) device. It should be understood that while many of the embodiments described below may be implemented in a head-wearing embodiment, other embodiments may be implemented in a fixation device. Additionally, while some embodiments may utilize AR technology to implement systems and methods for diagnosis, monitoring, and/or treatment for physician supervision (eg, medical safety issues, regulatory issues, etc.), other embodiments may utilize head-wearing Self-diagnosis and/or monitoring through a health device or AR device, or as part of a treatment protocol for a specific disease. For illustrative purposes, this disclosure will primarily focus on head-wearing medical devices, such as health systems, particularly AR devices, but it should be understood that the same principles may be applied to non-head-worn embodiments.

In one or more embodiments herein, the AR display may be used as a health device worn by a patient, eg, a health system worn by a patient. The device can generally fit a particular user's head, and the optical component is aligned with the user's eyes. This configuration step may be used to help provide an optimal augmented reality experience to the user without causing physiological side effects such as headache, nausea, discomfort, and the like. Accordingly, in one or more embodiments herein, a patient-wearing health system is configured (both physical and digital) for each individual user, and a set of programs can be tailored specifically for that user. In other scenarios, loose-fitting AR devices can be comfortably used by a variety of users. For example, in some embodiments of the present disclosure, the patient-worn health system may include the distance between the user's eyes, the distance from the head-worn display to the user's eyes, the curvature of the user's forehead, the distance between the ears, or the bridge of the nose for accurate fit. Recognize one or more of the heights. All of these measurements can be used to provide a head-mounted display system suitable for a particular user. In other embodiments herein, such measurements may not be necessary to perform ophthalmic functions.

For example, referring to Figures 4A-4D, the health system can be customized for each user. A user's head shape 402 may be considered when fitting a head mounted patient wearable health system in one or more embodiments as shown in FIG. 4A. Similarly, as shown in FIG. 4B , eye component 404 (eg, optics, optical structures, etc.) may be rotated or adjusted for user comfort, both horizontally and vertically, or can be rotated for your comfort. In one or more embodiments herein, as shown in FIG. 4C , the rotation point of the headset relative to the user's head may be adjusted based on the user's head structure. Similarly, as shown in FIG. 4D , the interpupillary distance (IPD) (ie, the distance between the user's eyes) may be compensated.

From the point of view of a patient-worn medical system, the system already has a set of measurements for the user's physical characteristics (eg eye size, head size, distance between eyes, etc.) and other data that can be used to treat and diagnose the patient. Because it has, this aspect of the headwear device can be advantageous.

In addition to the various measurements and calibrations performed on the user, the patient-worn health system may be configured to track a set of biometric data about the user for patient identification and communication safety. For example, the system may perform iris recognition and/or retinal registration for patient identification, including eye movements, eye movement patterns, blinking patterns, eye gaze, fatigue parameters, changes in eye color, focal length It can track changes in , and various other parameters, which can be used to provide users with an optical augmented reality experience. In the case of AR devices used in healthcare applications, it should be understood that some of the above aspects may be part of generally available AR devices, and other features may be integrated into specific health related applications.

Referring now to FIG. 5 , the various components of an exemplary patient-worn health indicator will be described. It should be appreciated that other embodiments may have additional or fewer components depending on the application for which the system is used (eg, a particular diagnostic tool). Nevertheless, Figure 5 provides a basic idea of some of the various components and types of biometric data that can be collected and stored via a patient-worn health system or AR device. 5 shows a simplified version of the head mounted health system 62 in a block diagram proper for illustrative purposes.

5, a suitable user display including a display lens 106 that may be mounted to the user's head or eyes by means of a housing or frame 108 corresponding to frame 64 (Figs. 3A-3D). One embodiment of (62) is disclosed. The display lens 106 may include one or more transparent mirrors positioned by the housing 108 in front of the user's eye 20 and reflecting the projected light 38 back to the eye 20 , and may include a local periphery. Facilitates beamforming while facilitating the transmission of at least some light in As shown, two wide field machine vision cameras 16 are coupled to the housing 108 to image the surroundings around the user; In one embodiment of the present application, the camera 16 is a dual capture visible/invisible (eg, infrared) camera.

With continued reference to FIG. 5 , a pair of scanned-laser-shaped-wavefronts (ie, for depth) having optics and display mirrors configured to project light 38 into the eye 20 as disclosed. A light projector module is shown. The illustrated embodiment consists of two miniaturized infrared cameras paired with an infrared light source 26 (such as a light emitting diode "LED") configured to be able to track the user's eye 20 and support execution and user input. 24). The system 62 may include a magnetic compass and X, Y, Z-axis gyro performance as well as X, Y, and Z-axis acceleration performance, preferably a sensor assembly capable of supplying data at a relatively high frequency, such as 200 Hz. (39) is characterized. The illustrated system also includes a head posture processor 36, such as an application specific integrated circuit (ASIC), a field programmable gate array (FPGA) and/or an ARM processor (advanced reduction-instruction-set machine), the capture device ( 16) may be configured to calculate a real-time or near-real-time user's head posture from the wide-field image information output from .

Also shown is a processor 32 configured to execute digital and/or analog processing to derive attitude from gyro, compass and/or accelerometer data obtained from the sensor assembly 39 . The illustrated embodiment also features a GPS 37 (Global Positioning System) subsystem to aid in attitude and position analysis. Additionally, the GPS may further provide remote-based (eg, cloud-based) information related to the user's surroundings. This information may be used for diagnostic purposes. For example, if a user is in an area surrounded by air with a high density of pollen distribution, this information may be useful in diagnosing and/or treating a particular disease. Alternatively, in another example, air pollution information for a specific air may be usefully used when considering treatment options for a specific user. Other types of information (eg, pollen count, pollution, demographics, ambient toxins, indoor climate and air quality conditions, lifestyle statistics, proximity to health care providers, etc.) may similarly be used in one or more applications.

For a user's view of the outside world, the illustrated embodiment comprises hardware for imaging the user's eye and running a software program configured to localize and provide rendering information to the user to facilitate operation of the scanner. It may include a featured rendering engine 34 . The rendering engine 34 is configured such that the rendered light is projected using a scanned laser array 18 in a manner similar to a retina scanning display device, including a sensor posture processor 32, an image pose processor 36, an eye tracking camera ( 24) and a projection subsystem 18 . The wavefront of the projection light beam 38 may be bent or focused to match a desired focal length of the projection light.

The camera 24 (eg, a miniature infrared camera) allows rendering and user input (ie, where the user is looking, the depth at which he or she is focusing; as discussed below, the edge of the eye is the depth of focus). can be used to track the eye to support The GPS 37, gyros, compass and accelerometer 39 may be used to provide a rough and/or quick attitude estimate. Camera 16 images and poses, along with data from relevant cloud computing resources, may be used to map the local world and share the user's view with other users and/or virtual or augmented reality communities and/or healthcare providers. have. In one or more embodiments herein, the camera 16 may be used to analyze the food, drugs, nutrients and toxins a user consumes as part of a comprehensive health care and/or wellness system or health care monitoring system.

Continuing to refer to FIG. 5 , the display device 62 may include a medication distribution module 21 for delivering medication to the user. The dosage distribution module 21 may include one or more outlets 22 and at least one drug container 23 that may be a reservoir for storing drugs to be dispensed through the outlet 22 . The outlet 22 may be connected to the container 23 by one or more channels 22a that deliver a drug (eg, liquid or gas) from the container 23 to the outlet 22 . In some embodiments herein, the outlet 22 may simply be an opening in the frame 108 , or may be a nozzle attached to or associated with the frame 108 . In some embodiments herein, the nozzle may be a nebulizer. In some embodiments herein, the channel 22a is defined by an opening in the frame 108 and/or the connector.

In one or more embodiments herein, the display device may include a light emitting module 27 that selectively administers light to the wearer, such as treating the wearer's eyes based on a treatment protocol. The light emitting module 27 may include a light source that may include a light emitting body that emits polychromatic polarized light, a laser, a light emitting diode, a fluorescent lamp, a dichroic lamp, a full spectrum light source, and the like. In some embodiments herein, one light emitting module 27 may be provided for both eyes. In some other embodiments of the present disclosure, the display device may include a plurality of light emitting modules 27 , and each eye may have at least one light emitting module configured to direct light to the eye.

Although most of the hardware in the display system 62 shown in FIG. 5 is shown coupled directly to the display 106 and to the housing 108 adjacent the user's eye 20, the hardware components shown are It can be mounted or installed within other components, such as belt-mounted components, for example as disclosed in 3D. Moreover, as noted herein, a plurality of sensors and other functional modules are disclosed together for ease of illustration and description. However, it should be understood that some embodiments may include only one or a subset of these sensors and/or modules.

In one embodiment of the present disclosure, with the exception of the image pose processor 36 , the sensor pose processor 32 , and the rendering engine 34 , all components of the system 62 shown in FIG. 5 are the display housing 108 . Directly coupled to, communication between the three excluded above and the remaining components of the system may be by wireless communication such as ultra-wideband or wired communication. The illustrated housing 108 is preferably head mounted and wearable by a user. It may also feature a speaker (eg, speaker 66 , FIGS. 3A-3D ), such as may be inserted into the user's ear and used to provide sound to the user.

With respect to the projection of light 38 towards the user's eye 20 , in some embodiments, the camera 24 may be used to measure the location where the center of the user's eye 20 is geometrically oriented. , usually coincides with the location of the focal point or the "depth of focus" of the eye 20 . The three-dimensional surface of every point the eye is facing is called a "horopter". The focal length can take a finite number of depths or vary infinitely. The light projected from the gaze distance appears to be focused on the subject eye 20 , but the light before or after the gaze distance is blurred.

Further, without being bound by theory, it has been found that spatially coherent light having a beam diameter less than about 0.7 millimeters is precisely resolved by the human eye regardless of where the eye focuses; Based on this understanding, the eye's gaze can be tracked with a camera 24 to create the illusion of an appropriate depth of focus, and the rendering engine 34 and projection system 18 can render every object sharp, and every other Objects can be used to render short-sighted trajectories or close to them at varying degrees of defocusing (ie, using intentionally created blurs). Preferably, the system 62 presents to the user at a frame rate of about 60 frames per second or higher. As mentioned above, preferably camera 24 may be used for eye tracking and software may be configured to capture gaze alignment as well as focus position signals acting as user input. Preferably, such a display system is configured with brightness and contrast suitable for day and night use.

In some embodiments, the display system preferably has a time for visual object alignment of less than about 20 milliseconds, an angular alignment of less than about 0.1 degrees, and a resolution delay of the order of about 1 arc minute, which Regardless of the theory, it is roughly accepted as the limit of the human eye. The display system 62 may be integrated with a positioning system, which may include GPS components, optical tracking, compass, accelerometer, and/or other data sources to aid in positioning and attitude determination; Geolocation information may be used to facilitate accurate rendering in the user's field of view of the relevant external world (eg, such information may enable the glasses to easily know where they are in relation to the real world). Having described the general components of some embodiments of a user wearable health system, such as an ophthalmic system, additional components and/or features related to healthcare and diagnosis will be discussed below. Some of the features described below are common to various embodiments of a health system worn by a user or many embodiments of an AR system used for health purposes, while others are more or less common for medical diagnosis and treatment purposes. You need to understand that you need components.

In some embodiments, the user-worn health system is configured to display one or more virtual images based on accommodation of the user's eyes. Unlike conventional 3D display approaches that allow the user to focus on where an image is projected, in some embodiments, the user wearable health system may provide a projected virtual It is configured to automatically change the focus of the content. For example, when the user's eyes currently have a focus of 1 m, the image may be projected to match the focus of the user. Alternatively, when the user moves the focus to 3m, the image is projected to match the new focus. Thus, rather than forcing the user to have a certain focus, the user-worn health system or AR display system of some embodiments allows the user's eyes to function in a more natural way.

Such user-worn health systems may eliminate or reduce the incidence of eye strain, headaches, and other physiological symptoms typically monitored associated with virtual reality devices. To achieve this, various embodiments of a patient-worn health system are configured to project virtual images at various focal lengths via one or more variable focal length elements (VFEs). In one or more embodiments herein, 3D recognition may be achieved via a multi-plane focus system that projects an image at a fixed focal plane away from the user. Another embodiment uses a variable plane focus, wherein the focus plane moves back and forth in the z-direction to match the user's current focus state.

In both the multi-plane focus system and the variable-plane focus system, the patient-worn health system can use eye tracking to determine the gaze angle of the user's eye, determine the user's current focus, and project a virtual image into the determined focus. have. In another embodiment, the user wearable health system includes a light modulator that variably projects light rays of varying focus in a raster pattern across the retina via a fiber optic scanner or other light source. Thus, the ability of the health system's display to project images at various focal lengths not only facilitates the patient's accommodation of seeing objects in 3D, as will be detailed below, but also reduces the patient's ocular dissonance. It can be used to supplement. In some other embodiments, the spatial light modulator may project an image to the user via various optical components. For example, as further described below, the spatial light modulator may project an image onto one or more waveguides, which then transmit the image to a user.

Referring now to FIG. 6 , an exemplary process flow for projecting one or more virtual images based on a user's accommodation reflex will be briefly described. At block 602, the system may determine the gaze angle of the user's eye via the eye tracking system. At block 604, the system may estimate the current focus of the user's eye based on the determined gaze angle. It should be understood that other embodiments of the AR system (or health system) do not necessarily use eye tracking, and images may be displayed sequentially at a high rate to provide 3D perception. Accordingly, the process flow of FIG. 6 should not be viewed as limiting, but is provided for illustrative purposes only.

If the health system uses a multi-depth flat panel display system (ie, light is projected onto multiple fixed depth planes), the system makes an estimate based on the gaze and accommodation of the eye, at block 608 . It is possible to determine the focal plane closest to the focused focal point. It will be appreciated that accommodation may be measured, for example, by use of an autorefractor or other device compatible with the display system. At block 610, the health system may project at least a portion of the image at the determined focal plane.

If the health system uses a variable-depth planar display system (ie, one or more focal planes onto which virtual content is projected can move back and forth in the z direction), then at block 612 the focus of the system is , is changed to match the estimated focus. At block 614, the health system may project at least a portion of the image in the focal plane. Similarly, other embodiments of the health system may use other 3D image generation techniques to provide the user with a comfortable, accommodated, reflex-friendly projection of virtual objects.

In some embodiments herein, the image is displayed based on the projection of light associated with projecting a virtual image into the user's eye, although any wavelength of light may similarly be projected into the user's eye. In addition to visible light, infrared light or other forms of light can similarly be projected through the health system worn by the patient. This aspect of a patient-wearing health system can similarly be used to compensate for health disparities, as described below.

Although various embodiments have been described herein in which light is projected into the user's eye in one or more embodiments herein, it should be appreciated that the health system may also receive light emitted from the user's eye. In one or more embodiments, the light source for the health system is a fiber scanning device (FSD) that projects light in various patterns (eg, raster scan, spiral scan, lissajous scan, etc.) onto the user's eye. ) can be Similarly, other light sources (eg, OLED, DLP, LCD, etc.) may be similarly used in other embodiments of the health system. In addition to projecting light, the FSD may receive emitted light in one or more embodiments. The same optical fiber that projects the light can be used to receive the light. In this mode the health system can function as a multi-depth scanner that multiplexes the output and modulated light waves along with the detected or captured light waves. In some embodiments, a fiber optic scanner is used in conjunction with or in place of the camera 24 (FIG. 5), for example to track or image a user's eyes. In one or more embodiments, rather than the FSD being configured to receive light, the health system may have a separate light receiving mechanism to receive light emitted from the user's eye and to collect data related to the emitted light. can Thus, as described below, in one or more embodiments, this emitted light and corresponding data may be analyzed to diagnose or treat dissonance.

Various details of the optical fiber scanning display will now be discussed with reference to FIGS. 28A-28C. Referring to Figure 28A, a gradient refractive index or "GRIN" lens 354 is disclosed fused to the end of a single mode optical fiber. An actuator 350 (eg, a piezoelectric actuator) may be coupled to the optical fiber 352 and used to scan the optical fiber end.

Referring to FIG. 28B , multicore optical fiber 362 is scanned (piezoelectric actuator 368) to create a set of optical bundles having multiple angles of incidence and intersection points that can be relayed to eye 58 by waveguide 370 (piezoelectric actuator 368). as by) can be Thus, in one embodiment, a collimated wide-area image can be injected into the waveguide without any additional refocusing elements, and the wide-area display can be interpreted directly in the human eye.

Display systems that use eye or gaze tracking as input have been created in the past, and in order to save computational resources by only generating high-resolution renderings of where a person is looking at the time, low-resolution renderings meanwhile have been used for the rest of the retina. displayed in; The position of the low resolution portion versus the high resolution portion may be dynamically dependent on the tracked gaze position in a configuration that may be referred to as a "foveated display".

Improvements to this configuration may include scanning fiber optic displays with pattern spacing that can be dynamically subject to tracked eye gaze. For example, a typical scanning fiber optic display operating in a spiral pattern as shown in FIG. 28C (the leftmost portion 510 of the image in FIG. 28C shows the spiral motion pattern of the scanned multicore optical fiber 514); For comparison, the rightmost portion 512 of the image in FIG. 28C shows the helical motion pattern of a single optical fiber 516 scanned), with a constant pattern pitch providing uniform display resolution.

It will be appreciated that, in addition to displaying an image or acting as an imager, the display system may provide illumination for imaging the eye or surrounding tissue. In one or more embodiments, the instrument is capable of using known visible light, including visible imaging, photo-refraction, optical coherence tomography (OCT), and light field microscopy (LFM); To allow scanning of the anterior and medial portions of the eye using invisible light spectrum technology, the health system may include an optical scanning or light sensing module. In one or more embodiments, the ophthalmic system may further include a wide field imaging module for capturing multiple images of the eye simultaneously at different focal lengths. A display device such as an FSD can be conveniently configured so that multiple frequencies of light can be simultaneously emitted by the display device. For example, an FSD may include a single core optical fiber or may include multiple optical fibers, and may conveniently emit multiple frequencies simultaneously.

In the context of healthcare and diagnosis, the type, frequency, color scheme, placement, etc. of one or more images provided to a user may conveniently be manipulated for diagnosis and treatment of one or more disorders. For example, some diseases may require strengthening of one eye compared to the other. To this end, treatment protocols can be devised to "train" the weak eye, for example, by providing increased stimulation to the weak eye compared to the strong eye. Alternatively, in another embodiment, certain portions of the retina may have reduced sensitivity due to macular degeneration; To prevent this, the image may be modulated or reset and projected onto the periphery of the retina, thereby offsetting the user's reduced field of view. Accordingly, the ability of a health system to adjust a number of parameters related to virtual image projection, as described in more detail below, may be used to diagnose and/or treat certain health conditions.

Further, using the various principles outlined above, medical systems can be designed to provide diagnostics using stimulus-response-measure analysis procedures. Such a device may be used by a clinician, or in other embodiments, a particular disease may simply be "diagnosed" or symptoms acknowledged by the patient (eg, eye strain, dry eyes, high blood pressure, stroke or seizures). initiation, etc.). This can be decisively helpful for the user to actively manage himself when certain symptoms occur to prevent the onset of the disease and to actively control his/her health. Such a diagnosis may be made by analyzing one or more tracked biometric parameters and historical data related to ambient changes and data at the time of measurement. In one or more embodiments, the health system may also be configured to provide informational signals, alert users and/or physicians, or others, or assist other means of response.

A health system can be configured either automatically (i.e., providing results directly to a user or another person or entity without input or control from the clinician or other person) or semi-automatic (i.e., with some input or control from the clinician or other person). can In other embodiments, the health system may include, for example, a network-based or any remote-based (eg, cloud-based) implementation (eg, a software-based implementation of a health system for diagnosis, monitoring or treatment), or the health It may be performed in embodiments where the system is worn by a clinician to examine a patient.

As discussed with respect to FIG. 5 , the health system may be designed with a number of additional health-related sensors in one or more embodiments. The health system may include multiple sensors (e.g., accelerometer, gyroscope, temperature sensor, pressure sensor, light sensor, non-invasive blood glucose sensor, ETCO2, EEG and/or other biosensor, etc.) to monitor one or more physiological responses from the user. ) may be included.

As described herein, a health system includes an eye tracking module in one or more embodiments. the eye tracking module may be configured to determine the gaze angle of the user's eye to determine what normal accommodation is suitable for the projection of one or more virtual images (via a direct relationship between gaze angle and accommodation); It may also be configured to track one or more eye-related parameters (eg, eye position, eye movement, eye pattern, etc.). This data can be used for a number of health-related diagnostic and treatment applications, as described below.

As will be apparent from the description herein, the health system may be used for diagnosis, monitoring and treatment, which may include eye related diagnosis, monitoring and treatment. In this eye-related application field, the health system can be said to be an ophthalmic system. As will be clear from the description herein, a user (or wearer) of an appliance may be referred to as a patient for whom diagnosis, monitoring and treatment are performed by the appliance. In some other embodiments, the user may be a clinician and the patient may be assessed and treated by the third party, who may be assessed and treated by the user. It should also be understood that the diagnosis and monitoring may be generally referred to as health analysis.

<u>Myopia / Farsightedness / Astigmatism</u><u></u>

Having described the various components of an ophthalmic system in the context of healthcare diagnosis and treatment, embodiments using the ophthalmic system to complement common eye-related diseases will be described below. It should be understood that the following examples are for illustrative purposes only and should not be viewed in a limiting sense. For example, embodiments described herein may also be applied to other non-ophthalmic systems.

Vision disorders such as near-vision (eg, nearsightedness) and far-vision (eg, farsightedness), and astigmatism, are very common in the general population. Often these defects are corrected with corrective lenses. In one or more embodiments, the optics of the ophthalmic system may be modulated to naturally compensate for a user's visual imperfections. In one or more embodiments, the ophthalmic system automatically or interactively determines the user's optical prescription (eg, during or after the setup process), and provides optical sub-parts of the ophthalmic system. It may be configured to incorporate an optical prescription. The optical prescription may be determined at any time during initialization of the ophthalmic system, calibration of the system, part of an ophthalmic prescription configuration program (eg, a porter or other vision test described herein), or use of the ophthalmic system. The biometric data may be used to identify the user and associated optics. In various embodiments, the wavefront of the light projected to the user's eye may be modified based on the determined prescription. In other embodiments, alternatively or in combination, a wavefront of ambient light in front of the user, eg, light passing through the ophthalmic system and from the surrounding world surrounding the user in front of the user to the user's eye, to provide optical correction. is corrected Accordingly, the user's optical prescription and changes therein may be used for real-time changes to the range of light incident upon the user, and may be configured to correct one or more optical imperfections or aberrations. One non-limiting advantage of the embodiments described herein is that the optical system can be configured such that as the user's vision changes over time, for example 2, 3, 4, 6 or more times per year, the The system can be configured to actively correct vision defects without the need for replacement or replacement of components. Rather, the components may be electrically and dynamically reconfigured during use of the ophthalmic device in real time based on changes in the user's vision (eg, optical prescription).

For example, in the case of myopia, light associated with one or more objects is focused on the front surface of the retina as shown in 7A rather than above the retina. This causes the object to appear out of focus. Referring now to FIG. 7B , a concave lens can be used to compensate for obstruction, change the properties of the incident light, and focus the light onto the retina.

In one or more embodiments, once the user's optical prescription is determined, a desired power spherical wavefront curvature (eg, negative exponential spherical wavefront curvature) may be encoded into the ophthalmic optics to calibrate the user's optical prescription. can For example, the phrase "encode with optics" may refer to applying a voltage to an electrode of an adaptable optic (eg, in an embodiment using an adaptable optic), wherein the voltage to be applied to the electrode and the applied voltage is determined based on the desired compensation wavefront to correct the refractive error of the eye. Or, in embodiments of a waveguide stack, the phrase "encode with optics" selectively directs the waveguide to a depth of focus appropriate for a particular portion of the light to create a compensating wavefront to correct for refractive errors in the eye. It can refer to addressing. In some embodiments, the negative exponential spherical wavefront is encoded with the optics of the ophthalmic system to correct for a user's low-dimensional aberrations (eg, defocusing), such as for myopia correction. In an augmented reality display system, this correction may be applied to ambient light from the surrounding world, for example in front of the user, similar to a pair of glasses. Or, in some embodiments, in combination or alternatively, by modifying the image projected to the user's eye by the display of the ophthalmic system (eg, by the processor of the ophthalmic system) to an appropriate negative spherical wavefront. can Thus, the phase of the projected image can be modified so that the projected image appears to be in focus and is corrected based on the optical prescription.

In the case of hyperopia, light associated with one or more objects is focused behind the retina as shown in FIG. 8A rather than the retina. This causes the object to appear out of focus. Referring now to FIG. 8B , a convex lens may be used to compensate for obstruction.

In one or more embodiments herein, once the optics prescription is determined, a compensating spherical wavefront (eg, a positive exponential spherical wavefront) may be encoded into the optics of the ophthalmic system. In some embodiments, the positive exponential power spherical wavefront is encoded with the optics of the ophthalmic system to correct for a user's low-dimensional aberrations (eg, defocusing), such as to correct hyperopia. Such corrections may be applied, for example, in front of the user, to correct for ambient light originating from the outside world surrounding the user. Alternatively, as described above, the processor may apply a corrected wavefront to modify the image projected by the ophthalmic system based on the prescription determined such that the projected image is in focus and appears corrected based on the optical prescription. have. Again, a combination of both can be used in augmented reality systems.

Astigmatism is a condition in which light entering the eye is inappropriately or partially focused on the retina. As schematically shown in Figure 9A, the shape of the eye can be deformed (generally due to an irregularly shaped cornea), causing the resulting image to be out of focus and distorted. For example, the curvature along the ocular meridian may be different from the curvature along the vertical ocular meridian. Referring now to FIG. 9B , the ophthalmic device may correct astigmatism by applying an appropriate level of compensatory wavefront curvature correction, for example along an appropriate transverse axis of the ocular meridian.

In particular, in various embodiments, once an appropriate optical prescription is determined, an appropriate compensating wavefront correction may be encoded into the ophthalmic optics. A wavefront incident on the optics of an ophthalmic system (e.g. a 4D wavefront) is modified by the optics (e.g., the phase of the incident wavefront is corrected) to produce a compensating wavefront incident on the user's eye to correct an eye defect. ) can be In other words, the optics of the ophthalmic system (eg, the adaptive optics described below) may include, for example, a refractive error of the eye, eg the shape of the eye, such as the shape of the cornea and/or lens of the eye, the user's It may be configured to vary the focus and/or wavefront of light reaching the user's eye based on the length of the eye (eg, the transmission length to the retina of the eye's natural optics) or the like. In some embodiments herein, the compensating wavefront may modify the phase of the wavefront incident on the optics of the ophthalmic device.

In some embodiments herein, high-order aberrations may be difficult to compensate with spherical wavefront correction as described above. Thus, in some embodiments, multiple independently controllable lenses may be controlled by the ophthalmic system to form a composite lens capable of correcting high-order aberrations, as described below. In other embodiments, alternatively or in combination, the ophthalmic system may be configured to retrieve a known aberration pattern based on the user's prescription and apply the pattern to an image stored in the ophthalmic system to provide to the user's eye. have.

For example, the ophthalmic system may store one or more images that can be retrieved by the ophthalmic system. In some embodiments, the image may be preloaded or generated by the ophthalmic system. In some embodiments, the image may be a part of a moving picture (eg, video). In other embodiments, the image may be supplied from another source external to the ophthalmic system (eg, remote data store 72 ). In other embodiments, alternatively or in combination, the image may be obtained based on ambient light in front of the ophthalmic system as described herein. The image may be projected to the user by the ophthalmic system, and may be modified by software included in the ophthalmic system. The ophthalmic system may generate one or more 2D images to be presented to the user's eyes, and the system may be configured to modify these images prior to projecting the images based on the user's optical prescription. In some embodiments, different image content projected at different depths of focus provides the user with a 3D perception of the image, as described below for embodiments of an ophthalmic system comprising a waveguide stack. Thus, each image can be a 2D representation of an image at a different depth of focus. Each image can be individually modified by software included in the ophthalmic system. For example, the pattern or collection of pixels forming each image can be modified to counteract, cancel or reduce the effects of errors introduced by the eye.

For example, a defect in the retina of the user's eye can cause errors in the intensity, shape, magnification or color seen by the user. In various embodiments, the light wavelength or light intensity of the image projected by the ophthalmic system may be modified to correspond to color blindness in the user's eye. For example, the wavelength of light provided to the user may be changed based on a color blindness prescription to compensate for color blindness. In some embodiments, correction of a 2D image (which may be, for example, a 2D representation of an image at each different depth of focus ) may be used to correct blind spots or weak points in the eye. For example, by mapping the eye to determine blind spots/weak spots, the light intensity of the projected image can be increased in identified areas of the eye or retinas with blind spots or weak spots. Accordingly, in some embodiments, the modification of the image may be performed by modifying the intensity of one or more portions of the image to be presented. For example, a fiber scanning display or spatial light modulator included in an ophthalmic system may vary in intensity while generating an image.

Another example of modifying an image includes modifying the intensity pattern of the image. For example, if it is known that an image viewed by a user will exhibit radial distortions (eg, barrel, pincushion, or mustache distortions), compensating distortion is applied to correct for such distortions. It can be applied to video. The distortion to be corrected may be the result of refractive errors in the eye or by the optics of the ophthalmic system, and thus may be known by the optical prescription or ophthalmic system. Accordingly, the ophthalmic system may modify the intensity pattern of the projected image to compensate for the refractive error. For example, if the user's eye causes pincushion distortion in the image, the ophthalmic system reduces barrel distortion, the opposite of pincushion distortion, by an amount capable of removing or reducing the amount of pincushion distortion in the image focused on the retina. It may be configured to modify the intensity pattern of the image projected to the user via the display device including the. Similarly, the ophthalmic system may be configured to correct an image by adding a pincushion distortion to the intensity pattern that creates an image on the display if the user's eye causes barrel distortion. In some embodiments, the correction of the image may be performed to correct for fisheye distortion by changing the image provided by the display device by applying an opposite angle and positive distortion.

In various applications, a combination of wavefront correction and correction of an image generated by an ophthalmic system (eg, correction of an intensity pattern comprising the image) may be used to compensate for astigmatism or any other defect in the user's eye. .

In some embodiments, the ophthalmic system may be the patient worn ophthalmic device shown in FIGS. 3A-3D and 5 that may be implemented to correct visual defects such as myopia, farsightedness, and astigmatism. The ophthalmic device includes a display device (62) comprising a light source (18) configured to project light (38) directed from a display lens (106) of the display device (62) to the user's eye. The ophthalmic device may also direct ambient light from the surrounding world, eg, in front of the user, through the display lens 106 to the user's eyes. Display 62 also includes one or more adaptive optics (eg, variable focus elements or VFEs, electrically reconfigurable reflective or refractive optics, etc.). Such adaptive optics may be included in the display lens 106 or located between the display lens 106 and the light source 18 or between the display lens 106 and the eye or anywhere else in the light path to the eye. can do. Adaptive optics or VFEs are optical elements that can be dynamically changed, for example by applying an electrical signal to the element to change the shape of a wavefront incident thereon. The adaptable optics include reflective optics such as deformable mirrors, or dynamic lenses (eg, liquid crystal lenses, electro-active lenses, conventional refractive lenses with moving elements, machine-deformation-based lenses, electrowetting). a transmissive optical element such as an electrowetting lens, an elastomeric lens, or a plurality of fluids having different refractive indices. By changing the shape or other properties of the adaptive optics, the wavefront incident thereon can be altered, for example, by changing the focus of the wavefront as described herein to provide optical correction.

In various embodiments herein, the ophthalmic device includes an outward looking camera configured to capture ambient light from an environment surrounding the user. For example, the ophthalmic device may include one or more wide-field-of-view machine vision cameras 16 operatively coupled to a local processing module 70 . Such a camera may be configured to image the surroundings around the user. In one embodiment, these cameras 16 are dual capture visible/infrared light cameras. The image captured by the camera 16 may be stored in the digital memory of the ophthalmic device and retrieved for subsequent processing. Then, the image may be retrieved by the ophthalmic device, and the ophthalmic device may return an image obtained by projecting the image on the display device 62 to the user.

In various embodiments, the ophthalmic device may include a biofeedback system configured to determine a comfort level of a user viewing an object or image. For example, if the user's gaze changes, accommodation changes, pupil size changes, gaze angle changes, etc., this may be an indication that the user cannot comfortably view an object or image. In some embodiments, changes in accommodation or accommodation-related behavior may be indicated by instability, random fluctuations, imbalances, and/or oscillations in the accommodation or behavior of the eye. Imbalances or oscillations in accommodation or accommodation-related behavior can be a sign that the user is having trouble focusing or accommodating an object or image. Accordingly, the biofeedback system may receive real-time input regarding the condition or characteristics of the user's eye.

In various embodiments, the ophthalmic device includes one or more eye tracking cameras or other cameras or imaging systems to track one or more eyes of a user. For example, some embodiments may use a camera 24 (eg, an infrared camera) paired with a light source 26 (eg, an infrared light source) configured to monitor and track the user's eyes. These cameras and/or light sources may be operatively coupled to the local processing module 70 . Such a camera and/or imaging system may monitor the direction of the eye, the size of the pupil of the eye, the gaze angle of the eye, and the direction corresponding to the gaze of each eye. As will be discussed below with respect to phoropter technology, the camera 24 may be configured to determine accommodation of a user's eye. In some embodiments, the camera 24 may be configured to determine the point of convergence of the eye, as described above with reference to FIGS. 5 and 6 .

In some embodiments herein, the ophthalmic device includes a gyroscope sensor, accelerometer, other sensor, or a combination thereof to monitor changes in head position, head posture or orientation. In some embodiments, the display device 62 may include a sensor assembly 39 configured to detect movement and orientation imparted on the display device 62 due to movement of the user's head. The biofeedback system may be configured to receive the detected head movement, and if the frequency and/or magnitude of the movement exceeds a threshold, the system may be configured to determine that the user is not comfortable viewing the image. . For example, a constant head movement may indicate searching for a comfortable viewing position of an image. If there are signs of a person's difficulty concentrating, the ophthalmic system may be configured to warn the user, perform a phoropter test or other vision test, or objectively and automatically prescribe the user's prescription to improve vision. can be evaluated.

In some embodiments, the adaptive optics may be operatively coupled to the local processing module 70 and configured to compensate for the wearer's visual impairment as shown in FIG. 3C . The local processing module 70 may store one or more optical prescriptions of the user. Alternatively, in some embodiments, the local processing module 70 may store one or more image modification programs (eg, programs configured to modify images provided to the wearer) corresponding to one or more optical prescriptions. The local processing module 70 is configured to encode an appropriate compensating wavefront into the adaptive optics of the display device 62 and/or modify the image generated by the ophthalmic system based on the optical prescription and/or the image modification program. can be configured. For example, as will be described in more detail with reference to FIGS. 10A and 11 , the local processing module 70 may, based on an optical prescription, provide an image generated by the ophthalmic device and/or presented to the user's eye. A logic element configured to modify the VFE or adaptive optics may be implemented to generate a corrected wavefront of ambient light.

In some embodiments herein, an ophthalmic device may include one or more transmitters and receivers that allow transmission and reception of data between the ophthalmic device and a remote processing module 72 and/or remote data store 74 . have. In some embodiments, any of the processing steps executed by the local processing module 70 and digital memory therein are performed by the user by the remote processing module 72 operatively coupled to the remote data store 74 . It is possible to do this remotely.

In some embodiments, display 62 includes one or more VFEs or adaptive optics included in display lens 106 . For example, a VFE or adaptive optics may be included in the waveguide stack, as described with respect to FIG. 10E . For example, VFE or adaptive optics 316a, 316b may be placed between the surrounding world and the waveguide stack or between the user and the waveguide stack. Thus, the VFE or adaptive optics is a wavefront 38 of the projected light that produces the image generated by the display 62 of FIG. 5 and/or ambient light that surrounds the user, e.g., in front of the user. can be configured to modify In other embodiments herein, alternatively or in combination, the VFE or adaptive optics is a light source, eg, a plurality of displays 200 , 202 , 204 , 206 , 208 and the waveguide stack shown in FIG. 10E . can be placed between them. In this case, correction of the wavefront of the image generated by the ophthalmic system is possible without modifying the wavefront of ambient light passing through the user's eye.

The VFE or adaptive optics may be any optical element implemented to modify the wavefront of an image. In various embodiments, light 38 projected by the display is incident on one or more VFEs or adaptive optics, which may change the phase of the wavefront incident thereon. The modified wavefront may be propagated to a user who perceives an image based on the modified wavefront. In another embodiment, the VFE or adaptive optics modifies ambient light in front of the user to correct for vision defects experienced when viewing the outside world. As described below, FIGS. 10B-10D show exemplary configurations in which VFEs or adaptive optics are used in the ophthalmic systems disclosed herein to correct vision defects. However, it will be understood that other VFEs or adaptable optics may be used.

The VFE or adaptive optics may use transmission, refraction, diffraction or reflection techniques to achieve variable focus and thus wavefront modification. For example, VFEs or adaptive optics can be liquid crystal lenses, electro-active lenses, conventional refractive lenses with moving elements, mechanical-strain-based lenses (such as fluid-filled membrane lenses, or flexible elements). a lens similar to a human lens that is bent and relaxed by an actuator), an electrowetting lens, or a plurality of fluids having different refractive indices. The VFE or adaptable optics may include one or more lenses formed using flexible and deformable elastomers (eg, elastomeric lenses). Such an elastomeric lens may be configured to receive a voltage applied to an electrode disposed on a different axis of the lens, which may deform along the axis to modify the shape of the lens and change the optical power. . VFE or adaptive optics are also switchable diffractive optics (e.g., those featuring a polymer dispersed liquid crystal approach in which a host medium, such as a polymer material, has microdroplets of liquid crystal dispersed within the material; when a voltage is applied; , the molecules change direction so that their refractive index no longer matches that of the host medium, creating a high frequency switchable diffraction pattern). Other arrangements are possible, as will be described below with respect to Figures 10B-10E.

10B and 10C show exemplary embodiments of adaptive optics. For example, the adaptable optics may include a variable focal element (VFE) 1020 (eg, a deformable mirror film as described above, any mirror-based VFE, deformable lens, elastomeric lens, phase modulator, etc.) ) may be included. In some embodiments, the VFE 1020 may be integrated with or embedded in the display lens 106 . In some embodiments, for example, one or more adaptive optical elements or VFEs 1020 may be integrated with the stacked waveguide assembly and/or disposed on one or more sides.

10B shows an exemplary embodiment of modifying the shape of the VFE 1020 based on the shape of the cornea 1026 . To compensate for astigmatism or any other corneal defect, the phase and/or focus of the light displayed to the user may be modified based on the shape 1026 of the cornea. For example, if the displayed image includes ambient light e.g. originating from the environment in front of the user, the focus (e.g., depth of focus) of the light transmitted through the lens to the wearer is the same as when the user moves around and the light passes through the lens. It is modified in real time as it is transmitted to the wearer through In another embodiment, wherein the displayed image is an image generated by the ophthalmic system to be displayed by the ophthalmic system as the user moves, the modification of the phase and/or focus of the light may be determined by the user based on the shape of the cornea 1026 . This can be done per frame or per pixel as it moves around. For example, the wavefront correction may be applicable to each frame of the image and the wavefront may be corrected for each pixel of the display which may differ from frame to frame and/or may differ from pixel to pixel. In one or more embodiments, the ophthalmic system may determine a refractive error caused by the shape of the user's eye, eg, the user's cornea 1026 , and determine the shape of the VFE 1020 based on the shape of the cornea. Can be modified. For example, reference may be made to the description below in relation to aberrometry and retinoscopy techniques. Although the present embodiment refers to the shape of the cornea as the cause of the visual defect, other causes of refractive error can also be corrected.

Some VFEs, such as deformable membrane (eg, lens or mirror) VFEs 1020, are coupled to a set of selectively controlled electrodes 1022 to modify the shape of the membrane (eg, lens or mirror), resulting in By changing the phase, wavefront shape and possibly the focus of the light. As shown in FIG. 10B, the shape of the VFE 1020 complements the shape (or other refractive error) of the cornea 1026 so that the image can be properly viewed by the user's eye as shown in FIG. 10C. Electrode 1022 may be controlled. This technique of changing the shape of the VFE 1020 for every frame (or every pixel) can be used in different applications, such as other shapes causing other types of refractive anomalies, detailed below, in Figure 10C, which is an example of astigmatism. It should be appreciated that is only one example.

Referring to FIG. 10D , the VFE or adaptive optics may be included with the waveguide stack 178 and may be driven to compensate for the shape of the user's cornea or to handle any other refractive conditions of the user. The optics shown in FIG. 10D include stacked waveguide assemblies of transmissive beamsplitter substrates, each configured to project light at or originate from a different focal plane. For example, a first waveguide may be configured to modify a wavefront of incident light by a first optical power, while a second waveguide may modify a wavefront by a second optical power. The first and second optical powers may be spherical wavefront corrections, and may be positive or negative corrections. The first and second optical powers need not be in the same degree of correction or in the same curvature correction direction. The VFE or adaptive optics of FIGS. 10D and 10E may be integrated with the display lens 106 of FIG. 5 , projecting an image generated by the ophthalmic system and allowing ambient light to pass through the waveguide stack into the user's eye. It can be configured to allow

The stacked waveguide assembly 178 includes a plurality of waveguides 182 , 184 , 186 configured together to transmit image information to the eye having varying levels of wavefront curvature for each waveguide level indicative of a focal length to be sensed with respect to the waveguide level. , 188, 190) and a plurality of lenses 198, 196, 194, 192 can be used to provide a three-dimensional perception to the eye/brain. In some embodiments, the plurality of lenses 198 , 196 , 194 , 192 is a weak lens, but the lenses 198 , 196 , 194 , 192 are not limited thereto, and may provide the desired properties of the waveguide stack 178 . It can be any lens suitable for providing. A plurality of displays 200 , 202 , 204 , 206 , 208 , or in other embodiments a single multiplexed display or a reduced number of multiplexed displays, emits light, eg, collimated light with image information. It may be used for implantation into waveguides 182, 184, 186, 188, 190, each of which may be configured to be substantially evenly distributed across the length of each waveguide for the entrance hole to exit downward towards the eye.

In some embodiments herein, one or more of the plurality of lenses 198 , 196 , 194 and 192 is, as described above, an adaptive optic configured to provide prescription correction in accordance with embodiments described herein. can In this case, the lenses 198, 196, 194 and 192 may be dynamic, adaptable or switchable adaptive optics, the shape and/or characteristics of these lenses providing refractive correction based on the user's prescription. may be changed to For example, the lenses 198, 196, 194 and 192 may be switchable and adaptable optical elements, deformable lenses such as elastomeric lenses with electrodes as described herein, or those of FIGS. 10B and 10C. VFE and/or any transmissive lens described herein.

The waveguide 182 closest to the eye may be configured to transmit collimated light to the eye as it is injected into such waveguide 182 , which may be typical of an optically infinite focal plane. Different waveguides may be configured to present a focal plane closer to infinity in the diopter range, so that different image content from different waveguides appears to originate from different depths or distances in the user, thus reducing the size of the image generated by the ophthalmic system. It provides 3D perception to the user.

For example, the next waveguide 184 is configured to send collimated light that passes through the first lens 192 (eg, a weak lens such as a weak negative lens) before reaching the eye 58 ; Such a first lens 192 may be configured to produce a slight convex wavefront curvature such that the eye/brain then directs the light coming from the waveguide 184 to a first focal plane closer inwardly towards the person from optical infinity. interpreted as coming from Similarly, the third waveguide 186 passes its output light through both the first lens 192 and the second lens 194 before reaching the eye 58 ; The combined optical power of the first lens 192 and the second lens 194 may be configured to produce different increments of wavefront divergence, such that the eye/brain moves away from its third waveguide 186 . Interpret the coming light as coming from the second focal plane closer inward towards the person from optical infinity than the light coming from the next waveguide 184 .

The other waveguide layers 188 , 190 and lenses 196 , 198 are similarly configured so that the highest or furthest waveguide 190 in the stacked body passes its output through all lenses between that waveguide and the eye to the human body. to the total focus power representing the plane of focus closest to . To compensate for the stack of lenses 198 , 196 , 194 , 192 when viewing/interpreting light coming from the outside world 144 on the other side of the stacked waveguide assembly 178 , a compensating lens layer 180 . ) is placed at the top or front of the stack to compensate for the overall power of the lens stacks 198, 196, 194, 192 below it. This configuration provides as many perceived focal planes as there are possible waveguide/lens pairs. Both the reflective aspect of the waveguide and the focal aspect of the lens may be static (ie, not dynamic, not electro-active, or not electrically switchable). In alternative embodiments, they may be dynamic, for example using an electrically active or electrically driven change of characteristic, as described above. This dynamic configuration allows a small number of waveguides to be multiplexed in a time-sequential manner to create a larger number of effective focal planes. In addition, such a dynamic configuration may enable dynamic correction of refractive errors of the user's eye.

As shown at 1050, the eye 58 is a normal eye with a normal cornea. In this case, different waveguides interact with the eye/cornea providing an image at various focal planes. In the case of an abnormal cornea, as shown at 1060, the adaptive optics of each waveguide can be selectively processed to compensate for the irregular shape of the cornea. The adaptable optics of each waveguide may include reflective optical elements such as deformable thin-film mirrors or dynamic lenses (eg, liquid crystal lenses, electro-active lenses, conventional refractive lenses with moving elements, machine-strain-based lenses, partially or fully transmissive optical elements such as electrowetting lenses, elastomeric lenses, or a plurality of fluids having different refractive indices. For example, a lens of the first waveguide may be identified to receive wavefront light of an image from one of a plurality of displays. The lens of the identified waveguide can be selectively modified or processed to reflect or pass light while modifying the incident wavefront and creating a desired wavefront curvature indicative of the focal length to correct the irregular shape of the cornea. Thus, by selecting the configuration of the lens for each waveguide to produce an appropriate wavefront curvature for the user, thereby resulting in irregular shape of the cornea, length of the eye, irregular lens shape or refractive error of the eye, or a combination of all of the above; The focus and/or wavefront of the image may be carefully distorted/altered.

10E shows an exemplary embodiment of the arrangement of a VFE or adaptive optics. In some embodiments, the ophthalmic system may include both the stacked waveguide assembly 178 of FIG. 10D and one or more VFEs or adaptive optics 1020 of FIGS. 10B and 10C, as shown in FIG. 10E. . For example, the stacked waveguide assembly 178 may be embedded or integrated into the display lens 106 . In some embodiments, VFE or adaptive optics 1020 may also be embedded or integrated within display lens 106 . In one embodiment herein, the VFE or adaptive optics 1020 may be positioned between the stacked waveguide assembly 178 and the surrounding world (eg, the adaptive optics 316a). In other embodiments herein, VFE or adaptive optics 1020 may be positioned between stacked waveguide assembly 178 and a user (eg, adaptive optics 316b). In another embodiment herein, one or more VFEs or adaptive optics 1020 may be positioned between the stacked waveguide assembly 178 and the plurality of displays 200 , 202 , 204 , 206 , 208 . There may be a single VFE or adaptive optic 1020 between the stacked waveguide assembly 178 and all of the plurality of displays 200 , 202 , 204 , 206 and 208 . or multiple VFEs or adaptive optics 1020, such as VFE or adaptive optics 1020 for each display 200, 202, 204, 206 and 208 (eg, adaptive optical component 316d). There may be optics 1020 . The VFE 1020 or adaptive optics may be positioned between the light source 18 and the waveguide stack 178 , or may be integrated into the light source 18 . VFE or adaptive optics 1020 may be integrated into waveguide stack 178 . In other embodiments herein, a VFE or adaptive optics 1020 may be disposed between one or more of the plurality of waveguides 182 , 184 , 186 , 188 , 190 to provide field of view correction based on the optical prescription. It can be configured to be changed.

Accordingly, various embodiments of an ophthalmic system may include a light modulator configured to variably project a light beam of variable focal depth through a fiber optic scanner or other light source in a raster pattern across the retina. In this embodiment, the ophthalmic system may project images at various focal lengths to compensate for visual defects in a manner similar to the stacked waveguide assembly 178 . Similarly, the light source may be configured to provide refractive correction to correct for nearsightedness, farsightedness, or astigmatism based on the user's optical prescription. In various embodiments, the ophthalmic system includes one or more spatial light modulators configured to modulate the phase of the light and change the shape of the wavefront to provide an appropriate optical correction based on the user's prescription. Such a phase modulator may receive light from a light source mounted to the ophthalmic system. In some embodiments, the spatial light modulator is further included in the adaptive optics or VFEs described herein.

In some embodiments, the ophthalmic system may be an augmented reality system that uses AR and/or VR technologies to compensate for the shape of a user's cornea and/or correct vision defects. For example, the ophthalmic system may be an augmented reality head mounted display system configured to pass light from the outside world in front of a user of the augmented reality system to the eyes of a person wearing the ophthalmic system. In this embodiment, the ophthalmic system also corrects or modifies the wavefront of light passed from the outside world based on the optical prescription of the person wearing the ophthalmic system. Such an ophthalmic device may also be configured to provide wavefront correction to AR image content generated by the ophthalmic system and projected onto the user's eye. In this way, the ophthalmic system modifies the image content presented to the wearer to correct for nearsightedness, farsightedness, astigmatism, and the like.

In another embodiment, alternatively, the ophthalmic system is a VR head mounted display system that is opaque and blocks the transmission of ambient light formed in front of the user and the VR head mounted display. The VR head mounted display device may be configured to display only virtual image content to a wearer or a user. In some embodiments, where ambient light is formed in front of the user and blocked by the VR head mounted display system, however, the VR head mounted display system is equipped with an outward-looking camera that provides a view of the outside world in front of the user. for example, a wide field mechanical field of view camera 16 ). These cameras can capture ambient light in front of the user, play back images containing a view of the external world in front of the user on a display device, and project these images onto the user's eyes. Virtual image content may be modified by wavefront correction based on optical prescription in a manner similar to AR image content of augmented reality head-mounted display systems. As noted above, for example, as shown in FIG. 10E , one or more adaptive optics may be adjusted to provide appropriate refractive correction. Such an ophthalmic system may be configured to provide wavefront correction to virtual reality imaging content. While VR systems are opaque to ambient light, VR imaging content can be any imaging content stored in memory or generated by the ophthalmic system, including images of ambient light in front of the user acquired by an outward-facing camera. can do.

Referring now to FIG. 10A , an exemplary process flow for correcting vision defects such as myopia, farsightedness and astigmatism is briefly discussed. The process flow 1000 relates to modifying an image presented to a user based on the user's prescription. In some embodiments, the process flow 1000 may be performed by a patient-worn ophthalmic device as described with respect to FIGS. 3A-3D . The process flow 1000 may be implemented by a local processing module 70 configured to execute logic devices within the local processing module 70 . In another embodiment, the local processing module 70 processes flow 1000 through a remote processing module 72 executed by a logic device of the local processing module 70 operatively coupled to a remote data store 74 . can be implemented. Adaptive optics, such as electrically reconfigurable mirrors or lenses, such as positioned lenses as shown in Figures 10B-10E, can be used to provide refractive correction based on the user's optical prescription.

Referring now to the process flow 1000 , the ophthalmic system may determine the user's prescription ( 1002 ). In one or more embodiments, the user may simply provide information to the ophthalmic system. For example, a user may enter a prescription into the user interface. Or, in another embodiment, the ophthalmic system may manually and interactively determine the user's prescription via an ophthalmic prescription configurator program, as further described below. For example, an ophthalmic device can be pre-programmed with individual, granular steps when adjusting focus or altered wavefronts. The focusing may include focusing on a first ocular meridian and/or a second ocular meridian, and adjustments to one ocular meridian may be independent of adjustments to the other ocular meridian. A user may specify, via an appropriate feedback structure (eg, a user interface), a desired wavefront to the ophthalmic system that may define an optical prescription. Or, in another embodiment, the user may select the option to gradually increase or decrease the prescription (eg, change focus and/or wavefront) until a comfortable viewing prescription is reached. See, for example, the description below in relation to the phoropter technology.

In another embodiment, the ophthalmic system may automatically and progressively change the user's prescription in real time, based on tracking and monitoring the eye via an eye tracking system or other system described herein, without requiring user input. have. In some embodiments, the ophthalmic system may utilize a biofeedback system to automatically change the user's prescription. For example, if the user's gaze is moving, unstable, vibrating, accommodating, etc. that changes (eg, in an irregular or random manner), this may be an indication that the user is not comfortable viewing the object. Accordingly, the biofeedback system may receive real-time input regarding the state of the user's eyes. When a determination is made that the user cannot comfortably view virtual reality content, augmented reality content, or real content displayed via display device 62 from ambient light in front of the user, the ophthalmic system automatically initiates the vision correction program. (eg, a phoropter, automatic refraction device, or other vision test described herein) may be initiated.

In some embodiments, as described above, the biofeedback system may utilize an eye tracking system to provide real-time input related to the user's eyes. For example, the eye tracking system may monitor accommodation status, as described below in connection with phoropter technology. The eye tracking system may detect variations (eg, changes) in accommodating the eye by, for example, comparing multiple measurements. In some embodiments, the accommodation may be monitored by monitoring the shape of the lenses of one or more eyes, the focus of the eyes, the size of the pupils of one or more eyes, and the like. In some embodiments, monitoring accommodation status involves projecting a small image into the eye (eg, single point or multiple points) and using an inward-facing camera to see if the image is centered on the center of the retina or repositioned. This may include monitoring. For example, as described herein with respect to automatic flexor, phoropter and SLO technology. Fluctuations in accommodation can result in uncomfortable depth of focus or blurred images. Therefore, the ophthalmic system can increase or decrease the prescription until the fluctuation stops or decreases, thus reaching a comfortable vision prescription.

Similarly, the biofeedback system may receive input regarding a change in eye position or gaze direction, and/or a change in the user's head position. In some embodiments, if these inputs vary constantly within a determined threshold (eg, a determined period of change), the biofeedback system may be configured to determine that the user cannot legitimately view the object or image. . Thus, the ophthalmic system does not require user input indicative of the comfort level of viewing an image, for example by warning the user of the need for a new optical prescription, or by initiating a trial to renew the prescription, and in real time, the user's optics You can change your prescription.

In some embodiments, the ophthalmic system may be configured to receive an optical prescription from a third party. For example, a physician may send an optical prescription to a user wirelessly (eg, via the Internet, Bluetooth connection, etc.), which is received by the recipient and stored in the digital memory of the local processing module 70 .

At block 1004 , the system may search the mapping table to determine an appropriate image modification program (eg, a program with an appropriate parameter set) to modify one or more images to be presented to the user. In some embodiments, the mapping table may include associations of different optical prescriptions to different image modification programs. For example, for a given optical prescription of the user, a mapping table may enumerate image correction programs configured to compensate for visual defects defined by the optical prescription.

In one embodiment of the present application, the image modification program defines modifications to the incident wavefront to produce a compensating wavefront. In another embodiment herein, an image modification program defines modifications to a 2D image generated by the ophthalmic system and presented to a user's eye. In one or more embodiments, the ophthalmic system may be pre-coded with such a program, or such a program may be downloaded to perform image modulation based on a prescription. See, for example, the description below in relation to the phoropter technology. In some embodiments, the remote processing module 72 may be executed to retrieve or browse mappings stored in a remote data store 74 .

In some embodiments, each image modification program may include a set of parameters to be applied to the VFE or adaptive optics of the display 62 based on the desired wavefront correction. These parameters may be a set of signals (eg electrical signals) defining modifications to be applied to the shape and/or properties of the adaptive optics, thereby changing the wavefront. For example, for VFEs or adaptive optics, which may include one or more VFEs or adaptive optics (eg, as described above with respect to FIGS. 10B-10E ), the parameter is the wavefront provided to the user. Modifications can be defined for the shape of the VFE or adaptive optics to be similarly modified. In other embodiments where a VFE or adaptive optics is included in the waveguide stack (eg, as described above with respect to FIG. 10D ), the parameters vary the phase, focal length and wavefront of the incident light based on the optical prescription. It is possible to define changes to be applied to the adaptive optics integrated into the waveguide. In another embodiment of the present invention, if the ophthalmic device comprises a light modulator, such as a phase modulator, configured to variably project a light beam of variable phase and focus it possibly in a raster pattern, the parameters may define the phase and/or focus of the raster pattern. By modulating the phase, the wavefront projected by the light beam can be controlled to correct for visual defects.

In another embodiment herein, each image modification program may include a set of parameters to be applied to an image generated by the ophthalmic system based on a desired modification to the image. For example, as described above, the ophthalmic system can correct eye defects by correcting color, magnification, shape, intensity, and/or distortion. In some applications, an image modification program may include a wavefront (eg, phase) and parameters that combine to modify the image.

The set of parameters and corresponding signals of the image modification program may be based on the optical prescription. For example, in the case of myopia, the image modification program is a set of parameters configured to optically encode a negative exponential spherical wavefront curvature into an ophthalmic system (eg, VFE or adaptive optics of display 62 ). can have In the case of hyperopia, the image modification program may have a set of parameters configured to encode a positive exponential spherical wavefront curvature into the optics of the ophthalmic system. In the case of astigmatism, the image modification program may have a set of parameters configured to define different depths of focus for the optics of the ophthalmic system based on the shape of the user's cornea. For example, the eyes of a user suffering from astigmatism may include different optical powers along the ocular meridian or other axis of the cornea of the eye. Thus, the image modification program may include a set of parameters that define different focal lengths, depth planes, optical magnifications, or other optical corrections based on the optical prescription and shape of the eye.

In some embodiments, encoding the corrected wavefront comprises modifying the wavefront of ambient light transmitted to the user from the surrounding world, eg, in front of the user and the ophthalmic system. Similarly, encoding the corrected wavefront may include modifying the image generated by the ophthalmic device and projected to the user by the display device into the wavefront. For example, an electrical signal may be applied to an electrode coupled to the adaptive optics that changes the shape or optical properties of the adaptive optics. This in turn can alter any wavefront incident on the adaptive optics. In some embodiments, the wavefront of ambient light and any projected image may be modified by either a single VFE or adaptive optics, or independently by another VFE or adaptive optics.

At block 1006, an appropriate program may be selected. In one or more embodiments, the mapping table may use one-to-one association, many-to-one association, or many-to-many association. For example, a mapping table provides parameters defining changes to be applied to the VFE or adaptive optics for modifying the wavefront, corresponding to one or more image modification programs (e.g., adaptive optics). program) with one or more optical prescriptions. For example, if a user suffers from one or more vision defects, one optical prescription may correspond to multiple image correction programs, and vice versa. Accordingly, in some embodiments, the ophthalmic system may utilize the local processing module 70 in communication with the remote processing module 72 to select the appropriate program based on the optical prescription originating from the remote data store 74 . In other embodiments, any aspect or block 1006 of process flow 1000 may be performed locally on local processing module 70 .

At block 1008, an appropriate image modification program may be applied to one or more images to be projected onto the user's eyes. In some embodiments, digital memory or remote data storage 74 may be configured to store image content (eg, AR and/or VR image content). A local processing module 70, independently or in communication with the remote processing module 72, may be configured to execute instructions based on parameters of an appropriate program to fetch this image content and modify the image projected to the user. In some embodiments, the local processing module 70 may execute instructions based on the parameters and corresponding signal sets to modify the ambient light. In other embodiments, the remote processing module 72 may execute instructions based on parameters of the appropriate program to change the ambient light delivered to the user.

The appropriate image modification program may be applied to correct the wavefront of the image. In some embodiments, wavefront compensation is performed by adjusting the shape of the adaptive optics. In some embodiments, the compensation may be implemented by changing the properties of the adaptive optics integrated with the waveguide stack, thereby changing the depth of focus, phase and/or wavefront of the incident light. In other embodiments, an appropriate image modification program may be applied to alter one or more 2D images provided by the ophthalmic display. For example, if each 2D image is a representation of the image at a different depth of focus, a 3D perception of the combined image may be provided to the user. In various embodiments, local processing module 70 may be implemented to encode the VFE or adaptive optics of display 62 to modify a wavefront based on an optical prescription according to process flow 1000 .

At block 1010, the modified image is projected to the user so that the user can comfortably view the image. For example, the ophthalmic system may project light 38 to the user to form an image in the user's eye. The image may be an image modified based on a wavefront correction applied to the image not modified by the VFE or the adaptive optics of the display device 62 . In other embodiments, alternatively or in combination, each 2D image generated by the ophthalmic system (eg, of a different depth of focus providing recognition of a 3D image) is executed in a local processing module 70 . It can be modified based on software and displayed through the display device 62 . In some embodiments of an augmented reality head mounted display system, while imaging the head mounted display and an object positioned in front of the user, wavefront correction may be applied to the image to be presented to the wearer. For example, AR imaging content provided by an ophthalmic system may be modified and projected in combination with ambient light. In some embodiments, ambient light passing from the outside world through lens 106 may be modified by an appropriate program to provide optical correction for the wearer viewing the outside world through lens 106 . In another embodiment, in the case of a VR head mounted display system that is opaque to the outside world in front of the user, the modified image is a visual representation, e.g., to an ophthalmic system and display in which VR image content is displayed. It may be a modification of the VR image provided by

Accordingly, the process flow 1000 may be implemented as a dynamic vision correction system. For example, the adaptive optics may be driven by electrical signals that change the shape and/or properties of the adaptive optics, thus changing the optical power of the adaptive optics. The altered properties of the adaptive optics may alter the shape of a wavefront incident on the adaptive optics to produce a corrected wavefront. This wavefront correction by the ophthalmic system can be changed in real time as the user's optical prescription changes over time. For example, vision correction may be adjusted in time intervals (eg, daily or at least twice a year, three times a year, or four times a year, possibly monthly, etc.). The interval may be predetermined and may be based on an expected rate or occurrence of a visual defect, deterioration or change. For example, the user's perspective may change as the user ages.

At block 1010 of some embodiments herein, the ophthalmic system may implement dynamic vision correction by initiating an eye-prescribing configuration program. At block 1010 , the ophthalmic system may be implemented to return to block 1002 , in some embodiments determining the user's prescription manually and interactively at each interval without user activation. Thus, the ophthalmic system may initially dynamically identify the first optical prescription, adjust the vision correction based on the prescription, identify the second optical prescription at a second time, and identify the vision based on the second prescription. Calibration can be adjusted. In another embodiment, at any point during use of the ophthalmic system, the biofeedback system may monitor movement and changes of the user's eye (eg, via camera 24 ) as described above. . If the eye is constantly moving or the properties of the eye are constantly changing, the biofeedback system may determine that the user is struggling to focus or accommodate. Accordingly, the ophthalmic system may initiate an ophthalmic prescription configuration program to determine a new optical prescription and/or adjust an image modification program.

The techniques shown in Figures 10A-10E are examples of techniques for modifying the optics of an ophthalmic system or software algorithm to correct certain ocular defects. It should be understood that any healthcare deficiencies described in greater detail below may use one or a combination of either optics or programming techniques to correct one or more irregularities.

<u>presbyopia</u>

In one or more embodiments, the ophthalmic system may be used to compensate for presbyopia. Presbyopia is a decrease in the accommodative amplitude of the lens of the eye and is generally associated with aging. For nearby objects, the lens of the eye changes shape and accommodates the light received by the eye to focus on the retina to form an image on it. With age, the lens of the eye changes shape and its ability to accommodate near vision decreases. Often presbyopia is caused by segmented lenses (e.g. bifocal lenses, trifocal lenses, etc.) or lenses with a continuous focal length gradient (e.g. progressive lenses), or multiple lenses that can mechanically deform variable focus or include liquid crystal lenses. The focus is treated using a corrective lens system.

In one or more embodiments herein, the ophthalmic system may be configured to assist with presbyopia. In various embodiments, the ophthalmic device may function as a solid state variable focus lens with an adjustable focus (eg, adaptive optics or variable focus element (VFE)). As noted above, for example, in the correction of myopia, hyperopia or astigmatism, the ophthalmic system may be equipped with one or more adaptive optics or VFEs. The adaptive optics can be changed dynamically, for example by applying an electrical signal to change the shape of the wavefront incident thereon. By changing the shape or other characteristic of the adaptive optics, the wavefront is altered, for example, to focus a wavefront on the retina for near-viewing for the purpose of providing presbyopia correction as described herein.

As previously described and shown in FIG. 5 , the ophthalmic device may include an augmented (or virtual) reality display 62 comprising a display lens 106 and a light source 38 , the light source comprising: and project light directed to the user's eye to form an image in the user's eye for viewing by the user. In various embodiments, the display includes a waveguide stack that receives light from a fiber optic scanning display disposed at an edge of the waveguide and couples the light from the back of the waveguide to the eye of the wearer. When the display device is an augmented reality display device, the ophthalmic device may direct ambient light from the surrounding world, for example light from the front of the user, through the display lens 106 to the user's eye. can This light may be transmitted to the wearer's eye, for example, through a waveguide stack. As noted above, the display device 62 may also include one or more adaptive optics or variable focus elements (VFEs). As noted above, the adaptive optics may be optical elements that can be dynamically changed to change the wavefront incident thereon. For example, the adaptable optics may be a reflective optical element, such as a deformable mirror, or a transmissive optical element, such as a dynamic lens as described in FIGS. 10B-10E.

In some embodiments herein, the user may manually adjust the focus of the variable focus lens by making input into the system. For example, in one or more embodiments, the ophthalmic device may have a feedback scheme (eg, user interface control) that increases or decreases the power of the optics or focus of the image presented to the user. The user input may cause one or more adaptive optics to change the focus of the wavefront such that the relevant light and image are focused on the retina by changing the shape.

In one or more embodiments, the ophthalmic system automatically (eg, based on a biofeedback system as described below) or interactively determines the user's optical prescription (eg, a refractor as described below) (by using phoropter technology), it is possible to integrate the optical prescription into an optical sub-component of the optical system. In some embodiments, the wavefront of the image projected to the user's eye may be modified based on the determined prescription. For example, a wavefront of ambient light in front of the user may be incident on the adaptive optics of the ophthalmic system and corrected on prescription. In another embodiment, alternatively or in combination, the wavefront of the image generated by the display of the ophthalmic system and presented to the user by the display of the system may be corrected based on the prescription. For example, the wavefront phase and/or focus of the projected image may be modified as the projected image is focused and corrected based on an optical prescription.

In some embodiments, an ophthalmic system configured to correct presbyopia may be similar to the ophthalmic system described above for correcting myopia, farsightedness and/or astigmatism. In some embodiments, the ophthalmic system may be configured to correct presbyopia with myopia, hyperopia, and/or astigmatism.

In some embodiments herein, the ophthalmic system may be an augmented reality system that combines AR and VR technologies to correct presbyopia. As described above, the ophthalmic system is configured to provide wavefront correction to the AR image content generated by the optical system, as well as provide wavefront correction to ambient light originating from the front external world of the user. It may be a head mounted display system. Alternatively, the ophthalmic system is provided to the user and generated by the ophthalmic system with a corrected wavefront while the user's eyes are covered with ambient light in front of the user by the VR head mounted display system. It may be a VR head mounted display system, configured to create VR video content. As previously described, a VR head-mounted display system is an outward-facing viewing system configured to capture ambient light originating from the outside world in front of the user and create and project a calibrated wavefront of these images into the wearer's eye. It may include a camera.

For example, the ophthalmic system may be the patient-worn ophthalmic device shown in FIGS. 3A-3D and 5 , which may be implemented to compensate for presbyopia. The ophthalmic device comprises a display device (62) comprising a light source configured to project light (38) directed from a display lens (106) to a user's eye and displayed by a rendering engine (34) of the display device (62). includes The ophthalmic device may also direct ambient light to the user's eyes from the surrounding world through an indicator lens 106 , eg, light originating in front of the user. The display 62 also includes one or more VFEs or adaptive optics. As noted above, the VFE or adaptive optics may include optical elements that may be dynamically changed to alter the wavefront incident thereon. For example, the adaptable optics may be a reflective optical element, such as a deformable mirror, or a transmissive optical element, such as a dynamic lens, as described above in 10B-10D. As discussed above in FIG. 10E , the VFE or adaptive optics may be included in the display lens 106 or positioned between the display lens 106 and the light source. The VFE or adaptive optics may be integrated into the waveguide stack or light source 18 . A VFE or adaptive optics may also be positioned between the ophthalmic device and the user's front exterior world and the waveguide stack. The VFE or adaptive optics may be positioned between the waveguide stack and the user's eye. In other embodiments, the adaptive optics may be positioned between the waveguides of the waveguide stack.

In some embodiments, the VFE or adaptive optics may be altered to modify the phase and/or focus of the incident wavefront.

In some embodiments, alternatively or in combination, the adaptive optics comprise a spatial light module configuration that modifies the phase on a pixel-by-pixel basis. Therefore, an optical correction can be imparted on the wavefront. Accordingly, in various embodiments, the ophthalmic device may be configured to drive a light modulator to compensate for presbyopia.

In various embodiments, the ophthalmic device includes one or more eye tracking cameras or other cameras or imaging systems for eye tracking. Such a camera and/or imaging system may monitor the direction of the eyes and the direction corresponding to the gaze of each eye. These cameras and imaging systems may also be part of a biofeedback system, configured to monitor the comfort of a user viewing the image and provide feedback for monitoring or modifying the optical prescription.

In one or more embodiments, the ophthalmic system may include one or more sensors configured to detect a gaze direction of a user. The sensor may be part of a biofeedback system. For example, when the wearer's eyes are tilted forward and downward, the wearer sees a closer object, such as a book, or a perspective corresponding to an image placed at a location typically associated with a nearby object (lower portion of the field of view). video content can be viewed. The gaze may also be determined based on the gaze angle of the eyes (see, for example, the description above with respect to FIG. 6 ), for example, how the gaze of a pair of eyes converges to a position and How dusty is that location relative to the wearer. Thus, by monitoring the gaze angle, the distance at which the viewer intends to see the object can be determined.

In other embodiments, one or more sensors may be configured to detect head position. In one embodiment, the distance at which the viewer intends to see the object may be estimated or detected based on the user's head position (eg, head posture or orientation), eg, forward tilt. For example, when the wearer's head is tilted forward and downward, the wearer sees a closer object, such as a book, or responds to an image placed at a location (lower part of the field of view) typically associated with the nearby object. You can see the projected video content.

In some embodiments, the ophthalmic device of FIGS. 3A-3D detects the user's head position (eg, head posture or head direction) or head movement (eg, straight, slanted, looking-up line, etc.) and a gyroscope sensor configured to determine. In some embodiments, the display device 62 may include a sensor assembly 39 having an accelerometer, a gyroscope, and/or other types of orientation and/or movement sensors, some of which are described elsewhere herein. is discussed The sensor assembly 39 may be configured to detect movement and direction imparted on the display device 62 due to movement of the user's head. The display device 62 is also operatively coupled to the sensor assembly 39 and is digitally and/or digitally and/or to derive head position, head posture and/or head orientation from motion detected by the sensor assembly 39 . It may include a processor 32 (eg, a head posture processor) configured to perform analog processing. In one embodiment, the sensor assembly 39 may generate motion data stored in a digital memory. In some embodiments, the motion data may be used to reduce noise while diagnosing a visual defect (eg, detecting head motion during an exam may indicate a defective exam and result). Processor 32 may retrieve this movement data and execute processing logic to determine head position (eg, head pose or orientation).

In one or more embodiments, gaze direction may also be based on tracking of eye movement via an eye tracking system. In one embodiment, the prescription may be associated with a set of user eye convergence points representing depth of focus of the eye. For example, the user's head position may not change, but the user's eyes may be tracked to a point of convergence below the horizon. This shift may represent an eye focusing on an object located at a near depth of focus. Also, as discussed above, the eye's gaze angle can help determine the distance at which a viewer focuses (eg, focuses) on a direction. The distance can be confirmed from the convergence of the line of sight of the eye. Thus, in various embodiments, the user's eyes may be tracked to a convergence point at a particular distance from the wearer.

Likewise, in various embodiments, the ophthalmic system may be configured to determine a depth of focus at which the eye is focused or accommodated. In some embodiments herein, the eye tracking system may be used to triangulate the user's point of convergence and adjust the focus of the image to be presented to the user accordingly. For example, the eye tracking system may determine a direction in which each eye looks (eg, a line extending from each eye) and determine a convergence angle at which the directions intersect. The convergence point may be determined from the determined convergence angle. In some embodiments, the eye tracking system may be included as part of a biofeedback device. As noted above, in various embodiments, the ophthalmic system may utilize a camera 24 (eg, an infrared light source and an infrared camera) paired with a light source 26 to track the position of each eye. , which may be operatively coupled with the local processing module 70 . The local processing module 70 may comprise software, which, when executed, may be configured to determine the convergence point of the eye with reference to FIG. 6 and/or the direction of the eye as described above. From this determination, the ophthalmic system may also execute a logic device to determine the focal position or depth based on the user's gaze orientation or direction.

In another embodiment of the present disclosure, the gaze direction may be determined through twinkle detection. The eye tracking system is configured to identify one or more sparkles or reflections from the eye, and determine a location of the one or more sparkles on the eye relative to a feature of the eye (eg, pupil, cornea, etc.). As the eye moves, the relative position of the twinkle on the eye can change. For example, if a text flash is placed on the top of the eye and the space between the twinkle and the pupil is increased, it may indicate that the gaze direction is tilted downward, and the eye may be accommodated to a near depth of focus.

In some embodiments herein, an ophthalmic device may include one or more transmitters and receivers that allow transmission and reception of data between the ophthalmic device and a remote processing module 72 and/or remote data store 74 . have. In some embodiments, any of the processing steps executed by the local processing module 70 and digital memory therein are performed from the user by the remote processing module 72 operatively coupled to the remote data store 74 . It can be done remotely.

In one embodiment, the ophthalmic system is operatively coupled with a processor 32 , a head posture processor 36 , a camera 24 , a light source 18 , a local processing module 70 and a remote processing module 72 . A rendering engine 34 may be included. The rendering engine 34 renders an image to be projected to the user via projected light 38 having a modified, curved, or focused wavefront at a selected depth of focus based on an optical prescription and/or gaze direction. may be configured to render.

Referring to FIG. 11 , an exemplary process flow of such a system is briefly described. The process flow 1100 is directed to modify the image presented to the user based on the user's prescription. In some embodiments, process flow 1100 may be performed by a patient-worn ophthalmic device, such as described in connection with FIGS. 3A-3D . In various embodiments herein, the VFE or adaptive optics described in FIGS. 10B-10E may be used to provide presbyopia correction based on the user's optical prescription. The process flow 1100 may, in one possible example, be executed by a remote processing module 72 executed by a logic element in a local processing module 70 operatively coupled to a remote date store 74, the local processing module ( 70) can be implemented. In other embodiments, process flow 1100 may be implemented by processor 32 , head posture processor 36 , and/or sensor assembly 39 . Other implementations are possible. Any combination of local and/or remote processing may be employed.

At block 1102 , a presbyopia prescription for the user is determined. As discussed above in reference block 1002 of FIG. 10A, the prescription may be determined by receiving information from the user, or by the ophthalmic system itself by adjusting the wavefront provided to the user, where the user may select the desired prescription. choose For example, the ophthalmic system may be configured to test optical prescriptions for different focal planes to be accommodated. In some embodiments, the ophthalmic system may be pre-programmed in discrete, subdivided steps in changing the wavefront of the image presented to the user via the display 62 for a plurality of depths of focus. For example, the ophthalmic system may use phoropter technology, as described herein. In some embodiments, the wavefront incident on a given waveguide of the waveguide stack 178 (eg, associated with a selected depth of focus) may be altered to correct for refractive errors to define an optical prescription. The prescription may be entered by the user through a user interface and stored in the remote data store 74 . The prescription may be invoked by one or more processors of the ophthalmic system, eg, remote processing module 72 .

In another embodiment of the present application, the ophthalmic system may automatically and possibly incrementally change the user's prescription via a biofeedback system. The biofeedback system may be configured to determine a comfort level of a user viewing an object or image. For example, as described above in connection with Figure 10A, if the user's eyes are unstable, move, vibrate, change accommodation (eg, in an irregular or random manner), etc., they It can be a sign that you cannot comfortably see an object. Accordingly, the accommodation, gaze angle, pupil size, etc. may be monitored and/or an autorefractor may be used to see if the image is focused in the fovea of the retina.

In some embodiments herein, the ophthalmic system may be configured to receive an optical prescription (eg, added optical power) for presbyopia from a third party. For example, the doctor may send an optical prescription to the user wirelessly (eg, Internet, Bluetooth connection, etc.), which is received by the receiver or transceiver and stored in the digital memory of the local processing module 70 .

At block 1104 , the system may store information regarding the compensating wavefront and/or lens type. The wavefront and/or lens type may be based on the user's optical prescription for various depths of focus of accommodation (eg, may also include other depths of focus for different parts of the eye). In some embodiments herein, the information may be an input parameter that changes the depth of focus, changes the shape, or changes the characteristics of the VFE or adaptive optics to provide refractive correction to the eye. In some embodiments, other lens types may refer to modified or altered VFEs or adaptive optics as defined by input parameters.

In some embodiments herein, each calibration function includes a set of input parameters that define adjustments to the shape and/or characteristics of the adaptive optics to achieve a desired wavefront correction. The input parameters may be similar to those of the image modification program of block 1004 of FIG. 10A, but based on an optical prescription for correcting the user's presbyopia when the wearer is focusing on near depth of focus. For example, if the adaptive optics is the VFE 1020 of FIG. 10B, the input parameter would modify the VFE 1020 to compensate for presbyopia based on the prescription when the wearer is focusing on the near depth of focus. A plurality of voltages to be applied to the electrode 1022 may be defined. In the case of the stacked waveguide assembly 178, the phase, focal length and wavefront of the incident light based on the optical prescription when viewing an image presented at a near object and/or near depth plane, as described above with reference to FIG. 10D, is determined. To change, the input parameter may define a change to be applied to the VFE or adaptive optics integrated into the waveguide. In some embodiments, each waveguide may be associated with a given depth of focus, such that the waveguide may be selectively processed to correct the wavefront for accommodation of a given depth of focus.

In an embodiment of the present application, the local processing module 70 may execute an instruction to retrieve a prescription from the digital memory, determine an input parameter for a VEF or an adaptive optics device, and store the input parameter in the digital memory. A remote processing module 72 and remote data store 74 may also be used in some embodiments.

Without referring to any scientific theory, the user's eye will experience different refractive errors and/or the need for optical correction based on the depth of focus to which the eye is accommodated. Thus, in one or more embodiments according to the present disclosure, the system of the present disclosure may include a plurality of different depth-of-focus planes (eg 2 or more, 3 or more, 4 or more, 5 or more, 6 or more, or more depth planes) can produce distance maps of the eye and corresponding correction functions to compensate for refractive errors associated with adjustments at various depths of focus. For example, the ophthalmic system may determine whether at least one eye of a user has a positive spherical wavefront while adjusting for one depth of focus, and the area of the user's eye may be adjusted to a negative spherical wavefront (or different amounts of a negative spherical wavefront for different depths of focus). prescription correction). Thus, different points of convergence and their control depths of focus are also associated with different prescription corrections.

In one embodiment herein, such information may further relate to a set of head positions (eg, head posture, orientation) and/or gaze direction. For example, if the user's head is tilted downward, the eye can adjust to a certain (eg closer) depth of focus. Alternatively, if the user's head is tilted to the right, the eyes may be adjusted for different depths of focus. Thus, in various embodiments, a presbyopia specific program may be programmed (or downloaded) into the ophthalmic system so that the correct head position (eg, head posture, orientation) and/or gaze direction and optics experienced by the eye This allows the depth of focus at which the defect appears to be accurately matched. Different gaze orientations and head orientations correlate with different prescription corrections for different depths of focus associated with accommodation. The ophthalmic system may thus be configured to provide different and different corrections to the measured gaze direction and/or head position, head posture or orientation.

At block 1106 , the system herein may detect the user's gaze and/or head position, head posture, or orientation via a gyroscope, accelerometer, IMU, other sensors, or a combination thereof. As noted above, the direction of gaze (including, for example, the convergence point of the eyes) and/or head position, head posture or orientation may indicate whether the wearer is looking close or far, and thus whether the wearer needs accommodation. can indicate Thus, different correction functions can be used for different, focal depths of accommodation.

In some embodiments, as described above, a user's head position, head posture, or orientation may be measured using a gyroscope, accelerometer, IMU, other sensors, or a combination thereof. For example, as described above, an ophthalmic device according to the present disclosure may include a head posture process 36 , a sensor assembly 39 , and a processor 32 that may be configured to detect movement, tilting and orientation of a user's head. ) is included. In some embodiments, a sensor may be operatively coupled to the local processing module 70 to enable a logic device to retrieve the detected head movement and/or determine a head position, head posture or orientation. . A downward movement of the user's head may indicate focusing on a nearby object.

In some embodiments, as noted above, the gaze direction may be based on tracking eye movement. For example, downward movement of one or both eyes of the user (eg, movement of the gaze from a horizontal direction to a horizontally downwardly positioned book) may indicate focus on a nearby object. Accordingly, if the eye tracking system determines that the user's eyes are facing downward, an appropriate corrective function may be determined based on the presbyopia prescription. In another embodiment, the eye tracking system may be configured to determine whether the angle of convergence is increasing (eg, the point of convergence is getting closer to the user). Such a decision may indicate focusing on an object at a nearby point. With this determination, the ophthalmic system can determine whether the convergence point is below horizontal, indicating that it also focuses on the near depth of focus. Thus, the ophthalmic system can determine the accommodative depth of focus.

In some embodiments, the system herein may use a camera 24 to track the position of each eye, which may be operatively coupled to a local processing module 70 . In other embodiments, the system herein may use a camera 24 to perform twinkle detection and monitoring, for example, the camera 24 may be configured according to an eye feature (eg, the edge of the eye, the eyelid of the eye). , pupil, etc.) can track the location of the twinkle. The local processing module 70 may include software and, when executed, may be configured to track eye movement, movement of the twinkle, and/or may be configured to determine a point of convergence of the eye. In some embodiments, the gaze direction may be stored in the remote data store 74 .

For example, in some embodiments, distance processing module 72 may be configured to associate gaze direction, angle of convergence, and/or head position information with an optical prescription, both of which are remote data store 74 . can be stored in

At block 1108 herein, based on the detected gaze direction and/or head position information, the system consults a mapping table (eg, information stored in block 1104 ) to determine and adapt an appropriate corrective function. Applied to possible optics to produce compensatory wavefronts and/or lens types. Based on, for example, gaze direction or orientation and/or head position information (eg, head posture, orientation), the system herein may determine the depth of focus in which the eyes are accommodated. In various embodiments, an optical prescription may be associated with one or more depths of focus associated with accommodation. For example, different convergence points and thus different depths of focus for different degrees of accommodation may be associated with different optical prescriptions and corrective functions.

At block 1108 of various embodiments herein, the system may retrieve the detected accommodating depth of focus and reference the mapping stored at block 1104 . Based on the mapping, the system herein can determine an appropriate corrective function for this identified depth of focus. Appropriate calibration functions include parameters for adapting optics or VFEs to the production of appropriate compensating wavefronts. For example, this compensation can be defined as a selected calibration function parameter.

In some embodiments herein, the local processing module 70 may retrieve the detected gaze direction stored in the digital memory at block 1106 . Alternatively, the local processing module 70 may retrieve the detected gaze direction directly from the eye tracking system, the sensor assembly 39 , and/or the head posture processor 36 . The local processing memory 70 executes the logic device to access the mapping table stored in block 1106, based on the gaze direction, convergence angle and/or head position (eg head posture, stereotactic) information, correspondingly Appropriate corrective functions can be selected and applied to the adaptive optics for the correction of presbyopia.

At block 1110, one or more suitable compensating wavefronts and/or lens types, eg, degrees of optical power (eg, positive spherical power), are applied to the image. In some embodiments, appropriate correction functions are applied to the VFE or adaptive optics to alter the shape and/or characteristics of the VFE or adaptive optics. This, in turn, can correct refractive errors, for example presbyopia, by modifying the wavefront incident thereon.

In some embodiments herein, the adaptive optic is a variable focus element (VFE), wherein the shape of the VFE is adjusted based on a voltage applied to the electrode to change the shape and/or optical characteristics of the VFE. In some embodiments, the local and/or remote processing module 70 , 72 may generate an appropriate compensation wavefront of the display 62 , based on the appropriate compensation function, such as selected based on the optical prescription and gaze direction. configured to be coded into a device or VFE. For example, the local and/or remote processing module 70 , 72 can adapt the VFE and adaptive optics to adapt the VFE and adaptive optics to the wavefront incident on it, and to deliver the correct wavefront to the user's eye based on the optical prescription. It is possible to implement a logic device configured to change possible optics. For example, local processing module 70 may be operatively coupled to an electrode coupled to an adaptive optic such that the electrode applies an electrical signal thereto to alter the adaptive optic and consequently change the shape of a wavefront incident thereon. .

At block 1112 , the modified image is presented to the user. For example, the ophthalmic system may include a rendering engine 34 operatively coupled (105, 94, 100/102, 104) to a processor 32 local processing module 72 , and/or a remote processing module 72 . may include The rendering engine 34 generates the projected light 38 having a focused, curved, or modified wavefront at the selected depth of focus, based on the selected correction function, as applied to the compensating lens at block 1110 . It may be configured to render an image projected to the user through the

In some embodiments, the image may be a modified image based on a wavefront correction applied to the unmodified image by the VFE or adaptive optics of the display device 62 . In some embodiments, where the ophthalmic device is an augmented reality head mounted display, wavefront correction may be applied to the image projected to the wearer, in the process also applying ambient light in front of the head mounted display to the user's eye. forward to For example, AR image information presented by the ophthalmic system can be transformed and projected in combination with ambient light. In some embodiments, ambient light may also be transformed and optically corrected using an appropriate program. In another embodiment, in the case of a VR head mounted display system that is opaque to the external world in front of the user, the deformed image is a modified image provided by the ophthalmic system for visual presentation, for example VR image information. It can be VR video.

Accordingly, process flow 1100 may be implemented to dynamically correct a user's presbyopia. For example, a VFE or adaptive optics may be actuated by an electrical signal that may correct a user's changing presbyopia over time by changing its shape and/or characteristics. The element or components can thus be dynamically reconstructed, for example, electrically reconstructed in real time as the user's optical prescription changes and as a result iteratively updated while using the ophthalmic system. For example, presbyopia prescription correction may be adjusted periodically or non-periodically at various time intervals (eg, daily, once a month, three times, a year, etc.). The ophthalmic system of the present disclosure is therefore adapted to dynamically correct for changes in the user's presbyopia prescription over time without replacing or replacing parts of the system, for example, 2, 3, 4, 6, or more times per year. can be configured. The interval may be predetermined based on the expected rate or occurrence of a vision defect, deterioration, or change. For example, a user's presbyopia may change as the user ages.

In some embodiments, at block 1010 the ophthalmic system of the present disclosure may execute an eye prescription configuration program. At block 1010, the ophthalmic system returns to block 1002 and updates or changes the prescription based on input from the biofeedback system, as described above, so as to manually update or change the user's prescription at each interval, without the user's activation. You can decide interactively. These procedures may be scheduled by protocol (eg once a month, several times a year, etc.) or may be scheduled to be performed if it is determined that vision, eg, myopia, is worsening. . As described above in another embodiment, the biofeedback system monitors movement or changes in the user's eyes (eg, via camera 24 or light source 26 ) to determine if the user is experiencing accommodation difficulties. can For example, the ophthalmic system may monitor gaze, pupil dilation and/or movement and/or shape of the natural lens of the eye. The ophthalmic system of the present disclosure may monitor images formed in the retinal fossa using autorefractometers, or other techniques disclosed herein. The ophthalmic system herein may then initiate an eye prescription configuration program to determine a new optical prescription and/or adjust correction functions (eg, update mapping tables for depth of focus and lens type).

In some embodiments, the ophthalmic system herein may allow a user to manually adjust the focus of one or more images presented to the user. For example, the system herein may be pre-programmed to adjust focus in individual steps. The user can then specify the desired focus for the ophthalmic system through the user interface. In some embodiments, the user may select incrementally increasing or decreasing regimens (eg, changing focus) until a comfortable viewing focus is reached. Alternatively, the ophthalmic system of the present disclosure may use a biofeedback system or other diagnostic technology (see, for example, phoropter and autorefraction techniques herein) to automatically increase or decrease prescriptions automatically. In some embodiments, such a user input prescription may be associated with a particular gaze or head orientation, and may be provided when the user has such a gaze or head orientation. In some embodiments, such user input prescription may be applied independently of such gaze or head orientation and does not change with changes in gaze, gaze, and/or head orientation.

<u>amblyopia/strabismus</u>

Another frequent vision disorder is amblyopia, a condition in which both eyes cannot be aligned at one point of convergence to produce a fused stereo image. This is typically due to an eye with weakened eye muscles that cannot coordinate its movement with that of a normal opponent. Likewise, it is a visual disorder in which the visual acuity of one or both eyes is reduced. This loss of vision may be due to abnormal development in infancy or childhood. Strabismus is often referred to as "lazy eye".

In some embodiments herein, an ophthalmic system comprising a wearable virtual reality head mounted device, similar to the device disclosed herein, may be used for the treatment or correction of convergence defects, such as defects resulting from amblyopia or strabismus. For example, when the convergence is offset in an angular manner, the convergence of both eyes may be merged by applying a prism correction that compensates for the convergence. The compensating prism correction may be applied by a processor, an adaptive optics element, or a combination of both. This procedure generally follows the method disclosed herein with reference to FIG. 10A herein.

In cases where the convergence of both eyes is offset angularly, one or more of the following techniques may be used. In one embodiment, the eye tracking system may determine the gaze vector and/or focus of the healthy eye. This information can be extrapolated to determine the target convergence point for both eyes. In some embodiments, an eye tracking system and a depth sensing system may be used together to determine the convergence points of both eyes. In some embodiments, the muscles of one or more eyes may be "re-trained" by a treatment protocol that may progressively align to the convergence and/or focus of both eyes. Treatment protocols include methods disclosed herein, including methods designed to strengthen the muscles of the weak eye and/or methods to promote a neural response to optical signals in the weak eye.

In some embodiments, a wearable augmented reality (or virtual reality) device may be used as an ophthalmic system to identify, treat, and/or correct convergence defects, such as those due to amblyopia and/or strabismus. The augmented reality device may be configured to correct or compensate for gaze visual defects by applying the compensatory prism correction disclosed herein. The augmented reality device may be configured to re-train the wearer's eyes so that both eyes can gradually align the convergence points. It should be appreciated that such a system may be used to examine and/or treat a wearer's eye, in a hospital or non-hospital setting. In one embodiment, a patient's individual ophthalmic system may be used, possibly under the supervision of a physician, or a hospital's own version of the ophthalmic system may be used for examination and/or treatment.

In various embodiments, the wearable augmented reality device is an augmented reality display configured to transmit light from the world or surroundings outside the wearer to the wearer's eyes through the display platform (eg, a front lens/adaptive optics element). including platform. Such a display platform may be configured similarly to the display lens 106 disclosed herein with reference to FIG. 5 . Accordingly, the wearer can view the image projected onto the display platform that overlaps with what the wearer can see in the world.

In some embodiments, the wearable augmented reality device includes the display platform described above and one or more light sources configured to project light into the eyes of the wearer. The one or more light sources may be configured to project light into the eye of the wearer to form an image in the eye. In some embodiments, the one or more light sources include a fiber optic scanning display as disclosed herein.

In some embodiments, the display platform includes a waveguide stack as disclosed herein. The waveguide stack is configured to project light from different focal planes. In some implementations, the waveguide stack includes one or more lenses as disclosed herein in the stack. The waveguide stack may be configured to be capable of applying compensatory prism corrections, for example, through lenses, mirrors, reflective elements, refractive elements, or any combination thereof. In various implementations, the waveguide stack may provide compensating prism correction through various mechanical configurations.

In some embodiments, the display platform may include an adaptable optics element configured to project light to a target region or a different region of the wearer's eye. In some embodiments, the adaptive optics device may include a VFE disclosed herein. In some embodiments, the VFE comprises a membrane mirror. The membrane mirror may include an adjustment system configured to adjust one or more electrodes on the mirror and one or more electrodes to modify the shape of the membrane mirror. The adaptive optics may be used to provide corrective prism corrections for the treatment and/or correction of convergence defects. In some embodiments, the augmented reality device is configured to vary the focus and/or position of the projected image through a change in a microelectromechanical system (MEMS). For example, the augmented reality device may comprise a MEMS equipped with micro-optics comprising reflective, refractive and/or diffractive optics that may be used to vary the focus and/or position of the projected image. In some embodiments, the augmented reality device includes a micro-mirror array configured to respond to a signal to change the direction of the signal. This may be done, for example, to provide image shift (eg compensating prism correction) and/or to blind the wearer. Other types of adaptable optics may be used to provide the prisms. For example, transmissible elastomeric materials that are affected by an electric field (such as those used in adaptive optics lenses) can be actuated by electrodes that change shape and introduce prisms. Camouflage modulators including transmissive or reflective phase modulators may also be used. Such a phase modulator may modulate a phase on a pixel-by-pixel basis. Possible phase modulators include liquid crystal phase modulators. In some embodiments, the augmented reality device includes one or more spatial light modulators configured to adjust the intensity, for example, to reduce or prevent intensity on a per-pixel basis. For example, a liquid crystal configured to selectively block one or two eyes of the wearer or a portion of the eye or eyes of the wearer. The liquid crystal may be configured to selectively turn on or off the effect of a diffraction grating (eg, a holographic diffraction grating). This can optionally be achieved by applying a prism effect. Such adaptive optics may be in the optical path from the display to the eye to provide a correction to the user when viewing image content on the display. Such adaptive optics may be included in the optical path from the eye wearer and the world in front of the eye to provide correction to the user when viewing the world in front of the eye wearer.

The augmented reality device may be configured to selectively introduce each shift or prism effect of an image provided by the wearer. This can be done for a variety of purposes and in a number of ways. For example, corrective prism correction may be applied as an optical correction for the wearer, to compensate for convergence defects in one or both eyes of the wearer. This correction compensates for the wearer's deficiencies, allowing the wearer to have approximately binocular monovision even if they suffer from amblyopia and/or strabismus.

Compensatory prism correction may be achieved through shifting of the image position provided to the wearer, eg, lateral shifting (eg, normal to the normal line of sight or normal to the optical axis). In some embodiments, the shift in position may be provided by image processing. For example, the augmented reality device uses software to compare the relative position of the image provided by the display device or the relative position of the image projected to the wearer without convergence defect or to the other eye without convergence defect on one side of the wearer or It may be configured to adjust the relative positions of images projected to both eyes. The augmented reality device may be configured to detect focus or alignment of the wearer's eye, or to adjust the position of each of the left and right images to be a target point within the field of view of each eye. For example, the augmented reality device may include eye tracking to determine the field of view of each eye. When the gaze location is determined, the augmented reality device may be configured to position the left and right images in the center of the visual fields of the left and right eyes. In some embodiments, to re-train the weak eye, the augmented reality device may move progressively toward a convergence point that is desired or targeted for the image presented to the weak eye. In this way, the weak eye can be re-trained to merge at the same point as the healthy eye. For example, the augmented reality device may include an adaptable optics element configured to optically shift the position of the image (eg laterally) with one or both eyes of the wearer or shift the image on the display device. Similarly, augmented reality devices may include adaptive optics elements that add prisms to shift light reaching the wearer from the world or surroundings outside or beyond the wearer. In some embodiments, laterally shifting position may be provided optically in combination with image processing.

In order to determine the degree of prism correction to be applied, the augmented reality device may be configured to monitor where images and light are projected onto the retina of the wearer's weak eye. If the prism correction allows light to shine on the retina, it is correct. If not, some correction is necessary. As disclosed herein, an SLO, autorefractometer, photorefractive medium, etc. can be used to determine whether compensating prism correction corrected or reduced the wearer's misaligned vision. In some embodiments, the augmented reality device is configured to determine (or receive an indication input) whether the user has exotropia or esotropia deviation. Once the deviation is known by the device, prism correction is applied until the vision defect is significantly corrected. This may be determined automatically or may be determined based on user input. In some embodiments, in order to automatically determine the correct or appropriate prism correction, the augmented reality device may include one or more inwardly-facing cameras to measure (eg fixation shift) each deflection and use a display to measure one eye. You can block the other eye while changing the prism prescription. In some embodiments, the augmented reality device may be configured to run a test similar to the Maddox road test to determine an accurate or appropriate prism calibration using user input. For example, the augmented reality device may provide a mechanical filter for filtering light for the test. As another example, the augmented reality device may provide image sources from two different depth planes. Based on the user input, the augmented reality device may adjust the prism correction until a satisfactory condition is satisfied (eg, the first image is aligned with the second image).

As another example, compensatory prism correction may be applied for therapeutic purposes, eg, to gradually re-train the eye to reach a desired point of convergence. Disclosed herein is a method of re-training the eye that emphasizes presenting images with different features to each eye of the wearer.

In some embodiments, the wearable augmented reality device includes an eye tracking system. Such an eye tracking system may be configured to determine the gaze of the wearer's eyes. Such eye tracking systems may include one or more sensors configured to sense properties of the wearer's eyes. In some embodiments, such one or more sensors include a camera disclosed herein. In various embodiments, one or more sensors, including cameras, may be configured to image twinkle and/or Purkinje fringes to determine gaze. The eye tracking system may include an analysis module configured to determine a gaze direction of the wearer's eye based on at least some information obtained with the one or more sensors.

In some embodiments, the wearable augmented reality device may include one or more outward looking cameras. In some implementations, the one or more outwardly looking cameras may be similar to the camera 16 disclosed herein with reference to FIG. 5 .

A wearable augmented reality device may include user interface features configured to allow input to the device by a wearer or other person. Such a user interface may be integrated into the device. In some implementations, such user interface features may be provided by devices or elements that are not physically integrated into the device. For example, the user interface may be provided by a device or system in communication with the device. This may be a computer device capable of wired or wireless communication with a smartphone, computer, tablet or other device. In some embodiments, user interface features may be provided by a combination of different devices and systems coupled to the device via, for example, a wired or wireless communication network or physically coupled to or integrated into the device. User interface features may be provided on a device equipped with a touch screen, where input may be made to the wearable augmented reality device through interaction with the touch screen. Speech recognition and/or virtual touch screen technologies may also be used. Such user interface features may include capacitive features sensitive to touch, keyboard, buttons, microphones, photodetectors, or various features implemented in software provided by a graphical user interface. In some embodiments, this user interface feature includes a gesture sensing element to allow the wearer to input via gesture. In some embodiments, such a user interface includes an element capable of detecting gaze and allows the wearer to enter an input by gazing with the eye (eg, this may occur when the wearer temporarily fixes their gaze on a button or when the gaze changes secured to a button and may include selecting a button or other element when the wearer blinks an eye). Such systems may be used with other devices or systems disclosed herein. User interface features may be provided to the device as a touch screen, where input may be made to the wearable augmented reality device through interaction with the touch screen.

In some embodiments, the wearer, clinician, physician, or other user may use interface features to adjust vision tests and/or treatment modalities. This may be achieved, for example, by adjusting the amount of prism correction applied, the degree of lateral displacement applied to the image, modifying the characteristics of the improved image, or other examination or treatment of convergence defects.

12 schematically depicts an exemplary method 1200 for treating a convergence defect, such as caused by amblyopia and/or strabismus. For ease of explanation, method 1200 will be described as being performed by an ophthalmic system, such as any augmented reality device disclosed herein. However, it should be understood that any element or sub-part or other similar device of the various augmented reality devices disclosed herein may be used in performing any step, combination of steps, or portion of the steps of method 1200 . Method 1200 includes "re-training" the lazy or poorly aligned eye by better blocking or less emphasizing the eye. It should be understood that many treatment protocols may be derived based on a user-specific regimen, and the exact parameters and/or techniques may vary.

At block 1202, the ophthalmic system determines a difference in focus and/or convergence point of both eyes. As discussed herein, such differences may be determined based on user input based on prescription tests performed by the ophthalmic system. Eye tracking and/or gaze detection may also be used. The ophthalmic system may be configured to perform any of the methods disclosed herein, for example, to determine focal and/or convergence points.

At block 1204 , the ophthalmic system may select a treatment protocol that assists in treating the wearer's vision defect. In some embodiments, such treatment protocols may be designed by a physician or clinician, or treatment protocols may be designed from an external location and downloaded to the ophthalmic system. The treatment protocol may include various parameters of such treatment protocol. For example, a treatment protocol may include the number of times a treatment is administered. The treatment protocol may include information about the type of image presented to the wearer and/or the difference between the two displays or images shown by each eye. For example, the treatment protocol may be based on binocular presentation, where images of different features are displayed to the wearer (eg, images that are different or identical to the image versions seen by the altered left and/or right eye). In some implementations, the image visible to the weak eye may be enhanced and/or the image visible to the strong eye may be reduced. For example, the image seen by the weak eye may be altered to be more interesting and exciting to the wearer (eg, brightened, color enhanced, three-dimensionally enhanced, focused, or reduced in resolution). higher, contrast is improved, movement, high refresh rate, etc.). Likewise, the image seen by the stronger eye may be altered to be less interesting or less exciting to the wearer (eg darkened, softer in color, flattened, faded, poorer in resolution, Contrast deteriorates, freezes, refresh rate is low, etc.). In various implementations, the image seen by the stronger eye is not changed, while only the image seen by the weaker eye is changed. In various implementations, the image seen by the weaker eye is not changed, while only the image seen by the stronger eye is changed. In various implementations, the image seen by both the strong eye and the weak eye is altered. The image seen by the stronger eye is not changed, while only the image seen by the weaker eye is changed. The treatment protocol may include information regarding the duration of the protocol. The treatment protocol may increase the user's adherence to the treatment plan by allowing the user to more enjoy "treatment" by employing interactive virtual objects. Treatment protocols may employ dynamic images (eg movies, games, etc.) to make "treatment" more enjoyable for the user, thereby increasing the user's adherence to the treatment plan.

At block 1206 , the ophthalmic system may detect or determine a time or time window at which the treatment protocol starts based at least in part on a scheduler attached to the treatment protocol. For example, the treatment protocol may be programmed such that eye re-training is performed daily at 10 PM or at some point between 8 AM and 9 AM. The treatment protocol may be prescribed, for example, only once a week. Treatment protocols may include more frequent treatment sessions, such as treatments twice a week, at least 5 times a week, daily and/or several times a day, such as once, twice, three times, four times, or five times a day. have. In some embodiments, a treatment protocol may be programmed in response to detection of a somewhat misaligned eye. In various embodiments, the treatment protocol may be programmed to occur when the eye has recovered from the previous treatment protocol.

At block 1208, the ophthalmic system changes the field of view of one or both eyes. This may include, for example, covering some or all of the eyes. In some embodiments, the ophthalmic system may present a different image to each eye, sometimes at a different location within the field of view, in order to strengthen the weak eye or to promote proper gaze for image fusion within the brain. It should be understood that this is just one exemplary technique, and that many other techniques may also be used to re-train or strengthen the muscles of the eye. Blocking may be some or all blocking. All or some defocusing, blurring, attenuation, or other alterations to the image presented to the wearer may also be used.

In some embodiments, the ophthalmic system may skip block 1208 . For example, in some treatment protocols the angular fields of view of the strong and weak eyes are not altered. The ophthalmic system may present images of different vision features to the wearer's eye to encourage the weak eye to regain vision.

As described herein, the field of view of one or both eyes may or may not be altered, or the content viewed by each eye may also be different. For example, less interesting content may be shown to the weaker eye. This can be achieved by projecting a brighter, higher resolution, more complete, moving, higher contrast, three-dimensional, color-enhanced image from multiple depth planes or the like onto the weak eye. Exciting content can be projected on the weaker eye while projecting less exciting content on the strong eye.

At block 1210, the ophthalmic system may project a stimulating image of interest to the weak eye. These stimulating images are presented at pre-prescribed locations and/or with enhanced visual features - color saturation, contrast, resolution, depth signals, three-dimensional effects, brightness, intensity, focus, etc. - to cause the eye to focus on the targeted location. may encourage visual content originating from the weak eye to match and/or encourage convergence and/or strengthen the weak eye. The virtual image is moved over time at a rate dictated by the treatment protocol, traversing multiple depth planes to bring the eye together to the focal point. When the eyes align to a common point of view, the images from each eye fuse and the brain sees one image instead of two. This can be achieved, for example, in the form of a game.

In various embodiments, for example, the ophthalmic system may be configured to simultaneously present images to both eyes, for therapeutic or therapeutic purposes. The image presented to each eye may be different in visual characteristics. This difference can improve the performance of the weak eye over time. For example, in order to provide a stereo image to the wearer, left and right images may be provided to the wearer. During treatment, the image corresponding to the weak eye may be improved compared to the strong eye. Improving an image may include, for example and without limitation, increasing the brightness of the image, increasing the contrast of the image, increasing the color saturation of the image, increasing the intensity of the image, increasing the three-dimensional effect of the image, adding content to the image, etc. have. Similarly, the image corresponding to the strong eye can be reduced. Reducing an image may include, but is not limited to, reducing the color saturation of the image, attenuating or reducing the intensity of the image, flattening the image, blurring the image, defocusing the image, shadowing the image, blocking part or all of the image, etc. may include In some embodiments, image defocus may be achieved by presenting an image to each eye from a plane of different depth of field. For example, multiple waveguides and associated lenses or other elements with optical power may be used to project images from planes of different depths. In some embodiments, treatment may include enhancing the image of the weak eye and attenuating the image of the strong eye. In some embodiments, treatment may include enhancing the image of the weak eye without altering the image of the strong eye. In various embodiments, treatment may include reducing the presence of the strong eye without altering the image of the weak eye. Image enhancement and/or reduction may be applied gradually and/or intermittently. For example, the quality of the image may be progressively improved or decreased every 30-60 seconds when the ophthalmic system detects that the eye is becoming more misaligned or every 30-60 seconds can be reduced each time. As another example, the image may be enhanced or decreased for one time and then this effect may be removed for a second time. This may alternate over the course of treatment.

In some embodiments, the treatment also includes various depth planes from which images are presented. This can be analogous to a Brock string that re-trains an eye with convergence defects using multiple depth planes. The images are projected from different depth planes, so that the eyes converge and focus on the images of different depths. A variety of depth planes can also be used to provide a treatment similar to gaze-pencil movement training. Such treatment involves presenting an image in a first plane of depth (eg, about 1 foot or more distant) and then moving the image closer to the wearer into a second plane of depth. Moving the image may include progressively moving the depth plane closer to the wearer from the first depth plane to the second depth plane. While the image is presented at this closer depth plane, the depth of the image can be adjusted so that the wearer can practice focusing on the image in an area that is difficult to focus (eg, a creator may have difficulties). Such treatment also includes providing an image of a second depth plane that is more distant compared to the first and second depths of focus. While the image is presented in the second depth plane, the wearer may alternate between focusing on the image in the second depth plane and focusing on the image presented in the third depth plane. This can, for example, strengthen the eye muscles. These methods may be combined with enhancement and/or attenuation of images during treatment.

In some embodiments, treatment may include selective blocking in one or both eyes. This can be done by presenting a visually stimulating image to the target area of the retina to increase the efficacy of the treatment. In some embodiments, the ophthalmic system may be configured to use selective blocking that obscures portions of objects visible to the user using, for example, spatial light modulators, shutters, and the like. For example, the spatial light modulator disclosed herein may be used. Adaptive optics can also be used to redirect light. Selective blocking also includes intermittently blocking the image of the eye. This can be accomplished by alternately presenting the image to the eye (eg, alternately presenting the image to the left eye followed by the presentation of the image to the right eye).

In some embodiments, treatment may include small adjustments to compensating prism compensation to gradually affect convergence of the eye. For example, the degree of compensatory prism correction and/or lateral image shift may be reduced during treatment that affects the weak eye to converge to the target point. The degree of compensatory prism correction and/or lateral image shift may be reduced over time during a single treatment or may be reduced over several treatments.

At block 1212, there is also the possibility that the system may detect the end of a predetermined time in the performing treatment protocol by detecting general functions of the eye, such as accommodation, gaze, etc. At this end time, the ophthalmic system stops treatment at block 1214 . This includes terminating blocking or de-emphasis on the wearer's eye. In some embodiments, the wearer may manually perform the treatment protocol according to the wearer's schedule. Similarly, many other treatment protocols may also be included herein.

At block 1212 in some embodiments, the ophthalmic system tracks the wearer's performance during treatment to determine whether treatment may be discontinued. If the wearer exhibits signs of fatigue or does not comply, the ophthalmic system stops treatment at block 1214 . For example, the ophthalmic system may include an eye tracking system configured to detect the wearer's gaze. Such an eye tracking system can detect whether the wearer's performance during treatment (eg whether the wearer can successfully focus on a presented image) has deteriorated over time. This indicates that the wearer is tired and the benefits of further training will be limited. In some embodiments, the ophthalmic system tracks the wearer's performance over time to determine if the wearer's convergence problems decrease over time (eg, in one treatment course and/or over several treatment sessions). can

In some embodiments, at block 1212 , the ophthalmic system receives user input indicating that treatment should be discontinued. Upon receiving this user input, the ophthalmic system stops treatment at block 1214 .

In some embodiments, at block 1212 , the ophthalmic system automatically detects the performance of the user during the applied treatment protocol. At block 1212 , the ophthalmic system is configured to return to block 1204 and update or adjust the treatment protocol based on the wearer's detected performance performance during the applied treatment protocol. For example, if the angle of convergence of the weak eye does not improve during treatment, the ophthalmic system may adjust the parameters of the treatment protocol and perform the method 1200 starting over at block 1204 . In this way, the ophthalmic system can use the wearer's performance during treatment as feedback to adjust the treatment protocol and/or use it to determine when treatment should end .

In various implementations, the ophthalmic system may be configured to interrupt a treatment protocol prior to completion. For example, if the ophthalmic system detects eye strain (eg, a weaker convergence angle deteriorates), the ophthalmic system may be configured to go from block 1212 to block 1214 and abort the treatment protocol.

As with amblyopia, strabismus or "lazy eye" is a condition in which one eye is weaker compared to the other. This may be due to the brain's preference for input from the strong eye compared to the weak eye. In some embodiments, the ophthalmic system enhances visual stimulation to the weak eye and consequently progressively intensifies the weak eye and/or by reducing the level of visual stimulation entering the strong eye or by selectively attenuating light intensity. In order to be able to reproduce the eye patch effect, it can be programmed to perform a method similar to method 1200 described with reference to FIG. 12 . Other treatment and training systems and techniques described above in connection with strabismus may also be used.

In various embodiments, to reduce distraction, the view of the world in front of the wearer's eyes via the augmented reality device must be blocked or otherwise not visible during the examination and/or treatment. For example, a liquid crystal spatial light modulator or a spatial light monitor that adjusts intensity such as a shutter may be used. This can be done, for example, when presenting a video to a viewer, but this approach is not required.

Although the system herein is described as an augmented reality device, in other embodiments the system herein may be a virtual reality device. In either case, the system may be an ophthalmic system provided by a physician or clinician for examination at a medical institution or optometrist's office or other location. In other embodiments, the system may be owned by the wearer or may be employed for other purposes such as entertainment (eg games or movies) and/or work activities. As noted above, one advantage of administering treatment on the wearer's system is at the wearer's discretion several times (at least 2, 3, 4, 5, 6, 8, 10, 12, 16, 18, 24 or More than that) the test can be conveniently performed. Likewise, the examination may be performed with or without an optometrist, ophthalmologist, nurse, technician, or physician assistant.

<u>higher order aberration</u>

Other common eye related disorders include higher order refractive errors, which may include any wavefront curvature correction that cannot be achieved with prism and/or lens correction. These higher order aberrations can account for 10% of all refractive errors. These higher-order refractive errors may be the result of an irregularly shaped optic surface of the eye, and are particularly common after refractive surgery. For example, shape abnormalities in the cornea and/or lens of the eye can cause higher order refractive errors for light passing through the eye and entering the retina. It may be possible to reduce such higher order aberrations with appropriate refractive correction.

The ophthalmic system disclosed herein may be applied and implemented in a manner that provides correction to the wavefront for such higher order aberrations. Almost all wavefront corrections, including all aberrations described by Zernike modes (eg astigmatism, coma, trefoil, spherical, quadrafoyl, etc.) It should be understood that this may be possible using

In some implementations, the ophthalmic system may be configured to correct microscopic defects in the cornea, lens, and other delivery media of the eye. These defects can produce complex refraction, reflection, and scattering patterns that have a disruptive effect on the quality of vision.

In various embodiments, the ophthalmic system of the present disclosure is capable of detecting patterns of projected light caused by such defects, for example, via an eye tracking system or other camera or imaging system. This information may be used by the ophthalmic system of the present disclosure to selectively filter out light rays entering the user's eye that may interact with eye defects, blocking light paths that may contribute to impaired vision.

The ophthalmic system of the present disclosure may be, for example, an ophthalmic system worn by a patient as shown in FIGS. 3A-3D and 5 , and devices such as those described above relating to myopia, astigmatism, farsightedness and other refractive abnormalities. Accordingly, it will be understood that the features discussed in connection with inclusion in the description above with respect to ophthalmic devices for the correction of visual abnormalities such as myopia, farsightedness, and astigmatism apply equally to the correction of higher order aberrations. In particular, the ophthalmic system may be configured to provide optical correction for reducing or correcting refractive anomalies, including higher order aberrations. For example, such devices include adaptive optics or tunable elements to introduce wavefront correction and can be used to introduce spheres and cylinders to compensate for defocus and astigmatism, as well as reduce higher order aberrations resulting from wavefront shapes. can also be used for

As described above, the ophthalmic device of the present application includes a display lens 106 and an augmentation ( or virtual) a reality display device 62 . In various embodiments, this display 62 includes a waveguide stack 178 that receives light from a fiber scanning display disposed at the edge of the waveguide stack 178 and couples the light coming from the waveguide from its backside to the eye of the wearer. include In the case where the display 62 is an augmented reality device, the ophthalmic device of the present disclosure may direct ambient light from the surrounding environment, for example light in front of the user, through the display lens 106 to the user's eyes. . Such light may be delivered to the wearer's eye, for example, via the waveguide stack 178 . As noted above, the display device 62 may also include one or more adaptive optics or variable focus elements (VFEs). As noted above, an adaptive optic may be an optical element that can be dynamically changed to change the wavefront incident thereon. For example, the optical element may be a reflective optical element, such as a deformable mirror, or a transmissive optical element, such as a dynamic lens, such as described above in FIGS. 10B-10E.

In some embodiments herein, the projected light 38 forming an image produced by the ophthalmic system may be incident on one or more adaptive optics or VFEs as described herein. Adaptive optics include reflective optical elements such as deformable mirrors or transmissive optical elements such as dynamic lenses (eg, liquid crystal lenses, electro-active lenses, conventional refractive lenses with movable elements, mechanically-deformable-based lenses). , an electrowetting lens, an elastomeric lens, or a plurality of fluids having different refractive indices). The adaptive optics may receive light having an incident wavefront from the optical fiber scanning display. The wavefront may be modified to compensate for higher order aberrations by adaptive optics as disclosed herein. This corrected or compensated wavefront may be directed to the user's eye through a transmissive beamsplitter.

In some embodiments, alternatively or in combination, the adaptive optics may include a spatial light modulator configured to transform an image on a pixel-by-pixel basis. Optical correction can therefore be imparted to the wavefront. In various embodiments, therefore, the ophthalmic device may be configured to cause the optical modulator to correct chromatic aberration.

In one or more embodiments, the ophthalmic system may include one or more subsystems or sensors configured to determine higher order aberrations in one or both eyes of the user. In one implementation, the ophthalmic system of the present disclosure may utilize wavefront aberration measurement techniques such as those described herein to evaluate refractive defects of the eye. In some embodiments, for example, the ophthalmic device herein may include a camera 24 and a light source 26 and may be configured to use an aberrometer, for example, as described below in connection with aberration measurement techniques. have. In some embodiments, camera 24 is an infrared camera. A camera 24 may be operatively coupled to the local processing module 70 to detect higher order refractive defects of the eye.

Similarly, one or more cameras or imaging systems may be employed to identify areas of the eye with microscopic defects that result in complex refraction, reflection and dispersion patterns that impair vision, such as the cornea, lens, and other transmissive media of the eye. can In response, the display may be operated to not direct light to the defective area.

Additionally, in some embodiments the ophthalmic device includes one or more transmitters and receivers to enable transmission and reception between the ophthalmic system and the remote processing module 72 and/or remote data store 74 . The transmitter and receiver may be combined into a transceiver. In some embodiments, remote processing module 72 and/or remote data store 74 may be part of a third party server or allow a third party (eg a doctor or other medical practitioner) to perform, for example, an optical prescription. It may be a database that transmits data to the ophthalmic device.

In some embodiments, various configurations of the ophthalmic device may be operatively coupled to the local processing module 70 . The local processing module 70 may be operatively coupled to the digital memory and, when executed, includes instructions to cause the ophthalmic device to correct higher order refractive aberrations of the eye.

In some embodiments, the ophthalmic system may be an augmented reality system that corrects higher order refractive errors. As described above, the ophthalmic system is a head-mounted augmented reality display system configured to provide wavefront correction for ambient light entering the world in front of the user, and wavefront correction for AR image content generated by the ophthalmic system. can be Alternatively, the ophthalmic system may produce VR image content generated by the ophthalmic system with a corrected wavefront to the user while the user's eyes are obscured from ambient light in front of the user by the VR head mounted display system. There may be an augmented reality head mounted display system configured to be provided. As described above, a VR head mounted display system can include an outward facing camera configured to capture ambient light from the world in front of the user and generate a calibrated wavefront of this image.

In some embodiments, the process flow for correcting higher order aberrations may be similar to the process flow 1000 of FIG. 10A described for correcting myopia, farsightedness, or astigmatism. In some embodiments process flow 1000 is performed by an ophthalmic device worn by a patient, such as that described in connection with Figures 3A-3D. The process flow 1000 is performed by a remote processing module 72 executed by a local processing module 70 , for example by a logic device of the local processing module 70 operatively coupled to a remote data store 74 . can be executed Adaptive optics or VFEs such as electronically reconfigurable mirrors or lenses such as lenses positioned as shown in FIGS. 10B-10E may be used to provide refractive correction based on the user's optical prescription.

At block 1002, the ophthalmic system determines the user's optical prescription, eg, higher order aberrations due to the irregular optical surface shape of the eye (eg, shape irregularities of the eye's cornea and/or lens). As described above, the ophthalmic apparatus includes a user interface through which the user must input an optical prescription, or the ophthalmic system may determine the higher-order refractive error of the eye through an eye prescription configurator program. For example, the ophthalmic system may include an aberrometer disclosed herein. In some embodiments, the ophthalmic system may be configured to receive optical prescriptions from a third party. For example, a physician may wirelessly send an optical prescription to a user (eg, over the Internet, Bluetooth connection, etc.), which is received by a receiver or transceiver and stored in the digital memory of the local processing module 70 .

At block 1002 of some embodiments, the ophthalmic system may detect a pattern of light projected by the ophthalmic system caused by a higher-order refractive defect of the eye. For example, light source 26 may be configured to project infrared light into the eye, and camera 24 may detect infrared light reflected from the eye due to higher order refractive defects in the eye. Based on the detected reflected or scattered light, the ophthalmic device may detect a pattern corresponding to a higher order aberration.

At block 1004, the ophthalmic system searches the mapping table to determine an appropriate image modification program for higher order aberration refractive error correction. In some embodiments, the mapping table may include associating different optical prescriptions to different image modification programs. For example, for a given user's optical prescription, the mapping table may list image modification programs that are configured to correct higher-order aberrations defined by the optical prescription.

In one implementation, the image modification program defines a transformation to an incident wavefront (eg, transformation to an image) to produce a correction wavefront. In another embodiment, the image transformation program defines transformations to one or more 2D images generated by the ophthalmic system and presented to the user's eye. In some embodiments, each 2D image may be a 2D representation of the image at different depths of focus, allowing the user to perceive the image as 3D. In one or more embodiments, the ophthalmic system may have such a program pre-coded, or such a program may be downloaded to perform image modulation based on a prescription. See, for example, the note below regarding phoropter technology. In some embodiments, remote processing module 72 may retrieve or look up mappings stored in remote storage 74 .

As described above, the image modulation program may include parameters applied to the adaptive optics of the ophthalmic system based on the VFE or desired wavefront correction. The parameters may be applied to the shape and/or characteristics of the adaptive optics to define displacements that alter the wavefront to correct higher order refractive aberrations. These parameters and corresponding signal sets may be based on the optical prescription and/or the aberration pattern of the detected defect. For example, to correct refractive anomalies of higher order aberrations, the image displacement program generates a set of parameters configured to code the corrected wavefront curvature into the optics of the ophthalmic system (e.g., VFE or adaptive optics of display 62). can have Compensatory wavefront curvature removes higher-order aberrations caused by the eye by detecting refractive errors in the shape of the eye's optical surface and correcting the wavefront of the image reaching the retina of the eye.

Without wishing to be explained by any scientific theory, the user's eyes may experience different higher order refractive errors and/or may require optical correction depending on the depth of focus to which the eye is accommodated. Accordingly, in one or more embodiments, the image modulation program may be configured to compensate for higher order refractive errors associated with accommodation to different depths of focus, such as a plurality of different depth planes (eg, 2 or more, 3 or more, 4 or more, 5 or more, 6 or more (or more depth planes) and the association of the eye's adaptation distance to the corresponding parameter. For example, while the user's eye imparts a second refractive error (e.g., requiring a different spherical wavefront) for different depths of focus, the ophthalmic system allows at least one of the user's eyes to accommodate one depth of focus. It may be determined to impart a first higher-order refractive error to the incident wavefront. Thus, different compensating wavefronts (eg, based on different optical prescriptions) may be associated with different accommodating focal depths, depending on the different higher order aberrations experienced by the user at different depths of focus.

In some embodiments, coding the corrected wavefront may include wavefront modulation of ambient light transmitted to the user from the surrounding world, eg, in front of the user and from the ophthalmic system. Similarly, coding the corrected wavefront may include wavefront modulation of the image generated by the ophthalmic device and projected to the user by the display device. For example, as described above, an electrical signal may be applied to an electrode coupled to the adaptive optics that changes the shape or optical characteristics of the adaptive optics. This may in turn alter the wavefront incident on the adaptive optics. In some embodiments, the ambient light wavefront and any projected image may be modified by both a single VFE or adaptive optics, or independently by different VFEs or adaptive optics. In some embodiments, where the ophthalmic system is a VR head mounted display, the outward-looking camera may acquire an image of ambient light in front of the user, the wavefront of which may be altered as disclosed herein.

In some embodiments, when the ophthalmic system detects a pattern of reflected light that is indicative of a refractive error, the image modulation program selectively filters the light beam projected into the user's eye that interacts with the defect in the eye causing the vision problem. It may be configured to block the optical path. For example, based on the correlation of the higher order aberrations with the mapping of the eye, the ophthalmic system can identify one or more rays that interact with the association of the eye and result in higher order aberrations. Once identified, the ophthalmic system will filter this light from the optically incident wavefront. Therefore, since these rays do not interact with the defects of the eye, higher order aberrations do not impair the quality of viewing the image presented to the user by the ophthalmic system.

In some embodiments, the remaining steps of process flow 1000 may be performed in a manner as described above for correcting myopia, farsightedness and astigmatism. Accordingly, at block 1006, the ophthalmic system selects an appropriate image modification program to apply to the image projected to the user by the display of the ophthalmic system. For example, the ophthalmic system may select an image modification program based on the mapping information. In such an embodiment, the image modification program will alter the portion of the incident wavefront to compensate for the eye of the portion with refractive defects. At block 1008, the ophthalmic system will apply a transformation program to correct the wavefront of the projected image using the image transformation program. At block 1010, the ophthalmic system may project the calibrated image wavefront to the user via its display. In various embodiments, the ophthalmic system may automatically apply a higher order refractive error correction to the incident wavefront based on information stored remotely (eg, external to the ophthalmic system), eg, in a remote data store 74 .

In some embodiments, where the ophthalmic system is an augmented reality head-mounted display system, wavefront correction may be applied to the image presented to the wearer by the ophthalmic system while imaging the head mounted display and an object positioned in front of the user. have. For example, AR image content presented by the ophthalmic system may be transformed and projected in combination with ambient light. In some embodiments, ambient light transmitted through lens 106 from the outside world may be transformed into an appropriate program to provide optical correction to the wearer viewing the outside world through lens 106 . In another embodiment, in the case of a VR head mounted display that is opaque to the world in front of the user, the deformed image is a VR image provided by the ophthalmic system and a display for visual presentation included therein, eg VR image content. may be modified.

In various embodiments herein, process flow 1000 may be implemented as a dynamic vision correction device as described above. For example, the adaptive optics may be actuated by electrical signals that change their shape and/or characteristics. The altered characteristics of the adaptive optics may then change the shape of the wavefront incident on the adaptive optics to produce a corrected wavefront. The wavefront correction by such an ophthalmic system can be changed in real time according to the user's optical prescription changing with time. For example, refractive defects in a user's eyes may change as the user ages. In some embodiments, at block 1010 the ophthalmic system may initiate the eye prescription configurator program to perform dynamic vision correction. At block 1010 , the ophthalmic system is configured to return to block 1002 so that, in some embodiments, the user's prescription can be determined at various points over time, passively and interactively, without the user's activation. Accordingly, the ophthalmic system dynamically identifies the first prescription at a first time and adjusts a correction for refractive coupling based on the prescription, and at a second time identifies a second optical prescription and applies the second prescription. Adjust the refractive defect correction on the basis of

<u>chromatic aberration</u>

In various embodiments, an ophthalmic system may be used to compensate for chromatic aberration. Chromatic aberration is, for example, an error resulting from the color (eg wavelength) of an image interacting differently with the optics of the user's eye's lens or ophthalmic system.

There are two kinds of aberrations, longitudinal and transverse. Longitudinal aberration occurs when different wavelengths of light are focused at different focal points along the optical axis. Thus, each color in the image can be focused at a different depth of focus. Transverse aberration occurs when light of different wavelengths is focused at different points on the focal plane of an optical system. The colors of the image are thus shifted or displaced relative to one another, for example laterally along the focal plane and orthogonal to the optical axis. Therefore, longitudinal chromatic aberration may cause discoloration or fringing in any part or all of the image, whereas lateral chromatic aberration does not occur in the center of the image.

In one or more embodiments, the ophthalmic system may be configured to project light of different wavelengths (eg, different colors) at different depths of focus to correct for longitudinal chromatic aberration. The image projected by the ophthalmic system to the user and viewed by the user may include several colors, and thus, it is possible to correct longitudinal chromatic aberration when viewing the image by projecting light of different wavelengths with different depths of focus. As noted above, in various embodiments, the ophthalmic system of the present disclosure may function as a solid state variable focus lens with variable focus (eg, adaptive optics or variable focus element (VFE)). As described above, for example in correcting myopia, farsightedness or astigmatism, the ophthalmic system of the present disclosure may be equipped with one or more adaptive optics or VFEs. The adaptive optics can be dynamically changed for a given color, for example by applying an electrical signal to it to change the shape of the wavefront incident thereon. By changing the shape or other characteristics of the adaptive optics for a given color, the wavefront is changed to match that color, for example by changing the focus of the wavefront as described herein to compensate for chromatic aberration.

In other embodiments, alternatively or in combination, the systems herein may be configured to project different wavelengths of light at different angles to compensate for lateral chromatic aberration. As described herein, a display device may include a fiber optic scanning device that vibrates to produce a 2D image pattern. In order to reduce lateral chromatic aberration, a beam that is projected from the display device to the retina and forms an image on the retina for one color may be moved. For example, the angle of the optical fiber may be shifted or offset. The amount of this shifted angle is different for different color components. Additionally or alternatively, through changing the angle of the beam projected onto the eye (eg, offsetting the angle of a fiber optic scanning device or providing angular cancellation to the shape of an adaptable optic), the wavefront changes for a given color. Thus, for example, the angle of incidence of the wavefront can be varied to compensate for lateral chromatic aberration. In various embodiments, the light is collimated but the angle of the beam changes as the beam is scanned to form an image on the retina. In some embodiments, the change in beam angle is constant while being scanned to write an image on the retina. In other embodiments, the change in beam angle may be varied as the beam is scanned to produce an image.

As described above, the ophthalmic system of the present disclosure includes a display lens 106 and a light source configured to project light 38 directed to the user's eye to form an image in the user's eye for viewing by the user. Augmented (or virtual) reality display 62 . In various embodiments, such a display device includes a waveguide stack that receives light from a fiber scanning display disposed at an edge of the waveguide and couples light from the backside of the waveguide to the eye of the wearer. If the display is an augmented reality display, the ophthalmic system may also direct ambient light from the surrounding world, eg, light in front of the user, through the display lens 106 to the user's eyes. Such light may be delivered to the user's eye, for example, through a waveguide stack. As noted above, display 62 may also include one or more adaptive optics or variable focus elements (VFEs). As noted above, an adaptive optic may be an optical element that dynamically changes to change the wavefront incident thereon. For example, the adaptable optics may be a transmissive optical element, such as a dynamic lens, or a reflective optical element, such as a deformable mirror, such as described in FIGS. 10B-10E. A spatial light modulator that modulates the phase may also be employed. These phase modulators can drive in transmission or reflection. For example, a liquid crystal spatial light modulator may be employed.

In some embodiments, the ophthalmic system may be configured to compensate for chromatic aberration, chromatic aberration due to the optics of embodiments of the ophthalmic system disclosed herein, or both, based on a predetermined light prescription of the user. For example, light passing through the user's eye may impart chromatic aberration to light received by the retina. Chromatic aberration due to the eye may be determined based on an optical prescription or an eye-prescription configurator program executed by the ophthalmic system described below with reference to FIG. 10A. Similarly, light passing through the optics of the ophthalmic system may also contribute to some chromatic aberration that is incident on the eye and ultimately received by the retina. Chromatic aberrations due to the system may be known based on the manufacturing requirements and specifications of the system. The ophthalmic system may be configured to compensate for the use of such predetermined aberrations when projecting an image into the wearer's eye.

When the system compensates for chromatic aberration, not all chromatic aberrations need be eliminated. For example, as described with reference to the light therapy disclosed herein, blue light can specifically damage retinal cells. Accordingly, the ophthalmic system may be configured to adjust chromatic aberration correction to reduce the amount of blue light incident on retinal cells of the eye. In other embodiments, alternatively or in combination, some chromatic aberrations may contribute to the creation of realistic depth-of-focus signals for a given user. Thus, chromatic aberration compensation can be adjusted to allow for some aberrations while correcting other factors for optimal vision. The system may however reduce the effect of chromatic aberration seen by the wearer of the ophthalmic system herein.

In some embodiments, an ophthalmic system that may be configured to correct chromatic aberration may be similar to an ophthalmic system as described above for the correction of myopia, farsightedness and/or astigmatism. In some embodiments, the ophthalmic system may be configured to correct chromatic aberrations of nearsightedness, farsightedness, astigmatism, or other refractive abnormalities.

As noted above, for example, the ophthalmic system herein may be the patient worn ophthalmic system shown in FIGS. 3A-3D and 5 that may be implemented to compensate for chromatic aberration. The ophthalmic system may include a display device 62 that includes a light source 18 configured to project light 38 that is directed from a display lens 106 of the display device 62 to the user's eye. The ophthalmic device may also direct ambient light from the surrounding world, eg, light in front of the user, through the display lens 106 to the user's eyes.

In various embodiments, the ophthalmic system includes an outward looking camera configured to capture ambient light from an environment surrounding the user. For example, the ophthalmic system may include one or more wide field-of-view machine vision cameras 16 operatively coupled to a local processing module 70 . Such a camera may be configured to acquire an image of the surroundings surrounding the user, for example, an ophthalmic device and an image of the surroundings in front of the user. In some embodiments, this camera 16 may be a dual capture camera of visible/infrared light. The images captured by the camera 16 may be stored in the digital memory of the ophthalmic device and retrieved for later processing.

In various embodiments, the ophthalmic system may include a biofeedback system, as described herein, configured to determine a level comfortable for a user viewing an object or image. For example, if the user's eyes shift, the adaptation changes, the pupil size changes, the binocular angle changes, etc., this may be a sign that the user cannot comfortably see the object or image. Instability or oscillation of accommodation or accommodation-related behavior may be a signal that the user is having difficulty focusing on an object or image. Accordingly, the biofeedback system may receive input in real time in relation to the state of the user's eyes.

The light source 18 may be configured to project light 38 into the user's eye to form an image in the user's eye. Thus, for example, based on an image stored in the digital memory of the local processing module 70, the image content projected to the user's eye through the display lens 106 and displayed by the ophthalmic apparatus may be included. . In one implementation, the image stored in the digital memory may be an image obtained by an outward-looking imaging device (eg, camera 16 ). In various embodiments, the image formed on the retina may include an image formed from ambient light originating from objects in front of the user reaching the user's eyes through the display lens 106 . In various embodiments, the image of the retina may include a plurality of color components. This color component may be, for example, red, green or blue. These color components may be the same color or a portion of an image including various portions of the same color. For example, an image cannot include various portions having blue (eg, a first color component) and various other portions having red (eg, a second color component). Although the color components are described as red, green, or blue, any color of the image may be applied, and the color components need not be limited to three. Based on the color of the image, there can be any variable number of color components. In another embodiment, the image may be a monochromatic image including a single color component.

Display 62 includes one or more variable focus elements (VFEs) or adaptive optics. As mentioned above, the VFE or adaptive optics can be configured to be dynamically changed to change the wavefront incident on it. For example, the adaptable optics may be transmissive optical elements, such as dynamic lenses, or reflective optical elements, such as deformable mirrors, as described above in FIGS. 10B-10D. As previously described in FIG. 10E , the VFE or adaptive optics may be positioned between the display lens 106 and the light source or included in the display lens 106 . VFE or adaptive optics may also be incorporated into the waveguide stack or light source 18 . Further, the VFE or adaptive optics may be positioned between the waveguide stack and the ophthalmic device and the world in front of the user. A VFE or adaptive optics may also be positioned between the waveguide stack and the user's eye. In other embodiments, the adaptive optics may be positioned between the waveguides of the waveguide stack.

In one embodiment, the display may include, for example, the waveguide stack 178 described above in connection with FIG. 10D. Stacked waveguide assembly 178 includes transmissive beamsplitter substrates, each substrate configured to project light as if it were coming from a different focal plane or to a different focal plane. The waveguide stack 178 includes a plurality of waveguides 182, 184, 186, configured to selectively send image information to eyes having various levels of wavefront curvature for each waveguide level indicating a focal length recognized for each waveguide level. 188 , 190 ) and a plurality of lenses 198 , 196 , 194 , 192 . A plurality of displays 200 , 202 , 204 , 206 , 208 , or in other embodiments a single multiplex display or a reduced number of multiplex displays, are connected to waveguides 182 , 184 , 186 , 188 , 190 . may be used for injection of light, eg, collimated light, along with image information, each of which may be configured to distribute the incoming light substantially equally over the length of each waveguide to be emitted towards the eye. .

The waveguide 182 closest to the eye may be configured to deliver collimated light, injected into this waveguide 182, to the eye, which may optically represent an infinite focal plane. As described in more detail above, different waveguides may be configured to exhibit a focal plane closer to infinity in the range of diopters, such that different image content originating from different waveguides may appear to originate at different depths or distances from the user. , it causes the user to recognize the image generated by the ophthalmic system in 3D. Different image content from different waveguides may be configured to be different color components of the image. Thus, each color component (eg, red, green, blue) may appear to originate from a different depth of focus.

For example, the waveguide 184 over the next is configured to emit collimated light of a first color component that passes through a first lens 192 (eg, a negative lens) before it can reach the eye 58 . can be; This first lens 192 creates a slight convex wavefront curvature so that the eye/brain then interprets the first color component coming from the waveguide 184 as coming from the first focal plane closer in towards the person from optical infinity. can Similarly, third waveguide 186 passes the output light of the second color component through both first 192 and second 194 lenses before reaching eye 58 ; The combined magnification of the first (192) and second (192) lenses creates an increasing amount of wavefront divergence so that the eye/brain is able to absorb light of the second color component coming from the third waveguide 186, and the second waveguide 184 ), rather than as coming from the second focal plane closer inward towards the person from optical infinity.

In some embodiments, the number of waveguides corresponds to the number of color components with varying depth of focus to compensate for chromatic aberration. For example, when the color components are red, green, and blue, the waveguide stack 178 may include three waveguides, one for each color component. However, in various embodiments, the waveguide stack may include only more than three of these other waveguides. For example, three waveguides, one for each component, may be included for each depth plane. Additional waveguides may also be added. Also, fewer waveguides may be used.

As mentioned above, the adaptive optics can be adapted for chromatic aberration correction. In particular, the adaptive optics can be adjusted to provide a different optical magnification when each color component is emitted. For example, at a first time a red light source will inject light into a corresponding waveguide, and the adaptive optics can be adjusted to provide it with a first optical power so that the red light is focused on the retina. At a second time, the green light source will inject light into its corresponding waveguide, and the adaptive optics can be adjusted thereto to provide a second optical power, different from the first optical power, so that the green light is focused on the retina. match At a third time, the blue light source will inject light into its corresponding waveguide, and the adaptive optics can be adjusted thereto to provide a third optical power, different from the first and second optical powers, such that the blue light Focus on the retina. Accordingly, the depth of focus of each color component of the image is selectively changed to reduce chromatic aberration and consequently to reduce longitudinal chromatic aberration.

In various embodiments, display device 62 includes adaptive optics or a VFE, such as similar to VFE 1020 described in Figures 10B and 10C. In some embodiments, the VFE or adaptive optics may be altered to modify the image and/or focus of the wavefront of a given color component of the incident image. As described above, the shape of the VFE 1020 can be deformed to change the phase, wavefront shape, and focus of light incident thereon. Thus, the shape of the VFE can be modified to adjust the depth of focus of a given color component of the wavefront incident on it. For example, if the VFE or adaptive optics is an adaptive optics lens VFE 1020, the VFE 1020 may be used to change the shape or index of the material containing the lens and eventually change the focus of the light. , optionally coupled to a set of adjustable electrodes 1022 . The adaptable optics lens may comprise an elastomeric material in a form that can be adjusted, for example, by application of a voltage or an electric field. The electrode 1022 can thus be adjusted in such a way that the shape of the VFE 1020 compensates for chromatic aberration so that the image is properly viewed by the user's eye. For example, a first color component can be projected, the adaptive optics can be modified to have a first depth of focus, a second color component can be projected, and the adaptive optics can have a second depth of focus. The adaptive optics can change in real time at a sufficiently high rate that the user is not aware of it.

In some embodiments, the shape of the VFE or adaptive optics can be selectively modified to change the position of different images of different color components. The positions may be arranged to allow for substantially different image alignments. In some embodiments, the shape of the VFE or adaptive optics can be selectively driven to modify the wavefront of the image-forming light to change the angle of incidence at which light of different color components is projected into the eye. Thus, in the focal plane, the first color component may be shifted from the first position to the second position. The second position may be configured to correct for lateral chromatic aberration so that the first color component focuses at about the same location as at least the second color component of the focal plane. In some embodiments, the location of the second component focuses on the fovea of the eye.

In still other embodiments, alternatively or in combination, the light source 18 of the ophthalmic device may comprise a fiber optic scanner, or other light generating source, configured to vary focus in a raster pattern across the retina. The fiber optic scanner may be configured to generate a raster pattern of a plurality of color components, where each color component projects a color component of an image to focus at different depths of focus. For example, the longitudinal position of the optical fiber can be interpreted as changing the focus. Accordingly, the ophthalmic device may be configured to compensate for longitudinal chromatic aberration.

In some embodiments, the ophthalmic device includes one or more transmitters and receivers, enabling data transmission and reception between the ophthalmic device and the remote processing module 72 and/or remote data store 74 . A transmitter and a receiver may be combined into a transceiver. In some embodiments, remote processing module 72 and/or remote data store 74 may be part of a third party server or database, such that a third party (eg, a physician or other medical administrator) may, for example, For example, it sends information such as an optical prescription to the ophthalmic device.

In various embodiments, the ophthalmic device may include a feedback mechanism (eg, a user interface) that may be configured to determine an optical prescription. In some embodiments, for a color component, the user may manually adjust the focus of the variable focus lens, for example, by providing an input to the system to increase or decrease the focus, or optical magnification, of an image presented to the user. can The user input changes the shape of one or more adaptive optics to change the focus of the wavefront and cause the associated light and image to focus on the retina. The user can perform this process for each color component. In other embodiments, such a system may automatically or interactively determine a user's optical prescription (eg, by employing a refractor described herein) to incorporate the optical prescription into the optical sub-part of the ophthalmic system. can be configured to For example, the ophthalmic system can objectively determine a prescription based on the biofeedback system described herein. The system can determine this process for each color component.

In one or more embodiments, the ophthalmic system may include one or more sensors configured to assess whether the user is comfortable viewing the image, for example when the user is struggling to focus on the image. For example, the ophthalmic system may determine whether a user can comfortably view an image as described herein, a change or change in gaze direction, head position, accommodation and/or gaze angle, and/or an eye Movements, possible pupil sizes, and possible shapes of natural lenses can be used. An inward-facing camera or other instrument such as an SLO may be used to monitor the eye to make this assessment.

For example, the display 62 may include a gyroscope sensor configured to determine a user's head movement or head position (eg, looking straight ahead, down, up, etc.). The movement of the user's head may indicate a user looking for an image having a better viewing angle. In some embodiments, the display device 62 may include a sensor assembly 39 having an accelerometer, gyroscope, and/or other type of direction and/or motion sensor, as discussed variously elsewhere herein. The sensor assembly 39 may be configured to detect the direction of the display device 62 and movement applied to the display by the device due to movement of the user's head. The display device 62 is operatively coupled to the sensor assembly 39 and is configured to perform digital and/or analog processing for deriving a head position from movement detected at the sensor assembly 39 ( for example, a head position processor). In one embodiment, the sensor assembly 39 may produce motion data stored in digital memory. In some embodiments, movement data may be used to reduce noise during diagnosing visual defects (eg, detection of head movement during a test may indicate a false test and result). Processor 32 may extract such movement data and execute processing logic to determine one or more head positions.

In another embodiment, the display may include an eye tracking system configured to monitor movement of the user's eyes. For example, as described above, the eye tracking module may be configured to determine a change in gaze direction that occurs as the eye moves around and/or the convergence point of the eye changes. In some embodiments, the eye tracking module may be configured to monitor changes in accommodation and accommodation reflexes (eg, changes in accommodation and gaze angles). This movement may also indicate that the user is looking for a better reagent angle and focus of the image. As noted above, the eye tracking system may include an inwardly facing camera, eg, a camera 24 capable of tracking each eye, which may be operatively coupled to a local processing module 70 . The local processing module 70, when executed, may be configured to determine the convergence point of the eye and/or the direction of the eye as described above with reference to FIG. 6 .

In some embodiments, various configurations of the ophthalmic device may be operatively coupled to the local processing module 70 . The local processing module 70 may be operatively coupled to the digital memory and, when executed, may include instructions to cause the ophthalmic device to compensate for chromatic aberration.

In some embodiments, local processing module 70 may include instructions that, when executed, are configured to compensate for chromatic aberration. In some embodiments, this compensation need not be performed in the optics of the display device 62 . For example, the image projected by the ophthalmic system may be transformed in a digital memory executed with local processing 70 either in a local processing module 70 or remotely of the ophthalmic system. The ophthalmic system may produce a 2D image that is presented to the user's eye, and such a system may be configured to transform this image prior to projecting it to compensate for chromatic aberration. For example, the pattern or set of pixels forming the image may be modified to counter, offset or reduce the effect of errors introduced by the optical system of the eye or ophthalmic system. For example, the pattern may be shifted laterally or radially. The deformed pattern of one color component may be combined with or superimposed on the modified (eg moved) or undeformed pattern of the other color component, presented to the user's eye by the ophthalmic device via the display device 62 . can The light fields (eg angle, wavelength and intensity) of the resulting image can also be modified to correct for chromatic aberrations. In one embodiment, for example, the blue component is shifted in one direction when presented by the display, the red is shifted in the other direction when presented by the display, and the green is shifted when presented by the display. doesn't happen The eye will see all three color components, ideally superimposed. Similarly, the angle of the incident ray can be changed based on transverse chromatic aberration (magnification chromatic aberration) to move the light corresponding to the color component of the image.

In some embodiments, the local processing module 70 may vary the intensity of a color component based on chromatic aberration. For example, the image may include a first color component corresponding to a first depth of focus and a second color component corresponding to a second depth of focus, wherein the second depth of focus is the retina of the eye (eg, the eye can correspond to the focus of The intensity projected by the light source 18 of the first color component may be varied with respect to the second color component to attenuate the effect due to chromatic aberration. Accordingly, the aberration-corrected second color component can be made to appear more dominant compared to the first color component causing visual impairment. For example, if the user's eye causes the red component to focus behind the retina (eg the focal plane of the eye), the user may perceive a larger area than desired. In response, the ophthalmic device may reduce the intensity of the red component to improve vision. In other implementations, if the blue component is focused or converges in front of the retina, the user then perceives less blue than desired. In response, the ophthalmic device may increase the intensity of the blue component to compensate for chromatic aberration.

In some embodiments, the ophthalmic system may be an augmented reality system that corrects chromatic aberration. As described above, the ophthalmic system is an augmented reality head mounted display system configured to provide wavefront correction to ambient light originating from the world in front of the user, and to provide wavefront correction to AR image content displayed by the ophthalmic system. can be The system described above may include an outward looking camera. Images from the outwardly looking camera may be re-rendered on the display for the user to view. The techniques described above for color correction can be applied to these images projected into the eye. Similarly, the AR head mounted display can also compensate for chromatic aberration of other image content displayed by the ophthalmic system and also projected to the user. Image content coming from an outward-looking camera may be combined with other image content and projected onto the user's eyes. The head mounted display may be configured to compensate for chromatic aberration in any projected image in the manner described above.

Similarly, the ophthalmic system may be a VR head mounted display system configured to produce VR image content that compensates for chromatic aberration. VR image content may be produced by the ophthalmic system and presented to the user while the user's eyes are obscured from ambient light in front of the user by the VR head mounted display system (eg opaque). As described above, the VR head mounted display system includes an outward looking camera (eg camera 16 ) configured to capture ambient light from the world in front of the user and produce an image based on the ambient light. can do. The VR head mounted display may be configured to compensate for chromatic aberration of any projected image in a manner substantially similar to that described above.

In some embodiments, process flow 1000 of FIG. 10A may be executed to compensate for chromatic aberration. In some embodiments, process flow 1000 is performed by an ophthalmic device worn by a patient, such as that described in connection with FIGS. 3A-3D . The process flow 1000 may be implemented by a remote processing module 72 executed by a local processing module 70 , for example a logic device of the local processing module 70 operatively coupled to a remote data store 74 . can

At block 1002, the ophthalmic system determines the chromatic aberration due to the optical prescription, eg, the irregularly shaped optical surface of the eye (eg, the irregular shape of the cornea, lens, and/or iris of the eye). The optical prescription may include a prescription for longitudinal chromatic aberration and/or transverse chromatic aberration. As described above, the ophthalmic device may include a user interface in which the user enters an optical prescription or the ophthalmic system may run an eye prescription configurator program to determine the chromatic aberration of the eye. In some embodiments, as described herein, the ophthalmic system objectively monitors and dynamically determines the user's optical prescription based on input received from the biofeedback system.

For example, the ophthalmic device may have discrete granular steps in adjusting the focus or changing the wavefront, or in changing the angle of incidence of the eye examination image presented to the user by the ophthalmic system via the display device 62 . Can be pre-programmed. The eye examination image may be any image including a conventional eye examination template including letters, numbers, graphics, drawings, drawings, designs, and the like. In some embodiments, the eye examination image may be a single color including a plurality of color components. Adjusting the focus may include adjusting the focus of one or more color components of the image. The user then specifically determines the desired correction, which can define the optical prescription to the ophthalmic system via an appropriate feedback mechanism (eg user interface). Alternatively, in another embodiment, the user may have the option to gradually increase or decrease the prescription (change in focus and/or wavefront) until a vision prescription that is comfortable for the user is reached.

The ophthalmic system may be configured to present a monochromatic image of the first color component. Such a system may then gradually change the depth of focus of the first color component. The user inputs into the user interface or feedback element, with each incremental change, whether viewing the first monochromatic image is enhanced or not, and then, after receiving the input, the ophthalmic system focuses on the first color component. It changes automatically to the next depth of focus for input on use. Once the system has determined the desired depth of focus for the first color component, the eye system then repeats the process for one or more other color components. In some embodiments, the color components are red, green and blue. Once the ophthalmic system performs an eye examination for each color component, the ophthalmic system can define an optical prescription for longitudinal aberrations.

The ophthalmic system may be configured to follow a similar procedure for determining a prescription for correcting transverse chromatic aberration (magnification chromatic aberration). For example, the focus of the first monochromatic image may be gradually shifted (eg, laterally or radially) around the focal plane automatically or according to a user's input to determine a viewpoint preferred by the user. For example, the focus of the first monochromatic image may be shifted to the retinal attention with respect to the fovea of the eye. In particular, the angle of incidence of the beam into the eye can be adjusted to correct the transverse color image. In some embodiments, the incident beam is substantially parallel. The angular offset may be different according to different positions of the image. A process can be performed for each color component, and an input from the user or as objectively determined by the ophthalmic system can be stored to define a transverse chromatic aberration (magnification chromatic aberration) prescription.

In some embodiments, at block 1002 the ophthalmic system may be configured to evaluate whether the user is comfortable viewing the image and thus can increase or decrease prescriptions based thereon. In some embodiments, the ophthalmic system may use a biofeedback system configured to objectively monitor in real time whether the user is comfortable viewing the image and whether the prescription can be increased or decreased based on the monitoring. For example, the ophthalmic system may include an eye tracking system that monitors changes in eye position, eye movements, changes in accommodation, or changes in the gaze angle of the eye, pupil size disclosed herein. Similarly, the sensor assembly 39 can be used to monitor head position. A change in head position, eye position, and/or eye movement may be an indication that the user cannot comfortably move the image. For example, the image may be blurry, and the user would find a comfortable viewing angle or location. Thus, the ophthalmic system may allow the user to comfortably view the image of the color component and, if not, automatically and progressively determine whether to adjust (eg increase or decrease) the user's prescription.

Another way to correct and/or determine whether an image is in focus is to use an autorefractor. Autorefractive systems of ophthalmic devices similar to those disclosed herein can be used to assess refractive errors and degree of focus. For example, the ophthalmic system may independently project one or more color components of light onto the eye into the eye. With the inwardly-facing camera, the system can determine whether the image is focused on the fovea of the retina, and then can determine if the color component is focused. If the color component is out of focus, the ophthalmic system then adjusts the prescription so that the color component is focused on the fovea. Another method of objectively determining a prescription may be to objectively measure a person's refractive error, for example, with a phoropter, SLO, autorefractor, or the like, as described herein. Such technology may be included as part of a biofeedback system configured to evaluate and adjust a user's prescription in real time.

In some embodiments, the ophthalmic system may be configured to receive optical prescriptions from a third party. For example, a physician may wirelessly send an optical prescription to a user, which is received by a receiver or transceiver and stored in the digital memory of the local processing module 72 .

At block 1004 herein, the ophthalmic system searches the mapping table to determine an appropriate image modification program to compensate for chromatic aberration. The mapping and image modification program is similar to that described above for the correction of myopia, farsightedness and astigmatism. In various embodiments, the mapping may associate an optical prescription with an image modification program that defines parameters that drive or encode an optical device of the ophthalmic system to compensate for chromatic aberration. In another embodiment, the mapping may associate an image transformation program defining transformations applied by the local processing module 70 with an image stored in a digital memory, for example by means of a software transformation. Accordingly, a given prescription may be mapped or associated with a given image modification program to compensate for the prescription.

For example, as described above, the longitudinal chromatic aberration prescription may be associated with an image modification program comprising parameters driving the waveguide stack. The parameter may define a wavefront curvature applied to the incident wavefront of a color component by a given waveguide or a dynamic lens associated with the waveguide based on the desired optical magnification of the waveguide and/or the reconfigurable element, e.g. a dynamic lens, so that chromatic aberration compensate for In this embodiment, the parameter will selectively address a specific dynamic lens in each waveguide to compensate for aberrations, as described above.

In another embodiment, the image modification program may include parameters to be applied to the VFE or adaptive optics of the ophthalmic system based on the desired compensation wavefront. The parameters may define a deformation to be applied to the shape and/or characteristics of the adaptive optics, resulting in a change in the wavefront to compensate for chromatic aberration. These parameters may correspond to a set of signals that may be based on an optical prescription. For example, the image modification program may have a set of parameters configured to code the compensating wavefront curvature into the optics of the ophthalmic system (eg, VFE of display 62 or adaptive optics). Compensatory wavefront curvature compensates for chromatic aberration in the shape of the optical system of the ophthalmic system and/or the optical surface of the eye by correcting the wavefront of the image reaching the retina of the eye.

In another embodiment, the image modification program may compensate for chromatic aberration as described above by defining parameters for deforming the 2D image generated by the ophthalmic system. For example, for a given optical prescription, the parameter may define an increase or decrease in intensity applied to one or more color components to reduce chromatic aberration effects (eg fringe discoloration). Intensity may be defined in luma and, as described above, may be based in part on the depth of focus of the color component and the uncompressed color component.

Although some exemplary embodiments have been described above, it should be understood that other configurations for compensating for chromatic aberration, other methods or approaches described herein, may also be used for compensating for chromatic aberration.

In some embodiments, the remaining steps of process flow 1000 may be performed in a manner similar to that described above for myopia, farsightedness, and astigmatism correction. Accordingly, at block 1006, the ophthalmic system may select an appropriate image modification program to be applied to the image projected to the user by the display of the ophthalmic system. For example, the ophthalmic system may select an image modification program based on the association of the optical prescription with a desired compensatory image modification program. In such an embodiment, the image modification program may compensate for longitudinal chromatic aberration by changing the depth of focus of one or more color components of the image. In another embodiment, alternatively or in combination, the image modification program may compensate for lateral chromatic aberration by changing the angle at which light of one or more light components is projected.

At block 1008, the ophthalmic system may apply an image modification program to compensate for chromatic aberration of the projected image.

At block 1010, the ophthalmic system may project an image of the corrected wavefront to the user via the display of the ophthalmic system. For example, the ophthalmic system may compensate for chromatic aberration by modifying the wavefront presented to the user by the ophthalmic system. As noted above, in one embodiment, the ophthalmic system generates a compensating wavefront by varying the depth of focus of one or more color components of the incident wavefront. Similarly, the ophthalmic system may produce a shifted image for one or more color components based on the changed angle of incidence for the color components to compensate for lateral chromatic aberration. In either case, the video content may be obtained by a forward-facing camera (eg camera 16 ), which will be included in both augmented reality head mounted display systems or virtual reality head mounted display systems. can The video content may be from other sources and may include other content.

In various embodiments, the ophthalmic system of the present disclosure may automatically apply chromatic aberration compensation to an incident wavefront based on remotely stored (eg external to the ophthalmic device) information, such as stored in remote storage 74 , for example. can As described above, the corrected wavefront may be projected onto the user's eye by the user's ophthalmic system through the display device 62 by being superimposed on or combined with an image based on the corrected wavefront.

In various embodiments, process flow 1000 may be implemented as a dynamic vision correction system as described above. For example, the adaptive optics may be driven by electrical signals that change their shape and/or characteristics. This altered characteristic of the adaptive optics then changes the shape of the wavefront incident on the adaptive optics to create a compensating wavefront. The wavefront compensation by the ophthalmic system may be changed in real time as the user's optical prescription changes with time. For example, chromatic aberration abnormalities in a user's eyes may change with age. In some embodiments, at block 1010, the ophthalmic system may initiate an eye prescription configurator program to perform dynamic vision correction. At block 1010, the ophthalmic system returns to block 1002 and provides the user's prescription at various points in time over time, manually and interactively, for example, with or without user initiation at block 1002 of Figure 10A. may be configured to automatically (or automatically) determine. Accordingly, the ophthalmic system may dynamically identify a first optical prescription at a first time and adjust a correction for a refractive defect based on the prescription, and identify a second prescription at a second time and based on the second prescription. can adjust the correction of refractive defects. Historical data related to different calibrations over time may also be stored and used to determine a user's health status or abnormality.

<u>refractometer (</u><u>phoropter</u><u>)</u>

14 , in one or more embodiments, the wearable augmented reality device 1400 is an ophthalmic system acting as a phoropter or refractor to determine appropriate refraction to correct or enhance the wearer's or patient's vision. can be used The results of these tests may be used, for example, to determine the wearer's or patient's optical prescription (eg for corrective lenses or augmented reality devices used in spectacles or contact lenses). It should be understood that such a system may be used to perform eye examinations, which may typically be performed in a physician's or clinician's hospital. In one or more embodiments, the patient's personal ophthalmic system may be used possibly under the supervision of a physician, or the hospital may have its own version of the ophthalmic system that may be used for diagnostic purposes. Although FIG. 14 is discussed in the context of an augmented reality device, similar features may be included in an augmented reality device, such as an eye-worn virtual reality device.

A typical phoropter is used by an eye care professional to examine the eye to determine the patient's refractive error and consequent corrective refraction to compensate for any eye anomalies. Using this information, an eye care professional can determine an optical prescription for a patient's eye to improve or correct the patient's vision. A phoropter typically includes different lenses that can be tested, and involves presenting an eye exam chart marked with letters of various sizes for an eye exam of a patient. The patient is looking at the eye examination chart, and after placing lenses of different refractive powers in front of the patient's eyes, it is judged whether the patient's vision has improved. These traditional setups tend to be bloated and leave the surgeon individually selecting the next sized lens. Clinicians typically ask for patient feedback on image clarity and change lenses accordingly.

In contrast, some embodiments of wearable augmented (or virtual) reality device 1400 may be used to perform many of these same functions without the need for a bloated phoropter installation. The wearable augmented (or virtual) reality device 1400 includes an augmented (or virtual) reality display platform 1402 configured to project an image into the wearer's eyes. The display platform 1402 may be configured similarly to the display lens 106 described herein with reference to FIG. 5 , for example. In some implementations, such as used in augmented reality devices, the display platform 1402 transmits light from the world or surroundings through the display platform 1402 (eg, through a lens in front of it) to the wearer's and may be configured to transmit through the eye. In this way, the wearer can view the image projected onto the display platform 1402 overlaid with the image the wearer sees in the world. In some embodiments, rather than a physical eye examination chart, a virtual eye examination chart 1420 may be projected to the wearer using the display platform 1402 . To provide a function similar to a phoropter, the focus of the image can be changed. The wearable augmented (or virtual) reality device 1400 may be configured to provide or perform an eye exam by automatically providing a gradual change to an optical prescription while changing the focus of the image. Similarly, eye exams may be performed by varying the refractive power of the adaptive optics elements of the display platform 1402 .

As disclosed herein, augmented reality devices 1400 may include adaptive optics configured to change their optical properties. Such adaptive optics or variable focus elements (VFEs) can provide various optical corrections, such as spherical, cylindrical and axial, or higher order aberration corrections. The adaptive optics element may include a deformable mirror configured to change the shape of the reflective surface to direct light to a target point. The adaptive optics element may include optics (eg, liquid crystals) configured to change the refractive index to selectively direct light to a target location. The adaptive optics may include one or more light modulators configured to selectively direct light using a plurality of pixels. The adaptive optics may include an acousto-optically modulated mirror configured to time-multiplex the incident light to selectively guide the incident light.

In some embodiments herein, the display platform 1402 may include a plurality of waveguides. The plurality of waveguides may be organized in a parallel or in-line fashion. The waveguide may be configured to project and receive light. The received light may be imaged or otherwise detected. It may be used for eye examination, in which case the waveguide is configured to image the wearer's retina to monitor the image formed on the retina. Individual waveguides may correspond to different depth planes. To determine the accommodative state of the eye, the retina's reflex action (eg, a reflection resulting from an image projected into the wearer's eye) can be measured using a waveguide. This makes it possible to quickly measure the accommodative state of the eye. For example, a series of point-source images (eg, outside the visible wavelength band) may be projected from a waveguide to the wearer's eye at various depths, where the retina may simultaneously measure reflections. The augmented (or virtual) reality device 1400 is configured to determine in real time the accommodation state of the eye by determining which depth plane is the brightest, smallest, or most focused image based on the most collimated reflections. can be configured. In effect, the waveguides can act as a set of tuned auto-collimators, with each waveguide corresponding to a particular focus and/or accommodation state. To this end, the virtual (or augmented) reality device 1400 of the present application may be configured to project a beam of light originating from a light source to the eye of the wearer. A portion of the projected beam may be reflected, scattered and/or diffracted due to the anatomical features of the wearer's eye, and may be received by one or more imagers. An electronic hardware processor may be used to analyze the light received by the wearer's eye to examine various structures of the wearer's eye. This makes it possible to determine an approximation or accommodation state of the eye, which may include lens shape, pupil constriction state, gaze angle, dynamic accommodation, and the like.

In some embodiments, refractive correction may be provided by augmented or virtual reality device 1400 using adaptive optics, wherein light is injected into the waveguide using deformable mirrors and/or refractive lenses. Refractive correction may be provided using a spatial light modulator (eg, a light component comprising an array of elements configured to change the phase of incident light). In certain embodiments, refractive correction is another light source, such as a scanning source (eg a fiber optic scanning device), directed to a deformable mirror that couples the light into a free space optical beamsplitter to selectively direct the light to a target location. Alternatively, it may be provided using light originating from an optical fiber. By changing the shape, index of refraction, or the nature of the phase, wavefront of the adaptive optics device, such as the image projected by the augmented reality device 1400, a refractive correction designed to compensate or reduce refractive errors in the wearer's eye can be applied. subject to change to provide.

In some embodiments, the adaptive optical modulation mirror may be configured to selectively direct light to one of a plurality of waveguides. Each waveguide may include optical elements (eg, lenses, mirrors, etc.) configured to provide a particular optical power. For example, augmented reality or virtual reality device 1400 may include a stack of 10 waveguides, where each stack may apply about 0.5D optical magnification. By selectively directing light into one of the waveguides and diverting the light through a plurality of other waveguides, a subset of the waveguides and associated optical power can be provided to the wavefront. Targeted refractive power/correction (eg spherical) can be achieved. In some embodiments, the waveguide stack may be used with adaptive optics to correct astigmatism and/or higher order optical aberrations.

In some embodiments, augmented reality device 1400 uses purely adaptive optics to achieve refractive correction. For example, the augmented reality device 1400 may include a plurality of lenses and mirrors. For example, an adaptable optics lens that is transmissive may be employed to correct the light projected by the light source of the display and ambient light coming from the world in front of the wearer. In some embodiments, a plurality of waveguides need not be employed as adaptive optics, but may be time-multiplexed to allow scanning of different colors (eg, red, green and blue) and depth planes. In certain implementations, colors may be scanned in individual depth planes before advancing to the next depth plane. In some embodiments, a beam splitter may be employed to couple the light from the light source inward, although other configurations are possible. In some embodiments a plurality of light guides may be included with an adaptable optics lens. Multiple color or depth planes are scanned simultaneously in some embodiments. Transmissive spatial light modulators that modulate the image can be used to change the wavefront shape and provide refractive correction. Adaptive optics mirrors may also be employed. In some embodiments, reflectors can be used to tailor the light path as desired.

In some implementations, to perform an eye examination, the user/wearer may be presented with various images of various sizes, and the user/wearer may provide input as to whether the images are clear through the user interface 1404 of the ophthalmic system. can In some embodiments, the ophthalmic system is configured to automatically determine whether the image is clear based, at least in part, on detecting whether the image is focused on the retina of the wearer. This may be done by imaging and analyzing the user's retina and/or monitoring reflections originating from the retina of the projected image. Rather than physically changing lenses as in a typical phoropter, if the user/wearer says that a particular image is not clearly visible or cannot be viewed comfortably, the focus of the image is automatically changed (e.g. as disclosed herein). (via VFE or adaptive optics, such as those)) provide a gradual change to the corresponding or equivalent optical prescription. Thus, eye examinations can be performed seamlessly through the ophthalmic system at that point or remotely. For example, but not limited to, a clinician or physician may remotely perform an eye examination by phone, video conference, network communication program, or the like. In some implementations, eye exams may be performed with or without direct contact with the clinician or with or with minimal effort and time from the clinician.

In some embodiments, optical prescription adjustments may be performed automatically by the ophthalmic system based on physical changes in the eye that occur while attempting accommodation and/or gaze. For example, the ophthalmic system can be programmed to detect a pattern of behavior in a particular eye that is a symptom of a weakened eye. The ophthalmic system may automatically perform eye adjustments based, at least in part, on the behavior of the eye being tracked. For example, if the system detects that the wearer is struggling with accommodation, it can initiate a phoropter test as disclosed herein, or the system can tell the wearer or clinician that the wearer is struggling with accommodation. You can send a warning that In some embodiments, the system is capable of detecting and detecting micro-variations in accommodation (eg, small and/or rapid changes in lens shape, gaze angle, pupil size, etc.) that the wearer is having difficulty with accommodation. can In certain implementations, accommodation difficulties may be detected by monitoring the focal state of the image projected onto the wearer's retina, as disclosed herein. If the retinal reflexes are variable, the system may be configured to determine that the wearer has accommodation difficulties. The system herein presents an image to the wearer, performs different optical corrective tests and allows the user to provide feedback on whether the optical correction improves the image. In some implementations, rather than allowing the wearer to request feedback, or in addition to requesting feedback, the system of the present disclosure monitors, measures, and/or analyzes an image that is focused on the wearer's retina to determine if the image is in focus. can be configured to determine. As noted above, different inspection calibrations can be performed during inspection using one or more VFEs or adaptive optics. In some embodiments, the systems herein may be used to determine the wearer's strabismus by presenting an image to the wearer's eyes, one eye at a time. In certain implementations, the system herein may be used to monitor the wearer's gaze with respect to a target. If the wearer is exotropic when focusing on a nearby image (eg an image projected from the near depth plane), the system of the present disclosure determines whether the wearer is presbyopia or tired and/or the wearer may be strabismus or amblyopia. can be configured to determine The system herein may be configured to perform various examinations of the field of view by providing images from a variety of different depth planes.

In some embodiments, the display platform 1402 includes, for example, a fiber optic scanning device as discussed herein. In various embodiments, a fiber optic scanning device may be configured to provide different depth planes into which an image or portion of an image is projected. In some embodiments, the display platform 1402 includes a waveguide stack described herein. The waveguide stack may be configured to provide different depth planes into which an image or portion of an image may be projected. In certain implementations, the waveguide stack includes one or more lenses in the stack as described herein. In some embodiments, display platform 1402 includes adaptive optics configured to project light having different focal planes. In certain implementations, the adaptive optics element includes a variable focus element (VFE), as described herein. In some embodiments, the device 1400 may be configured to change the focus of a projected image by changing the optical path of one or more of the display platform 1402 elements. In certain implementations, the apparatus 1400 is configured to allow the optical path length to be varied through the use of a fiber optic light source. For example, a fiber optic light source may be configured to vary the length of the optical fiber (eg, to carry light from optical fibers of different lengths) and/or position (eg, by mechanically moving the optical fiber). In certain implementations, the apparatus 1400 may be configured to change the focus of a projected image by changing a microelectromechanical system (MEMS). For example, the device 1400 may include a micro-optical device implemented using MEMS that includes diffractive, refractive and/or reflective optical elements that may be used to change the focus of an image. Other types of variable focus elements or adaptable optics elements may be used.

The image provided by the ophthalmic system may be a stored image. The wearable augmented (or virtual) reality device 1400 may include a data store containing one or more stored images suitable for determining the wearer's optical prescription or performing an eye examination. The stored image may be letters, numbers, symbols, etc. such as those used for eye charts. The image may be presented to the viewer at infinity or at a desired depth plane at an otherwise great distance, such as at least 20, 40, 60, 80, or 100 feet away. As described herein, the stored image can be processed to produce a corrected wavefront for projection to the wearer. The corrected wavefront may be configured to address an optical prescription or anomaly of the wearer's eye. In some embodiments, the adaptive optics of the display platform are used to provide adjustments to the image viewed by the wearer to process the optical prescription. In certain implementations, adaptive optics and/or software may be used in combination to provide appropriate optical corrections to adjust the projected image to address anomalies in the wearer's eye(s). The software may, for example, change the intensity pattern comprising the image to compensate, for example, a fisheye or a distortion in which straight lines appear. For example, to compensate for pin cushion distortion, some barrel distortion can be introduced into the intensity pattern comprising the image. Similarly, some concave distortion may be introduced into the intensity pattern comprising the image, for example to compensate for convex distortion. Other types of modifications to the intensity pattern that make up the image may be introduced by the software used to drive the light source or spatial light modulator to produce the desired intensity pattern. In some embodiments, the wearable augmented or virtual reality device 1400 may be configured such that the display platform 1402 is used to project images of various sizes or images originating from various depth planes to the wearer. In some implementations, the image may include characters or shapes of various sizes projected from various depth planes. In various implementations, the depth plane and/or size of the characters and/or features projected to the wearer may change during an eye examination. In some embodiments, the system may be configured to perform a brightness or glare test comprising an objective measure of functional visual acuity in different brightness and glare conditions. In various embodiments, the system may be configured to run a brightness acuity test to determine functional acuity in light conditions of varying brightness. For example, the system can provide light conditions of 3 or more brightnesses: 1) high-direct overhead sunlight; 2) medium - partly cloudy; and 3) low-bright overhead overhead lighting: Optometry may be similar to what would be measured in these three conditions using a standard eye examination chart (eg eye chart 1420). These test results may be an assessment of functional visual acuity. These tests can be used to test for sensitivity to bright light, photophobia, impaired scotopic adaptation, etc. In some embodiments, the system may be configured to test individual colors. For example, the ophthalmic system herein can be configured to determine refractive errors for individual colors (eg, red, green, blue, yellow, etc.). In some embodiments, the system may be configured to test various depth planes. For example, the ophthalmic system herein may be configured to determine refractive anomalies in individual depth planes. This may lead to an optical prescription that changes based, at least in part, on the depth plane. Refractive correction for presbyopia may also be determined.

In some embodiments, the wearable augmentation (or virtual) device 1400 may include one or more outwardly looking cameras. In certain embodiments, one or more outwardly looking cameras may be similar to the camera 16 described herein with reference to FIG. 5 . One or more outwardly looking cameras of the augmented reality display may be configured to capture images of the surrounding environment to determine where to superimpose test images, such as text or symbols, for example. For example, the augmented reality device may superimpose an image of an eye chart, such as a standard Snellen chart or other eye examination chart, onto an area in the wearer's field of view corresponding to the wall of the optometrist's office. In another example, the outward looking camera may be configured to capture images of an eye chart, such as a standard Snellen vision chart or other vision chart actually hanging on the wall of an optometrist's office. The wearable augmented or virtual reality device 1400 may then be configured to deform the captured image based at least in part on the desired depth plane to present the image. For example, the acquired image may be projected by platform 1402 at infinity accommodation. Then, via user interface 1404, light coming from the image can be manipulated to provide functionality similar to exchanging a lens with a typical phoropter. For example, spherical, cylindrical, or higher order aberration corrections may be introduced. If a cylinder is added, the appropriate axis can also be determined. In this way, an eye examination may be performed to determine the wearer's optical prescription. In some embodiments, the system objectively measures the optical prescription through monitoring, measuring, and/or analyzing the manipulated image to determine if the retina of the wearer is in focus, as disclosed elsewhere herein. or configured to estimate.

The wearable augmented reality device 1400 may include one or more user interface features 1404 configured to allow a wearer or other user to provide input to the device. The user interface feature 1404 may be incorporated into a device 1400 , as shown in FIG. 14 . In some implementations, the user interface feature 1404 is provided by a device or element that is not physically integrated with the device 1400 . For example, the user interface feature 1404 may be provided by a device or system in communication with the device 1400 . This may be a wired or wireless smart phone, computer, tablet, or other computer device that communicates with the device 1400 . In some embodiments, the user interface feature 1404 may be implemented by a combination of different devices and systems coupled to a device, for example, via a wired or wireless communication network or device physically coupled to or incorporated into the device or device. can be provided. Touch screens, voice recognition systems, or virtual touch screens are some examples of interfaces. Accordingly, the user interface features 1404 include capacitive features that are sensitive to touch, keyboard, buttons, microphones, photodetectors, cameras, and/or various software-implemented features provided by a graphical user interface. User interface features 1404 may be presented on a device equipped with a touch screen, where interaction with the touch screen provides input to the wearable augmented or virtual reality device 1400 . In various embodiments, the virtual touch screen is provided through a sensor that detects an image projected into the user's eyes and the user's moving body, eg, a finger. In some embodiments, the user interface feature 1404 may include a gesture detection element that allows the wearer to input a user via gesture. In some embodiments, the user interface feature 1404 includes a gaze detection element to allow the wearer to provide user input via the gaze of the eye (eg, when the wearer temporarily fixes the gaze on a button or when the gaze fixed to this button and may include selecting a button or other element when the wearer blinks an eye).

In the ophthalmic system herein, the user interface feature 1404 may be used by the wearer to provide feedback related to the quality of the image perceived by the wearer. The wearer determines whether the user can comfortably view the image projected to the user, for example, depending on changes in the applied refractive power (eg, increasing numerical and/or higher-order aberration corrections of spheres, cylinders, and axes). Feedback may be provided via the user interface feature 1404 . In this way, an optical prescription suitable for the wearer can be determined.

In some implementations, the clinician or physician may also use the interface feature 1404 to change the focus and/or depth plane of an image projected to the wearer or to change the size of the projected image. These changes can be used incrementally, if desired.

15 depicts an example method 1500 for determining an optical prescription of a wearer of a simulated (or augmented) reality device configured for use as a virtual phoropter. For ease of explanation, the method 1500 will be described herein as being performed by an ophthalmic system, such as the augmentation (or virtual) device 1400 described with reference to FIG. 14 . However, it is noted that any element or sub-part of the various augmented reality (or virtual) devices or other similar devices disclosed herein may also be used in the performance of any step, combination of steps, or portions of the method 1500 above. should be understood

At block 1502, the ophthalmic device of the present disclosure initiates an eye examination program. The eye examination program may be a stored process or sequential functions provided by the ophthalmic device. Initiation of the eye examination program may include determining and retrieving a starting optical prescription, such as for a wearer who has previously had an eye examination or will undergo other eye examinations. In some implementations, an eye examination program may incorporate information related to an abnormality in the wearer's eye, wherein the information related to the eye abnormality may be stored in a prior eye examination program, or a data repository (eg, an ophthalmic system or a networked data store). part) and may be input by the wearer or a clinician. The initiation of the eye examination program may include the determination of sequential potential images or images projected to the wearer. Initiating the eye examination may include determining whether a clinician or physician will perform the eye examination or whether the wearer is performing the examination herself. In some embodiments, the ophthalmic device may initiate an eye examination program in response to input received from the wearer or clinician.

At block 1504, the ophthalmic system projects an image into the wearer's eye. For example, the ophthalmic system may project an alphabet, letter, and/or shape of a target size to the wearer. The image may be a stored image or may be obtained by an ophthalmic system. The image may be configured to aid in determining the wearer's visual acuity, where visual elements include, for example, but not limited to, icons, symbols, characters, shapes, and the like. The visual element of the image may have various sizes within the image and/or the size of the visual element may vary by the ophthalmic system.

At block 1506, the ophthalmic system receives a user input related to an image. The user input indicates whether the user can see the image clearly or not. In one or more embodiments, the ophthalmic system may be initiated by projecting a relatively small sized character, which grows in size until the received user input indicates that the wearer can clearly see the projected image. In some embodiments, the ophthalmic system is configured to present an eye exam table, such as a conventional eye exam table, such as a Snellen optometry table. In such an embodiment, the received user input may include a projected chart of a portion or portions clearly visible to the wearer.

At block 1508, the ophthalmic system determines whether the user can comfortably view the image (eg, a projected eye chart). In some embodiments, the system is configured to receive a user input via a user interface as to whether the user can comfortably view an image. As noted above, examples of such a user interface may include a voice recognition system, a touch screen, or a virtual touch screen.

In some embodiments, the user input received at block 1506 is automatically determined through analysis of the wearer's physical and/or optical characteristics. For example, the automatically determined user input includes an analysis of whether the image is in focus by monitoring, measuring and/or analyzing the wearer's retina. As disclosed herein, by measuring the reflexes of the retina, the ophthalmic system can be configured to assess the degree of focus or quality of images formed by the wearer's eye. In some embodiments, the ophthalmic system may be configured to project a pair of dots into the wearer's eyes. The reflexes of these projected points can be measured and analyzed to determine the quality of the focus of the image. For example, at the point where the image of the projected point on the retina is aligned, the ophthalmic system may determine whether the wearer is focusing on the projected image or whether the wearer is properly adapted to the target point.

In some embodiments, the ophthalmic system is configured to determine whether the wearer can comfortably view the image based at least in part on the relaxed adaptation and/or detection of the gaze angle. As described herein, an ophthalmic system may include a tracking element and/or an eye detection element configured to monitor an eye. Such factors may detect the wearer's adaptation, gaze angle and/or pupil size. Lens adaptations can be detected with an autorefractor (as described in more detail elsewhere herein), which measures the size of the image focused on the retina, or with, for example, OCT (described in more detail elsewhere herein) imaging the lens. can The gaze angle and pupil size may be measured with one or more inwardly facing cameras. In some embodiments, the ophthalmic system may monitor eye movements as the user attempts to focus on a target object or image. For example, when the eye focuses on a static stimulus, the magnification of the lens of the eye changes rapidly and continuously. If a person has difficulty focusing a static object, this fluctuation may increase. This increase in variation may be measured and/or monitored by the ophthalmic system to determine that the wearer is not focusing on the targeted image or object. In some embodiments, the ophthalmic system may be configured to monitor these fluctuations and move the projected image (eg, changing the plane of depth onto which the image is projected) until the wearer successfully focuses on the object. For example, the ophthalmic system could project an image from a depth plane relatively close to the wearer and push the image back (increasing the distance between the wearer and the plane of depth) until the ophthalmic system determines that the wearer is accurately focused on the image. have.

Monitoring of the eye's adaptive reflexes may be employed by the ophthalmic system to determine if the wearer does not fit the current prescription or if the wearer needs optical correction. Imaging systems such as OCT that can show the front or back of the eye's natural lens can be used to determine if the wearer is making adjustments. For proximate objects, an increase in the convexity of the lens is expected. An OCT or other imaging system (eg, ophthalmoscope, SLO, confocal microscope, etc.) disclosed herein may be capable of monitoring lens movement and/or changes in the curvature of the lens surface or changes in the shape of the lens or structural features of the eye. may determine whether the wearer has an adaptation, examples of which are described elsewhere herein. Additionally, autorefractors can be used to determine if the wearer is adapting by monitoring the size of the image projected through the lens to the retina, examples of which are described elsewhere herein. This adaptive monitoring method can be used to determine whether the wearer is acclimatized, which can be useful in assessing whether the wearer requires optical correction.

The gaze angle can be employed to help determine if optical correction is also needed, where the gaze angle is monitored by examining the adaptive reflection. Using inward-facing cameras and processing electronics, the ophthalmic system can be configured to track changes in the gaze of the left and right eyes and determine the time of day. Using this gaze-visual information, it is possible to determine whether the wearer's eyes respond as expected to images presented in various depth planes. For example, when images of relatively close depth planes are presented and both eyes are substantially parallel and do not converge, the ophthalmic system may interpret this result as indicating that the wearer is not comfortably viewing the image and that the wearer is indicative of a visual defect. can be configured to interpret. Gaze angles for different depth planes can be determined, and it can be evaluated whether the eye can match an appropriate gaze angle for a particular depth plane. Likewise, potentially if the gaze is monitored as pointing inward with respect to the depth plane at infinity, the wearer may require optical correction.

As another example, the ophthalmic system may test the adaptive reflex by determining the wearer's pupil size or a change in the wearer's pupil size when an image is projected to the wearer. The ophthalmic system may be configured to track changes in pupil size using an inward-facing camera imaging the eye, and particularly the iris. Using this information, it can be determined whether the wearer's eyes respond as expected to images presented in various depth planes. For example, the size of the pupil is expected to contract when looking at a near object (compared to a distant object). Accordingly, the ophthalmic system may be configured to present images originating from a proximal depth plane and to track the wearer's pupil response. If the pupil does not constrict or does not constrict sufficiently, the ophthalmic system may be configured to interpret this result as indicating that the wearer cannot comfortably view the image.

Thus, to determine the comfort of the wearer viewing the image, when a particular image is projected to the user, the ophthalmic system may determine the wearer's adaptation, diurnal time, and/or pupil size as part of the adaptive reflex test. Similarly, wearer comfort can be determined when an image is projected through various depth planes. In some embodiments, the ophthalmic system may compare the measured adaptation, gaze angle, and/or pupil size to predicted adaptation, gaze angle, and/or pupil size. If the one or more measured features are within the target range of the one or more predicted features, then the ophthalmic system may determine that the wearer is viewing the image comfortably and accurately (eg, the wearer is viewing the image as appropriate, or to determine whether to see with normal vision). If the one or more measured features are outside the target range of the one or more predicted features, then the ophthalmic system may determine that the wearer is not viewing the image comfortably and accurately (eg, the wearer is viewing the image with impaired vision). are watching). In some embodiments, the ophthalmic system may combine information related to the measured feature with information received or determined by the user input at block 1506 to determine when the wearer is comfortable viewing the projected image. For example, when viewing images from a relatively close depth plane, the wearer's eyes are expected to move or converge toward each other, the pupil is expected to contract, and the convexity of the lens is expected to increase. A departure from one or more of these expectations may be interpreted as indicating that the user is not viewing the image comfortably and accurately (eg the wearer is viewing the image with impaired vision).

If the ophthalmic system determines that the wearer cannot comfortably view the image by receiving input from the user through the user interface or evaluating the user's accommodation and/or gaze, the ophthalmic system proceeds to block 1510 to focus to gradually increase the prescription (eg adding or subtracting more positive or negative ranges to get more and more positive or negative spherical wavefronts). The system is also capable of astigmatism and thus can progressively change the axis and cylinder. The ophthalmic system then returns to block 1506 to receive or determine user input and again determine whether the user is comfortable viewing the image (eg, with normal vision). This loop can be repeated until the user can comfortably view the image.

In some embodiments, the ophthalmic system operates the optical system at block 1510 based at least in part on user input received at block 1506 and/or the objective assessment determined at block 1508 or feedback as disclosed elsewhere herein. configured to adjust the calibration. In some embodiments, the ophthalmic system is configured to adjust the optical correction at block 1510 based at least in part on measurements of adaptation, gaze angle, adaptive reflexes, and/or pupil size of the wearer when viewing the projection image. Accordingly, in certain implementations, the ophthalmic system may be configured to perform an eye examination using subjective and objective examinations to determine a corrective prescription for the wearer.

In some embodiments, the subjective component of the eye examination is projecting an image and changing the diopter of the image (eg, ±0.01D, ±0.1D, ±0.125D, ±0.25D, ±0.5D, ±1.0). D, or a substantially continuous change in diopter, such as through an adaptive optics element, etc.) and receiving user input as to whether the quality of the image has changed. In certain implementations, the ophthalmic system may also be configured to determine changes in the wearer's eye (adaptation, gaze angle, pupil size, etc.) when the diopter changes. This objective examination data can be combined with the wearer's subjective response to determine whether changes in diopters can result in changes in the wearer's vision.

If the ophthalmic system determines that the wearer can comfortably view the image, the ophthalmic system proceeds to block 1512 to determine a prescription for the wearer's eyes. In some implementations, the same procedure may be repeated for both eyes (e.g., both eyes may be treated together by applying the same correction to each eye, or different corrections may be applied to the left and right eyes separately). must be understood In some embodiments, it can be used to treat immobility where two different prescriptions are applied to each two eyes of the wearer. In some embodiments, the ophthalmic system may be configured to dynamically switch between optical prescriptions depending on what is seen to the wearer and/or the activity the wearer is performing. For example, static lenses may tire the wearer when viewing primarily close-up images or primarily distant images as compared to when the wearer views a mixture of near, medium, or far-range images. Accordingly, the ophthalmic system may be configured to dynamically change the applied optical prescription in real time based at least in part on a known optical prescription for the treatment of immobility, myopia, or hyperopia of the wearer.

The method 1500 may be used to provide information to an augmented (or virtual) reality device, such as device 1400 described herein with reference to FIG. 14 or other device described herein. Accordingly, the augmented (or virtual) reality device may be configured to change the focus or other aspect of the projected image based on the wearer's optical prescription as disclosed herein. In some embodiments, the eye exam described herein may be performed using the same wearable augmented (or virtual) reality device that the wearer uses for pleasure, work, or other purposes.

Method 1500 may be used to determine optical prescriptions, optical corrections, or refractive corrections for different depths of field. For example, there may be a first optical prescription for a far depth plane, a second prescription for a mid-depth plane, and a third prescription for a near-depth plane or perspective, circle and middle, near and mid-depth planes. have.

The method 1500 and system may be used to correct or improve a wearer's vision at points where the wearer suffers from presbyopia. Different optical corrections may be applied to different depth planes and associated content projected from those depth planes. Alternatively, the wearable augmented reality device may be configured to switch between providing prescriptions for near (if any) and far (if any) based on a sensed orientation of the user, such as, for example, the user's head or eyes. As described herein, orientation sensors or other sensors may be used to determine the orientation of a user's head or eyes.

Method 1500 may be performed in real time to automatically determine the wearer's optical prescription. This information can be stored in the ophthalmic system and used for later examination. For example, the ophthalmic system may be configured to update the wearer's current optical prescription based on the examination. For example, the ophthalmic system may be configured to monitor the eyes and record eye behavior of the wearer over time. Based at least in part on this information, the ophthalmic system can dynamically adjust the wearer's optical prescription over time. For example, an ophthalmic system can measure eye behavior when presenting an image at a known depth. The ophthalmic system can determine whether the eye deviates from the predicted eye response to the image to determine whether it is behaving as expected. The ophthalmic system may be configured to initiate an examination and/or update the wearer's optical prescription or schedule or initiate an eye examination update if the ophthalmic system determines that it is out of range, eg, a targeted, acceptable range. .

In some embodiments, the ophthalmic system may be configured to determine an optical prescription overtly. For example, this may occur when an alternative functionality cannot be provided to the wearer while an eye examination is being performed.

In some embodiments, the ophthalmic system may be configured to unobtrusively determine the optical prescription. For example, this may occur if the system is configured to measure the wearer's eye behavior while the wearer is doing something else (eg watching a movie, reading a text, watching a video, etc.). To compare the measured eye characteristics of the wearer, and to determine deviations resulting from expected characteristics of the wearer's eyes, the ophthalmic system may be configured to measure characteristics of the wearer's eyes while the wearer performs these other activities. In some embodiments, the system may be configured to determine an optical prescription based at least in part on such a determined deviation. In some embodiments, the expected characteristics of the wearer's eyes may be based, at least in part, on the image characteristics projected onto the wearer and the depth plane. In some embodiments, if such deviations are monitored, the system may ask the user whether to undergo the inspection applied by the system, or may determine whether inspection optical corrections are sufficient or insufficient. In some implementations, the ophthalmic system may be configured to track physical changes in the wearer's eye attempting to acclimatise and gaze while performing these other activities. In some embodiments, this information can be compared to measurements obtained while not trying to adapt and gaze to determine an optical prescription.

In some embodiments, the ophthalmic system may be configured to objectively measure the wearer's optical prescription. In various implementations, this may be done without receiving feedback from the wearer on image quality. In certain implementations, this may be achieved without projecting images of various sizes to the user. For example, the ophthalmic system may be configured to project an image (eg, the ophthalmic system puts the image at infinity) from a virtual infinite depth. The ophthalmic system then measures the wearer's adaptive reflexes, adaptations, gaze angles and/or pupil size. Based at least in part on the wearer's adaptation, gaze and/or pupil size, and deviation of the wearer's adaptation, gaze and/or pupil size from what is expected, the ophthalmic device may objectively determine the wearer's optical prescription. . For example, if the wearer's eyes adapt to +1D when the image is set to infinity, the ophthalmic system can objectively determine the optical prescription.

In some embodiments, the ophthalmic system may be calibrated to determine an appropriate diopter and/or perform an appropriate diopter correction based, at least in part, on the configuration of the display platform. For example, when adjusting the depth plane of an image projected to the wearer, the ophthalmic system may be configured to be calculated to accurately correlate changes in the depth plane with changes in diopters or refractive power. In some embodiments, during the calculation, the iris of the measurer may be analyzed. The iris can be uniquely used to identify a patient, and this unique identification allows access to relevant patient records to associate a person with their medical records/prescriptions, etc.

In various embodiments, to reduce distraction, what is visible to the world in front of the wearer's eyes via the augmented reality device is blocked or otherwise invisible during the examination. This may happen, for example, when an image is presented to a viewer, but this approach is not required.

Although the system shown in FIG. 14 is described as an augmented reality device, in other embodiments, such a system may be a virtual reality device. In any case, such a system may be a system provided by a physician or clinician for examination at a medical institution or optician's office or other location. In other embodiments, the system may be owned by the user and may be employed for entertainment (eg games and movies) and/or other purposes such as work activities. As mentioned above, one advantage of administering a test on a user's system is that the test can be conveniently performed several times throughout the year (at least 2, 3, 4, 5, 6, 8, 10, 12, 16, 18, 24, or more). In some embodiments, the frequency and/or schedule of examinations may be based, at least in part, on the rate of deterioration of the wearer's vision. If, for example, the rate of exacerbation increases, the frequency of the examination may be increased. Likewise, the examination may be performed with or without a medical professional such as an optician, an ophthalmologist, a nurse, a technician, a medical assistant, or the like.

<u>red reflection</u>

The ophthalmic system may also perform a reflex examination of the wearer's eye to detect various abnormalities. The reflex test may include shining or projecting light into the patient's eye. For example, the red reflex test makes it possible to detect abnormalities in the retina based on monitoring the typical red reflected off the retina. The red reflex test can detect abnormalities in the eye including cataracts, cancer of the eye, retinoblastoma, retinal detachment, glaucoma, strabismus, amblyopia, and lower and higher order aberrations. A corneal reflex test, or Hirschberg test, refers to detecting light reflected by the cornea, and can be used to detect strabismus, misalignment, imbalance, or other symptoms of the cornea such as corneal scarring. In some embodiments, reflectometry may detect anomalies using visible and/or infrared light of monochromatic, polychromatic, or white light.

In some embodiments, the ophthalmic system may be a user display 62 such as shown in FIG. 5 , which includes a light source such as a projection subsystem 18 configured to project light 38 into the eye 20 of the wearer. include The user device 62 may include a display lens 106 that may be mounted by the user's head or eyes using a housing or frame 108 . The display lens 106 is positioned by a housing 108 in front of the user's eye 20 and is configured to reflect (and also potential beamforming) light that is projected onto the eye 20 (and also potential beamforming). one or more transparent mirrors or reflective features. This reflective surface is partially transmissive such that at least some light originating from the local surroundings is transmitted, for example light originating in front of the wearer. 10D also shows a display implementation comprising a plurality of displays 200, 202, 204, 206, 208 that may be used to inject light into a plurality of respective waveguides 182, 184, 186, 188, 190. Including another field of view of the example, each waveguide distributes each incident light over the length of the waveguide, as described above, so that it exits downwards towards the eye. The waveguide may project light into the eye from different depth planes. The display devices 200, 202, 204, 206, and 208 are a fiber optic scanning device (FSD) to form an image. Such a device may be configured to project light through the waveguide stack 178 to a portion of the retina. The system may further comprise one or more fiber scanning displays and/or adaptive optics elements, such as variable focus elements, configured to project light to a particular portion of the eye. In some embodiments, the ophthalmic system may include a separate light source in addition to the display 62 for projecting light into the eye to form a reflection.

The system may then detect reflections originating from the wearer's eyes. For example, the system may include one or more cameras, such as eye tracking camera 24 , or similar detection methods for receiving a portion of light reflected from the wearer's retina, cornea, or other structure. The camera 24 may detect the color and/or intensity of the reflection, the shape, location and/or size of the reflection, or any other detectable quality of the reflected light. In some embodiments, camera 24 may capture reflected images for immediate or later analysis. If the inspection is performed in both the left and right eyes of the wearer, the camera 24 and/or other components of the device 62 may compare the quality of any reflections to the two eyes to compare the quality of any reflections to the two eyes of the wearer. can detect imbalances or other differences in In some embodiments, the system may be configured to perform an alternate or unilateral cover test to detect deviation of the eye. In the cover test, one eye may be covered, or both eyes may be covered alternately, and the movement of each eye is when one eye is covered or not and/or the other eye is covered or not. can be detected when not. The ophthalmic system may cover the wearer's eyes by using the spatial light modulators disclosed elsewhere herein and/or by providing an image to only one eye or a portion thereof. In various embodiments, left and right eye examinations may be performed simultaneously or at different times, and one camera 24 or multiple cameras 24 may be involved. In some embodiments, the camera and/or light source may include one or more light pipes. Light from the light source may propagate through the light pipe to the eye or waveguide 178 . Similarly, light collected by the light pipe or waveguide stack 178 may propagate through the light pipe or one or more cameras.

In some embodiments, the reflex test may be performed along the normal line of sight of the wearer's eye. That is, light collected from a light source, camera 24 and/or a common point, such as a waveguide or light guide, generally follows the eye's line of sight (i.e., within a maximum angular range such as ±5 or ±10 degrees of the normal line of sight). may be aligned so that at least some of the projected and reflected light travels substantially along the optical axis of the eye. In some embodiments, the examination is not limited to the optical axis and/or normal line of sight. In such an embodiment, the light source may be positioned to project light into the wearer's eyes at a first angle, and the camera 24 may be positioned at a second, different location outside of normal line of sight that may receive the reflected light. In some embodiments, the reflectometry may include multiple projections of light coming from different first angles at the same time or at different separate times.

Red reflex tests usually involve macroscopic imaging of the retina of the patient's eye. The camera may generally focus on the eye, but may focus on the cornea or retina, for example. Because reflex tests do not require the camera to resolve features of the retina, the camera does not need to zoom in on the retina. Light can be projected into the patient's two eyes, and the retina's reflection can be imaged or monitored. If the reflected redness of both eyes is the same or similar, and if the size, location and shape of the reflections of both eyes are the same or similar, then a normal result can be monitored. If the eye reflects gray or white rather than red, it could indicate the presence of a cataract, retinoblastoma, or other condition. Different sizes or shapes of the reflective areas between the two eyes may be indicative of abnormalities such as refractive errors, misalignment, strabismus, differential refraction, or other conditions. Refractive abnormalities can be monitored as linear or crescent-shaped areas of the retina that do not exhibit red reflexes. For example, farsightedness may appear as an upward-pointing crescent, while myopia may appear as a downward-pointing crescent.

Retinal monitoring can be facilitated by using mydriatic agents to dilate the pupil in response to projected light and avoid constricting the pupil. The mydriatic agent may be a variety of well-known, mydriatic inducing drugs used in optical tests, such as tropicamide and the like. Other methods of reducing pupillary constriction or inducing dilatation may also be used. This solution may be accomplished by a port of an eye display device as described elsewhere herein. In some embodiments, retinal monitoring may be performed without mydriatic using short beams of light rather than using a stable light source. If a short light is applied while the pupil is not constricting, the reflected light from the retina can be monitored briefly before the pupil contracts in response to the light. This phenomenon causes the red-eye effect commonly seen in photography. Accordingly, the light source may be configured to transmit light momentarily, and the inward facing camera may be configured to capture an image of the reflected light after an appropriate time delay.

When red reflex testing is the objective, reflected light is frequently applied and viewed at a distance of about 8 inches to 4 feet from the patient's eye. If the examination is to be performed using an adjacent head mounted ophthalmic device, it is not practical to install the irradiating or receiving device at a great distance from the eye. Thus, an optical element in the device can be used. For example, the ophthalmic system may include one or more lenses, such as, for example, negative magnification lenses, allowing projection of light that appears to be coming into a more distant plane of depth. Similarly, the lens may be configured to form a virtual image corresponding to a typical reflex test field of view distance that may be detected by a camera 24 disposed within a head mounted ophthalmic system. In some embodiments, the light source and/or image sensor may be mounted to a portion of a head mounted ophthalmic system, such as an ear frame, and a mirror may be used to create longer projections and/or viewing distances.

Corneal reflex tests, such as the Hirschberg test, may use a fixed target for the wearer. For example, the wearer may be presented with a target in the center of the field of view. In some embodiments, the stationary target may be positioned off-center of the field of view. A stationary target may additionally be projected in multiple depth planes, such as by use of a waveguide stack 178 . The depth of the fixed target can be changed during the examination, for example by presenting a first fixed target in a first depth plane or a position at a first time, followed by an additional fixed target in a different depth plane or position, such that adaptation of the wearer's eye causes The fixed target may be a small image, for example a dot or recognizable picture, a dark spot in the image, and the like. Once the wearer's gaze is fixed on the fixed target, a difference in the location of the corneal light reflection between the wearer's two eyes may indicate the presence of strabismus. In some embodiments, the projected light may be tailored for reflection from the cornea, rather than other structures of the eye. For example, the light could be of a lower intensity than the light used for the red reflex test, avoiding the creation of strong reflections from the retina. Furthermore, corneal reflex tests can be performed without the use of mydriatic agents. In the absence of mydriatic agents, the pupil can constrict in response to projected light, further reducing any retinal reflexes that may interfere with monitoring corneal reflexes. In some embodiments, the system may use a cover test by blocking, defocusing, blurring, and/or de-emphasizing the wearer's other eye while not obscuring it. Blinding of one eye can be simulated by projecting a fixed target to only the other eye.

In some embodiments, various reflection test results may be imaged, such as by camera 24 , and stored for analysis. Once stored, the test results can be compared with known, known or otherwise available data from normal and/or abnormal results of reflex tests. For example, to determine whether any abnormality is present, a red light image reflected from the patient's retina may be compared to a red light image reflected from a normal retina (ie, not exhibiting any detectable abnormality characteristic). can If a part of the patient's eye appears to be inconsistent with the normal eye condition, the test data may be further compared with image data of various known abnormalities to accurately diagnose the patient's eye condition.

<u>intraocular pressure</u>

In one or more embodiments, the augmented reality or virtual ophthalmic system may be configured to measure intraocular pressure in a user's eye. Referring back to FIG. 5 , this embodiment may be practiced by constructing the ophthalmic system 62 with one or more additional elements along with the necessary electrical circuitry and processing power. In one or more embodiments, the ophthalmic system may be configured to include additional element/sensor(s), or in other embodiments, the additional element may be in addition to the ophthalmic system.

Intraocular pressure (IOP) is typically determined by the degree of pressure of the fluid in the eye. While some changes in IOP are normal (eg day and night differences), high IOP or significant differences in intraocular pressure between the left and right eyes are glaucoma. It can be indicative of other physiological problems such as iritis, retinal detachment, uveitis, and corneal hypertrophy. IOP is typically about 10-21 mm Hg, with an average of about 15 or 16 mm Hg, varying by about 3.5 mm Hg during the day.

In some embodiments, the ophthalmic system may use tonography to determine IOP. The system uses contact tonometry to flatten an area of the cornea by applying a contact force to infer the IOP from the applied pressure and subsequent response. In some embodiments, the system uses non-contact tonometry, and may apply a rapid pulse of air, negative pressure, or other indirect force through an electro-optic system to flatten the cornea and detect corneal flattening. The system may also include optical coherence tomography (OCT), such as the OCT described herein, using such an OCT system to measure the response of the eye via 3D imaging. Compression can be determined by measuring changes in corneal curvature or by measuring motion of the apical corneal interface to a posterior interface such as the retina.

The ophthalmic system 62 as described may be configured to measure intraocular pressure using optical and ultrasonic measurement techniques. In some embodiments, the system 62 can apply a force to induce compression of the cornea and use optical or ultrasonic detection methods to monitor the response to measure eye pressure. The force may be applied by mechanical compression, air blast, and/or sound waves such as ultrasound. In another embodiment, the system may use optical, ultrasonic and/or optoacoustic detection methods to measure eye pressure without applying force to the eye. For example, ultrasound or sound waves can be used to perturb the surface of the cornea. Imaging methods, including ultrasound imaging, can be used to measure changes that result in shape, eg, flattening of the cornea. In some embodiments, 3D optical imaging and/or ultrasound may be used to determine the density of a fluid in the eye, which may be used to calculate intraocular pressure based on known properties of the fluid. Such an ultrasound system is described elsewhere herein with reference to, for example, FIG. 24A. The 3D optical imaging system can determine the density or change in density of the fluid based on known light absorbance and/or reflection properties. The system may further include a temperature sensor, such as a non-contact infrared thermometer or other suitable temperature sensor, to detect changes in eye temperature that may affect the reliability of any of the measurements described above.

The system may further include a processor 32 and a sensor configured to measure intraocular pressure of the eye 20 . The sensor may be any type of monitoring device including an optical sensor, a 2D imaging head, an interferometric 3D imaging head, and/or other sensors. In some embodiments, the ophthalmic system of the present disclosure may use ultrasound imaging or optoacoustic ultrasound imaging in addition to, or instead of, the optical sensing techniques described above. For example, ultrasound or optical time-of-flight measurements may be used to determine any one or more properties that occur in the cornea of the wearer's eye by an applied force. Ultrasonic time-of-flight measurements can additionally be used to determine intraocular pressure without applying force to the eye, since the density of the fluid in the eye depends on the intraocular pressure and affects the speed of ultrasound in the eye. Reduced time-of-flight may indicate higher fluid density, which correlates with higher intraocular pressure. In some embodiments, intraocular pressure may be determined based on the shape (eg, applanation) of the outer surface of the eye, tension, or other characteristics of the outer surface of the eye. The sensors described above may include any camera 16 or 24 of the ophthalmic system 62 herein. For example, in embodiments using ultrasound or optoacoustic ultrasound imaging, the sensor may include one or more ultrasound transducers configured to produce an electrical signal based on the detected ultrasound. Similarly, the sensor may include a camera configured to detect visible or infrared light, as appropriate in embodiments using visible or infrared imaging or optical sensors.

In some embodiments, as described elsewhere herein, a light source, such as a fiber optic scanning display (FSD) 18 , or a separate light source element may project a beam of light 38 into the user's eye. Such a light source may further include an adaptive optics element 316b, a variable focus element 316a, a waveguide stack 178, and/or one or more lenses, as described elsewhere herein and in FIG. 10E. can The light source may further be configured to project light to the wearer from different depth planes. In embodiments where the light source uses a fiber optic scanning display, the optical fiber length of the display may be variable. The light source may be a display device or a separate light source. In one or more embodiments, a parameter set associated with backscattered or reflected light may be measured by an FSD or other light monitoring device or photo-detector (as described herein, FSD may be used for light collection). Backscattering or reflection of the emitted light, especially when compared to previous measurements, can be indicative of intraocular pressure. For example, as shown in FIG. 16A , the light emitter 1640 may emit a light beam 1642 in the direction of the cornea 1625 of the wearer's eye 1620 . A portion of the light beam may be reflected as reflected light beam 1644 , which may enter the photo detector 1646 . The remaining incident ray 1642 may be scattered to other portions. A compression-inducing device, such as an air tube 1630 , may cause flattening of the cornea 1625 , such as by emitting an air jet or pulse 1635 . A lower IOP will result in a larger, flatter reflective surface, allowing more incident ray 1642 to be reflected back to the photodetector 1642, resulting in a greater apparition. Thus, fewer reflected rays going to the photo detector may, in one or more embodiments, indicate a high IOP. Because a low IOP causes more rays to be reflected, resulting in more significant apparition, a higher number of reflected rays going to the photodetector may indicate a low or normal IOP. Other configurations are also possible. Additionally, the wavelength of light projected into the eye can be varied to provide depth information. For example, infrared wavelengths can penetrate deeper into the eye.

In some embodiments, optical sensing may include analysis of one or more Purkinje images in the wearer's eye. For example, the sensor may be configured to detect a first Purkinier image produced by a so-called P1 image, a corneal reflection, or a reflection of light originating from the outermost surface of the cornea called a glint. The sensor and processor may analyze the presence, shape, location, intensity, or other detectable characteristic of the sparkle. Based on this twinkle analysis, gaze angle, adaptation, curvature, apparition or other eye characteristics can be monitored. Repeat measurements can detect changes in any of the aforementioned characteristics. In some embodiments, glint analysis may include measurement of glint characteristics during adaptive or induced changes in gaze to increase the accuracy and reliability of IOP measurements based on the characteristics of the detected glint, for example as a noise filter. have.

The processor 32 of the ophthalmic system of the present application shown in FIG. 5 may be configured to determine the intraocular pressure based on the output of any of the sensors described above. For example, the processor may compare output results from one or more sensors to a correlation database that associates detected parameters with known IOP values. The correlation database may be stored locally in the memory circuitry of the ophthalmic system of the present application, or may be stored remotely and accessed via wireless communication. The processor 32 may be further configured to detect the presence of ocular hypertension based on information such as a threshold pressure or other medical information defining the measured intraocular pressure and ocular hypertension. Threshold pressure readings and other related information may be stored locally or remotely as described above in a correlation database.

In addition, the intraocular pulse of the eye can be monitored based on IOP detection as described above. Intraocular pulses occur because pulsatile eye blood flows into the choroid or vascular bed of the eye. The IOP of the eye changes slightly each time blood is pumped into the eye. Thus, the vibration of the IOP can be monitored to match the ocular pulse rate, which can be equal to or substantially equal to the wearer's heart rate. In addition, there may be systolic and diastolic IOPs associated with the systolic and diastolic states of the cardiac cycle. Thus, increased IOP is associated with increased blood pressure. Furthermore, intraocular pulse width (OPA), a measure of the difference in IOP between systolic and diastolic hearts, can be used as a diagnostic screening tool for carotid artery stenosis. A low OPA may indicate the presence of carotid artery stenosis, and a lower value indicates more severe stenosis. OPA may also be positively or negatively associated with the presence of glaucoma damage, the axial length of the eye, and/or other eye features or hemodynamics. OPA can be measured repeatedly over a period of days, months or years, and the trend of increasing or decreasing OPA is similar to that of the wearer's blood pressure.

With reference to FIG. 16B , an exemplary process flow 1600 for determining an IOP is disclosed. At block 1602, the tonometry program is initiated. At block 1604 , light is projected onto a known portion of the user's eye. At block 1606, a pattern or amount of backscattered or reflected light emitted in response to the projected light is measured. As noted above, this may be done by the FSD itself or in some embodiments via a separate optical measurement module. In some embodiments, as described above, 2D or 3D imaging may be used in addition to or instead of backscattered or reflected light quantity detection. As disclosed herein, optical imaging of the eye, eg, the cornea, OCT imaging, and the like can be used to determine changes in surface shape or applanation. Ultrasound and/or optoacoustic ultrasound may be used to image the shape of the eye, for example to determine the degree of flattening of the eye. In some embodiments, applanations may be detected interferometry. The interferometer can detect small changes in distance, for example. Thus, an interferometer can be used to detect changes in the position of an eye surface such as the cornea.

At block 1608 , the system herein may consult a correlation database. The correlation database may be a predefined database that associates a pattern or amount of backscattered light in the eye tissue with a known IOP value. In some embodiments, the correlation table may associate other eye properties, such as applanations or other eye shape data, with corresponding IOP values. At block 1610, the results may be presented to a user or a clinician performing an intraocular pressure test. In some embodiments, results may be analyzed locally in an ophthalmic device. In other embodiments, results may be transmitted to a remote location for IOP and/or ocular hypertension diagnosis, analysis.

Tonometry as described above may be performed individually on demand, or may be performed periodically and/or repeatedly over time. Iterative analysis makes it possible to track cyclical changes or long-term progression of the wearer's IOP. Thus, the IOP test may be incorporated into a device mounted only for ophthalmic diagnostics, or it may be part of a device mounted regularly for things such as entertainment, work or other purpose(s), in which case the exam may be performed at regular intervals and / or may be performed automatically at various times of the day, week, month, year, etc. In some embodiments, therefore, intraocular pressure may be measured by the device at least 2, 3, 4, 6, 8, 10, 12, 16, 18 or more times per year. In some embodiments, intraocular pressure may be measured by the device at least 2, 3, 4, 6, 7, 8, 10, 12, 14, 16 or more times per week. In some embodiments, intraocular pressure may be measured by the device at least 1 time, 2 times, 3 times, 4 times, 6 times, 7 times, 8 times, 10 times, 12 times, 14 times, 16 times or more times per day. have. Repeated and/or periodic inspections per day provide a measure of the daily change in the wearer's IOP. Repeated and/or periodic examinations over long periods of time, such as weeks, months, years, etc., allow for long-term follow-up of IOP increases or decreases, for example, to detect increases in IOP prior to the onset of ocular hypertension, or for diagnosed eye The efficacy of treatment for hypertension can be monitored. In some embodiments, the frequency of the regular schedule of examinations may be adjusted based on an increase or decrease trend in the results of an intraocular pressure test. The system may also be configured to alert the wearer and/or clinician if an abnormally high IOP or other abnormality is detected.

<u>pinhole</u><u> veil</u>

In one or more embodiments, the ophthalmic system of the present disclosure may be used for an eye exam, similar to an eye exam performed through a pinhole blind device. Pinhole shading devices focus light and eliminate effects by refractive errors (eg, nearsightedness, farsightedness, etc.). With a pinhole shield with a hole in the center, any defects in the shape of the lens have little or no effect, as light can only pass through the center of the lens of the eye. In some embodiments, a pinhole occluder device may be used to distinguish visual defects caused by refractive errors from visual defects caused by other abnormalities. For example, a pinhole visor device could compensate for dilated patients who are unable to contract the iris.

In one or more embodiments, the ophthalmic system may provide a version of a pinhole shield. For example, the ophthalmic system of the present disclosure may obscure the field of view of one or both eyes, so that peripheral viewing is obscured while maintaining a central field of view (ie, viewing through a pinhole). Accordingly, in various embodiments, the ophthalmic system of the present disclosure may obscure, block, de-focus, de-emphasize, or block some or portions of light rays that contribute to image formation from entering the user's eye.

In one implementation and not wishing to be bound by any theory, the present ophthalmic system may be used to provide a means for diagnosing an eye defect where a pinhole visor device may be used. The ophthalmic system of the present disclosure is configured to obscure the field of view of one or both eyes so that the periphery is blocked, but the central field of view (ie, seeing through the pinhole) can be maintained. For example, if visual acuity is improved by use of a pinhole blinding device with the ophthalmic system of the present disclosure, this may indicate a refractive error in the peripheral area or peripheral cataract. Or, if your vision deteriorates with the use of a pinhole visor, this may indicate macular degeneration or a central lens defect. If there is no change in vision, it may be that the eyes are normal, or strabismus ("lazy eyes") as described above. Accordingly, the ophthalmic system of the present disclosure may be configured to automatically or interactively obtain information related to a user's health condition or symptom and/or information related to an abnormality of the user.

In other implementations and without wishing to be bound by any theory, the ophthalmic device of the present disclosure may be configured to correct a visual defect of a user using a pinhole blinding device. For example, in the case of a user with peripheral refractive error, the ophthalmic system blocks the peripheral vision by blocking the field of view of one or both eyes, but maintains the central field of view (ie, seeing through the pinhole). Therefore, the light rays originating in the surroundings are blocked and do not interact with the refractive error of the user's eyes, and as a result, the user's eyesight can be improved. Similarly, pinhole blinds may correct refractive errors, such as, but not limited to, other vision combinations such as scotomas (eg blind spots) in eccentricity (nonfoveal portion of the eye), among others. In other implementations, the ophthalmic system of the present disclosure may be configured to apply multiple pinholes to the display, each individually functioning as an iris or field-stop (eg, blocking unrelated rays). This configuration may improve the eye's focusing on the image. For example, and not wishing to be bound by any theory, the use of multiple pinholes allows light to pass through the pinholes and propagate through a small area of the eye lens. Because light can only pass through a small area of the eye lens, lenticular defects can have a reducing effect. Thus, more light can pass through the plurality of pinholes, but these rays do not interact with defects on the surface of the eye.

In some embodiments, the ophthalmic system herein may be an augmented reality system that corrects vision defects. As described above, the ophthalmic system of the present application is an augmented reality head mounted display configured to apply a pinhole veil to ambient light coming from the world in front of the user, and also to apply a pinhole veil to AR image content generated by the ophthalmic system. It may be a device system. Alternatively, the ophthalmic system of the present disclosure provides an image of VR content generated by the ophthalmic system, applies a pinhole visor, and provides the VR content to the user while the user's eyes are obscured from ambient light in front of the user. It can be a VR head mounted display system that is configured. As previously described, a VR head-mounted display system uses a forward-facing camera (e.g., camera 16 of FIG. 5).

In various embodiments, the ophthalmic system herein may be a patient-mounted ophthalmic device as shown in FIGS. 3A-3D and 5 in connection with the correction of myopia, farsightedness, astigmatism and other refractive abnormalities. Accordingly, it is to be understood that the descriptions and elements described above in relation to the ophthalmic devices disclosed herein for the correction of visual defects equally apply thereto.

For example, as described above, the ophthalmic device of the present disclosure includes a display lens 106 and a light source configured to project light 38 directed to the user's eye to form an image in the user's eye for the user to see. Augmented (or virtual) reality display 62 comprising 18 . In various embodiments, this display device 62 receives light from a fiber scanning display disposed at the edge of the waveguide stack 178 and couples the light from its backside of the waveguide to the eye of the wearer. ) is included. When the display device 62 is an augmented reality display device, the ophthalmic system of the present disclosure may also guide ambient light from the surrounding world, for example, light in front of the user, through the display lens 106 to the user's eyes. have. Such light may be delivered to the user's eye, for example via a waveguide stack. As discussed above, display 62 may also include one or more adaptive optics or variable focus elements (VFEs) (eg, VFEs 316a and 316b). As discussed above, the adaptive optics can be dynamically changed to change the wavefront incident on it. For example, the adaptable optics device may be, for example, a deformable mirror or a reconfigurable transmissive optical element such as a dynamic lens, such as a reflective optical element, such as the lens described in FIGS. 10B-10E.

In one or more embodiments, the ophthalmic system of the present disclosure may include a pinhole shield as described below with respect to FIGS. 17A and 17B . In various embodiments, the pinhole visor may be integrated as part of an ophthalmic system, eg, display 62 . Also in some embodiments, the pinhole shade may be a separate component that can be positioned on the ophthalmic system, for example mechanically attached to the ophthalmic system.

It should be understood that the peripheral field of view (eg FIG. 17B ), the central field of view (eg FIG. 17C ) or any target area may be obscured by digital or physical means. For example, the physical means may include a mechanically opaque filter configured to include pinholes positioned at desired locations. In some embodiments, one or more spatial light modulators (eg, FIGS. 10B and 10C ) may be coded to generate a pinhole shade, which may be altered based on a desired point of the pinhole.

In some embodiments, the ophthalmic system of the present disclosure may digitally obscure a portion of the scene. For example, local processing module 70 may retrieve images from digital memory and/or remote data storage 74 and present them to a user via display 62 . The ophthalmic system of the present application may include a local processing module 70 configured to perform an instruction to transform the image to simulate a pinhole veil on the 2D image generated by the ophthalmic device.

In other embodiments, the scene may be digitally obscured to de-focus one or more regions of the image while other regions of the image are in focus. The in-focus area may correspond to a pinhole, and the out-of-focus area may correspond to a covered area. In some embodiments, the ophthalmic device of the present disclosure uses a waveguide stack 178 (eg, FIG. 10D ) to selectively project light at various depths of focus as described in FIG. It is possible to present an image with one or more in-focus areas surrounded by these out-of-focus areas. In some embodiments, the portion of the image corresponding to the small area being viewed may be presented in the first depth plane on which the wearer is focused. Conversely, image content other than the small area may be presented in the second depth plane. The image content of this second depth plane may be intentionally blurred, or it may be blurred when the vision focuses on the image information of the first depth plane or both.

In another implementation, a scene may be obscured to present an image having one or more regions with enhanced saturation (eg color) or luma (eg intensity). For example, an area selected to present a pinhole may be enhanced by applying more electricity to the light source 18 or increasing the output of the light source 18, while the surrounding area remains the same or chroma or luma. is reduced

While not wishing to be bound by any scientific theory, by increasing the saturation and/or luma of the selected region compared to the rest, the selected region may become more dominant. For example, the ophthalmic device of the present disclosure may improve the saturation and/or luma of the central region of the image. This can make the central area of the image brighter and more conspicuous compared to the surrounding area, so that the user can see it more clearly. This imaging area enhanced may correspond to an area in the eye identified as having a visual defect. Thus, a light beam passing through an area of the eye that is not defective is superior to a light beam passing through an area of the eye that has a vision defect and is easier to see.

FIG. 17A schematically illustrates a scene 1720 as viewed by a user's eye through an ophthalmic device, such as, for example, display lens 106 of FIG. 5 , in accordance with various embodiments disclosed herein. The scene may be an image displayed by the ophthalmic device of the present application. Alternatively, the scene may be an ophthalmic device and ambient light transmitted to the user from in front of the user. Alternatively, the scene may be a combination of the image displayed by the ophthalmic device of the present application and ambient light. As shown, scene 1720 includes a person 1721 located approximately in the center of the scene, a tree 1722 located off the center of the scene, and a sun 1723 located along the perimeter of the scene 1720. may include Scene 1720 is for illustrative purposes only, and that any scene, including, but not limited to, ambient light originating from the surrounding world, VR image content, and/or AR imagery, as described herein may be used. will be understood

FIG. 17B shows a scenario in which the ophthalmic system of the present invention obscures the peripheral area field of view in the scene and the central area (eg seen through a pinhole) is maintained. In this implementation, the pinhole shade acts as an diaphragm or field stop that thwarts light coming from the periphery. For example, the ophthalmic system of the present disclosure may implement a shade 1730a having a pinhole 1735a positioned along the visual optical axis of the eye. The shade 1730a is positioned so that light rays originating from the person 1721 can pass through the display lens 106 and be visible to the eye. In contrast, the rays coming from the trees 1722 and the sun 1723 are each obscured. In some embodiments, the shade may include one or more spatial light modulators, such as, for example, a liquid crystal spatial light modulator that modulates the intensity of light reflected from or transmitted through a plurality of individual electrically reconfigurable pixels. In addition to being physically implemented, the shade 1730a may be digitally implemented as described herein. For example, the image content presented on the display device may be limited to a small portion as if it was hidden. Similarly, the image that can be viewed on a display device can be limited to a small portion, by changing the pixels outside the small portion so that the image is less distinct compared to the small portion of the display device. . The processing electronics that control the display, such as a fiber optic scanning display, can apply this transformation to the image content.

In various embodiments, the region 1730a through which light passes through, for example, a pinhole may be circular, square, oval, rectangular, or any other shape. For example, the region 1730a may have a lateral size (eg, diameter, width, length, etc.) of about 0.5 mm to 2.0 mm. Thus, "pinholes" should not be limited to sizes smaller than one millimeter, although other sizes are possible. For example, a small sized pinhole can test for visual acuity, while a larger sized pinhole can test for reduced visual acuity through reduced retinal light.

17C depicts another embodiment, wherein a central region is obscured, while one or more portions of the peripheral region are delivered to the eye for peripheral vision examination. For example, the ophthalmic system of the present disclosure may apply an optical axis along the peripheral field of view of the scene 1720 or a shade 1730b with an off-line pinhole 1735b. The shade 1730b may be positioned similarly to the shade 1730a. For example, the shade 1730b may be positioned so that light rays from the sun 1723 pass through the lens display 106 and are visible to the eye. On the other hand, the rays coming from the person 1721 and the tree 1722 are each obscured. Similar to that shown in FIG. 17C , any area of the eye except for a specific target area can be occluded to test that target area. In this embodiment, referring to scene 1720 , light rays from the normal line of sight of the eye and/or trees 1722 located off the central axis pass through the ophthalmic system, whereas rays from the trees and the sun, respectively, are obscured. .

In some embodiments, the diagnosis of refractive errors examines different areas of the eye by measuring the user's response to various stimuli in different areas of the eye and comparing the results to tests conducted, for example, similar to the visual field tests disclosed herein. includes doing Similar to a small dot moving around a user's field of view, a pinhole can also be moved around the field of view to examine or diagnose various parts of the eye. The ophthalmic system of the present disclosure may include a spatial light modulator configured to project a raster pattern comprising a pinhole shield, as described above. Although the pinhole may be rasterized, in other embodiments, the pinhole may be moved in a manner other than raster, such as in a random manner. In one or more embodiments, the ophthalmic devices of the present disclosure may have a feedback mechanism (eg, user interface adjustment) to adjust the pinhole shade. The user may input a response based on occlusion of the image (eg, improving or worsening visual acuity). The ophthalmic system of the present disclosure may analyze user input through a pinhole occlusion test program (eg, as described in FIG. 17D ), executed by the local processing module 70 . This pinhole occlusion test program may be pre-coded (eg stored in the digital memory of the local processing module 70 ) or downloaded from a remote data store 74 to the ophthalmic system.

So, for example, if a user says that their vision improves when they apply a pinhole visor (eg in the center, periphery of the eye, or any other area), this could indicate a refractive error in that area or the surrounding cataract. and the area here is the center of the eye. Or, if the user says that the visual acuity deteriorates when the user applies the pinhole visor, this may indicate macular degeneration or a defect in the center of the lens. If the user says there is no change in vision, as described above, this may indicate either normal eyes or strabismus ("lazy eyes"). It should be understood that the present system is capable of analyzing the results of the pinhole occlusion inspection program (eg, FIG. 17D). The pinhole occlusion test program can be pre-coded or downloaded to the ophthalmic system. Similar to that discussed above, different regions of the eye can be examined by measuring the user's response to various stimuli in different regions and comparing the results.

Additionally, in one or more embodiments, the present ophthalmic system allows a user to manually adjust a focus dial to determine one or more refractive anomalies. A virtual phoropter similar to that discussed hereinabove applies various optical magnifications in turn, allowing the user to indicate which is most clearly seen. This, in turn, makes it possible to determine the user's prescription from a series of user reactions. In another embodiment, a Scheiner double pinhole alignment test or a Shack-Hartmann grid alignment test can be similarly performed through the present ophthalmic device. Any such system can be used with pinhole occlusion.

In one or more embodiments, the present ophthalmic device configured to act as a pinhole shield may include any of the features and components of the systems, devices, and methods disclosed herein. For example, the ophthalmic system may include one or more sensors configured to detect information of the world around the user in real time. For example, the ophthalmic system may include a plurality of outward-facing cameras to capture intensity images of ambient light coming from the surrounding world in real time. For example, the ophthalmic device may include one or more wide viewing angle machine vision cameras 16 operatively coupled to a local processing module 70 . Such a camera may be configured to detect the amount of light by photographing the environment around the user. In one embodiment, this camera 16 is a dual capture visible/infrared light camera. The images captured by the camera 16 are stored in the digital memory of the present ophthalmic system, so that they can be retrieved for later processing and re-rendered on the display device 62 .

In some embodiments, images of ambient light from the world surrounding the user in front of the user captured by the outward-facing camera may be re-rendered on display 62 and obscured as described herein. For example, a re-rendered image as described above can be digitally obscured, increasing the sharpness and/or focus of one area (eg a pinhole) and blurring or defocusing another area. can Similarly, the saturation and luma of the area representing the pinhole can be improved, so that the brightness increases and the contrast becomes stronger. The re-rendered image may then be projected to the user by the display device 62 . In such embodiments, the ophthalmic system of the present disclosure may be used for diagnosis, and in some embodiments, may be used as a means of treatment of macular degeneration, color blindness, etc., as described elsewhere herein with reference to macular degeneration.

In one or more embodiments, the ophthalmic system herein may include one or more sensors configured to detect information related to at least one eye of a user in real time. In one or more embodiments, as described above, the ophthalmic system herein may include one or more sensors configured to detect a user's gaze direction. In other embodiments, alternatively or in combination, the user's gaze may be estimated or detected based on one or more eye tracking of the user via an eye tracking system. For example, the user's gaze may be based on the user's head position, head posture, or orientation, e.g., leaning forward, and the angle of convergence triangulated through imaging of the eyes and imaging of the surrounding world, as described above. can be decided.

In some embodiments, the ophthalmic device may include a gyroscope sensor configured to determine the direction of the gaze based on the position of the user's head or head movement (forward, downward, or upward). In some embodiments, the display device 62 includes a sensor assembly 39 that includes an accelerometer, a gyroscope, and/or some other type of orientation and/or motion sensor as described elsewhere herein. can do. The sensor assembly 39 may be configured to detect the direction of the display device 62 and the movement transmitted thereto due to movement of the user's head. The display device 62 also includes a processor 32 operatively coupled to the sensor assembly 39 and configured to perform digital and/or analog processing to derive a position of the head from movement detected by the sensor assembly 39 . ) (eg head posture processor). In one embodiment, the sensor assembly 39 may generate motion data that is stored in a digital memory. Processor 32 may fetch such movement data and execute process logic to determine one or more head positions. In some embodiments, head movement data may be used to reduce noise while diagnosing visual defects (eg, detection of head movement during examination may indicate erroneous examination and results).

In one or more embodiments, real-time information related to the user's eyes may also be based on tracking of eye movements via an eye tracking system. As noted above, in various embodiments, the ophthalmic system of the present disclosure may use an inwardly facing camera 24 (eg, an infrared camera) for tracking the eye, which may be operatively coupled to a local processing module 70 . can The local processing module 70, when executed, may be configured to determine the convergence point of the eye and/or the direction of the eye, as described above with reference to FIGS. 5 and 6 . With this determination, the ophthalmic system of the present disclosure may also execute a logic device to determine the location or depth of focus based on eye tracking.

As described above, in some embodiments, the ophthalmic system of the present disclosure may use an eye tracking system to triangulate the user's convergence point and convergence angle. For example, while the user's head position remains unchanged, the user's eyes may move, which may be tracked by the eye tracking system. For example, if a user looks down to view a book, for example, the system may monitor eye movement to determine that the point of convergence is inward and downward and the associated angle of convergence has increased. In some embodiments, an increase in the angle of convergence may indicate that the eye is focusing on an object (eg, a book) located at the near depth of focus.

In another embodiment, the system may track eye movement based on detection of eye twinkle or Purkinje fringes, as described above or elsewhere herein. For example, the camera 24 tracks the location of the twinkle in relation to the eye features (eg, the junction of the rim of the eye, the eye, the pupil, and the like).

In various embodiments, the ophthalmic devices herein may include a biofeedback system, as described herein, configured to determine a degree of comfort of a user viewing an image or object. For example, if the user's eye shifts, is unstable, vibrates, or the adaptation changes (eg, in an unstable or random manner), this may indicate that the user is unable to see the object comfortably. . Instability or oscillations in adaptation or behavior associated with adaptation may be a signal that the user is having difficulty focusing on an object or image. Accordingly, the biofeedback system may receive abnormal or unstable fluctuations in the state of the user's eye, eg, adaptation and/or behavior associated with adaptation.

Referring to FIG. 17D , an example of a process flow 1700 for diagnosing a vision defect using a pinhole blinder program is shown. In some embodiments, process flow 1000 may be performed by an ophthalmic device worn by a patient, such as that described in connection with FIGS. 3A-3D . Process flow 1700 may be implemented by local processing module 70, for example, by executing a logic device to perform instructions stored in a digital memory operatively coupled to the local processing module. Process flow 1700 may be performed by an ophthalmic device described herein, including, for example, the waveguide stack, adaptive optics, and/or VFE shown in FIGS. 10B-10E . The ophthalmic device of the present disclosure may include a light source having a fiber-optic scanning projector, as described above.

At block 1702, a pinhole occlusion program is initiated. At block 1704, an area of the eye is selected. For example, the region may be automatically selected by the ophthalmic system of the present disclosure performing a occlusion program. In some embodiments, the program may screen the viewing area in the center of the eye, the area around the eye, or any target area in the eye, which uses an inward-facing camera (eg camera 24 ) to track the eye. location can be determined based on The program may determine one or more regions of the eye to locate the pinhole so that multiple regions of the eye may be examined. Based on the number of positions and the step size between each position, the program can be configured to examine most of the eyes. In other embodiments, alternatively or in combination, the region may be manually selected by the user via the user interface of the ophthalmic device herein.

At block 1706 , all other areas of the eye may be obscured except for the selected area. For example, the local processing module 70 may be operatively coupled to one or more mechanically opaque filters. Local processing module 70 may instruct the filter to locate pinholes or other transparent areas. The local processing module 70 may give an instruction to cover an area not selected by the program. In various embodiments, alternatively or in combination, the local processing module 70 may be operatively coupled to one or more spatial light modulators to effect an occlusion effect of another region or regions, as described hereinabove. .

At block 1708 , a stimulus (eg, an image, a virtual phoropter, etc.) is presented to the user. For example, the ophthalmic system of the present disclosure may project light 38 into the user's eye via the display 62 to produce an image that can be viewed by the user. In other embodiments, the image may be based, at least in part, on ambient light transmitted to the user from the front of the user via the display device 62 . In another embodiment, the image may be an image obtained by an outward-facing camera (eg camera 16 ) imaging ambient light coming from in front of the user.

At block 1710, the ophthalmic system of the present disclosure receives input from the user relating to an image presented to the user by the ophthalmic system via a feedback mechanism. For example, the user may indicate whether the image can be viewed or not, whether it is clearly visible, and whether it is in focus or not. Based on the user's input, the ophthalmic system of the present application may determine the health or condition of the part corresponding to the selected area of the eye. As described above, for example, if the user input indicates that stimulation is enhanced due to execution of the occlusion program, this may indicate a refractive error or a cataract in a region other than the selected region of the eye. Alternatively, if the user input indicates that the stimulus is aggravated due to the execution of the occlusion program, this may indicate macular degeneration or a lens defect in the selected area of the eye. If there is no change, the eye in that area may be normal, or it may be strabismus ("lazy eye") as described above.

In some embodiments, the ophthalmic system herein may include an inwardly facing camera configured to provide an input related to vision. The inward facing camera may be coupled to a light source that projects light into the eye through a pinhole visor. The projected light may be received by the retina while at least partially obscured. The ophthalmic system of the present disclosure may provide or store a predicted return pattern of light, such as, for example, a normal return pattern based on a healthy eye. An inward facing camera may detect a light pattern reflected from the retina, and the ophthalmic system of the present disclosure may compare the reflected light pattern to a predicted healthy pattern. From this, the system can objectively determine the visual acuity without user input. For example, light that enters the fovea through the center of the pupil must be reflected straight, unaffected. However, if there is a refractive error in the eye, the reflection pattern detected by the camera will be refracted based on this abnormality, resulting in an abnormal reflection pattern.

In some embodiments, the user's input may be stored in the digital memory of the local processing module 70 for later access, retrieval or processing. The user input may be associated with a selected region of the eye, which may also be stored in a digital memory. In other embodiments, local processing module 70 may be operatively coupled to remote processing module 72 and remote data store 724 , where the inputs and regions may also be stored and associated.

At block 1712, the ophthalmic system determines whether other areas have been similarly examined. If YES, blocks 1704-1710 are repeated. For example, the ophthalmic system herein may scan across multiple regions of the eye to examine the entire surface of the eye and receive input 1710 related to the entire surface of the eye. The number of eye areas that have been examined and which are areas to be examined (eg step size between each examination), along with the sequence of examinations, may be stored in the digital memory of local processing module 70 and/or remote storage 74 . have. For example, the optical prescription of each region may be defined by the input received at block 1710 , which region of the eye based on eye imaging by an inward-facing camera (eg, camera 24 ). may be mapped to anatomical structures. The number of regions can be any number, eg, one (eg, center, perimeter, or in between), two regions (eg, central and single perimeter) or more regions. The local processing module 70 can retrieve this information and determine which region is the next region to be inspected or whether there are remaining regions to be inspected. Accordingly, the ophthalmic device may perform blocks 1704-1710 for multiple open angles of the eye.

After all regions have been inspected, the ophthalmic system herein analyzes the received input for each region, at block 1714, to determine any visual discrepancies. As noted above and as described throughout this application, for example, an input to each region of the eye may be that the particular region exhibits refractive errors, cataracts, macular degeneration, central lens defects, amblyopia, and the like. This may be done, for example, in one or more embodiments, by comparing the user's response to historical data for the user (eg, prior examinations performed by the ophthalmic device herein). This may indicate that the user's history is deteriorating. Alternatively, in other embodiments, the data may be compared to standard data, or typical responses of individuals in a particular age group. Similarly, many such approaches and corresponding algorithms may be used to analyze the received data. Pattern recognition may be used in various embodiments. The received data may be stored in a digital memory, and the local processing module 70 may execute an instruction to perform an algorithm for analyzing the received data.

17F is an exemplary process flow for correcting a vision defect. In some implementations, the ophthalmic system of the present disclosure may be configured to apply a pinhole visor to the display 62 for correcting a user's visual defects. For example, if a user with refractive errors in one or more areas of the eye sees the world through a pinhole visor, the user's eyesight may be improved. In another embodiment, the ophthalmic device of the present disclosure may be configured to apply a plurality of pinholes (eg, pinhole glasses, eyeglasses with small holes, etc.) to the display device, and, as described above, the display device is at least partially may or may not act as a visual stop (e.g., blocking an irrelevant light beam). Without wishing to be bound by any theory, such a configuration may enhance the eye's focusing on the image. For example, the size and number of holes may be adjusted and determined based on the user's visual impairment and/or determined in a different configuration or otherwise. Fig. 17E schematically shows such a configuration as seen through multiple pinhole shades. The user can view the scene 1720 through the display device 62 and the shade 1730c having a plurality of pinholes 1735c. While not wishing to be bound by any particular scientific theory, in some cases, this improves vision by stopping down light rays that interact with a vision defect in the wearer's eye.

Referring to FIG. 17F , an exemplary process flow for therapeutically correcting vision defects (eg, refractive errors, cataracts, macular degeneration, central lens defects, etc.) using a pinhole visor is briefly described. The process flow 1760 may be guided to modify the image presented to the user based on the user's prescription. In some embodiments, process flow 1760 may be performed by an ophthalmic device worn by a patient, such as that described in connection with FIGS. 3A-3D . Process flow 1760 may be implemented by local processing module 70 configured to execute logic devices in local processing module 70 .

At block 1762, the ophthalmic system herein may determine, retrieve, or receive the user's optical prescription. As described above, the ophthalmic system of the present disclosure may include a user interface whereby a user may enter an optical prescription or the ophthalmic system of the present disclosure may determine a vision defect via an eye-prescription configurator program. For example, process flow 1700 may be one input used to define an optical prescription. Other methods of determining visual impairment are possible, for example, as disclosed throughout this application. In some embodiments, the ophthalmic system herein may be configured to receive an optical prescription from a third party. For example, a physician may wirelessly transmit an optical prescription to a user (eg, Internet, Bluetooth connection, etc.), which is received by a receiver or transceiver and stored in the digital memory of local processing module 72 . .

In another embodiment, the ophthalmic system herein may automatically (and possibly incrementally) change the user's prescription based on feedback from the eye tracking system. As described above, the system can determine whether a user has difficulty viewing an object or image. For example, as described above, as a result of monitoring, for example, gaze angle, pupil size, and lens shape or movement as described herein, if the user's eye is shifting, unstable, or vibrating, or if the adaptation changes (eg, in an unstable or random manner), etc., this may indicate that the user is not comfortable viewing the object. In response, the system may start an eye prescription configurator program.

In some embodiments, the ophthalmic system herein may be configured to receive an optical prescription from a third party. For example, a physician may wirelessly transmit an optical prescription to a user (eg, Internet, Bluetooth connection, etc.), which is received by a receiver or transceiver and stored in the digital memory of the local processing module 70 . .

At block 1764, the ophthalmic system of the present disclosure determines whether blinding is required. The need for occlusion may refer to the number of pinholes, the arrangement of the pinholes, or the size of the pinholes. In various embodiments, the need for occlusion may be based on the user's optical prescription. For example, in some embodiments, the local processing module 70 retrieves the defect region of the eye from block 1714 of FIG. 17D and correlation of visual differences in digital memory. Based on this information, the local processing module 70 issues an instruction to determine where one or more pinholes should be located and the size of the pinholes to correct for these differences.

At block 1766, the ophthalmic system of the present disclosure may obtain input from the ophthalmic system through the user's eyes and/or ambient light of the world surrounding the user and an outward looking camera (eg, real-time information). . The ophthalmic system herein may receive such input, for example, from one or more sensors configured to detect the intensity of ambient light in the surrounding world in real time. Such sensors may include, for example, a sensor assembly 39 , an eye tracking system and/or an outward-facing camera (eg, camera 16 ). These inputs may be stored in the digital memory of the local processing module 70 for later retrieval and processing tasks.

In other embodiments, the gaze direction may be an example of the obtained input. The gaze direction may be determined by the sensor assembly 39 and/or the eye tracking system. Such a sensor may determine whether the user's gaze direction has changed compared to a previous direction. For example, an eye tracking system may monitor eye movement. For example, if the wearer's head is tilted forward or downward and/or the wearer's eyes are tilted down, the wearer may be looking at an object, such as a book, or position typically associated with a nearby object ( You may be viewing the projected image content corresponding to the image placed in the lower part). This gaze can also be used to determine the gaze angle of the eyes, how the gaze of a pair of eyes hunts to a point and how far the point is from the wearer. By monitoring the gaze angle (eg that described in FIG. 6 ), the gaze direction in which the viewer intends to look at the object can be determined.

Another example of input at block 1766 may be ambient light originating from the surroundings surrounding the user. In this regard, the ophthalmic system of the present disclosure may also include an outward-facing camera (eg, camera 16 ) to measure surrounding ambient light intensity. In another embodiment, the local processing module 70 may be configured to determine a time of day, which may represent a light intensity figure (eg the light intensity may be weak during the night as compared to the day).

At block 1768 , the ophthalmic system herein may modify the occlusion requirements based on the obtained input resulting from block 1766 . For example, local processing module 70 may retrieve one or more inputs stored in block 1766 from digital memory to adjust the size, shape and arrangement of the pinhole shade.

In some embodiments, the level of ambient light detected by the outward-facing camera may be fetched by the local processing module 70 and used as an input to determine whether to adjust the aperture stop of the display 62 optics. For example, if the ophthalmic system of the present disclosure detects that the level of ambient light in front of the user is low using an outward-facing camera, the local processing module 70 may issue an instruction to increase the aperture stop of the display lens 106 . , thereby increasing the intensity of the light projected to the user by the present ophthalmic system. Conversely, if the system detects that the level of ambient light in front of the user is high, the local processing module 70 causes the aperture stop to be reduced, thereby reducing the light projected to the user.

In various embodiments, the ophthalmic system of the present disclosure may be configured to modify pinhole veiling requirements (eg, pinhole size, shape, arrangement, etc.) based on other inputs from the world surrounding it. For example, the ophthalmic device of the present disclosure may use a sensor assembly 39, an eye tracking system, or an outward-facing camera (eg, camera 16) to detect the near-adaptation of the eye as described above. , the user may be configured to determine which object is being viewed. When viewing a nearby object, the user may require more or more intense light from the object being viewed and less light from the surrounding surroundings. If the user has a dead or weak spot in the visual area in the center of the eye, the ophthalmic system of the present application applies a central pinhole to cook the ambient light coming from the surrounding world in front of the user while contrasting the light coming from the visible object. may be configured to increase. In another embodiment, if the occlusion requirement includes multiple pinholes, the pinhole occlusion may be configured to defocus, for example, a peripheral area of the image content projected by the display device to the eye.

At block 1770 , the occlusion feature may be applied to one or more images projected to the user's eyes. In some embodiments, the digital memory or remote data store 74 may be configured to store image content (eg, AR and/or VR image content as described above). Local processing module 70, independently or in communication with remote processing module 72, fetches such image content and based on image and/or occlusion requirements presented to the user by the ophthalmic system of the present application. The system may be configured to execute instructions to create a pinhole shade that obscures ambient light transmitted to the user from the front.

At block 1772, the obscured image is projected to the user so that the user is comfortable viewing the image. For example, the ophthalmic system of the present application projects light 38 to the user to form an image in the user's eyes. The image may be a occluded image based on a physical or mechanical pinhole shading, such as, for example, one or more spatial light modulators to obscure the undeformed image. In another embodiment, alternatively or in combination, the 2D image generated by the ophthalmic system of the present disclosure may be digitally blocked based on software running in the local processing module 70 not representing the portion of the image being blocked. Thereafter, it may be displayed on the display device 62 .

At block 1772 in some embodiments, the ophthalmic system of the present disclosure may initiate an eye-prescription configurator program to dynamically perform vision correction. At block 1772, the ophthalmic system herein may be configured to return to block 1762 to manually and interactively determine the user's prescription at each interval, in some embodiments, without the user's activity. For example, the ophthalmic system of the present disclosure may monitor whether a user is comfortable viewing and adjust prescriptions and/or vision corrections automatically and possibly progressively when the user is not comfortable viewing images presented to them. can For example, as described above, the ophthalmic system of the present disclosure is based, in part, on shifting, instability, oscillation, abnormal and/or involuntary fluctuations in eye movement, pupil size, gaze angle, adaptation, and/or gaze direction, An eye tracking system (eg camera 24 ) may be used to determine if the user is having difficulty viewing the image. If it is determined that there is difficulty, the ophthalmic system herein may initiate an eye-prescription configuration program to determine a new optical prescription and/or adjust vision correction (eg, modifying pinhole visor requirements). In some embodiments, when a difficulty is determined, the ophthalmic system of the present disclosure may alert the user of this, or the ophthalmic system of the present disclosure may perform other types of examinations described herein.

In some embodiments, when the ophthalmic device of the present application is an augmented reality head-mounted display system, pinhole occlusion may be applied to an image presented to the wearer while imaging the user and an object positioned in front of the head mounted display. For example, AR image content presented by the ophthalmic system of the present application may be obscured and projected in combination with ambient light. In some embodiments, AR imaging content may include ambient light transmitted from the outside world through lens 106 , which also provides optical compensation for the wearer viewing the outside world through lens 106 . may be blocked from providing. In another embodiment, in the case of a VR head mounted display system that is opaque to the world in front of the user, the occluded image is provided by the ophthalmic system of the present disclosure or a display in the system for visual presentation, such as, for example, VR image content. One or more VR image regions may be blocked.

<u>Early W4LT</u><u> test</u>

Another test performed via the ophthalmic system disclosed herein is the Worth Four Light Test or Worth Four Dot Test (referred to herein as "W4LT"). The W4LT approaches the angle of the patient's binocular vision and binocular monovision. Binocular vision includes images projected by each eye simultaneously as a single image of the anterior field. W4LT can detect inhibition of either the right or left eye. Inhibition can occur during binocular vision when the brain is not processing information received from either eye. This is a common adaptation of strabismus, amblyopia (as described above), and anisotropia (each eye perceives an image at a different size).

Traditionally, when performing the W4LT test, the patient wears red-green glasses (usually red lenses for the right eye and green lenses for the left eye). The examination can be performed close to the patient or away from the patient, both cases resulting in a different assessment of the patient's vision. When performed from a distance, the W4LT equipment consists of a wall-mounted box with four lights arranged in a diamond shape, with red on top, two green lights on either side and white light underneath. When performed at close range, the same composition of light is arranged in a handheld device similar to a flashlight.

Since the red filter blocks green light and the green filter blocks red light, it is possible to determine whether the patient is using both eyes simultaneously in a coordinated manner. A patient with normal binocular vision with both eyes open will perceive 4 lights. If the patient closes or presses one eye, the patient will see two or three lights. If the patient does not fuse the images from both eyes, the patient will see five lights (also known as double vision).

The ophthalmic system of the present application may be programmed to perform a W4LT test by providing a depth signal of near glasses by presenting an independent image to be converged at a predetermined distance to each eye. These images may be colored dots similar to the W4LT test or any other suitable image pair. For example, an image pair may include a colored dot, a colored symbol, a polarized object, and the like. The user's response is recorded and analyzed to determine if the user has any visual defects. These results can be reported to the clinician or patient.

In some embodiments, the mountable augmented reality device may be used as an ophthalmic system to perform an eye exam by projecting independent left and right images into the wearer's left and right eyes. This vision test may be a W4LT or other similar testing program. The ophthalmic device of the present application may use the results of the visual acuity test to confirm the defect of vision. For example, the ophthalmic device of the present disclosure may evaluate the angle of binocular vision and binocular monovision of the wearer using the results of the visual acuity test (eg, whether the wearer suffers from double vision or double vision). As another example, the ophthalmic device of the present disclosure may determine whether the wearer's right or left eye is pressed using the results of the vision test. The augmented reality device may be configured to present different images to the left and right eyes, receive user input as to what is perceived by the wearer when the image is presented, and determine a vision defect based on the received user input. have. The augmented reality device is configured to present different images to the left and right eyes to automatically evaluate what is perceived by the wearer when the images are presented to determine a visual defect based on the automatic evaluation. It should be understood that such a system may be used to examine and/or treat a wearer's eye, which typically may take place in a physician's or clinician's office. In one or more embodiments, the patient's personal ophthalmic system may be used under the supervision of a physician if possible, or the physician's office may have its own ophthalmic system and use it for examination and/or treatment. In some embodiments, the ophthalmic system performs the examination periodically (or non-periodically), but records the results multiple times over a period of days, months, or years or more. In some embodiments, the ophthalmic system may alert the wearer by notifying the wearer that it may be an appropriate time for an examination. The system can monitor changes in the history of test results, so it can identify any problems, such as loss of vision or other health problems.

The wearable augmented reality device of the present disclosure includes an augmented reality display platform configured to project an image to each of the left and right eyes of the wearer. The display platform may be configured similarly to the display lens 106 , as described in greater detail herein with reference to FIG. 5 . The display platform may include left and right displays for the wearer's left and right eyes, respectively. In some implementations, the display platform may be configured to transmit light originating from the world or surroundings beyond the ophthalmic system to the eye of the wearer via the display platform (eg, lenses and/or adaptive optics elements in front of it). can In this way, the wearer can view the image projected onto the display platform superimposed on what the wearer sees in the world.

In some embodiments, the wearable augmented reality device includes a display platform and at least one light source configured to project light into the eye of the wearer as described above. The at least one light source may be configured to project light to the eyes of the wearer to form an image on the eyes of the wearer. In some embodiments, the at least one light source comprises a fiber optic scanning display, as described in more detail elsewhere herein. The fiber scanning display associated with adaptive optics, such as variable focus optics, may be configured to display or transmit light from one or more depth planes and to change the depth planes. In some embodiments, the inspection may be performed by projecting an image from a far depth plane (eg, about 6 m from the wearer) and/or a near depth plane (eg, about 0.33 m from the wearer).

In some embodiments, the display platform includes a waveguide stack, described in greater detail elsewhere herein. The waveguide stack may be configured to project light from different focal planes. In certain implementations, the waveguide stack includes one or more lenses in the stack as described in more detail elsewhere herein. The waveguide stack may be configured to display or transmit images from one or more depth planes. In some embodiments, the display platform includes adaptive optics configured to project light or images from different depth planes. In certain implementations, the adaptive optics element includes a variable focus element (VFE), as described in more detail elsewhere herein.

The wearable augmented reality device may include interface features configured to enable a wearer or other person to provide input to the device. The user interface feature may be incorporated into the device. In some implementations, user interface features may be provided by the device or may be provided by a device not physically integrated into the device. For example, a user interface feature may be provided by a device or system in communication with the device. It may be a smartphone, computer, tablet, or other computer device connected wirelessly or wired to the device. In some embodiments, user interface features are provided by a combination of different devices and systems coupled to the device, for example via a wired or wireless communication network or via a component physically coupled to or integrated into the device. can be In various embodiments, the user interface includes voice recognition or a virtual touch display. The user interface feature may also be presented to a device equipped with a touch screen, wherein interaction with the touch screen provides input to a wearable virtual reality device. Thus, the user interface features may include capacitive features that are sensitive to touch, keyboard, buttons, microphones, cameras, motion sensors, photodetectors, or various software implemented features provided by a graphical user interface. In some embodiments, the user interface includes one or more features or sensors configured to collect gestures of the wearer to provide input. In various embodiments, the virtual touch screen is provided via a sensor that detects an image projected into the user's eyes and the user's moving body, eg, a finger. In some embodiments, the user interface feature includes a gesture detection element that enables the wearer to provide user input via gesture. In some embodiments, the user interface feature includes a gaze detection element to enable the wearer to provide user input through the gaze (eg, this may occur when the wearer temporarily fixes the gaze on the button or when the gaze is on the button) fixed and may include selecting a button or other element when the wearer blinks an eye). Such user interface systems may be employed in other devices and systems described herein.

In some implementations, the wearer, clinician, or physician uses interface features to control aspects of the W4LT. This can be done, for example, by changing the depth plane of the projected image, modifying the properties of the projected image, or otherwise configuring it to perform a binocular examination.

18 schematically illustrates an exemplary method 1800 of performing the Worth Four Light Test or Worth Four Dot Test to assess the degree of binocular monovision of a wearer. For convenience of description, method 1800 will be described as being performed by an ophthalmic system, such as any augmented reality device described herein. It should be understood, however, that any element or subpart or other similar device of the various augmented reality devices disclosed herein may be used to perform any step, combination of steps, or part of a step of method 1800 . .

At block 1802, the ophthalmic device initiates the W4LT program. The W4LT program may be a stored process or a continuous function provided by the ophthalmic device. Starting the W4LT program may include determining or retrieving a starting depth plane or a continuous depth plane for the projected image. In some implementations, the W4LT program may incorporate information on anomalies of the wearer's eye(s), wherein the information on the eye abnormalities is determined from a previous eye examination program, or retrieved from stored data, and the wearer's or clinical may be entered by a user (eg, part of the ophthalmic system or a networked data store). The initiation of the W4LT program may include the determination of a continuous tentative image or image projected to the wearer. The initiation of the W4LT program may involve a clinician or physician deciding whether to perform an eye examination or whether the wearer himself/herself will perform the examination. In some embodiments, the ophthalmic system herein initiates the W4LT program in response to input received from the wearer or clinician. In some cases, the system initiates the W4LT test based on a predetermined protocol as the system may monitor for fading of vision.

At block 1804, the ophthalmic system presents an image in one eye (eg, a set of colored dots in the right eye), and at block 1806, the ophthalmic system of the present disclosure presents the image in the other eye (eg, a set of colored dots in the right eye). A different virtual image is presented, for example, a small colored dot of the reward set in the left eye. For example, the present ophthalmic system can project a left image to the left eye using the left display device, and project the right image to the right eye using the right display device. The right and left images may contain matching elements (eg may be aligned when viewed by a normal binocular monovision person). The right and left images are unique and may contain non-parallel elements (eg elements that would be perceived as being in different positions by a person with normal binocular monovision). The right and left images may include colored dots, colored features, colored objects, colored icons, or other similar elements. Similarly, the right display and the left display may be configured to project a polarized image (eg, a dot, feature, object, icon, etc.). The ophthalmic system of the present disclosure may be configured to project an independent image to each eye of the wearer, wherein the independent image is configured to discriminately view a person with binocular monovision, double vision, and/or depression of one eye. In some embodiments, the ophthalmic system herein may be configured to project an independent image to each eye of the wearer, wherein the image is projected from different depth planes.

At block 1808, the system may receive a user's input regarding the convergence of both images, via some kind of user interface, such as the user interface described herein. In some embodiments, the present ophthalmic system may be configured to present multiple options from which the wearer may select. The option may correspond to a different image corresponding to the result of viewing the projected image by a person with normal vision or a visual defect. For example, if the image presented to the wearer corresponds to the 4 dots of the W4LT, the image shows the wearer the 4 dots according to their health status, eg the health of their eyes and optical path; It can be seen as 5 small dots, 3 small dots, 2 small dots, etc. The ophthalmic system of the present application may receive a user input indicating which of the presented images corresponds to what the wearer perceives when viewing the projected image. In some embodiments, the ophthalmic system herein may receive other indicia from the wearer that may indicate what the wearer perceives. The mark may include words, colors, numbers, sizes, positions, and the like corresponding to images recognized by the wearer.

In some embodiments, the ophthalmic system of the present disclosure is configured to objectively determine convergence of both eyes. For example, the system may be configured to monitor an image projected onto the retina. By comparing the projected images of the retina, the system can be configured to match them and determine if the images are aligned to the same section of the retina. When the images are aligned, the system can automatically determine whether the wearer has normal or corrected vision. If the image is not properly aligned, the system may automatically determine that the wearer is diplopia. In some implementations, the system is configured to monitor alignment of an image of the wearer's eye. If the system determines that it will not align properly, the system may issue an alert or initiate an eye examination.

At block 1810, the ophthalmic system herein analyzes the received input to find the user's visual impairment. In some embodiments, the ophthalmic system of the present disclosure is configured to determine an angle of binocular vision or binocular monovision. In some embodiments, the ophthalmic system of the present disclosure is configured to detect angles of diplopia, esotropia, exotropia, hypotropia, hypertropia, and the like. In some embodiments, the ophthalmic system of the present disclosure is configured to detect suppression of the right or left eye. The ophthalmic system of the present disclosure may be configured to determine a visual defect by comparing the projected image with the received input. The ophthalmic system of the present application may be configured to automatically determine a visual defect by alignment of an image formed on the wearer's retina. The ophthalmic system of the present disclosure may be configured to determine a visual defect by comparing the received input to depth plane information for the projected image.

In some embodiments, the ophthalmic system herein is configured to, if the system determines that the wearer experiences vision problems or is struggling with focusing, return from block 1810 to block 1802 to initiate the examination. This is indicated by a dashed line going from block 1810 to block 1802 .

In various embodiments, to reduce distraction, the view of the world in front of the wearer's eyes entering through the augmented reality device is obscured and otherwise not visible during the examination. This may be done, for example, when an image is presented to a viewer, but this is not required. In some embodiments, to block ambient light from the outside world in front of the lens, the system may include one or more spatial light modulators, such as liquid crystal arrays, that can be switched to block varying amounts of light.

Although the present system is described as an augmented reality device, in other embodiments the present system may be a virtual reality device. In either case, the ophthalmic system of the present disclosure may be a device that is provided to a physician or clinician for examination in a hospital or ophthalmic hospital or other location. In other embodiments, the ophthalmic system of the present disclosure may be worn by the wearer and may be used for entertainment (eg, games and movies) and/or work activities. As noted above, one advantage of performing an inspection on a wearer system is that the inspection can be conveniently performed several times (at least 2, 3, 4, 5, 6, 8, 10, 12, 16, 18, 24, or exceeding number of times). The system can also record historical data related to previous inspections so that changes in data can be assessed over time. In some embodiments, the frequency or schedule of examinations may be changed based on trends and/or results of examination results. For example, if the test results indicate that the vision defect is worsening or that the wearer is having more difficulty focusing on the image (e.g., adaptive fluctuations, visual disturbances, squinting one eye), the procedure Change the frequency or schedule of procedures to increase the frequency of procedures and/or decrease the intervals between procedures. Likewise, the examination may be performed with or without the aid of a medical professional, such as an optometrist, ophthalmologist, nurse, technician, medical assistant, or the like.

<u>retinal examination</u>

The wearable augmented reality (or virtual reality) device disclosed herein may be used as an ophthalmic system that functions as a retinograph to determine a patient's or wearer's visual impairment. In particular, the augmented (or virtual) reality device may be operated as a retinograph and used to detect nearsightedness, farsightedness, astigmatism and/or other visual defects. The augmented (or virtual) reality device may be configured to determine, for example, a refractive error of a patient's eye, using, for example, a retinoplasty technique, such as neutralization. Neutralization involves adjusting the refractive index in front of the eye until a ray or spot of light swept across the eye forms an image in the retina that substantially stops moving across the retina. The augmented (or virtual) reality device may be configured to provide beams with different optical corrections until neutralization is achieved. The augmented (or virtual) reality device may thus be configured to determine an optical prescription for correcting the identified visual defect. It should be understood that such a device may be used to perform eye examinations, which may typically be performed automatically in the office of a physician or clinician or at the wearer's home. In one or more embodiments, a patient's individual ophthalmic system may be used possibly under the supervision of a physician, or a hospital may have its own ophthalmic system that may be used for hospital diagnostic purposes. In various embodiments, such augmented (or virtual) reality devices may be configured similarly to the devices disclosed herein.

In some embodiments, the wearable augmented (or virtual) reality device may be used to perform a retinoscopy to detect vision defects using light swept across the wearer's eye. Examples of devices that can be configured to perform retinoscopy are described herein and include, but are not limited to, those described herein with reference to FIGS. 5 , 10D, 10E, 22A, and 22C. The wearable augmented (or virtual) reality device includes an augmented reality display platform configured to project light rays into the wearer's eyes. The display platform may include a display lens 106 described herein with reference to FIG. 5, or other display system or platform described herein (eg, with reference to FIGS. 5, 20A, 22A, 23B, 24A, 24C). Display systems 62 , 2062 , 2262 , 2362 2462 , 2662 respectively and/or may be configured similarly to display platform 1402 of FIG. 14 . In some implementations, such as for augmented reality devices, the display platform may be configured to transmit light of the world or surrounding environment to the wearer's eyes through the display platform (eg, a lens in front of it). In this way, the wearer can see objects in the world in front of the wearer, and there is the possibility of fixing the gaze on a circular or near object, for example depending on the type of retinoscopy. The focus of the beam projected into the eye may be varied or an optical correction may be provided. Thus, the wearable augmented reality device may be configured to perform a retinal examination to measure refractive errors of the wearer's eye.

In some embodiments, the mountable augmented reality device includes the display platform described above and at least one light source configured to project light into the eye of the wearer. Exemplary light sources suitable for this purpose are described in detail herein, such as, for example, light sources 2268 described herein with reference to FIG. 22A and/or light sources described herein with reference to FIG. 22C. Such light sources, which may include waveguides, may augment corresponding waveguides (eg, waveguide stacks) and display light sources employed for projection into the wearer's eyes to provide augmented reality or virtual reality content. The one or more light sources used for retinal examination may be configured to provide a beam of light sweeping across the wearer's eye. In some embodiments, the wearable augmented reality device may also include a sensor configured to measure light reflected off the retina in response to light rays from the at least one light source sweeping across the wearer's eye. In various embodiments, the sensor images the eye. Such sensors may include eye tracking sensors or other inwardly looking cameras or optical sensors that are configured to point towards the eye to image the eye, for example. The wearable augmented reality device may be configured to perform a retinal examination to measure refractive errors of the wearer's eye. For example, the augmented reality device may detect, measure, or image a reflection, or reflex, from the back of the wearer's eye (eg, retina, fundus, etc.), or determine a vision defect through monitoring or measuring the reflex. To do so, the beam may be configured to sweep across the wearer's eye in one or more directions. Optical corrections can be introduced with light beams, and reflections can be monitored to determine whether such optical corrections are sufficient to offset the wearer's refractive error.

The at least one or more light sources may be configured to provide a beam of light moving around or across the eye of the wearer of the augmented reality device. The ray may have a cross-section perpendicular to its elongated light path direction, wherein the cross-section is longer in one direction as compared to a direction perpendicular thereto. Thus, the light beam, in certain embodiments, comprises a strip. Light provided by the at least one or more light sources may be configured to move in one or more directions. When the light provided by the at least one light source is a relatively narrow beam or strip of light, the direction of the beam or strip of light may be changed. Accordingly, the at least one light source may be used to detect myopia, farsightedness, astigmatism, pigmentation, age-related macular degeneration and other vision defects.

The sensor is configured to detect light reflected from the back of the eye or retina of the wearer of the augmented reality device (eg, a retinal reflex, red reflex, or reflex) and, in various embodiments, form an image of the eye. can be Thus, the sensor may be an image sensor or camera, one or more photodetectors, or other device capable of providing a signal in response to detected light and possibly an image of the eye. In some embodiments, the sensor is tailored to selectively pass reflections originating from the wearer's eyes, and one or more filters (eg, anticipating reflections) that selectively block light in other wavelength bands. a bandpass filter adapted to pass a band of wavelengths of interest).

The one or more light sources and sensors (eg cameras) process information about the characteristics, direction, orientation, and/or position of the light provided by the at least one light source, the characteristics of the light detected by the sensor; It may be coupled to a control system configured to process information about orientation, orientation, and/or position. From this information, the accommodation system can be configured to determine one or more visual defects of the wearer's eye. In some embodiments, the conditioning system is configured to at least partially apply light provided by the at least one light source (eg, orientation, orientation, and optical correction provided to a beam, etc.) to analysis of light detected by the sensor. It can be configured to deform based on In some embodiments, the adjustment system may be configured to perform a predefined routine to determine a vision defect. In some embodiments, the adjustment system may adjust the retinal examination routine based on analysis results of light detected by the sensor at any point during the routine.

The augmented reality system herein may be configured to project an image to the wearer. As described herein, the augmented reality system of the present disclosure may provide the wearer with images corresponding to different depth planes, both far and near. Accordingly, the wearer may fix his/her gaze on the display device while viewing an image simulating a distant and near-field object. In this way, the wearer may have a comfortable adaptation or may exhibit an examination dependent adaptation.

The augmented reality system herein may thus be provided to provide static and/or dynamic retinal imaging. In the case of static retinoscopy, for example, the augmented reality device of the present disclosure may be configured to determine refractive errors when the wearer makes comfortable adaptations. In the case of dynamic retinography, for example, the augmented reality device of the present disclosure may be configured to perform retinography while the wearer adapts to different distances. This can be achieved by providing an object or virtual image on which the wearer is focused while performing a retinal examination. The distance to the image or object can be varied while tracking the eye adaptation through the methods and systems described herein. The distance to the image may be varied by changing the depth plane of the display, for example in a manner as described herein. For example, a lens associated with a waveguide stack through which light is projected to form an image may have an optical power provided for a particular focal length and associated depth plane. Illustrative, non-limiting examples of such configurations are provided in the description herein of waveguide stacks and lenses with reference to FIGS. 10D and 10E. The distance from the eye to the depth plane may thus be known. In some cases, such lenses and other optical elements that project light rays have variable optical power that can be selected or adjusted, for example, by applying an electrical signal. The depth plane can thus be changed or adjusted as desired in this case. Alternatively, or in addition, the distance to the object may also be varied in such a way as to place a real object in front of the wearer within the wearer's field of view, the object being viewed through the display platform of an augmented reality device as described herein. . Any of these methods may be used, for example, to determine the wearer's adaptive response to changes in target distance. This method can also be compared to static retinoscopy, which determines the near point of the eye, for example, among other things.

In some embodiments, the one or more light sources include a fiber optic scanning display as described herein. In some embodiments, the one or more light sources include a fiber optic scanning display and a light generating source. The optical fiber scanning display may be configured to provide various depth planes from which light rays may be projected. The optical fiber scanning indicator can thus provide a different range of amounts to determine the appropriate optical correction for the wearer. In various embodiments, the optical fiber scanning display may be configured to transmit or transmit light toward and collect or receive light reflected from the eye of the wearer. The optical fiber scanning display may be configured to move or flash light across or around the eye of the wearer. The fiber scanning display may be configured to display or transmit light from one or more depth planes. In certain implementations, the optical fiber scanning display may be configured with one or more optical fibers for generating or distributing light and for receiving light reflected from the wearer's eyes. In various implementations, one or more optical fibers of the optical fiber scanning display may be configured to generate or distribute light, and one or more different optical fibers may be configured to receive light reflected from a wearer's eye. The optical fiber scanning display may include a multimode optical fiber in some embodiments. An example of this is described herein with reference to multicore optical fiber 362 shown in FIG. 28B.

In some embodiments, the display platform includes a waveguide stack described above or elsewhere herein. The waveguide stack may be configured to project light from different depth planes. In certain embodiments, the waveguide stack includes one or more lenses or other elements (eg, reflective or diffractive, etc.) having optical power in the stack, as described herein.

In some embodiments, the display platform includes adaptive optics configured to project light to different target regions of the wearer's eye. In certain implementations, the adaptive optics element comprises a variable focus element (VFE) as described above or elsewhere herein. Illustrative, non-limiting examples thereof are described herein with reference to FIGS. 10B, 10C, and/or 10E. In some embodiments, the variable focus element comprises a film mirror. The membrane mirror may include one or more electrodes on the mirror, and a control system configured to adjust the one or more electrodes to modify the shape of the membrane mirror. Other types of adaptable optics and VFEs may be employed. The adaptive optics and VFE can provide optical corrections, such as spheres and/or cylinders (and axes) of different amounts and orientations, that can be examined through neutralization using retinoscopy.

In some embodiments, the mountable augmented reality device includes a camera that is part of the display platform. The camera may be coupled to a waveguide providing different depth planes. Thus, in certain implementations, the ophthalmic system of the present disclosure may be configured to project light from a first depth plane and measure reflection in a second depth plane that is different from the first depth plane. An illustrative, non-limiting example of such an image acquisition system is described herein with reference to FIG. 22C.

A wearable augmented reality device may include one or more user interface features configured to allow users and others to provide input to the device. The user interface feature may be incorporated into the device. In some implementations, the user interface feature is provided by a device or element that is not physically integrated with the device. For example, the user interface feature may be provided by a device or system in communication with the device. It may be a smartphone, tablet or other computer device that is in wireless or wired communication with the device. In some embodiments, the user interface features may be provided by a combination of different devices or systems coupled to the device via, for example, a wired or wireless communications network, or via a device integrated or physically coupled to the device. . The user interface feature may be presented to a device with a touch screen, wherein the user provides input to the mountable augmented reality device through interaction with the touch screen. A voice recognition system as well as a virtual touch function may additionally or alternatively be included. Accordingly, the user interface features may include various software-executed features provided by a graphical user interface or capacitive features sensitive to gestures such as touch, keyboard, buttons, microphones, photodetectors, cameras or the wearer's pointing. . In various embodiments, the virtual touch screen is provided via a sensor that senses the user's moving body, such as an image projected onto the user's eyes, for example, a finger. In some embodiments, the user interface feature may include a gesture detection element that allows the wearer to provide user input via gesture. In some embodiments, the user interface feature includes a gaze detection element that allows the user to provide user input through the gaze of the eye (eg, this may occur when the wearer temporarily fixes her gaze on the button or when the gaze changes to the button). may include selection of a button or other device when the wearer blinks an eye). Such user interface systems may be employed in other devices and systems described herein.

In some implementations, the wearer, clinician, or physician may use the interface features to control aspects of the retinoscopy examination. This may be done, for example, by changing the depth plane on which the light or image is projected and/or the characteristics of the image or light provided. This can be used to modify the optical prescription and light provided to the wearer, in order to determine an appropriate optical prescription for the wearer.

In some embodiments, an ophthalmic device (eg, an augmented or virtual reality device) herein may be configured to provide both static and dynamic retinal imaging. Since the focus of the image can be dynamically modified via the adaptive optics element (eg VFE) of the ophthalmic device of the present disclosure, both types of retinal examination can be performed with the same device. It should be appreciated that the ophthalmic device herein may also provide a static or sweeping light path to the retina. This may be a light source that is projected by a light source, such as an FSD (fiber optic scanning display), or a light source that produces the light of the ophthalmic device herein. In some implementations, the ophthalmic devices of the present disclosure may include additional elements configured to scan light across the retina or otherwise configured to direct light to the retina. The augmented reality device of the present disclosure may be used to objectively determine refractive errors by performing a retinal examination, which may be an advantage over other devices that use the patient's subjective feedback to determine refractive errors.

To provide static retinography, the augmented reality device of the present disclosure is used to comfortably adapt to the wearer's eye. This can be achieved, for example, by using cyclopegic drops in the wearer's eye. A weak spot or light beam is provided and moves across the wearer's eye. Lenses and/or refractive correction or other elements that can alter the shape of the wavefront may be applied to neutralize or compensate for visual defects. Adaptive optics or VFEs including reflection, diffraction and/or refraction may be employed. In some embodiments, when operating as a static retinoscopy, the image provided by the augmented reality device to the gaze fixation view is remote, eg, at a distance of substantially infinity. In some embodiments, when operating as a static retinoscopy, the light provided by the augmented reality device sweeping across the eye may be provided from a static depth plane. The depth plane from which the virtual image is projected can lie between infinity and about 0.1 m. In certain implementations, the augmented reality devices herein include administration devices for administering sprays or other eye drops or sprays used to ease the adaptation of the wearer's eye and/or to dilate the pupil. For example, the augmented reality device may be configured to spray a accommodative numbing agent into the eye of the wearer.

To provide dynamic retinoscopy, the augmented reality device herein can be used when the wearer's eyes are allowed to adapt. The image may be displayed to the wearer, or an object on which the wearer may fix their gaze may be provided. The distance of an image or object may be variable to induce adaptation. In some embodiments, adaptation of the wearer's eye may be monitored and/or measured. Adaptive lag or lead can be measured using this technique.

The augmented reality device herein can be used to switch between static and dynamic retinoscopy. This may be accomplished while the augmented reality device of the present disclosure is in use. The augmented reality device may be configured to provide images from various depth planes viewed by the wearer, thereby making it possible to perform both dynamic and static retinal examinations. For example, images provided by the augmented reality device may be dynamically transformed to switch between static and dynamic retinal examinations.

As in the case of the previous embodiment, the input may be received by the wearer to determine a diagnosis. In some embodiments, the augmented reality device herein may also include an eye scanning module configured to measure the retina's response to swept light. These responses can be recorded and analyzed based on retinal imaging-specific algorithms to diagnose the patient. For example, the algorithm may be based, at least in part, on a retinal scan where light is swept across the eye and a reflex is monitored and measured, wherein a refractive error is combined with the monitored and measured reflex characteristic. are related In some implementations, the direction of reflection can be used to determine refractive anomalies. If, for example, the reflex moves in the same direction as the direction of light sweeping across the eye, or represents a "accompanying" movement, the augmented reality device herein may determine that the wearer's eye is farsighted. Likewise, if the reflex moves in the opposite direction to, or "retrogrades" to, light sweeping across the eye, the augmented reality device herein may determine that the eye is nearsighted. If the reflex moves in a direction that is not parallel to the direction of the light sweeping across the eye, the augmented reality device may determine that the wearer's eye is farsighted. In addition, the direction of travel of the reflection relative to the direction of travel of light provided to the eye may indicate whether positive or negative refractive power is required to correct a vision defect. For example, "accompanying" motion indicates that positive power may be required for correction of refractive error, "retrograde" motion indicates that negative power may be required, and oblique motion indicates that cylindrical power may be required. As discussed above, different optical corrections (eg, spheres and/or cylinders of various axes) may be provided to determine the wearer's prescription and appropriate refractive correction.

In some implementations, in combination with the virtual working distance of the augmented reality device herein, the speed of the reflex may also be used to characterize a vision defect. For example, the rate of the reflex may be correlated with an aplastic eye or refractive error of the eye (eg, a higher rate indicates less aplastic eye or refractive error of the eye).

In some implementations, the width of the reflex may be used to characterize a vision defect. For example, the width of the reflex may be correlated with the refractive error of the eye (eg, a wider reflex indicates less anomalous vision or less refractive error in the eye).

In some implementations, the direction of reflection relative to the light source beam may also be used to characterize the vision defect. For example, rotation in the direction of reflection relative to the light source beam may be indicative of astigmatism.

In some implementations, reflexes may also use relative brightness to characterize a vision defect. For example, the relative brightness of the reflexes can be used to determine refractive errors in the eye (eg, brighter reflexes indicate low anomalous or less refractive errors in the eye).

Any combination of the reflex characteristics described above can also be used to determine refractive anomalies. Likewise, the changes in reflex characteristics described above, alone or in any combination with each other, may be used to determine whether refractive correction has improved or worsened the determined refractive anomaly, wherein refractive correction is applied to the augmented reality device. resulting from the addition or removal of refractive optical elements or other elements that introduce optical corrections. In some embodiments, the ophthalmic system herein may be configured to determine in real time whether refractive correction has improved or worsened the determined refractive error. The ophthalmic system herein may be configured to measure or monitor adaptive reflexes by measuring adaptation, gaze angle and/or pupil size, and variations in these physical characteristics to assess whether the wearer can see images with normal vision. For example, when the gaze is fixed on a stationary target, the adaptation of the eye, the gaze angle and/or the pupil size changes. These fluctuations increase when the eye has trouble focusing the image. Accordingly, the ophthalmic system of the present disclosure is configured to monitor fluctuations in features of the eye, and use such biofeedback to evaluate the quality of an image seen to the wearer (e.g., when the wearer sees an object or image in normal field of view). whether you see it).

19 illustrates an exemplary method 1900 for measuring refractive errors in a wearer of an augmented reality device configured as an ophthalmic device for performing retinal examination. For convenience of description, method 1900 will be described as being performed by an ophthalmic system, such as the augmented reality device described herein. It should be understood, however, that any element or subpart of the various augmented reality devices or other similar devices described herein may be used for the performance of any step, combination of steps, or portion of a step in method 1900 . do.

At block 1902, the ophthalmic system of the present disclosure begins the retinal examination program. The retinal imaging program may be a continuous function or a stored procedure provided by the ophthalmic system. Initiation of a retinoplasty program includes determining or recalling an initiating optics prescription for a person, such as a wearer, who has previously had a retinoscopy or other eye examination. In some implementations, the retinography program may incorporate information about an abnormality in the wearer's eye(s), wherein the information about the eye abnormality may be input by the wearer or a clinician, or from a previous retinography program. It can be determined, or it can be retrieved from stored data (eg the data storage is part of the ophthalmic system or networked). The initiation of the retinal examination program may include a light beam projected onto the wearer. The initiation of a retinography program may involve a clinician or physician deciding whether to perform an eye examination or whether the wearer will perform the examination on their own. In some embodiments, the ophthalmic system initiates a retinal imaging program in response to input received from the wearer or clinician.

At block 1904, a beam of light sweeps through the wearer's eyes. The light may be, for example, a beam, for example a point projected into the eye. The light may be configured to be parallel, converging, or diverging. Light can cross the eye or move around the eye. The light beam may be provided with an optical correction to be inspected, eg a sphere and/or cylinder (with varying axes), to determine focus and astigmatism.

At block 1906 , the eye scanning component of the ophthalmic system is configured to measure an eye response of the wearer in response to sweeping light, such as a reflection originating from the eye of the wearer. The eye scanning component may be a camera or other sensor described herein. The eye scanning component may be configured to analyze a measurement of the reflection to determine a refractive error. For example, the component (eg, camera) may include an analysis module configured for pattern recognition measurement, response pattern identification, sensor measurement, reflection tracking, brightness measurement, speed tracking, direction determination, and the like. A retinoscope program may be pre-coded with a pattern recognition algorithm to identify patterns and/or analyze a given pattern. The detector program can be pre-coded with previous images of the wearer to identify changes in past analysis.

At block 1908 , the wearer's eye response may be compared to a correlation table holding corresponding response values of the various vision defects. For example, at block 1908 the ophthalmic system compares the information measured at block 1906 with a correlation table or other data corresponding to expected values of measurements for various vision defects. The comparison may be used at block 1906 to determine a refractive error based on the measured reflective properties.

At block 1910, the values are compared to determine any visual defect. Examples of traits and their relationship to visual acuity are as described hereinabove. For example, the direction, speed, brightness, and/or width of the reflection may be used to determine refractive anomalies. The shape of the reflex can be used to determine other visual defects, such as astigmatism. In some embodiments, testing may be initiated if the wearer has difficulty focusing or if vision problems occur, as indicated by the dashed lines in blocks 1910 - 1902 .

In various embodiments, to reduce distraction, the world view outside the wearer's eyes via the augmented reality device is blocked or invisible during retinal examination. For example, when an image is presented to the wearer, this may occur, although this approach is not required. In some embodiments, eye tracking may be used to monitor if the wearer is distracted. The system can be configured to dynamically filter out distractions based on the results of monitoring the gaze eye system.

Although the system has been described as an augmented reality device, in other embodiments the system may be a virtual reality device. In either case, the system may be a system provided by a physician or clinician for examination in a medical facility or optometrist's office or elsewhere. In other embodiments, the system may belong to the wearer and may be used for other purposes, such as, for example, entertainment (eg, games and movies) and/or work activities. As noted above, one advantage of performing retinal examination on the wearer's system is that the procedure can be conveniently performed multiple times (at least 2, 3, 4, 5, 6, 8, 10, 12, 16, 18, 24 or more times). In some embodiments, the frequency or schedule of the procedure may be changed based on results and/or trends in retinal examination results. For example, the frequency or schedule of the procedure if the test results indicate that the visual impairment has worsened or if the system detects that the wearer is having vision difficulties (e.g., through analysis of accommodative agitation, visual agitation, etc.) may be changed to increase the frequency of procedures and/or to shorten the time between procedures. Likewise, the above procedure can be performed with or without a medical professional such as an optometrist, an ophthalmologist, a nurse, a technician, or a medical assistant.

<u>photo refraction</u>

As described herein, an augmented reality device may include an optical scanning or optical sensing module configured to allow the device to scan the anterior and/or medial portion of the eye using known visible and invisible spectral techniques. have. One such technique involves photo-refraction, which involves imaging fundus reflections from the eye(s) of the wearer of the augmented reality device. Images of fundus reflexes can be used to determine various refractive anomalies. This technique can be advantageous for screening non-communicative people because no feedback from the wearer is required and errors can be objectively measured.

The augmented reality device may be configured similarly to the augmented reality devices described herein. The augmented reality device may include a display platform configured to project an image onto the wearer's eyes. The display platform may include one or more light sources configured to illuminate the wearer's eyes. The augmented reality device may include an inwardly oriented imaging device (eg, a camera) configured to generate an image of the wearer's eyes. The display platform may be configured to pass light from the perimeter through the display platform to the eyes of the wearer.

To act as a light-refracting device, the augmented reality device may be configured to project a static image into the wearer's eyes (eg, positioned in the center of the wearer's field of view). When the wearer's eyes are fixed on the fixed image, the augmented reality device may project light configured to illuminate the wearer's eyes, so that the image pickup device may capture the bottom reflection image from the projected light. The bottom reflection image may be used to determine one or more refractive errors for the wearer. The depth plane of the projected light may be substantially the same depth plane as the fixed image. In some embodiments, rather than providing a fixation image, the wearer is instructed to focus on a fixation object positioned at a target distance from the wearer. In such an embodiment, the depth plane of the projected light may be substantially the same distance as the target distance to the fixed object. The imaging device may be configured to image the eye from a depth plane substantially equal to the fixed image or object and projected light. In this way, the wearer's eyes are focused substantially to the same depth as the imaging device. In some embodiments, the imaging device may be configured to be in the conjugate plane of the wearer's retina. Thus, in various embodiments, the effective distance from the eye to the imaging device, the effective distance from the projected light to the eye, and the effective distance from the static image or object to the eye may be substantially the same. In some embodiments, the effective distance from the eye to the fixation target, camera, and/or projected light is about 0.33 m or more and/or about 10 m or less, about 0.5 m or more and/or about 7 m or less, about 1 m or more and/or about 5 m or less, or about 2 m or more and/or about 3 m or less (eg, about 2.4 m).

In some embodiments, the light source may provide projected light along an optical axis different from the optical axis from the wearer's eye to the imaging device. When the light source provides projection light at an off-axis location, the image of fundus reflection captured by the imaging device may be correlated with refractive anomalies. In emmetropic eyes, fundus reflexes will normally fill the retina. For myopic eyes, fundus reflexes form a crescent shape, like light projected off-axis by a crescent on the opposite side of the retina. The light-refractive device may also be configured to detect anisometropia, fragmented retinal magnification, lens disorders (eg, cataracts, tumors, etc.), strabismus, and the like. In some embodiments, the augmented reality device is configured to compare an image obtained from the wearer's eye with stored eye images having other refractive anomalies to determine refractive anomalies, if any, in the wearer's eyes. In some embodiments, the augmented reality device is configured to perform pattern recognition to identify and/or determine refractive errors, if any, of the wearer.

The augmented reality device may be configured to determine a refractive correction amount suitable for correcting the detected refractive error. For example, the properties of fundus reflexes can be used to determine the magnitude of refractive errors in the eye. Accordingly, the augmented reality device may be used to automatically determine a refractive correction based at least in part on the measurements described herein. For example, there is a relationship between the size of the crescent moon and the size of the wearer's refractive error. In general, the size of the crescent is related to the effective distance between the wearer's eye and the imaging device, the diameter of the wearer's pupil, and the size of the wearer's refractive error. Thus, the augmented reality device may measure, by controlling or knowing the depth plane of the imaging device, by measuring the wearer's pupil size, and/or by determining a characteristic of the fundus reflex (eg, the size of the crescent moon). and to determine the refractive error of the eye.

In some embodiments, the sensitivity of the augmented reality device to refractive error when operating as a photo-refractor increases with increased pupil size. To increase sensitivity, it may be advantageous to allow or cause the wearer's pupils to dilate. Likewise, for increased sensitivity, it may be advantageous for the wearer to anchor to a target at infinity. In various embodiments, the target may be generated by an augmented reality device. In some implementations, the augmented reality device may be configured to block ambient light.

In some embodiments, the augmented reality device may use the light-refractive function described above to track the performance or behavior of the wearer's eyes. This may be used to provide feedback to one or more inspection protocols and/or correction protocols. The feedback can be used to evaluate the wearer's performance, improve or degrade wearer vision, track wearer fatigue, and the like.

For example, in various embodiments, the light-refractive system determines whether a natural crystalline lens focuses an image on the retina and/or, for example, for closer objects, to see if refractive correction sufficiently compensates for refractive errors. To see if the eye is accommodating correctly, it can be used. The system monitors accommodation and may monitor whether the wearer is struggling to accommodate or is successfully accommodating. The system may help evaluate optical correction and/or help the wearer know if his/her vision is deteriorating, and may benefit from additional examination of optical corrections or refractive errors or otherwise.

<u>slit lamp</u><u> Slit Lamp</u>

Various embodiments of the augmented reality/virtual reality device described herein may be configured as a slit lamp ophthalmic diagnostic device. For a description of the slit lamp lamp equipment, see https://en.wikipedia.org/wiki/Slit_lamp. The augmented reality/virtual reality device may include a head mounted display having an inward facing camera configured to provide an image of the wearer's eye. Such a device may include, for example, a frame 64 , a display system 62 positioned in front of the wearer's eye, and a hardware electronic processing system 70 as shown in FIGS. 3A-3C and 5 . can The device may also include a light source and an outward looking camera. These devices are wearable by the user and are used to obtain images and perform diagnostic tests on the user's eyes. In particular, such ophthalmic devices may include a bright light source that illuminates an aperture (eg, a slit) and produces a thin beam of illumination. The resulting thin beam of illumination may be conditioned by one or more lenses and filters and directed to the user's eye. In some embodiments, the dimensions of the openings (eg, the length and/or width of the slits) may be adjusted to change the dimensions of the light beam. Further, in some embodiments, the angle of incidence and/or brightness of the thin illumination beam on the eye may also be adjusted in various embodiments of the slit lamp lamp diagnostic device. The light reflected from the eye may include various anatomical structures of the wearer's eye, including, but not limited to, the eyelids, lacrimal duct, cornea, sclera, conjunctiva, iris, lens, retina, etc. upon which a thin beam of light is incident. may be received in a receiving system (eg, a camera, microscope, and/or lens system) to test the In various embodiments, this thin beam of light comprises a thin sheet of light at the location where the beam is incident on the eye.

Other anatomy of the wearer's eye, or a perspective view thereof, can be investigated by changing the direction of the illumination beam, the direction of the gaze, the amount of defocus of the illumination beam and/or the depth of focus of the illumination beam (https://en.wikipedia.org /wiki/Slit_lamp). Depending on the desired monitoring and opacity of the wearer's eye, methods other than direct focus examination may be used. More specifically, the light may be provided at various angles and in various widths from a narrow range to a wide range.

20A schematically shows a wearable augmented reality device/virtual reality device 2050 configured with a slit lamp ophthalmic diagnosis device. The device 2050 may be configured to perform a slit lamp lamp examination of the eye periodically (eg, hourly, daily, weekly, biweekly, monthly, twice a year, annually, etc.). The device 2050 may be configured to detect symptoms of visual impairment in the user's eye 2020 and perform a slit lamp lamp test of the eye when such symptoms are detected. In various embodiments, the device 2050 may be configured to perform slit lamp lamp tests of the eye at irregular time intervals. For example, device 2050 may be configured to perform slit lamp lamp tests of the eye several times an hour, several times a week, several times a month, several times a year, and the like. Accordingly, such examinations may be performed 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24 or more times per year. These tests may be performed more frequently if the user has health problems. The device 2050 may be configured to be used in a doctor's office or hospital as a slit lamp lamp diagnostic tool. In contrast to the conventional table/bench mounted slit lamp device, the ophthalmic device 2050 can be worn by the user 2060 . The wearable slit lamp lamp device 2050 is smaller and smaller in volume than the conventional table/bench mounted slit lamp lamp device.

The wearable device 2050 includes a frame 2064 attached to a display system 2062 . The display system 2062 may be configured to be positioned in front of the wearer's 2060 eye. Among various embodiments of the ophthalmic device 2050 , the display system 2062 may include a display lens 2076 mounted to a frame 2064 . In some embodiments, the display lens 2076 may be a single lens comprising two eyepiece regions, each eyepiece region positioned in front of the wearer's eye 2020 . In some embodiments, the indicator system 2062 may include two display lenses mounted to a frame 2064 , each indicator lens being positioned in front of a respective eye 2062 of the wearer's eyepiece. includes area.

The wearable device 2050 may be configured to project an illumination beam 2038 from a light source 2068 to an eye 2020 of a wearer 2060 . In some embodiments herein, light source 2068 may be part of display lens 2076 and/or a lighting system of wearable augmented reality device/virtual reality device 2050 configured to provide illumination to the wearer's eyes. have. In some such embodiments, the illumination beam 2038 may be projected from a display lens 2076 into the user's eye. In some embodiments, light source 2068 may be an auxiliary light source disposed on a side of display system 2062 . In this embodiment, the wearable augmented reality device/virtual reality device 2050 is configured to direct an illumination beam 2038 to the wearer's eye 2020, eg, a deflector, a reflector, a beam splitter, diffractive optics. It may include optical components such as elements, lenses, and the like.

A portion of the projected illumination beam 2038 may be reflected, scattered, and/or diffracted by various anatomical features of the user 2060 eye and may be received by one or more imagers 2074 . The electronic hardware processor 2070 may be used to analyze the light received from the user's 2060 eye to examine various structures of the wearer's eye.

The illumination beam 2038 may have sufficient brightness to be detected by one or more imagers 2074 . In various embodiments, the imaging device 2074 may face inward. The cross-sectional shape of the illumination beam 2038 may be configured such that the dimensions of the cross-sectional shape along the upper-lower axis of the wearer's face and eyes 2020 are greater than the dimensions of the cross-sectional shape along the axis of the nose-temple. For example, illumination The beam may have a rectangular cross-sectional shape in which the length measured along the upper-lower axis of the wearer's face and eyes 2020 is greater than the width along the nose-temporal axis. As another embodiment, the illumination beam may have an elliptical cross-section with a major axis oriented along the upper-lower axis of the wearer's eye 2020 and a minor axis oriented along the nose-temporal axis of the wearer's eye 2020 .

The height of the cross-sectional shape of the illumination beam 2038 measured along the upper-bottom axis of the wearer's face and eyes 2020 and the cross-section of the illumination beam 2038 measured along the temple-nose axis of the wearer's face and eyes 2020 The aspect ratio, which represents the ratio of the width of the shape, is, for example, between 1.1:1 and 1.5:1; between 1.25:1 and 1.9:1; between 1.51:1 and 2.6:1; between about 2:1 and 2.75:1; between about 2.49:1 and about 3.26:1; between about 3.01:1 and about 5.2:1; It can have an aspect ratio between about 5.01:1 and about 10:1 or any of the subranges of the aforementioned ranges. Thus, the light beam may include a thin sheet at the location where it is incident on the eye.

In various embodiments, the display system 2062 may be configured similarly to the display system shown in FIG. 5 and may include one or more features of the display system described with reference to FIG. 5 . For example, the display system 2062 may include one or more light sources 2016 (eg, infrared or visible lasers/light emitting diodes) and one or more imaging configured to track the eye 2020 of the user 2060 . device 2024 (eg, infrared and/or visible cameras). In various embodiments, the light source 2068 may include an eye tracking light source 2026 . In various embodiments, one or more imaging devices 2074 may include eye tracking imaging devices 2024 .

As shown in FIG. 20A , one or more imagers 2074 may be disposed on the periphery of the display system 2062 and configured to receive light from the wearer's eye 2020 . In some embodiments, the one or more imaging devices 2074 include cameras configured to image surroundings surrounding the user and having optical and mechanical characteristics similar to those of the wide field machine vision camera 16 already described above with reference to FIG. 5 . do. In various embodiments, more than one imager 2074 and light source 2068 may be integrated into a single device, as discussed below.

As shown in FIG. 20A , a light source 2068 may be disposed around the perimeter of the display system 2062 . In various embodiments, the light source 2068 may include one or more light emitting diodes disposed around the perimeter of the display system 2062 , including lenses, prisms, beam splitters, mirrors, and/or other optical components. is configured to project an illumination beam 2038 into the wearer's eye 2020 using an optical system. In some embodiments, light source 2068 may have structural and functional properties similar to projection system 18 described with reference to FIG. 5 .

In various embodiments, the light source 2068 may be similar to the optical fiber scanning device (FSD) described above. In such embodiments, the fiber optic scanning device may incorporate one or more optical components (eg, a light guide having a lens, a reflective element, a diffractive optical element), and the light from the fiber optic scanning device enters the wearer's eye 2020 . can be directed towards. In some embodiments herein, the display lens 2076 may include a plurality of waveguides having optical and structural characteristics similar to the stacked waveguide assembly 178 of FIG. 10D . In some such embodiments, light source 2068 comprising an FSD may be configured to inject light into one or more of the plurality of waveguides such that light originating from the FSD propagates through the one or more plurality of waveguides. Diffractive optics or other optical components integrated with the plurality of waveguides may be used to direct light from the plurality of waveguides to the eye 2020 of the wearer.

The light source 2068 including the FSD may project light in various patterns (eg, raster scans, spiral scans, Lissajous patterns, etc.). In some embodiments of the light source 2068, it may include one or more optical fibers similar to FSD. In such embodiments, the one or more optical fibers may be configured to direct light from the light source to the display lens 2076 . The scanning optical fiber may be driven to scan in a pattern to produce a beam in the eye in the form of a thin sheet having a cross-sectional shape longer along the up-down direction than along the nose-temporal direction. One or more optical fibers of the light source 2068 , such as comprising an FSD, may be configured to receive light from the wearer's eye 2020 to the imager 2074 . Alternatively, another optical fiber, which may or may not scan with the fiber scanning display fiber, may be used to collect the reflected light and image the eye.

The illumination beam 2038 projected from the light source 2068 may be directed to be incident on a particular location of the wearer's eye 2020 . For example, the illumination beam 2038 may be directed to the wearer's eye 2020 such that the center of the illumination beam 2038 is incident at an angle between 0 and about ±90 degrees with respect to a normal normal to the surface of the wearer's eye at the desired location. may be incident at a desired position of For example, the center of the illumination beam 2038 may be scanned over an angular range that extends 180 degrees with respect to an axis orthogonal (or perpendicular) to the surface of the eye. As another example, the center of the illumination beam 2038 may be scanned over an angular range that extends 180 degrees to an axis that crosses the eye and passes through the pupil. In various embodiments, the center of the illumination beam 2038 may be scanned across the entire surface of the user's cornea, fundus, and/or lens to image and/or examine various regions of the eye. The system 2050 may be configured to image the eye in various directions oriented at various angles with respect to an axis that crosses the eye and passes through the pupil. The system 2050 may be configured to image the eye along an axis that crosses the eye and passes through the pupil.

In various embodiments, light source 2068 may include a scanning laser device that outputs an illumination beam having a spot size between about 1 micrometer and about 1.0 millimeter. For example, the illumination beam may be between about 1-3 micrometers, between about 2-10 micrometers, between about 5-25 micrometers, between about 10-30 micrometers, between about 20-100 micrometers, between about 50- Between 200 micrometers, between about 75-250 micrometers, between about 100-300 micrometers, between about 225-500 micrometers, between about 375-600 micrometers, between about 500-750 micrometers, between about 650-850 micrometers It can have a spot size of between meters, about 725 micrometers-1 mm, or any value in this range or subrange. The scanning laser device may be configured to scan a desired area of the eye in a desired scanning pattern. For example, the desired scanning pattern may have a length along an upper-lower axis of the wearer's face that is greater than a length along the nose-temporal axis of the wearer's face. The scanning laser device may be configured to scan at a rate between about 1 kHz and about 5 MHz to produce a desired scan pattern. Thus, a desired scanning pattern created in a desired area of the eye may be considered to include a plurality of pixels that are illuminated sequentially (eg, one at a time) during scanning. In some such embodiments, the one or more imagers 2074 may include a photo detector configured to receive scattered or reflected light from each of a plurality of pixels. The intensity of light received by the photodetector may be correlated with the scan angle and/or position of the illumination beam to produce a two-dimensional image of the desired area.

Light projected from the light source 2068 may be focused at different focal lengths of the wearer's eye 2020 . For example, the focus of the projected light may coincide with the cornea, iris, innate lens, vitreous, or retina. In various embodiments, as described above with reference to FIGS. 10B, 10C and 10D, one or more adaptive optics or variable focus elements (VFEs) may optionally include the angle of incidence of light projected from light source 2068 and/or the light source ( 2068) can be focused or used to change the optical plane in which it appears to occur. For example, the light output from the light source 2068 may be a lens, a prism, such that the depth at which the illumination beam 2038 is focused on the eye and/or the direction of the illumination beam 2038 on the user 2060 eye 2020 can be varied. and/or a mirror (eg, optical element 1024 of FIG. 10C).

In various embodiments, the VFE may include a deformable mirror arrangement. For example, a VFE may include one or more electrodes coupled to a thin-film mirror. The control system may be configured to selectively control one or more electrodes to change the shape of the thin film mirror. Thus, the wavefront of the light emitted from the stacked waveguide assembly can be modified by changing the shape of the thin-film mirror. Embodiments of the wearable device 2650 that do not include a light source, including a scanning laser device or a fiber optic scanning device, are modified to steer the beam and/or change the depth at which the beam is focused within the user's eye. Possible mirror arrangements may be included. In various embodiments, the VFE may include a deformable lens. In various embodiments, the VFE may include a deformable lens. A deformable lens can include an elastomeric material that can be deformed by application of electrostatic energy to create a lens or lenticular surface with a different curvature. In some embodiments, the VFE may include a lens that may deform upon activation of the electrode. Some lenses can change the refractive index by applying a voltage to the electrodes (eg, liquid crystal lenses). In various embodiments, device 2050 may include a spatial light modulator to modulate phase. Embodiments of the wearable device 2650 comprising an optical source comprising a scanning laser device or fiber scanning device may modulate the phase to adjust the beam and/or to change the depth at which the beam is focused within the user's eye. a deformable lens and/or a spatial light modulator.

The display lens 2076 may also include a plurality of stacked waveguides configured to receive light output from the light source 2068 . The plurality of stacked waveguides may have similar structural and functional properties to the stacked waveguide assembly 178 shown in FIG. 10D and described with reference to FIG. 10D. In various embodiments, the plurality of stacked waveguides may include diffractive optical elements configured to couple light output from the light source 2068 into one or more stacked waveguides. The plurality of stacked waveguides may further include diffractive optics configured to out-couple light propagating in one or more of the stacked waveguides. In various embodiments, a diffractive optical element configured to couple or out of coupling light from a light source 2068 to or from a plurality of stacked waveguides is a focal plane and/or eye 2020 of the wearer 2060 may be configured to modify the direction of the illumination beam 2038 towards In various embodiments, the plurality of stacked waveguides may include one or more lens forming layers. For example, the lens forming layer may be coupled with the waveguides of a stacked waveguide assembly as shown in FIG. 10D .

In various embodiments, the lens-forming layer may be static such that the focal length and/or other optical properties of the lens-forming layer are fixed. In this embodiment, light from light source 2068 is optical and mechanical to produce an output light beam that has a desired direction and can be focused or defocused at a desired location of the wearer's eye 2020 . and may be coupled to a waveguide of a plurality of stacked waveguide assemblies coupled with a lens forming layer having properties.

In various embodiments, the lens-forming layer or other adaptable optics included in the waveguide stack may be such that the focal length and/or other optical properties of the lens-forming layer may be changed by application of electrical, magnetic, optical and/or mechanical forces. so it can be dynamic. In such embodiments, light originating from light source 2068 may be coupled to one or more waveguides of a plurality of stacked waveguide assemblies, wherein the optical and/or mechanical properties of one or more lenses, lens forming layers, or adaptive optics elements are: It can be modified to produce an output light that has a desired orientation and can be focused on a desired location of the wearer's eye 2020 . Thus, the focus of the slit beam with respect to the eye can be changed, for example, by adjusting the adaptive optics or the variable focus element.

As noted above, the illumination beam 2038 may have a width of between about 25 micrometers and about 1 mm. In some embodiments, the illumination beam 2038 may have a width of less than about 25 micrometers. For example, the illumination beam 2038 may be between about 1-24 micrometers (eg, between 1-3 micrometers, between 2-10 micrometers, between 3-15 micrometers, between 8-24 micrometers). can have a width of Without wishing to refer to any theory, the width of the illumination beam 2038 may be the maximum distance along the temple-nose direction of the eye 2020 and the wearer's face of the illumination cross-section in the focal plane. For example, the width of the illumination beam 2038 may be between about 25 micrometers and about 1 mm, between about 40 micrometers and about 950 micrometers, between about 60 micrometers and about 900 micrometers, between about 80 micrometers and about 850 micrometers. between about 100 micrometers and about 800 micrometers, between about 140 micrometers and about 750 micrometers, between about 180 micrometers and about 700 micrometers, between about 220 micrometers and about 650 micrometers, about 280 range between micrometers and about 600 micrometers, between about 325 micrometers and about 550 micrometers, between about 375 micrometers and about 500 micrometers, between about 400 micrometers and about 450 micrometers, or any of these values. Or it can be a value from a sub-range.

In various embodiments, the camera includes a lens or other imaging optics. This lens or other imaging optics may provide an enlarged field of view of the eye. This lens or other imaging optics may include adaptive optics or variable focus optics, configured to be changed to change focus, for example.

Thus, the FSD of an ophthalmic device can be used to provide a narrow beam (or broad beam) of light using the systems and methods discussed above to illuminate the anterior or posterior portion of the eye. It should be understood that the focus of the light beam may be altered by one of the many methods discussed in U.S. Patent Application Serial No. 14/555,585, incorporated by reference above. Similarly to the above, the eye scanning module may scan the user's eye response (eg, a reflection pattern, a diffraction pattern, a scattering pattern) and analyze it to determine whether there is a vision defect. In various embodiments, a pattern matching algorithm may be used on the image of the illuminated portion of the eye to determine any anomalies.

Apparatus 2050 comprising a fiber optic scanning device is configured to shape, shape, and steer an optical beam. Thus, the device 2050 can generate a beam 2038 having any width, pupil position, direction, and focal point, and thus can be configured to reproduce the functionality of a slit lamp diagnostic device. The diffractive optics coupled to the waveguide of the stacked waveguide assembly may be configured to produce a number of different output beams, each having a different set of beam parameters. The various beam parameters may be further modified by additional dynamic optical elements that may be coupled with the waveguides of the stacked waveguide assembly. Further, the waveguides of the stacked waveguide assembly may be configured to be bidirectional, capable of projecting an optical beam as well as collecting and imaging backscattered light from the eye.

20B depicts an exemplary flow diagram 2000 of a method for performing a slit lamp lamp inspection using an augmented reality/virtual reality device 2050 . The method of performing the slit lamp test may be executed by the electronic hardware processor 2070 . The slit lamp test may be run on a schedule or when the device 2050 detects that the user 2060 has a visual impairment. Referring now to FIG. 20B , at block 2002 , a slit lamp lamp program may be initiated. At block 2004 , a beam of light of a particular focus (ie, generated by a light source 2068 , such as an FSD, scanning laser, or other display or auxiliary light source) may be projected onto at least a portion of the user's eye 2020 . have. At block 2006 , an image of the illuminated portion of the user's eye 2020 may be captured by the imaging system 2072 . Said portion of the user's eye 2020 may consequently be illuminated. At block 2006 , an image of the illuminated portion of the user's eye 2020 may be captured by imaging system 2072 . It should be understood that this function may be performed, for example, by an eye tracking camera, or a camera specifically designed for this purpose. At block 2008, a pattern matching algorithm may be run on the captured image. The pattern matching algorithm may be executed by the electronic hardware processor 2070 . In some embodiments, images captured in imaging system 2072 may be transmitted to electronic hardware processor 2070 using wired or wireless technology. The pattern matching algorithm may have several known eye image patterns representing various eye abnormalities. In various embodiments, the images captured by the device 2050 may be compared to images of the user's eye 2020 obtained during a previous ophthalmoscopic examination for historical analysis. Such comparisons may be useful in tracking the progression of certain diseases of the eye over time. If the captured image matches any of these known paddle patterns, the ophthalmic system can determine an appropriate anomaly as shown in block 2010 .

In various embodiments, the electronic hardware processor 2070 may be configured to generate a three-dimensional map of the wearer's eye based on the light received by the one or more imagers 2074 . For example, the acquired images may be combined and merged using an image processing method to generate a three-dimensional topographical map of one or more regions of the eye. Generating a three-dimensional map of the eye based on the image obtained by the device 2050 may include changing the position and intensity (luma) of the light source, changing the wavelength and/or the color (saturation) of the light source and/or one or more may be embodied by the different capabilities of the device 2050 discussed above, including, but not limited to, changing the position/lens/filter of the imaging device.

<u>color blindness</u>

The ophthalmic device may also, in one or more embodiments, perform color testing to test a patient's defects in detecting a particular color. For example, it can administer the Ishihara color vision test, where the device is designed to test for red-green color perception defects. The examination involves showing the wearer a series of colored plates ("Ishihara plates") similar to those shown in FIG. 21A. As shown in Fig. 21A, the color plate contains a circle of small dots that are random in size and appear to be random or uniform in color. Inside each circle is a dot pattern of small dots that form a number or shape. In some circles, numbers or shapes are clearly visible to users with normal color vision, but are difficult or impossible to see for users with red-green perception deficits. In other circles, numbers or shapes are only visible to users with red-green defects. In some embodiments, the color plate may be selected and/or modified based on known conditions and/or prior reactions of the wearer. Colors or other stimuli can be changed progressively to determine the extent of the wearer's color perception deficit. That is, the color may change from the first color to the second color through the plurality of colors. For example, a wearer with a perceived red-green deficiency may be presented with a plate that gradually changes from red to orange or purple, and the wearer's response to the gradual change may be recorded.

In one or more embodiments, the ophthalmic device may be programmed in a manner similar to the process flow above to administer the Ishihara color vision test by providing a virtual image of each color plate and receiving user input regarding the color plate. Referring to FIG. 5 , the virtual image of the color plate may be provided by the display device 106 or another light emitting module 27 . A color plate may be projected onto the augmented reality display 62, with light from the outside world forming a background surrounding the color plate. In some embodiments, the device may provide a background in addition to the color plate to enhance the visibility of the color plate. For example, the background may be a solid color or a dark background. Dark backgrounds close to black are not projected, but a result of poor lighting. Thus, one or more spatial light modulators (SLMs), for example two or more that can be used to attenuate light rays such that the area surrounding the color plate appears black, nearly black, gray or other colors that darken to the wearer. By using the SLM stack, a dark background can be created. Various SLMs can be used, such as liquid crystal display panels, MEMS shutter displays, DLP DMD arrays, and the like. One way to selectively attenuate suggestive recognition is to block all incoming light from one angle while transmitting light from another. In some embodiments, multiple SLMs may be used to block more angles of light.

For example, FIG. 21B includes two SLMs 2180 and 2182, which may be a liquid crystal display panel, a MEMS shutter display, a DLP DMD array, or the like, which may be independently controlled to block or transmit different light beams. An example is shown. For example, if the second panel 2182 blocks or attenuates the transmission of light rays at point "a" 2184, all of the depicted light rays will be blocked. However, if only the first panel 2180 blocks or attenuates the transmission of light rays at point "b" 2186 , then only the lower incident light rays 2188 will be blocked or attenuated, and the rest will be transmitted towards the pupil 2145 . will be. An additional number of SLMs in excess of two provides more opportunities for more precise control of the selectively attenuated beam. Thus, as described above, a relatively dark background may be provided to correspond to the display of the color plate.

The ophthalmic system may automatically determine whether the user has a red-green visual field defect or other defect based on input received from the wearer in response to the color test. User input regarding the color plate may be generated and/or received by any suitable method for the user to enter a description of a number, letter, shape, or other image characteristic. For example, the input may be received via a user interface such as a keyboard, number pad, or touch screen with keys or virtual buttons corresponding to numbers used in the Ishihara version. In some embodiments, the system may be configured to receive voice input from the wearer and determine the wearer's response to the test using voice recognition. The user interface may further have an option to indicate to the wearer that the number or shape has not been monitored.

In some embodiments, the wearer may provide input through the ophthalmic device, for example, by selecting a virtual button projected by an FSD or other display element of the ophthalmic device. Alternatively or additionally, the ophthalmic device may be further configured to determine whether the wearer viewed the number or shape of the projected Ishihara plate without input intended by the wearer. For example, the system may detect fixation of the wearer's gaze on the location of the number or shape of the Ishihara plate for a sufficiently long period of time as an indication that the number or shape has been seen, whereas an extended scanning period of the image by the wearer may indicate that it is impossible to see a number or shape. For example, the system may track the wearer's gaze for up to 1 second, 5 seconds, 10 seconds or more.

In various embodiments, the system may use patterns and/or images other than the Ishihara plate to test the wearer's ability to detect different colors. For example, the ophthalmic device may be configured to function as an RGB anomaloscope. A test based on the color match of two images and/or light sources is used to provide a color sensing test. One light source or image may have a fixed adjustment color, while the other source or image may be adjusted by a ruler (eg, a fixed-spectrum image whose brightness may be adjusted). A viewer may be provided with various adjustment colors, and tries to match the adjustable image with the adjustment image, or determines that matching cannot be achieved.

The ophthalmic device may perform this function by projecting a plurality of colored rays or images onto the retina. As described above, the light source may be an FSD (or DLP, etc.) or a separate light source 27 configured for the same purpose. For example, multiple FSDs can be used to project light, each FSD projecting a different color of light required for an RGB colorblindness tester. Alternatively, a light source that produces multiple colors may be used. An image may be projected using a display device, for example, through one or more waveguides as described elsewhere herein.

In some embodiments, a general divided image may be displayed. In another embodiment, a full-field image may be displayed. In other embodiments, an opaque back screen may be added digitally or mechanically, for example using electronic devices and/or shutters and/or movable baffles. As noted above, it may be administered by a clinician or physician, or, in other embodiments, may simply be used by a user. The ophthalmic system may determine one or more vision deficits by receiving input (eg, a match or a bad match) for each image. As described above with reference to the Ishihara color vision test, user input may be provided through a user interface such as a keyboard, touchpad, voice recognition or other input device and/or may be provided through a virtual user interface projected within the ophthalmic device. have. Based on the received input, the ophthalmic system may provide a diagnosis or evaluation of the RGB colorblindness test.

In various embodiments, the ophthalmic system may be configured to administer color tests repeatedly and/or periodically. For example, the system may periodically check the wearer's color perception, such as several times a day or more than once a week, month or year, and compare the results over time. The ophthalmic system is for example once a year, twice a year, 3 times a year, 4 times a year, 6 times a year, 8 times a year, 10 times a year, 1 It may be tested 12 times a year, 16 times a year, 18 times a year, or more. Also, the ophthalmic system can be used once a week, twice a week, 3 times a week, 4 times a week, 6 times a week, 8 times a week, 10 times a week, 12 times a week, 14 times a week , 18 times a week, or more. Also, the ophthalmic system may be tested, for example, once a day, twice a week, three times a week, four times a week, five times a week, six times a week, or more. In some embodiments, the frequency of regularly scheduled tests may be automatically adjusted based on trending color blindness test results and/or based on detecting that the wearer has difficulty distinguishing colors. In such cases, the system may be better able to detect the severity or temporal change of the wearer's color detection defects by testing the wearer's color vision at various times of the day and in various lighting conditions. Similarly, the system may obtain more complete and/or accurate results by repeatedly examining the wearer's color vision in different depth planes, angles of accommodation, and/or retinal regions. Thus, the system may change the depth plane, accommodation, and/or area of the retina when performing color blindness testing. Repeated examinations over longer time periods, such as months or years, can track improvement or regression in the wearer's color detection defects due to macular degeneration or other progressive conditions.

The ophthalmic system may be configured for a therapeutic function, such as compensating for a wearer's color detection deficiencies. In some embodiments, the system may be configured for both detection (as described above) and therapeutic functions. The therapeutic function may include modifying the color, intensity and/or other quality of an image and/or light of the external world entering the user's eye. For example, the system may function as a color enhancer by increasing the intensity of light in the portion of the image that contains the reduced detected color. In some embodiments, the system may shift the color of those regions, such as by changing the wavelength of the light or adding a different wavelength of light, to present a color of light that is better detectable by the wearer. Color shift can be achieved through a multi-notch optical filter capable of notch filtering the spectral overlap between different photopigments. For example, in some cases of color blindness, the absorption spectra of red and green overlap more than normal, making it difficult to distinguish between red and green. Multiple notches to filter out some of the wavelengths of light between red and green (i.e. wavelengths with relatively high absorption for the red and green cones) so that the wavelengths reaching the eye can be more easily identified as red and green. A filter may be used. In embodiments involving augmented reality devices, the system may similarly modify the wearer's view of light from the outside world. Augmented reality systems can detect the color of light entering the device in real-time or near real-time, and can transform some of the light or project additional light to correct the wearer's color detection flaws. For example, a system could use an outward-facing camera to image the outside world and a color sensor to determine the color of an object. The system may at least partially mitigate color detection imperfections of the wearer by projecting additional light of the same or a different color to increase intensity in areas of reduced detection capability. The system may further include a labeling function, wherein the name of a known defective color may be augmented over an area of light outside the range determined by that color. In some embodiments, superposition may be used to enhance color in a portion of a display by projecting light of a desired amplitude, such as to add tint to an image.

A similar method may be used in a virtual reality system. The virtual reality system may have forward and outward looking cameras that image the outside world in front of the wearer and determine the color of the object. The virtual reality system may reproduce an image of the outside world to the wearer based on the output of the camera facing outward through some modification of color and/or brightness and/or other parameters as described above. For example, the virtual reality system may at least partially alleviate the wearer's color detection defect by increasing the intensity of the image in the region where the detection ability is reduced.

<u>ophthalmoscope/</u><u>fundus</u><u></u><u>inspector</u>

As described herein, various embodiments of the augmented reality/virtual reality device that the user 2260 can wear may be configured to function as an ophthalmoscope/fundoscope. 22A schematically depicts a wearable device 2250 configured as an ophthalmoscope/fundoscope. The device 2250 includes a frame 2264 attached to a display system 2262 . The display system 2262 may be configured to be positioned in front of the user 2260 's eye 2220 . Device 2250 may be configured such that a light beam 2238 from a light source 2268 is projected onto an eye 2220 of a user 2260 . A portion of the projected beam 2238 may be reflected, scattered, and/or diffracted by various anatomical features of the user 2220 eye and may be received by one or more imagers 2274 . The electronic hardware processor 2270 may be used to analyze the light received from the user's 2260's eye 2220 to examine various structures of the user's eye 2220 .

In various embodiments of ophthalmic system 2250 , frame 2264 may be structurally and/or functionally similar to frame 64 of FIGS. 3A-3C . In various embodiments of ophthalmic system 2250 , display system 2262 may be structurally and/or functionally similar to display system 62 of FIGS. 3A-3C and 5 . In various embodiments of ophthalmic system 2250 , electronic hardware processor 2270 may be similar to local processing and data module 70 of FIGS. 3A-3C .

The wearable device 2250 configured as an ophthalmoscope may be used to examine various portions of the user's eye 2220 , including but not limited to the fundus of the eye 2220 . The fundus contains the retina of the eye, the optic disc, the macula, the central and posterior poles of the eye, and other structures. The wearable device 2250 may be configured to allow a clinician to view various shapes of a user's eye and to detect any anomalies by monitoring the output of one or more imaging devices 2274 . For example, the fundus of the eye is a part of the body where microcirculation can be monitored. Accordingly, the fundus examination by the wearable device 2250 may be advantageously used to detect not only eye-related health conditions but also other health conditions of the body (eg, brain abnormalities, heart abnormalities, etc.).

The display system 2262 of various embodiments of the device 2250 may include a display lens 2276 mounted to a frame 2264 . In some embodiments, the display lens 2276 may be a single lens comprising two eyepiece regions, each eyepiece region positioned in front of the user's eye 2220 . In some embodiments, display system 2262 may include two display lenses mounted to frame 2264 , each display lens being an eyepiece area positioned in front of each of the user's eyes 2220 . includes

In some embodiments, light source 2268 may be part of an illumination system of display lens 2276 and/or wearable device 2250 configured to provide illumination to the user's eyes. In some such embodiments, beam 2238 may be projected from display lens 2276 to eye 2220 of user 2260 . For example, the light source 2268 may include a fiber optic scanning device (FSD), and the display lens may include a plurality of waveguides. Light from the FSD may be injected into one or more of the plurality of waveguides, and may be emitted from one or more of the plurality of waveguides to the user's eye 2220 to perform an ophthalmoscope/fundusoscope function.

In some embodiments, light source 2268 may be an auxiliary light source disposed on a side of display system 2262 . In this embodiment, the wearable system 2250 may include, for example, a lens or other refractive component, a reflective surface, a deflector, a beam splitter, to direct the beam 2038 to the eye 2220 of the wearer; may include optical components such as diffractive optics, waveguides, or other optical components. For example, in certain embodiments, the ophthalmic system 2250 may include an additional FSD, and the display lens may include an additional waveguide (eg, an additional stack of waveguides). Light from the added FSD may be injected into one or more additional waveguides and may be emitted from the one or more additional waveguides to the user's eye 2220 to perform an ophthalmoscope/fundus examination function.

In various embodiments, the light source 2268 may include a scanning laser device that outputs an illumination beam having a spot size between about 1 micrometer and about 1.0 millimeter. For example, the illumination beam may be between about 1-3 micrometers, between about 2-10 micrometers, between about 5-25 micrometers, between about 10-30 micrometers, between about 20-100 micrometers, about 50 between -200 micrometers, between about 75-250 micrometers, between about 100-300 micrometers, between about 225-500 micrometers, between about 375-600 micrometers, between about 500-750 micrometers, between about 650-850 micrometers It can have a point size between micrometers, between about 725 micrometers-1 mm, or any value in this range or subrange. The scanning laser device may be configured to scan a desired area of the eye in a desired scanning pattern. The scanning laser device may be configured to scan at a rate between about 1 kHz and about 5 MHz to produce a desired scanning pattern. Thus, a desired scanning pattern created in a desired area of the eye may be considered to include a plurality of pixels that are illuminated sequentially (eg, one at a time) during scanning. In some such embodiments, the one or more imaging devices 2274 may include a photo detector configured to receive scattered or reflected light from each of the plurality of pixels. The intensity of light received by the photo detector may be correlated with the scan angle and/or position of the illumination beam to produce a two-dimensional image of the desired area.

In various embodiments, the wearable ophthalmic system 2250 may include a concave mirror having a central aperture through which light received from the eye 2220 is directed toward one or more imaging devices 2274 . can be In this embodiment, the light beam 2238 is reflected to the user's eye by a concave mirror. In various embodiments, the lens may be rotated into the aperture of the mirror to neutralize the refractive power of the eye, which results in a sharper image of the fundus. Accordingly, in some embodiments, the wearable ophthalmic system 2250 directs a light beam 2238 from a light source 2268 into the user's eye and directs the light received from the user's 2260 eye 2220 to one or more devices. one or more optical components configured to direct to 2274 . The optical component may include a reflective optical element, a beam splitter, a diffractive optical element, a refractive optical element, a light guide with a redirecting element, and the like.

As noted above, a system 2250 configured for a non-health application (eg, watching a movie or video, entertainment such as playing a game, work, etc.) also provides an ophthalmoscopy-like application. can be used System 2250 may be configured to perform ophthalmoscopy/fundoscopy exams periodically (eg, hourly, daily, weekly, biweekly, monthly, twice a year, annually, etc.). In various embodiments, system 2250 may be configured to perform ophthalmoscope/fundoscopy examination of eye 2220 at irregular time intervals. For example, system 2250 may be configured to perform ophthalmoscopy/fundoscopy examinations several times an hour, several times a week, several times a month, several times a year, etc. Accordingly, such examinations may be completed 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, or more times per year. These tests can be performed when the user has a health problem or when the system 2250 detects symptoms of a visual impairment (eg, the system 2250 detects that the user 2260 is having difficulty focusing on an object). case), it can be done more frequently. System 2250 may be configured for use in a physician's office or hospital for ophthalmoscopy/fundoscopy testing. In contrast to a conventional table/bench mounted ophthalmoscope/fundus ophthalmoscope, the ophthalmic system 2250 may be worn by the user 2060 . The wearable ophthalmoscope/fundoscope device 2050 may be smaller and less bulky than a conventional table/bench-mounted ophthalmoscope/fundoscope device.

Projection beam 2238 may have sufficient brightness to be detected by one or more imaging devices 2274 . In various embodiments, the projection beam 2238 may be configured to illuminate a circular portion of the eye having a diameter between about 1 micrometer and about 25 mm. For example, the circular portion of the eye illuminated by the projection beam 2238 has a diameter substantially equal to (eg, about ±10% (or less)) the diameter of the retina measured from the center of the average eye. can have As another example, the circular portion of the eye illuminated by the projection beam 2238 is between about 1 micrometer and about 25 micrometers, between about 25 micrometers and about 100 micrometers, between about 50 micrometers and about 250 micrometers. , between about 100 micrometers and about 500 micrometers, between about 200 micrometers and about 750 micrometers, between about 350 micrometers and about 800 micrometers, between about 500 micrometers and about 1.0 mm, between about 600 micrometers and about between 1.5 mm, between about 1.0 mm and about 2.0 mm, between about 2.7 mm and about 25 mm; between about 3.0mm and about 22mm; between about 3.5mm and about 20mm; Between about 4.0mm and about 18mm; between about 4.5 mm and about 15 mm; Between about 5.0mm and about 12.5mm; between about 5.5mm and about 11.0mm; between about 7.5 mm and about 10 mm; or a diameter in one of these ranges or subranges. In various embodiments, the projection beam 2238 may be configured to illuminate an eye region having a dimension of between about 1 micrometer and about 25 mm. For example, the dimension of the area illuminated by the projection beam is about 1 micrometer or more and about 3 micrometers or less, about 2 micrometers or more and about 5 micrometers or less, about 5 micrometers or more and about 10 micrometers or less, about 10 micrometers or more. meter or more and about 15 micrometers or less, about 12 micrometers or more and about 25 micrometers or less, about 25 micrometers or more and 25 mm or less, about 50 micrometers or more and about 20 mm or less, about 100 micrometers or more and about 15 mm or less, about greater than 250 microns and less than or equal to about 10 mm, greater than about 500 microns and less than or equal to about 5 mm, greater than about 1.0 mm and less than or equal to about 2.5 mm, or any of these ranges or subranges.

In various embodiments, the projection beam 2238 may be directed (eg, focused) towards a desired location. Scanning fiber optic devices, scanning laser devices and/or adaptive optics may be used to direct the beam to a specific location. For example, the projection beam 2238 may be directed to the cornea to examine other parts of the eye in addition to the fundus; may be induced in the iris; may be induced in the lens; It may be directed to the vitreous or may be directed to the retina. Projection beam 2238 may be focused at various depths within the eye to examine different parts of the eye, which may include varying the scan angle of the scanning fiber optic device, the adaptive optics used to focus the projection beam 2238 . This may be accomplished by changing the focal length of the device and/or changing the zoom of one or more imaging devices 2274 .

Various embodiments of the device 2250 shown in FIG. 22A may be configured to capture images from various depths of the user's 2260 eye. In some embodiments of device 2250 , one or more imaging devices 2274 may include imaging cameras configured to capture light emitted from different depths in the user's eye 2260 . For example, the focal length of the imaging camera lens may be varied to capture light emitted from different depths within the user's eye 2260 . Some embodiments of the device 2250 configured to capture light emitted from different depths of the user's eye 2260 may focus on structures within the user's eye 2260 located at different depths in the user's eye 2260 . It may include a plurality of imaging cameras. Light emitted from a particular depth of the user's eye 2260 may be captured by an imaging camera that is focused to view structures within the user's eye 2260 at that particular depth. Embodiments of device 2250 that include a plurality of imaging cameras focused on the structure of user's eye 2260 may be used to collect simultaneously emitted light from different depths of user's eye 2220 .

A scanning light source (eg, a fiber optic scanning device) configured to inject light into a stacked waveguide assembly comprising a plurality of lens systems (eg, lenses or diffractive optical elements having an overall negative optical power) An output coupling element configured to emit light from the waveguide such that the overemitted light appears to occur for different depth planes may be used to simultaneously collect light from different depths of the user's eye 2220 . 22C illustrates a plurality of waveguides (eg, 22005a, 22005 and 22005c) and a first plurality of scanning optical fiber devices (eg, 22003a and 22003b) configured to inject light from one or more light sources into one of the plurality of waveguides; It is a schematic partial view of an embodiment comprising a stacked waveguide assembly comprising: The lens forming layer 22007 may be coupled to each of the plurality of waveguides. The lens forming layer 22007 may include a lens element that provides a net negative optical power so that the user recognizes that light emitted from different waveguides originates from different depth layers. The lens forming layer 22009 may be coupled with each of the plurality of waveguides to image optical power resulting from different depths of the eye. Lens forming layer 22009 coupled with a waveguide configured to image the cornea, iris, or lens may include lens elements that provide a net positive optical power. Lens forming layer 22009 coupled with a waveguide configured to image the retina may include lens elements that provide a net negative optical power to compensate for the optical power provided by the cornea and lens.

In some embodiments, the lens forming layers 22007 and 22009 may include static lens elements having a fixed focal length and/or optical power. In some embodiments, the lens forming layers 22007 and 22009 may include a dynamic lens element having a variable focal length and/or optical power. For example, the lens forming layers 22007 and 22009 may include variable focus elements and/or adaptive optics with variable focal lengths and/or optical power as described herein.

According to the principle of reciprocity of light, light emitted from different depths in the user's eye 2220 may be collected by the various waveguides of the stacked waveguide assembly and coupled to a second plurality of scanning fiber optic devices (e.g., 22010a and 22010b). can Each of the second plurality of scanning optical fiber devices (eg, 22010a and 22010b) is associated with a waveguide of the stacked waveguide assembly and is configured to direct received light toward a detector. In various embodiments, the first plurality of scanning optical fiber devices may be configured to collect light from the associated waveguide as well as to emit light to the associated waveguide. Thus, the need for a second plurality of scanning optical fiber devices can be eliminated in such an embodiment. Also, in embodiments wherein the first plurality of scanning fiber optic devices are configured to collect light as well as emit light, the optical fiber coupler/splitter is configured to separate the optical path from the light source and the optical path towards the detector. It can be combined with each of the optical fiber devices. The lens forming layer (eg, 22009a and 22009b) including the lens element having a positive optical magnification may be configured to compensate for the effect of the lens element having a negative optical magnification on received light. In various embodiments, a lens element with positive optical magnification may be disposed at the output of the waveguide instead of being integrated with the stacked waveguide assembly as shown in FIG. 22C.

Each of the first and/or second plurality of optical fiber scanning devices may include a single-core optical fiber or a multi-core optical fiber. Implementations of the system described above may also be configured to simultaneously emit and/or receive multiple wavelengths of light. Implementations of the system discussed above may include eyewear configured with a slit lamp-lamp diagnostic instrument, eyewear configured with a confocal microscope, eyewear configured with a scanning laser ophthalmoscope, eyewear configured with a two-photon microscope, eyewear configured with an OCT system, and the like. It may be integrated with other ophthalmic devices described herein, including but not limited to.

In various embodiments, the light source 2268 may be configured to produce white light. Thus, in this embodiment, the projection beam 2238 may comprise white light. In some embodiments, light source 2268 may be configured to generate colored light that includes a range of wavelengths in the visible spectral region. For example, the light source 2268 may be between about 440 nm and about 510 nm; between about 460 nm and about 550 nm; between about 490 nm and about 560 nm; between about 530 nm and about 610 nm; between about 550 nm and about 620 nm; or any color light having a wavelength in the value region of one of these ranges or subranges.

In some embodiments, light source 2268 may be configured to generate infrared light comprising one or more wavelengths in a wavelength range of the infrared spectrum. For example, the projection beam 2238 may be in near-infrared spectral light; may include one or more wavelengths in the mid-infrared spectral light and/or in the far-infrared spectral light. As another example, the projection beam 2238 may be between about 700 nm and about 1.5 micrometers; between about 1.0 micrometer and about 2.3 micrometer; between about 1.8 micrometers and about 3.2 micrometers; between about 2.4 micrometers and about 5.8 micrometers; between about 3.2 micrometers and about 7.0 micrometers; and/or one or more wavelengths between about 6.0 micrometers and about 13.0 micrometers. The penetration depth of the projection beam 2238 in the eye 2220 of the wearer 2260 may depend on the wavelength included in the projection beam 2238 . Thus, varying the wavelength included in the projection beam 2238 may advantageously allow imaging of structural and anatomical features at different depths in the eye 2220 of the user 2260 .

Embodiments of a system 2250 that include a light source 2268 configured to generate visible/infrared light may be configured for use in fluorescence ophthalmology. For example, a fluorescent dye may be applied to the user's eye 2220 , and the fluorescence that occurs after illuminating the fluorescent dye with radiation from the light source 2268 to obtain information about the health of the user's eye 2220 . can be analyzed. In various embodiments, the fluorescent dye may be delivered by a fluid delivery system integrated with system 2250 . For example, the fluorescent dye may be delivered by an administration module similar to the drug administration module 21 illustrated in FIG. 5 and described with reference thereto. A system 2250 configured for use in fluorescence ophthalmology may be useful in detecting and/or diagnosing various ophthalmic diseases and conditions. For example, corneal ulcers stained with a fluorescent dye appear green under cobalt blue light. Accordingly, corneal ulcers can be detected when a fluorescent dye (eg, fluorescein) is applied to the cornea and illuminated by a beam 2238 having a wavelength similar to that of cobalt blue light.

Various embodiments of one or more imaging devices 2274 may allow the imaging device 2274 to selectively receive light in one or more desired wavelength ranges from the eye 2220 of the wearer 2260, while attenuating or filtering other wavelengths. It may include one or more wavelength filters configured to be there. For example, the imaging device 2274 may include one or more wavelength filters configured to allow the imaging device 2274 to selectively receive light in the visible spectral range, the near-infrared spectral range, the mid-infrared spectral range, and/or the far-infrared spectral range. may include As another example, the imaging device 2274 may be between about 440 nm and about 12.0 micrometers; between about 500 nm and about 10.0 micrometers; between about 550 nm and about 8.5 micrometers; between about 600 nm and about 5.0 micrometers; between about 650 nm and about 3.0 micrometers; Attenuating or filtering wavelengths outside the selected range while the imaging device 2274 selectively receives light having any value between about 1.0 micrometer and about 2.5 micrometer, or any value in the ranges and subranges described above. It may include one or more wavelength filters configured to

As shown in FIG. 22A , one or more imagers 2274 may be disposed around a perimeter of the display system 2262 and configured to receive light from a user's eye 2220 . In various embodiments, the one or more imagers 2274 may include a camera similar to the infrared camera 2224 configured to track the user's eye 2220 described above with reference to FIG. 5 . In some embodiments, the one or more imagers 2274 may include a camera similar to the wide field machine vision camera 16 described above with reference to FIG. 5 and configured to image the user's surrounding environment. In various embodiments, one or more imaging devices 2274 and light sources 2268 may be integrated into a single device, as described below.

As shown in FIG. 22A , a light source 2268 may be disposed around the perimeter of the display system 2262 . In various embodiments, light source 2268 may include one or more light emitting diodes disposed around a perimeter of display system 2262 configured to project the beam 2238 to the user's eye 2220 . Some embodiments include lenses, prisms, beamsplitters, mirrors, light guides (with or without diffractive optics), diffractive optical components, prism components, and/or directing the beam 2238 to the user's eye 2220 . One or more optical systems including other optical components to guide may be used. In some embodiments, light source 2268 may have characteristics similar to projection system 18 described with reference to FIG. 5 .

As discussed above, in various embodiments, the light source 2268 may be similar to the optical fiber scanning device (FSD) described above. In such embodiments, the light source 2268 may include one or more optical fibers configured to transmit light from a light emitter (eg, a laser/LED) towards the eye 2220 of the user 2260 . In such embodiments, the fiber optic scanning device may be integrated with one or more optical components (eg, a reflective element, a refractive element, a diffractive optical element, a diffractive optical element, and/or another optical component as a light guide), Light originating from the scanning device may be directed towards the user's eye 2020 . In some embodiments, display lens 2276 may include a plurality of waveguides having optical and structural characteristics similar to stacked waveguide assembly 178 of FIG. 10D . In such embodiments, the light source 2268 comprising the FSD may be configured to inject light into one or more of the plurality of waveguides such that light originating from the FSD propagates through the one or more plurality of waveguides. A diffractive optical element or other optical component integrated with the plurality of waveguides may be used to direct light from the plurality of waveguides to the user's eye 2020 .

Light source 2268 configured with FSD can scan at various patterns (eg, raster scans, spiral scans, Lissajous patterns, etc.) and speeds. The projected light pattern of the beam 2238 may depend on the scanning pattern of the FSD, the scanning speed of the FSD, and/or the speed of the one or more imaging devices 2274 . In some embodiments of light source 2268 configured similarly to FSD, optical fibers configured to transmit light from the light source may also be used to receive light from user's eye 2220 .

The projection beam 2238 projected from the light source 2268 may be directed to be incident on a specific location of the wearer's eye 2220 . For example, the projection beam 2238 may be incident at a desired location of the wearer's eye 2220 such that the projection beam 2238 is at an angle between 0 degrees and about ±90 degrees relative to the normal of the wearer's eye surface at the desired location. enter the company For example, the center of the projection beam 2238 may be scanned over an angular range that extends 180 degrees with respect to an axis normal (or normal) to the surface of the eye. As another example, the center of the projection beam 2238 may be scanned over an angular range that extends 180 degrees with respect to an axis that crosses the eye and passes through the pupil. The projection beam 2238 may be configured to illuminate the entire posterior hemisphere of the user's eye 2220 . As another example, the projection beam 2238 from the light source 2268 may be incident at a desired location of the user's eye 2220 at an angle to the user's gaze. Light projected from light source 2268 may be focused at different focal lengths of user's eye 2220 . For example, the focal plane of the projected light may coincide with the cornea, iris, natural lens, vitreous, central, or retina.

In various embodiments, as described above with reference to FIGS. 10B, 10C and 10D , the angle of incidence of light projected from light source 2268 and/or a focal plane into which light projected from light source 2268 is focused An adaptive optics system or a variable focus element (VFE) may optionally be used to change. For example, from the light source 2268 , the depth at which the beam of light 2238 is focused at the user's eye 2220 and/or the direction of the beam 2238 on the user's 2260 eye 2220 can be selected. The resulting light output may be modified using an optical system that includes lenses, prisms, and/or mirrors (eg, optical element 1024 of FIG. 10C ). Adaptive optics may be used to control/shape the wavefront of the light beam 2238 , control the direction of the light beam 2238 , the convergence or divergence of the light beam 2238 , and/or light received from the eye. remove the aberration from

In various embodiments, the VFE may include deformable mirror values. For example, a VFE may include one or more electrodes coupled to a thin-film mirror. The control system may be configured to selectively control one or more electrodes to change the shape of the thin film mirror. Thus, the wavefront of the light emitted from the stacked waveguide assembly can be modified by modifying the shape of the thin film mirror. Embodiments of the wearable device 2650 that do not include a light source, including a scanning laser device or fiber optic scanning device, include a deformable mirror that steers the beam and/or changes the depth at which the beam is focused within the user's eye. device may be included. In various embodiments, the VFE may include a deformable lens. A deformable lens can include an elastomeric material that can be deformed by application of electrostatic energy to produce a lens or lenticular surface with a different curvature. In some embodiments, the VFE may include a lens that may deform upon activation of the electrode. Some lenses can change the refractive index by applying a voltage to the electrodes (eg, liquid crystal lenses). In various embodiments, device 2250 may include a spatial light modulator to modulate phase. Embodiments of a wearable device 2650 comprising a light source comprising a scanning laser device or fiber optic scanning device may be configured to adjust a deformable lens and/or beam and/or change the depth at which the beam is focused on the user's eye. It may include a spatial light modulator.

The display lens 2276 may include or be integrated with a plurality of stacked waveguides configured to receive light output from the light source 2268 . The plurality of stacked waveguides may have similar characteristics to the stacked waveguide assembly 178 shown in FIG. 10D and described with reference to FIG. 10D. In various embodiments, the plurality of stacked waveguides may include diffractive optical elements configured to incouple light output from the light source 2268 to one or more stacked waveguides. The plurality of stacked waveguides may further include diffractive optics configured to outcouple light propagating in one or more of the stacked waveguides. In various embodiments, the diffractive optical element configured to incouple and outcouple light originating from the light source 2268 to or from the plurality of stacked waveguides, the focal plane and/or illumination of the user 2260 eye 2220 . It may be configured to modify the beam direction. In various embodiments, the plurality of stacked waveguides may include one or more lens forming layers. For example, a lens forming layer may be associated with each waveguide of a stacked waveguide assembly as shown in FIG. 10D . In various embodiments, the light source used to provide illumination for the ophthalmoscope/fundusoscope may include such a waveguide configuration. In some embodiments, the waveguide assembly and/or optical fiber scanning display or other light source that couples light to the waveguide assembly may include the same components used to project images into the eye for augmented reality or virtual reality. In some embodiments, the waveguide assembly and/or fiber optic scanning display or other light source that couples light to the waveguide assembly may be integrated with similar components used to project images into the eye for augmented or virtual reality. Additional waveguides may be added to the waveguide assembly, for example, to provide illumination to the eye and/or collect light from the eye to provide an ophthalmoscope/funscopy image. Similarly, an additional light source, such as an FSD, may inject light into the waveguide of the waveguide assembly to provide illumination to the eye, and collect light from the eye to provide an ophthalmoscope/funscopy image.

In various embodiments, the lens-forming layer can be static such that the focal length and/or other optical properties of the lens-forming layer are fixed. In this embodiment, the light originating from the light source 2268 is combined with a lensing layer having properties that can produce an output light beam with a desired direction, which can be focused on a desired location of the user's eye 2220 . A plurality of stacked waveguide assemblies may be coupled to the waveguides.

In various embodiments, the lens-forming layer may be dynamic such that the focal length and/or other optical properties of the lens-forming layer may be changed by application of an electrical signal. In such an embodiment, light originating from light source 2268 may be coupled to one or more waveguides of a plurality of stacked waveguide assemblies, and the properties of one or more lensing layers may be modified to produce an output light beam having a desired direction, and , which may be incident on a desired location of the user's eye 2220 .

A system 2250 including the optical fiber scanning device and/or scanning device described above is configured to form, shape, and steer an optical beam. Accordingly, system 2250 may generate beam 2238 having any width, pupil position, direction, and focal point, and thus may be configured to reproduce the function of an ophthalmoscope or ophthalmoscope. The diffractive optics coupled to the waveguides of the stacked waveguide assembly may be configured to produce a plurality of different output beams, each having a different set of beam parameters. Various beam parameters may be modified by additional dynamic optics that may be coupled with the waveguides of the stacked waveguide assembly. In addition, the waveguides of the stacked waveguide assembly may be configured to be bidirectional, capable of projecting an optical beam as well as collecting and imaging backscattered light from the eye.

Accordingly, the FSD (or other light source) of the ophthalmic device may be configured to project a beam of light onto an anterior or posterior portion of the eye and capture images of the user's eye using the systems and methods described above. It should be understood that the focus of the light beam may be altered by one of the many methods discussed in US patent application Ser. No. 14/555,585, incorporated above by reference. Similarly to the above, the eye scanning module may scan light from the user's eye (eg, a reflection pattern, a diffraction pattern, a scattering pattern) and analyze it to determine if there is a vision defect. As in other embodiments described above and elsewhere herein, the ophthalmic system may receive input from a user, or analyze the captured image and execute it through various pattern matching algorithms to determine any anomalies. In various embodiments, the images captured by the system 2250 may be compared to images of the user's eye 2220 obtained during a previous ophthalmoscopic examination for historical analysis. Such comparisons can be useful for tracking the progression of certain diseases in the eye over time.

22B shows an example flow diagram 2200 of a method of examining an eye (eg, fundus or retina) using an ophthalmic system 2250 . The method of examining the eye may be executed by an electronic hardware processor 2270 in cooperation with the optical system 2250 . System 2250 may be configured to initiate an ophthalmoscopy/funscopy of the eye upon detecting that user 2260 is having difficulty focusing or has another visual impairment. Referring now to FIG. 22B , at block 2202 , a fundus imaging program may begin. At block 2204 , a beam of light of a particular focus may be projected onto at least a portion of the user's eye using light source 2268 . As noted above, light source 2268 may include a fiber optic scanning device or other light source, such as, for example, an infrared source configured to track a user's eyes. At block 2206 , the system may capture an image of the illuminated portion of the user's eye. It should be understood that this function may be performed by an eye tracking camera, an FSD, or a special camera designed for this purpose as described above. At block 2208, a pattern matching algorithm may be used to compare the captured images with some known images indicative of various eye anomalies. In various embodiments, images acquired/captured by system 2250 may be processed using a color matching algorithm, wherein the color of one or more portions of the acquired/captured image is determined by determining the color of one or more portions previously acquired/captured. can be compared with the color of the image or some stored image. Several known images may be stored in a library accessible by the electronic hardware processor 2270 . For example, images acquired/captured by system 2250 may be stored in an electronic medical record (EMR) associated with user 2260 for historical analysis.

The images acquired/captured by the system 2250 may be analyzed using, for example, image processing algorithms such as pattern matching algorithms, color matching, etc. to determine any anomalies. For example, images can be analyzed to determine whether the optic disc is distended or edges/blanks appear blurred. As another example, the image may be analyzed to determine the size of the optic disc and/or the optic cup. The measured size of the optic disc and/or the eyeball can be used to obtain a cup-to-disk ratio calculated as the ratio between the diameter of the cup portion of the optic disc and the total diameter of the optic disc. High values of the cup-to-disk ratio may be indicative of glaucoma. As another example, the image may be analyzed to determine the color of the fundus. A dark fundus may indicate retinal pigmentation. Conversely, a pale-colored fundus may be seen in patients with arterial occlusion. Images obtained by an ophthalmoscope can be analyzed to detect other abnormalities such as, for example, bleeding or exudates. A green filter (which substantially attenuates red light) can advantageously make it easier to detect bleeding or exudate. A user with hypertensive retinopathy may exhibit strong effusion, hemorrhage (rarely optic nerve papilledema), and/or retinal edema, which can be detected in images obtained by system 2250 . Some users with diabetic retinopathy may exhibit spot and speckle bleeding and/or strong exudation. Some users with diabetic retinopathy may also exhibit cotton wool spots or soft exudation.

In addition to looking for common eye defects as described above, microcapillaries in the eye can also indicate other health problems. The condition of the retina or retinal blood vessels may indicate a particular vascular disease or other disease. For example, to determine whether an artery is usually thin and cross veins, to determine the number of blood vessels, to determine whether a blood vessel is straight or tortuous, to determine the color and width of a blood vessel, light reflection Vessels in each of the four quadrants of the acquired image can be examined to determine their intersection with the . Such a determination may indicate the health status of the user. For example, arteriole changes, arteriolar vasoconstriction/stenosis, changes in arteriolar walls (atherosclerosis), etc. may indicate hypertensive retinopathy. As another example, signs of copper and hidden arterioles, and "arterio-venular (AV) nicking/nipping", due to venous constriction and weiring, may indicate hypertensive retinopathy. New blood vessel formation around the optic disc and/or microaneurysm may be a sign of diabetic retinopathy.

As noted above, in various embodiments, the pattern matching algorithm may be configured to compare captured images with a library of known patterns indicative of other types of diseases and/or conditions that may affect eye health. . If the captured image includes a pattern matching any known pattern, the ophthalmic system 2250 may be configured to determine a corresponding abnormality or disease progression as shown in block 2210 . The results of the pattern matching algorithm and/or captured images may be displayed to clinicians and/or users in one or more embodiments.

<u>confocal</u><u> Microscopy / Two-photon Microscopy / </u><u>SLO</u>

Various embodiments of a user-wearable augmented reality/virtual reality system as described herein may be configured to perform confocal microscopy. 24C schematically depicts a wearable device 2650 that may be configured to perform confocal microscopy. The device 2650 includes a frame 2664 attached to a display system 2662 . Display system 2662 can be configured to be positioned in front of user 2660 , eye 2620 . Device 2650 can project light 2638 from light source 2668 onto eye 2620 of user 2660 . A portion of the projected beam 2638 may be reflected, scattered, and/or diffracted by various anatomical features of the user 2660 eye 2620 and may be received by one or more imagers 2674 . The electronic hardware processor 2670 may be used to analyze the light received from the user's 2660's eye 2620 to examine various structures of the user's eye 2620 .

In various embodiments of ophthalmic system 2650 , frame 2664 may have similar characteristics to frame 64 of FIGS. 3A-3C . In various embodiments of ophthalmic system 2650 , display system 2662 may have similar characteristics to display system 62 of FIGS. 3A-3C and 5 . In various embodiments of ophthalmic system 2650 , electronic hardware processor 2670 may be similar to local processing and data module 70 of FIGS. 3A-3C .

The display system 2662 of various embodiments of the ophthalmic system 2650 may include a display lens 2676 mounted to a frame 2664 through which the wearer may view the outside world. In some embodiments, the display lens 2676 may be a single lens comprising two eyepiece areas, each eyepiece area located in front of the user's eye 2620 . In some embodiments, display system 2662 may include two display lenses mounted to frame 2664 , each display lens defining two eyepiece areas located in front of user's eye 2620 . may include

The light source 2668 may include a light emitter including one or more lasers, one or more LEDs, one or more flash lamps, and/or one or more super light emitting diodes. In some embodiments, light source 2668 may be part of an illumination system of wearable device 2650 configured to provide illumination to display lens 2676 and/or eye 2620 of user 2660 . For example, the light source 2668 may include a fiber optic scanning device (FSD), and the display lens may include a plurality of waveguides having characteristics similar to the waveguide stack 178 described above with reference to FIG. 10D. . includes Light originating from the FSD may be injected into one or more of the plurality of waveguides and may be emitted from one or more of the plurality of waveguides into the user's eye 2620 to perform confocal microscopy. The plurality of waveguides of the display lens may be coupled with an adaptable focusing element capable of changing the characteristics of the wavefront emitted from the plurality of waveguides.

In some embodiments, light source 2668 may be an auxiliary light source disposed on a side of display system 2662 . In this embodiment, the wearable system 2650 may be configured to direct a beam toward the wearer's eye 2620, for example, a lens or other refractive component, a reflective surface, a deflector, a reflector, a beam splitter, diffractive optics. devices, waveguides, or other optical components, and the like. For example, the light source 2668 may include an additional FSD and the display lens may include an additional waveguide stack. Light from the additional FSD may be injected into one or more waveguides of the additional waveguide stack and emitted from the one or more waveguides of the waveguide stack into the user's eye 2620 to perform confocal microscopy. The waveguides of the additional waveguide stack may be coupled with an adaptable focusing element that may alter the properties of the wavefront emitted by the additional stack of waveguides.

When device 2650 is configured as a confocal microscope, light output from light source 2638 may be directed through a first aperture toward a desired area (such as the retina) of eye 2620 and through a first lens. Focus can be made on this part of the eye. In various embodiments, the first lens images the first aperture to the eye, particularly the region of the eye to be imaged. The first aperture and this area of the eye to be imaged are in the conjugate focal planes (of the first lens). Light scattered/reflected/diffracted from the portion of the eye is directed through the second lens toward one or more imaging devices 2674 through the second aperture. The second aperture and the area of the eye being imaged are in the combined focal plane (of the second lens). The second aperture may be dimensioned such that out-of-focus light from a desired area of the eye does not enter the one or more imaging devices 2674 as it is rejected by the second aperture.

In various embodiments, a single lens is used as the first lens and the second lens. A single lens may be disposed between the eye and the beam splitter, and the beam splitter may be in the optical path between the first aperture and the lens as well as in the optical path between the second aperture and the lens. As mentioned above, the first aperture and the area of the eye to be measured are in the combined focal plane of the lens. Similarly, the second aperture and the area of the eye to be measured are in the combined focal plane of the lens.

In various embodiments, device 2650 includes only a single aperture disposed in a confocal extensor plane of a lens configured to direct focused light to a desired area of eye 2620, while not receiving out-of-focus light. The first and second apertures may coincide to receive light from a desired area of 2620 .

Various embodiments of device 2650 comprising a light source 2668 and/or a fiber optic scanning device configured to receive light from a desired area of the eye 2620 and direct it toward one or more imaging devices 2674 are isolated It is not necessary to include the first and/or second openings that are provided. Instead, in some embodiments, an output aperture of an optical fiber included in a fiber optic scanning device may be configured with first and/or second apertures. The first and/or second hole may include a pinhole. A device configured such that the same optical fiber of the fiber optic scanning device not only projects an illumination light beam, but also receives light from a desired area of the eye 2620 and is directed towards one or more imagers 2674 as shown in FIG. 24D-1 . Various embodiments of 2650 are, by their nature, configured as confocal microscopes.

As described above, various embodiments of device 2650 configured as a confocal microscope may be configured to direct light from a light source 2668 toward a desired area of the user's eye 2620 and/or a beam splitter disposed in the optical path and/or Fiber optic splitters/combiners may be included. The beam splitter may be further configured to direct light originating from a desired area of the user's eye 2620 towards one or more imaging devices 2674 . Various embodiments of device 2650 may be configured such that the light output from light source 2668 may be scanned across an area (eg, retina, cornea, lens, vitreous humor) of user's eye 2620 , such that one or more scanning mirrors (eg, horizontal and vertical scanning mirrors), deformable mirror devices, and the like, and confocal microscopy may be performed by device 2650 . Horizontal and vertical scanning mirrors can scan in the lateral direction (x and y) compared to the longitudinal direction (z), which may correspond to the optical axis of the system and may be orthogonal to the lateral directions (x and y). 24D-2 is a schematic fragmentary view of one embodiment of eyewear including a light source 2668, one or more imaging devices 2674, a beam splitter, a lens forming system, and a scanning mirror. The scanning mirror shown in FIG. 24D-2 may include a deformable mirror arrangement in some embodiments.

In one or more embodiments of device 2650 that includes a fiber optic scanning device (FSD) as light source 2668 , the FSD may function as a 3D scanning head configured to scan light across an area of the user's eye 2620 . have. In one or more embodiments, a beam of light (eg, outside the visible spectrum) of varying wavelengths may be projected to provide additional 3D resolution.

24D-1 includes a fiber optic scanning device configured to output a projection beam 2638 as well as receive light from a desired area of the eye 2620 and direct the received light toward one or more imaging devices 2674. A schematic diagram of a partial view of an embodiment of an apparatus 2650 is shown. In the illustrated embodiment, the FSD is configured to inject light into one or more waveguides of the stacked waveguide assembly. Light propagating through the waveguide may be outcoupled from the waveguide by diffractive optics coupled to the waveguide. The stacked waveguide assembly may further include any variable focus element (VFE) and/or selectively adaptable optics configured to vary the wavefront of light outcoupled from the waveguide. In some embodiments, the stacked waveguide assembly may further include a plurality of deformable mirror devices capable of scanning the projection beam 2638 in horizontal and vertical directions across the area of the user's eye 2620 .

Light projected from the light source 2668 may be focused at a different focal length of the wearer's eye 2620 . For example, the focus of the projected light 2638 may coincide with the cornea, iris, natural lens, vitreous, or retina. In various embodiments, one or more adaptive optics or variable focus elements (VFEs) may focus light projected from light source 2668 and/or light source 2668 as discussed above with reference to FIGS. 10B, 10C, and 10D. It can optionally be used to vary the angle of incidence of the projected light from the focal plane that appears to be aligned or generated. For example, the light output from the light source 2668 can be an eye in which the projected beam 2638 can be focused and/or the direction of the illumination beam 2638 over the user 2660 eye 2620 can be changed. may be modified using an optical system that includes lenses, prisms, and/or mirrors (eg, optics 1024 in FIG. 10C) to be the depth in .

In various embodiments, the VFE may include a deformable mirror arrangement. For example, a VFE may include one or more electrodes coupled to a thin-film mirror. The control system may be configured to selectively control one or more electrodes to change the shape of the thin film mirror. Thus, the wavefront of the light emitted from the stacked waveguide assembly can be modified by changing the shape of the thin-film mirror. Embodiments of wearable device 2650 that do not include a light source, including a scanning laser device or fiber optic scanning device, include a deformable mirror device that steers the beam and/or changes the depth at which the beam is focused within the user's eye. may include. In various embodiments, the VFE may include a deformable lens. A deformable lens can include an elastomeric material that can be deformed by the application of electrostatic energy to produce a lens or lenticular surface having a different curvature. In some embodiments, the VFE may include a lens that may deform upon activation of the electrode. Some lenses can change the refractive index by applying a voltage to the electrodes (eg, liquid crystal lenses). In various embodiments, device 2650 may include a spatial light modulator to modulate phase. Embodiments of the wearable device 2650 comprising a light source comprising a scanning laser device or fiber optic scanning device may be adapted to adjust a deformable lens and/or beam and/or vary the depth of the beam focused on the user's eye. It may include a spatial light modulator for modulating the phase for the purpose.

In various embodiments, light source 2668 may include a scanning laser device that outputs an illumination beam having a spot size between about 1 micrometer and about 1.0 millimeter. For example, the illumination beam may be between about 1-3 micrometers, between about 2-10 micrometers, between about 5-25 micrometers, between about 10-30 micrometers, between about 20-100 micrometers, between about 50- Between 200 micrometers, between about 75-250 micrometers, between about 100-300 micrometers, between about 225-500 micrometers, between about 375-600 micrometers, between about 500-750 micrometers, between about 650-850 micrometers It may have a point size of between meters, about 725 micrometers-1 mm, or a value in this range or subrange. The scanning laser device may be configured to scan a desired area of the eye in a desired scanning pattern. The scanning laser device may be configured to scan at a rate between about 1 kHz and about 5 MHz to produce a desired scanning pattern. Thus, a desired scanning pattern created in a desired area of the eye may be considered to include a plurality of pixels that are illuminated sequentially (eg, one at a time) during the scanning period. In some such embodiments, the one or more imaging devices 2274 may include a photo detector configured to receive scattered or reflected light from each of the plurality of pixels. The intensity of light received by the photo detector may be correlated with the scan angle and/or position of the illumination beam to produce a two-dimensional image of the desired area. In various embodiments, a plurality of light detectors may be disposed at the periphery of the eyewear configured to collect backscattered radiation. In this embodiment, the 2D image of the desired region may be generated by averaging the intensities detected by the plurality of detectors over time.

In various embodiments, the light source 2668 may be configured to produce white or colored light that includes a wavelength range in the visible spectral region. For example, the light source 2668 may be between about 440 nm and about 510 nm; between about 460 nm and about 550 nm; between about 490 nm and about 560 nm; between about 530 nm and about 610 nm; a range between about 550 nm and about 620 nm; or any color of light having a wavelength in one of these ranges or subranges.

In some embodiments, light source 2668 may be configured to generate infrared light comprising one or more wavelengths within a wavelength range of the infrared spectrum. For example, the projection beam 2668 is in the near-infrared spectrum light; may include one or more wavelengths in the mid-infrared spectral light and/or in the far-infrared spectral light. As another example, the projection beam 2668 may be between about 700 nm and about 1.5 micrometers; between about 1.0 micrometer and about 2.3 micrometer; between about 1.8 micrometers and about 3.2 micrometers; between about 2.4 micrometers and about 5.8 micrometers; between about 3.2 micrometers and about 7.0 micrometers; and/or one or more wavelengths between about 6.0 micrometers and about 13.0 micrometers.

The penetration depth of the projection beam 2668 at the eye 2620 of the wearer 2660 may depend on the wavelength included in the projection beam 2638 . In addition, the optical path length difference between the projection beam 2638 and the reference beam may also be wavelength dependent. Accordingly, varying the wavelength included in the projection beam 2638 may advantageously allow imaging of structural and anatomical features at different depths within the eye 2620 of the user 2660 .

24C , one or more imagers 2674 may be disposed on the periphery of display system 2662 and configured to receive light from a user's eye 2620 . In various embodiments, one or more of the imaging devices 2674 may include an inwardly facing camera. For example, the one or more imaging devices 2674 may include a camera configured to track the user's eye 2620 and having characteristics similar to the infrared camera 2624 described above with reference to FIG. 5 . In some embodiments, the one or more imagers 2674 may include cameras similar to the wide field machine vision camera 16 described above with reference to FIG. 5 and configured to image the surroundings around the user. The one or more imagers 2674 may include photodiodes (eg, silicon-based, germanium-based for infrared light, photomultiplier tubes (PMTs), charge coupled devices (CCDs), CMOS-based sensors, Shack- Hartman) wavefront sensor, etc.). As noted above, in various embodiments, one or more imaging devices 2674 may be integrated with an FSD comprised of light sources 2668 . For example, the optical fiber of the FSD may be configured to receive light received from the eye and direct the received light to one or more imaging devices 2674 .

Various embodiments of one or more imager 2674 may be configured such that imager 2674 may selectively receive light in one or more desired wavelength ranges from eye 2620 of wearer 2660 while attenuating or filtering other wavelengths. It may include one or more wavelength filters configured. For example, the imager 2674 includes one or more wavelength filters configured to enable the imager 2674 to selectively receive light in the visible spectral range, the near infrared spectral range, the mid-infrared spectral range, and/or the far-infrared spectral range. can do. As another example, the imaging device 2674 may be between about 440 nm and about 12.0 mm; between about 500 nm and about 10.0 mm; between about 550 nm and about 8.5 mm; between about 600 nm and about 5.0 mm; between about 650 nm and about 3.0 mm; one or more wavelength filters configured to selectively receive values in the range between about 1.0 mm and about 2.5 mm, or any values in the ranges and subranges, while attenuating or filtering out wavelengths outside the range. .

Information and/or images captured by one or more imaging devices 2674 may be processed in real time. In various embodiments, system 2650 may include a light source and detector to track eye movement. The light source and detector for tracking eye movement may have similar characteristics to the light source 26 and camera 24 described with reference to FIG. 5 . Eye tracking light sources and detectors may be used to reduce noise and/or cancel the effects of eye movement and eye movement.

As noted above, the wearable device 2650 not only projects light related to visible light (which is typically done via an RGB light source), but also other multi-spectral components (e.g., a laser light source, an infrared light source, an LED light source). etc.) to emit light having a wavelength range and spectral composition. Or, in another embodiment, a tunable laser capable of varying the wavelength of light over time on a frame-sequential basis, line-sequential basis, pixel-by-pixel basis, etc. laser) may be used (eg, the cavity length may be varied in the laser or the diffraction grating may be modified).

Multispectral light emission can be advantageous for imaging purposes as different parts of the eye respond better to different colors or spectra of light, leading to more accurate imaging techniques. Accordingly, the wearable device 2650 configured as a confocal microscope may include additional components configured to emit multispectral light.

24E shows an example flow diagram 2600 of a method of examining an eye using an ophthalmic system 2650 . The method of examining the eye may be executed by an electronic hardware processor 2670 in conjunction with the optical system 2650 . An exemplary process flow 2600 of FIG. 24E is now provided. At block 2602 , a confocal microscopy program may be initiated. At block 2604 , one or more light beams may be directed through the first aperture using light source 2654 to a desired area of the user's eye. At block 2606 , one or more images of the desired area are passed through one or more imagers 2674 . In block 2608 , the acquired image of the desired region may be analyzed to detect an abnormality of the eye 2620 . For example, the acquired image may be compared to a stored image accessible by the electronic hardware processor 2670 using a pattern matching algorithm to detect anomalies. The stored image may include an image of a healthy eye, an image representing characteristics of an eye affected by a specific disease, and/or an image of a user's eye obtained from a past examination. The electronic hardware processor 2670 may be configured to obtain quantitative measurements (eg, volume measurements) of various portions of the acquired image of the user's eye. Quantitative measurements can be passed on to a clinician for further analysis. As another example, one or more parameters may be extracted from the acquired image to detect an abnormality. The obtained images and/or quantitative measurements can be used to monitor eye health or disease progression.

Various embodiments of device 2650 may be configured to perform scanning laser ophthalmoscopy (SLO), including confocal microscopy for diagnostic imaging of the retina or cornea. An embodiment of the device 2650 configured as a scanning laser ophthalmoscope includes a laser as the light generator of the light source 2668 . Light from the laser may be focused on a desired area of the eye (eg, the retina). Laser light can be scanned across a desired area, and the reflected light can be captured through a small hole (eg, a pinhole) so that out-of-focus light can be suppressed or eliminated. One or more scanning mirrors may be used to move the laser light across a desired area. In some embodiments, laser light may be generated by an FSD that may be configured to scan in various patterns (eg, raster scans, spiral scans, Lissajous patterns, etc.) and velocities. The projected light pattern over the desired area may depend on the scanning pattern of the FSD, the scanning speed of the FSD, and/or the speed of one or more imagers. In this way, SLO can be used to obtain a sharp, high-contrast image of a desired area. Images obtained by SLO can have a high degree of spatial sensitivity.

Various embodiments of device 2650 may be configured to perform adaptive optics scanning laser ophthalmoscopy (AOSLO) using adaptive optics to remove optical aberrations of the eye, such as corneas and lenses. In various embodiments, for example, device 2650 optionally includes one or more adaptive optics elements or VFEs disposed in the optical path from laser light source 2654 to the eye and from imaging device 2674 to the eye. can do. The adaptable optics or VFEs may include, for example, deformable mirrors, and may be configured as described herein. Additionally, an aberrometer, such as a Shack-Hartman wavefront sensor, may be arranged to receive light returned from the eye as described herein. The aberration meter is configured to measure the aberration wavefront of the eye as described above. The processing electronics may be configured to drive adaptive optics, eg, a deformable mirror, to alter the wavefront to and from the eye to compensate for or reduce the effects of the eye's aberrations on the wavefront. Due to the reduced aberration caused by the eye, AOSLO can provide higher accuracy compared to SLO.

For performing confocal microscopy, scanning laser ophthalmoscopy or adaptive optics scanning laser ophthalmoscopy, the above-described systems and methods may also include multi-photon microscopy or two-photon microscopy (or multi-photon fluorescence or two-photon fluorescence microscopy). ) can be used to perform monitoring. For example, a fluorescent dye may be provided to a desired or targeted area of the user's eye. In some embodiments, the fluorescent dye is ejected from a port on the wearable device 2650 and applied to the eye as described herein. The wearable device 2650 may be configured such that one or more drops of a fluorescent dye may be applied or sprayed to the eye. Fluorescence can be generated in the target region by absorption of two-photons. Two-photon absorption involves the absorption of low-energy light by the medium followed by the emission of high-energy light. In a particular case, two photons of light with lower energy are absorbed and one photon of higher energy is emitted. The amount of light required to excite fluorescence by a two-photon absorption process can be large. Accordingly, the light emitter of the light source 2668 in the wearable device 2650 configured to perform two-photon microscopy monitoring may comprise a high light source. The luminance of the light emitter included in a system configured to perform two-photon microscopy is in some embodiments 10¹⁰ to 10¹²W/cm² may be to the extent The light emitter may include a continuous wave (CW) laser with sufficient power to provide radiation levels for performing two-photon microscopy monitoring. In some embodiments, the light emitter may include, for example, a pulsed laser such as a femtosecond laser or a picosecond laser. Pulsed lasers can be configured to operate at high repetition rates to achieve high peak powers, which can help increase two-photon excitation efficiency. In some other embodiments, the light emitter may comprise a mode-locked laser or fiber laser configured to output ultrafast pulses (eg, picosecond pulses or femtosecond pulses). Light emitted from the laser may have a wavelength between about 700-1600 nm. In embodiments of various light sources included in eyewear configured to perform scanning laser ophthalmoscopy, the adaptive optics scanning laser ophthalmoscope and/or multi-photon microscopy may include a laser. Light from the laser may in certain embodiments be coupled to a fiber optic scanning device (FSD) that injects the light into one or more waveguides of a stacked waveguide assembly. Light propagating through one or more waveguides may be outcoupled by diffractive optical elements or other optical elements in various embodiments. The light output from the waveguide may be formed by one or more variable focus elements comprising adaptive optics and may be directed towards a target area of the user's eye. However, the FSD need not be used with the waveguide stack. In various embodiments, the FSD may be configured to scan in various patterns (eg, raster scans, spiral scans, Lissajous patterns, etc.) and speeds. The light pattern projected onto the target area may depend on the scanning pattern of the FSD, the scanning speed of the FSD, and/or the speed of one or more imaging devices. In some embodiments, a deformable mirror device may be employed to steer the light output from the waveguide to a target area of the user's eye. A deformable device may be employed in addition to or instead of scanning the FSD in various directions.

In various embodiments herein, the light source included in eyewear configured to perform scanning laser ophthalmoscopy, adaptive optical scanning laser ophthalmoscopy, and/or multi-photon microscopy is between about 1 micrometer and about 1.0 millimeter. It may include a scanning laser device that outputs an illumination beam having a spot size. For example, the illumination beam may be between about 1-3 micrometers, between about 2-10 micrometers, between about 5-25 micrometers, between about 10-30 micrometers, between about 20-100 micrometers, about 50 between -200 micrometers, between about 75-250 micrometers, between about 100-300 micrometers, between about 225-500 micrometers, between about 375-600 micrometers, between about 500-750 micrometers, between about 650-850 micrometers It can have a spot size that is between micrometers, between about 725 micrometers-1 millimeters, or any value in this range or subrange. The scanning laser device may be configured to scan a desired area of the eye in a desired scanning pattern. For example, the desired scanning pattern may have a length along the upper-lower axis of the wearer's face that is greater than the length along the axis of the nose-temple of the wearer's face. The scanning laser device may be configured to scan at a rate between about 1 kHz and about 5 MHz to produce a desired scanning pattern. Thus, a desired scanning pattern created in a desired area of the eye may be considered to include a plurality of pixels that are illuminated sequentially (eg, one at a time) during the scanning period. In some such embodiments, the one or more imaging devices 2074 may include a photo detector configured to receive scattered or reflected light from each of the plurality of pixels. The intensity of light received by the photodetector may be correlated with a scan angle and/or position of the illumination beam to generate a two-dimensional image of a desired area. In some embodiments, the light output from the waveguide may be focused on a target area of the user's eye 2620 by a variable focus element. Two-photon excitation can be achieved at the focal volume of the target region where the light energy is sufficiently high. For example, in various embodiments, two-photon excitation may be excited at a diffraction-limited focal volume of a target region of the user's eye 2620 . In various embodiments, light output from the laser may be focused to a point size corresponding to a diffraction-limited point. Light emitted from the volume of the target region where two-photon excitation is achieved may be directed to one or more imaging devices 2674 . As described above, the light output from the waveguide may be scanned horizontally and/or vertically in the target area of the user's eye to construct a two-dimensional image of the target area onto the target area of the user's eye. Additionally, by varying the depth of the eye where the light output from the waveguide is focused, a three-dimensional image can be constructed. In various embodiments, the depth of the eye at which the light output from the waveguide is focused may be varied based on the scanning angle of the optical fiber scanning device. In some embodiments, the depth of the eye at which the beam 2638 is focused may be altered by changing the wavelength of the light. In some other embodiments, the depth of the eye through which the beam 2638 propagates may be altered by scanning the beam along a longitudinal axis of the beam 2638 that is aligned with the direction of propagation of the beam 2638 . In various embodiments, the longitudinal axis of the beam 2638 may be aligned with the line of sight of the user 2620 .

Because the light received by one or more imaging devices is confined to the focal volume when the device 2650 is configured as a two-photon microscope, out-of-focus light or any other stray light is not available for the wavelength of the two-photon emission. By supplying an appropriate filter configured, it may not be accepted. Such a filter may include a transmission filter configured to substantially transmit light having a wavelength corresponding to the emission of the two-photon excitation process while reducing transmission of other wavelengths. Other types of filters or filter configurations may be used that can separate the wavelengths corresponding to the emission of the two-photon excitation process from other wavelengths.

Thus, augmented or virtual reality eyewear may include a variety of photon microscopes or two photon microscopes.

The device 2650, comprised of a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope, can be used to detect retinal morphology, deep fundus imaging (ie, lesion detection), retinal pigment epithelium (RPE) changes, and others. It can be used to visualize age-related macular degeneration. <u></u>The device 2650, configured as a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope, may also be used to provide multispectral imaging comparisons through spectral and depth-enhanced differential fields of view. It can help improve the visual identification of retinal and sub-retinal features.

In various embodiments, the device 2650 configured with a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope allows the clinician to view the acquired images of the user's eye in real time. For example, the system may be configured to allow a clinician to read the word the user is looking at and/or to view the scene the user is looking at. The device 2650 may be configured to allow the clinician to determine in real time which part of the retina the user is viewing with. For example, most users generally rely on the central region of the retina to see. However, patients with macular degeneration depend on other parts of the retina to see. Various embodiments of the augmented/virtual reality eyewear described herein, such as, for example, the device 2650 configured with a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope, are micro-field may be configured to perform an inspection. The device configured to perform the microfield test includes placing a small object visible to a user on the retina, and determining a blind spot of the retina based on the user's feedback and/or ability to see the small object.

Various embodiments of the device 2650 configured as a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope may be configured to measure refractive error. For example, the size of an image at the back of the retina can be measured by a clinician to determine whether it is small, large, out of focus, or has other defects.

Various embodiments of the device 2650 configured with a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope may be configured to track eye movements of the user 2660 , which It may be advantageous to provide the user 2660 with the ability to view objects and landscapes in real time.

Various embodiments of the device 2650 configured as a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope are configured to measure the thickness of the retina, the thickness of the macula, and/or the thickness of individual retinal layers. can be configured.

For example, a scanning laser ophthalmoscope or a confocal scanning laser ophthalmoscope (cSLO) may be used to scan across the retina according to a scanning pattern (eg, a raster scan). Light originating from the scanned region of the retina may be received by one or more imaging devices 2674 to construct a 2/3 dimensional image of the retina. For example, sequential cSLO scans captured at increasing depths can be combined to create a three-dimensional morphological image of the retina or optic disc. Image stacks can be aligned to create a final composite image that provides measurements of retinal thickness, macula and other parametric parameters of the retina. In one or more embodiments, an iris may be placed in front of one or more imagers 2674 to reject out-of-focus light that may add noise or aberrations to retinal images configured in 2D/3D.

Various embodiments of the device 2650 configured as a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope may be configured to image the macula of the user 2660 . Macular imaging can be useful for measuring the thickness of the macula as mentioned above. Macular imaging may also be useful in measuring the dilatation of the macula. This may be beneficial for early detection of glaucoma, which causes structural changes before functional changes in the macula. For example, glaucoma can cause loss of retinal ganglion cells, changes in inner retinal layers, thinning of certain retinal layers, and the like. These structural changes can be determined from images of the retina and/or macula.

Various embodiments of the device 2650, configured with a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope, are capable of determining accommodation status and/or measuring refractive error based on the shape of the lens. To do this, the lens may be configured to image the shape and/or thickness of the front and back surfaces of the lens of the user 2660 . For example, the user 2660 may focus on a target at different depths by projecting beams 2638 from different depth planes. Changes in lens accommodation status, as well as the size and accuracy of images formed on the retina, can be imaged to help determine refractive errors.

Various embodiments of the device 2650 configured with a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope may be configured to determine the spatial distribution and anisotropy of cones around the central retina. This may be advantageous in determining whether the user is nearsighted, emmetropic or farsighted. For example, a myopic user may exhibit a decrease in central cone placement density for myopia compared to an emmetropic eye. Changes in cone mounting density can also be monitored in users with cone dystrophy and/or retinitis pigmentosa. Macular dystrophy can lead to abnormal photoreceptor structures. Thus, macular dystrophy can be determined by imaging the user's photoreceptor structures.

Various embodiments of the apparatus 2650 configured with a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope, and/or a two-photon microscope may be configured to perform fluorescence microscopy. For example, a fluorescent dye could be injected into a user's blood vessels, and fluorescence microscopy could be used to track blood flow in the fundus or retina in real time. As another example, a fluorescent dye may be injected into the user's blood vessels, and fluorescence microscopy may be used to image individual capillaries of the nerve fiber layer, determine the thickness of the nerve fiber layer, and/or determine the fundus blood vessel pattern. In various embodiments, the fluorescent dye may be delivered by a fluid delivery system integrated with the system 2650 . As described herein, the device may include an output port for delivering a fluorescent dye. Therefore, fluorescence microscopy may be useful in determining changes in nerve fiber layer thickness or vascular changes due to other diseases of the eye, such as retinal damage, such as glaucoma, macular dystrophy, and the like. As another example, fluorescence microscopy can be used to analyze cone structure images and cone/retinal pigment cell ratios simultaneously with lipofuscin granule autofluoresence analysis to track retinal damage in retinal dystrophy. As another example, optical damage from specific wavelengths to the macula can be monitored with fluorescence microscopy.

The ophthalmic system 2650 can be used for confocal microscopes, scanning laser ophthalmoscopes, adaptive optical scanning laser ophthalmoscopes and/or two-photon microscopes, as well as non-health applications (eg, entertainment, such as watching movies or videos, playing games, etc.) etc.) can be configured for The system 2650 may be configured to perform confocal microscopy periodically (eg, hourly, daily, weekly, biweekly, monthly, biennial, yearly, etc.). In various embodiments, the system 2650 may be configured to perform confocal microscopy of the eye 2620 at irregular time intervals. For example, the system 2650 may perform confocal microscopy, scanning laser ophthalmoscope, adaptive optical scanning laser ophthalmoscope and/or two-photon microscopy several times per hour, several times per week, several times per month, It can be configured to perform several times a year, etc. Accordingly, such examinations may be completed 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24 or more times per year. These tests may be performed more frequently if the user has health problems. When the system 2650 detects that the user 2660 is suffering from a visual impairment or having difficulty focusing, the system 2650 may include a confocal microscope, a scanning laser ophthalmoscope, an adaptive optical scanning laser ophthalmoscope. and/or two-photon microscopy. The system 2650 may also be configured for use in a physician's office or hospital as a confocal microscope. However, the ophthalmic system 2650 may be worn by the user 2660 .

<u>automatic refractometer</u>

In one or more embodiments, the ophthalmic device may be configured to function as an autorefractor. An automatic refractor objectively measures a person's refractive error. Unlike a phoropter, which requires a patient's subjective response, an automatic refractor does not depend on the user's response. Accommodative paralysis agents (eg, eye drops) may be used that keep the ciliary muscles in a relaxed position, resulting in a loss of accommodation for the user. The relaxed position of the eye provides a more consistent view of the retina. The patient may be asked to view the image projected into the automatic refractor device. As the machine reads to determine when an image is focused on the retina, the image can be moved to focus and out of focus across the plane of depth. The machine may average the results to determine a prescription.

To this end, the ophthalmic device may provide one or more images at various depths using the FSD and scan through an eye-scanning module to capture images of the retina while the eye focuses on images of various depths. have. As in the previous embodiment, various algorithms can be used to determine when the patient is properly focused on the image, followed by determining the optical prescription for the user. The processor of the ophthalmic device may be used to perform a number of objective refractive tests using visible or infrared light. In one or more embodiments, image quality analysis/contrast peak detection techniques may be used in the analysis. Similarly, Scheiner double pinhole alignment, Shack-Hartmann grating alignment and/or retinal reflex neutralization may also be used.

26A shows an exemplary embodiment of an augmented and/or virtual reality system 2600 configured with an automatic refractor. In some embodiments, the system 2600 is a stacked waveguide assembly 178, a variable focus element (VFE) (eg, a deformable mirror film whose shape is controlled by electrical signals applied to a plurality of electrodes). or an adaptive optical element, such as an optical element capable of otherwise changing optical properties in a controlled manner, or any combination thereof. An example of such is disclosed herein with respect to FIGS. 10A-10D. The system 2600 may also include a beamsplitter 2602 , a camera 2604 , a processor 2606 , and a positive lens 2608 . The system 2600 may be head-mounted to align with the user's eyes 58 . Although the automatic refractor system 2600 is shown for a single eye, it may be a binocular automatic refractor capable of simultaneously examining the refraction of both eyes of a patient. The system 2600 may also include any other elements or features described herein. In some instances, additional elements used in the automatic refractor embodiments but not necessarily required for other functions described herein may be provided as additional attachments to augmented and/or virtual reality systems.

The stacked waveguide assembly 178 may be used to transmit light with varying values of wavefront curvature to the eye 58 . For example, the stacked waveguide assembly 178 may be configured to detect light beams having different values of gaze angles, including parallel beams as well as light beams having positive or negative gaze angles. 58) can be transferred.

The stacked waveguide assembly 178 may include multiple waveguides 182 , 184 , 186 , 188 , 190 and multiple lenses 192 , 194 , 196 , 198 . In some embodiments, the lenses 192 , 194 , 196 , 198 are negative lenses. As shown in Figure 26A, the waveguide and negative lens may be arranged in an alternating stack configuration. The stacked waveguide assembly 178 also includes a plurality of light sources 200 , 202 , 204 , 206 , 208 . As discussed herein, these light sources may be optical fiber scanning displays, although other light sources may also be used. Each light source may inject light into a corresponding waveguide 182 , 184 , 186 , 188 , 190 that distributes the light substantially equally over its length and redirects the light back to the eye 58 . In some embodiments, the light sources 200 , 202 , 204 , 206 , 208 may inject collimated light into respective waveguides 182 , 184 , 186 , 188 , 190 , each waveguide having a different output angle. A collimated light beam can be output in the range. The light provided by the light sources 200 , 202 , 204 , 206 , 208 may be in the visible or infrared spectrum.

In some embodiments herein, the first waveguide 182 closest to the eye 58 may be used to deliver a beam of light having a positive gaze angle to the eye. This may be accomplished, for example, by providing a positive lens 2608 between the first waveguide 182 and the eye 58 . Positive lens 2608 may impart a positive viewing angle to all rays passing through it. 26B shows an example of a light beam with positive gaze angle transmitted to eye 58 . As noted above, this amount of the main visual beam may originate from light originating from the first waveguide 182 .

The remaining waveguides 184 , 186 , 188 , 190 may deliver the light beam to the eye 58 at different values of gaze angle. For example, the second waveguide 184 in the stack may be used to provide a light beam having a positive viewing angle that is less angled than the first waveguide 182 in the stack. This may be accomplished, for example, by sending light from the second waveguide 184 through the negative lens 192 . The negative lens 192 imparts a negative gaze angle to the passing light beam, such that the positive gaze angle is relatively smaller as compared to that output from the first waveguide 182 in the stack.

In a similar manner, the third waveguide 186 in the stack may be used to provide a light beam having a positive viewing angle that is a smaller angle than that output from the second waveguide 184 in the stack. For example, the third waveguide 186 may be used to provide a zero viewing angle collimated light beam to the eye 58 . This may be accomplished by transmitting light from the third waveguide 186 through the first negative lens 192 and the additional negative lens 194 . Each of these negative lenses 192 and 194 imparts a negative viewing angle to the light beam passing through them, so that a relatively small amount of light compared to the light output from the first or second waveguide 182, 184 in the stack. to have a vision. 26C shows an example of a collimated light beam with zero gaze angle transmitted to eye 58 . As noted above, this parallel beam may originate from light originating in the third waveguide 186 .

A fourth waveguide 188 in the stack provides a beam of light to the eye 58 with a much smaller amount of viewing angle than exiting from the first, second, and third waveguides 182, 184, 186 in the stack. can be used For example, the fourth waveguide 188 may be used to provide a light beam having an angle of gaze with respect to the eye 58 . This can be achieved due to the fact that the ray exiting the fourth waveguide 188 passes through an additional negative lens 196 compared to the light beam output from the waveguides in front of the stack.

Finally, the fifth waveguide 190 in the stack can be used to provide a beam of light having a much greater negative viewing angle than that coming from the fourth waveguide 188 . Once again, this may be accomplished by a transmitted light beam that is output from the fifth waveguide 190 through another negative lens 198 along the optical path to the eye 58 . 26D shows an example of a light beam transmitted to eye 58 with a negative gaze angle. As described above, the negative main visual beam may come out of the fifth waveguide 190 .

The stacked waveguide assembly 178 may also include a compensating lens layer 180 . This lens layer may compensate for the cumulative effect of negative lenses 192 , 194 , 196 , 198 when a user views light originating from the outside world 144 from the other side of the stacked waveguide assembly 178 . . Further, the compensating lens layer 180 may be designed to compensate for the positive lens 2608 provided between the stacked waveguide assembly 178 and the user's eye 58 (if such a positive lens is present).

As described above, the waveguides of the stacked waveguide assembly 178 transmit light beams with different viewing angle ranges, from positive viewing angle beams to parallel beams, negative viewing angle beams. ) can be used to controllably provide Although the embodiment has been described in terms of the output beam having the largest angle of negative viewing angle exiting the final waveguide 190, while the output beam having the maximum angle of positive viewing angle exiting the first waveguide 182, This can be reversed through selection of the appropriate lens (192, 194, 196, 198, 180, 2608). Also, the system is not necessarily required to output beams of positive, negative and zero gaze; Some systems may output beams that are a subset of these possible gaze angles. Finally, although the illustrated stacked waveguide assembly 178 includes five waveguides, other embodiments may be used to provide a light beam having a wider range of gaze angles and/or finer steps between available gaze angles. Additional waveguides may be included. Alternatively, other embodiments may include fewer waveguides to simplify the device and reduce cost.

Referring again to FIG. 26A , the light beam output from the stacked waveguide assembly 178 propagates along the viewing axis toward the user's eye. In the illustrated embodiment, these beams are transmitted through a beam splitter 2602 provided between the stacked waveguide assembly 178 and the eye 58 . The beam splitter 2602 is aligned with the viewing axis of the eye 58 , so that the camera 2604 sees the eye 58 . Beam splitter 2602 is shown positioned between stacked waveguide assembly 178 and eye 58, but may alternatively be positioned on the opposite side of stacked waveguide assembly 178 from eye 58, A camera 2604 may view the eye 58 through the stacked waveguide assembly 178 .

As already discussed, the automatic refractometer system 2600 may provide an image to the eye 58 using a beam of light having a viewing angle of various angles. When this image is provided to the eye 58 , the camera 2604 can be used to monitor the retina of the eye 58 . The camera 2604 may provide a retina image to the processor 2606 . The processor 2606 may perform image processing algorithms on the retinal image to determine when the image projected by the automatic refractor system 2600 is best focused on the retina of the eye 58 . Such image processing algorithms may include, for example, contrast peak detection (the image projected onto the retina of the eye 58 generally has relatively low contrast when the image is blurred, and the image is sharpened by the eye 58 ). has peak contrast when in focus). The processor 2606 determines the eye (positive, parallel, or negative) angle of gaze that the eye 58 needs to allow light to focus on the retina. 58) can be calculated. The processor 2606 may determine the image quality at multiple ocular meridians to calculate the cylindrical power and axis as well as the spherical power of the eye.

The processor 2606 may control the operation of the automatic refractor system 2600 . In an embodiment of the present application, the control method is configured such that one or more light sources 200 , 202 , 204 , 206 , 208 control a beam of light having a first viewing angle value (whether positive, parallel, or negative). using to project an image towards the eye 58 . The processor 2606 may use the camera 2604 to capture retinal images of the eye 58 . The processor 2606 may analyze the captured retinal image to determine a quality measurement criterion of an image formed on the retina when the light beam having the first gaze angle value is used.

The processor 2606 may then cause one or more light sources to project an image towards the eye 58 using a beam of light having a second gaze angle value different from the first gaze angle value. Then, the processor 2606 recaptures the retinal image of the eye 58 using the camera 2604, and the quality metric of the image formed on the retina when using the beam of light having the second viewing angle value. The retinal image may be analyzed to determine . Then, the processor 2606 may compare the first image quality criterion with the second image quality criterion. Based on this comparison, the processor 2606 may use any of a variety of optimization algorithms to select a third gaze angle value to use when projecting the image towards the eye 58 . Next, the processor 2606 may calculate a third image quality determination criterion indicating the quality of an image formed on the retina when a beam of light having a third viewing angle is used. This procedure may be repeated until the image quality criterion is maximized or determined to be sufficient. Finally, the processor 2606 may calculate the refractive power of the eye 58 based on the gaze angle value corresponding to the image quality determination criterion. In addition, the processor 2606 may initiate execution of the phoropter method described herein when the automatic refractor system 2600 identifies refractive anomaly(s) above a threshold. The phoropter system can be used to verify the accuracy of measurements by the automatic refractometer system 2600 and vice versa. In this way, the autorefractor system 2600 and the phoropter system can jointly be used to characterize a patient's vision.

26E shows another example embodiment of an augmented and/or virtual reality system 2650 configured as an automatic refractor. The automatic refractor system 2650 may include all features of the automatic refractor system 2600 shown in FIG. 26A (although beam splitter 2602, camera 2604, and processor 2606 are provided for clarity). although not shown). In addition, the autorefractor system 2650 shown in FIG. 26E may include a Scheiner pinhole disc 2660 positioned along the optical path of the system in front of the eye 58 . A Scheiner disk 2660 may be positioned, for example, between the stacked waveguide assembly 178 and the beam splitter 2602 . It is an opaque disc with two or more small openings. As shown in Figure 26E, when a collimated light beam is incident on the Scheiner disk 2660, the beam is blocked from transmission to the eye except for the light beam that can pass through the two apertures. In the case of an emmetropic eye, the rays transmitted through each of the two apertures focus on a common point on the retina of the eye 58 . Accordingly, the retinal image captured by the camera 2604 represents a single point.

Figure 26E shows the effect of a parallel beam passing through Scheiner disk 2660 on the normal eye, whereas Figures 26F and 26G show the same effect on the farsighted eye and myopic eye, respectively. As can be seen in FIG. 26F , the optical magnification of the farsighted eye is not strong enough to focus the rays transmitted through the two apertures of the Scheiner disk 2660 to a single point. Thus, the retinal image taken by camera 2604 will show two distinct points in the case of a parallel beam illuminating the Scheiner disk in front of the primordial eye. As can be seen in FIG. 26G , the optical power of the nearsighted eye is so strong that the rays transmitted through the two apertures of the Scheiner disk 2660 are focused at the front of the retina of the eye. This also causes the formation of two distinct spots on the retina.

Thus, the autorefractometer system 2650 can vary the viewing angle of the light beam incident on the Scheiner disc until a dot is formed on the retina of the eye. The refractive power of the eye 58 may be calculated based on the viewing angle of the beam required to form a single point on the retina.

The processor 2606 may control the operation of the automatic refractor system 2650 . In an exemplary embodiment of the present disclosure, the control method includes: one or more light sources 200 , 202 , 204 , 206 , 208 , on the Scheiner disk 2660 , on the Scheiner disk 2660 , a first gaze angle value (whether positive, parallel or negative) and projecting a beam of light having a value of . The processor 2606 may then use the camera 2604 to capture a retinal image of the eye 58 . The processor 2606 may analyze the retina image to determine the number of distinct spots. If only one spot is evident, the processor 2606 may calculate the refractive power of the eye 58 based on the first gaze angle value. Alternatively, if multiple points are apparent, the processor 2606 may select a second gaze angle value different from the first gaze angle value. The processor 2606 may then generate a beam of light having a first viewing angle value to be projected onto the Scheiner disk 2660 . The processor 2606 may again use the camera 2604 to capture a retinal image of the eye 58 and analyze the retinal image to determine the number of distinct dots. If a single point is apparent, the processor 2606 may calculate the refractive power of the eye 58 based on the second gaze angle value. Otherwise, a third gaze angle value can be chosen and repeated over and over until a single point is formed on the retina. Thereafter, the processor 2606 may calculate the refractive power of the eye 58 based on the gaze angle value.

Any automatic refractor or other diagnostic method described herein may be used for real-time adjustments while the user watches the content to ensure that the content is in focus. In addition, monitoring of a user's refractive error may be performed over a long period of time (eg, weeks, months, or years) to provide long-term monitoring and analysis of the user's refractive error. The frequency of regularly scheduled exams can be adjusted automatically based on trends in the exam results or when the system detects that the user is having vision problems.

<u>Optical coherence tomography</u><u>(OCT)</u>

Various embodiments of an augmented reality/virtual reality wearable device that may be worn by a user as described herein may be configured to function as an optical coherence tomography (OCT) system. 23A and 23B schematically depict a wearable device 2350 that may be configured to function as an OCT system. The device 2350 includes a frame 2364 attached to a display system 2362 . The display system 2362 may be configured to be positioned in front of an eye 2320 of a user 2360 . Portions of projected beam 2338 may be reflected, scattered, and/or diffracted as rays 2356 by various anatomical features of user 2360 eye 2320 , and received by one or more imagers 2352 . can be Electronic hardware processor 2370 may be used to analyze light received from user 2360 eye 2320 to examine various structures of user's eye 2320 .

In various embodiments of the wearable device 2350, the frame 2364 may have similar characteristics to the frame 64 of Figures 3A-3C. In various embodiments of the wearable device 2350 , the display system 2362 may have similar characteristics to the display system 62 of FIGS. 3A-3C and 5 . In various embodiments of the apparatus 2350, the electronic hardware processor 2370 may be similar to the local processing and data module 70 of Figures 3A-3C.

The display system 2362 of various embodiments of the ophthalmic system 2350 may include a display lens 2376 mounted to the frame 2364 . In some embodiments, the display lens 2376 may be a single lens comprising two eyepiece areas, each eyepiece area located in front of the user's eye 2320 . In some embodiments, the display system 2362 may include two display lenses mounted to the frame 2364 , each display lens positioned in front of each eye 2320 of the user. includes the eyepiece area.

The light source 2354 may include one or more LEDs, one or more flashlights, one or more super light emitting diodes and/or possibly one or more lasers. In various embodiments, the light source is a non-coherent light source. In some embodiments, the light source 2354 may be part of an illumination system of the device 2350 configured to provide illumination to the display lens 2376 and/or the eye 2320 of the user 2360 . . In some such embodiments, the beam 2338 may be projected from a display lens 2376 to the eye 2320 of the user 2360 . For example, the light source 2354 may include a fiber optic scanning device (FSD), and the display lens may include a plurality of waveguides having properties similar to the waveguide stack 178 described above with reference to FIG. 10D. can a stack 178 . Light originating from the FSD may be injected into one or more of the plurality of waveguides and may be emitted from one or more of the plurality of waveguides into the eye 2320 of the user to perform an OCT function. The plurality of waveguides of the display lens may be coupled with an adaptable focusing element capable of changing the characteristics of the wavefront emitted from the plurality of waveguides.

In some embodiments, the light source 2354 may be an auxiliary light source disposed on a side surface of the display system 2362 . In this embodiment, the wearable device 2350 may be configured to direct the beam 2338 to the eye 2320 of the wearer, for example a lens or other refractive component, reflective surface, deflector, reflector, beam may include optical components such as separators, diffractive optical elements, waveguides, or other optical components. For example, the light source 2354 may include an additional FSD and the display lens may include an additional waveguide stack. Light from the additional FSD may be injected into one or more waveguides of the additional waveguide stack, and may be emitted from one or more waveguides of the additional waveguide stack to the eye 2320 of the user to perform an OCT function. The waveguides of the additional waveguide stack may be coupled with an adaptable focusing element that may alter the characteristics of the wavefront emitted from the additional waveguide stack. As discussed in detail below, the beam 2338 originating from the light source 2354 may be incident on a desired area of the wearer's eye 2320 . The beam 2338 may be scanned along the x, y, and z directions across a desired area of the wearer's eye 2320 to a 2D/3D image of the desired area.

The wearable device 2350 configured as an OCT system may include an interferometer and subsurface a translucent or opaque material (eg, various structures of the user's eye 2320 , various ophthalmic tissues within the user's eye 2320 ). Images can be acquired with a resolution equivalent to that of a low-power microscope. The system may be configured to use optical image reflection within tissue to provide cross-sectional images for generating micrometer resolution 3D images. In various embodiments, light originating from light source 2354 may produce a projection optical beam 2338 directed to tissue and a reference beam directed toward a reflective reference, such as a mirror or reflective element. A small portion of this light that the projection optical beam 2338 reflects from the subsurface shape of the tissue to which it is directed as light beam 2356 is collected and interfered with the reflected light from the reflection reference. Interferometric techniques can be used to record the optical path length of received photons, thus rejecting most photons that scatter multiple times before detection.

In various embodiments, a beam splitter may be disposed in the optical path of light emitted from the light source 2354 to produce a projection beam 2338 and a reference beam. 23A-1 , in an embodiment of device 2350 in which the light source 2354 includes an FSD, a fiber optic splitter/combinator generates a projection beam 2338 and a reference beam, and the eye 2320 ) can be used to combine scattered or back-reflected light from various structures in ) and the reflected reference beam. In various embodiments, the reflector may be a movable reflector. 23A-1 also shows a light guide having a divergence characteristic in a waveguide stack that may be used to direct the OCT light beam to an eye and receive light returning therefrom. The waveguide guide may be included in a waveguide stack, such as the waveguide stack configured to project an image onto the eye as described herein. The inset shows the light reflected from the reference reflector and the light returned from the eye ( It also shows a detector that accepts, for example, reflected or backscattered, etc.).

As noted above, in some embodiments, a non-coherent light source such as an LED (eg, a super emitting LED) may be used. Such a light source provides the interferometer with reduced interference length. As a result, OCT devices have a short focal length or area over which light is collected as an image. This region is scanned in the longitudinal direction (z) along the direction of the beam, creating what is called an A scan. Also, a small spot size beam incident on the eye can provide reduced lateral resolution. Again, the beam can be scanned in the transverse directions (x and y), perpendicular to the longitudinal direction to produce B and C scans, thus producing 2D and 3D images representing the tissues and structures of the eye.

The region can be scanned in the longitudinal direction (z-direction) by changing the position of the reflected reference, the wavelength of the projection beam 2338 and/or the reference beam, or the angle between the projection beam 2338 and the reference beam, which is the projection Vary the optical path length difference between beam 2338 and the reference beam. By changing the optical path length difference between the projection beam 2338 and the reference beam, the device 2350, advantageously configured as an OCT system, collects light reflected directly from the surface of interest while not accepting a background signal, thereby reducing the thickness of a thick sample. It allows you to build clear 3D images.

In one or more embodiments of the device 2350, the light source 2354 includes an FSD capable of functioning as a 3D scanning head configured to project a light beam as well as receive a backscattered light beam 2356 from the eye. can do. In one or more embodiments, light beams (eg, via FSD or other light sources) of various wavelengths (ie, outside the visible light spectrum) may be projected to provide additional 3D resolution. The OCT system may include time domain or frequency domain OCT. In various embodiments, the device 2350 may be configured as a spectral (Fourier) domain OCT capable of simultaneously receiving and measuring reflected/backscattered light originating from the eye comprising a plurality of wavelengths within a spectral range.

In various embodiments, the light source 2354 may include a scanning laser device that outputs an illumination beam having a spot size between about 1 micrometer and about 1.0 mm. For example, the illumination beam may be between about 1-3 micrometers, between about 2-10 micrometers, between about 5-25 micrometers, between about 10-30 micrometers, between about 20-100 micrometers, between about 50- Between 200 micrometers, between about 75-250 micrometers, between about 100-300 micrometers, between about 225-500 micrometers, between about 375-600 micrometers, between about 500-750 micrometers, between about 650-850 micrometers It can have a point size in the range between meters, about 725 micrometers-1 mm, or a value in this range or subrange. The scanning laser device may be configured to scan over a desired area of the eye in a desired scanning pattern. The scanning laser device may be configured to scan at a rate between about 1 kHz and about 5 MHz to produce a desired scanning pattern. Thus, a desired scanning pattern created in a desired area of the eye may be considered to include a plurality of pixels that are illuminated sequentially (eg, one at a time) during scanning. In some such embodiments, the one or more imaging devices 2352 may include a photodetector configured to receive backscattered or backreflected light from each of the plurality of pixels. The intensity of light received by the photo detector may be related to the scanning angle and/or position of the illumination beam to produce a two-dimensional image of the desired area.

The light projected from the light source 2354 may be focused at a different focal length at the wearer's eye 2320 . For example, the focus of the projected light may coincide with the cornea, iris, natural lens, vitreous, or retina. In various embodiments, one or more adaptive optical elements or variable focus elements (VFEs), optionally as described above with reference to FIGS. 10B, 10C and 10D, focus or It can be used to change the focal plane that appears to be generated and/or the angle of incidence of light projected from the light source 2354 . For example, light output from light source 2354 may be modified using an optical system that includes lenses, prisms, and/or mirrors (e.g., optical element 1024 in FIG. 10C), such that the beam ( 2338 may be focused on the eye and/or the direction of the beam 2338 on the user 2360's eye 2320 may be changed.

In various embodiments, the VFE may include a deformable mirror arrangement. For example, the VFE may include one or more electrodes coupled to a thin film mirror. The control system may be configured to selectively control one or more electrodes to change the shape of the thin-film mirror. Thus, the wavefront of the light emitted from the stacked waveguide assembly can be modified by changing the shape of the thin film mirror. Embodiments of the wearable device 2650 that do not include a light source, including a scanning laser device or a fiber optic scanning device, are deformable, which steer the beam and/or change the depth at which the beam is focused within the user's eye. It may include a mirror device. In various embodiments, the VFE may include a deformable lens. The deformable lens may comprise an elastomeric material that can be deformed by the application of electrostatic energy to produce a lens having a different curvature or a lenticular surface. In some embodiments, the VFE may include a lens that may deform upon activation of the electrode. Some lenses can change the refractive index by applying a voltage to the electrodes (eg, liquid crystal lenses). In various embodiments, the device 2350 may include a spatial light modulator to modulate the phase. Embodiments of the wearable device 2650 comprising a light source comprising a scanning laser device or fiber optic scanning device may be configured to adjust the beam and/or change the depth at which the beam is focused into the user's eye and/or deformable lenses. It may include a spatial light modulator that modulates the phase.

In various embodiments, the light source 2354 may be configured to generate white light or colored light that includes a wavelength range in the visible spectral region. For example, the light source 2354 may be between about 440 nm and about 510 nm; between about 460 nm and about 550 nm; between about 490 nm and about 560 nm; between about 530 nm and about 610 nm; between about 550 nm and about 620 nm; or light of any color having a wavelength in a range of values in one of these ranges or subranges.

In some embodiments, the light source 2354 may be configured to generate infrared light including one or more wavelengths within a wavelength range of the infrared spectrum. For example, the projection beam 2338 may be in near-infrared spectral light; may include one or more wavelengths in the mid-infrared spectrum light and/or in the far-infrared spectrum light. As another example, the projection beam 2338 may be between about 700 nm and about 1.5 micrometers; between about 1.0 micrometer and about 2.3 micrometer; between about 1.8 micrometers and about 3.2 micrometers; between about 2.4 micrometers and about 5.8 micrometers; between about 3.2 micrometers and about 7.0 micrometers; and/or one or more wavelengths between about 6.0 micrometers and about 13.0 micrometers.

The penetration depth of the projection beam 2338 within the eye 2320 of the wearer 2360 may depend on the wavelength included in the projection beam 2338 . In addition, the optical pathlength difference between the projection beam 2338 and the reference beam may also be wavelength dependent. Thus, varying the wavelength included in the projection beam 2338 may advantageously allow imaging of structural and anatomical features at different depths within the eye 2320 of the user 2360 .

The device 2350 may be configured to image the retina and/or various retinal layers by varying the depth of the projection beam 2338 . Thickness measurements of the retina and/or various retinal layers can be obtained from these images. Thickness measurements of the retina and/or the various retinal layers can be used for posterior pole asymmetry analysis (PPAA), which maps the thickness of the retina across the posterior pole and graphically shows the asymmetry between both hemispheres and between the eyes. can Accordingly, the device 2350 may compare the thickness of the retina and/or the various retinal layers of one of the user's eyes 2320 to the thickness of the retina and/or the various retinal layers for an average healthy eye and/or another user may be used to compare the thickness of the retina and/or various retinal layers for the eye 2320 of

The device 2350 may be configured to image the macula of the wearer's eye 2320 . The macular image may be useful for measuring the thickness of the macula as described above. Macular imaging may also be useful in measuring the dilatation of the macula. This may be beneficial for early detection of glaucoma, which causes structural changes in the macula before functional changes occur. For example, glaucoma can cause loss of retinal ganglion cells, changes in inner retinal layers, thinning of certain retinal layers, and the like. These structural changes can be confirmed in images of the retina and/or macula.

The device 2350 may be configured to image the lens of the wearer 2360 to determine an accommodation state based on the shape and/or thickness of the front and back surfaces of the lens, and to measure the refractive error. For example, the wearer 2360 may focus on a target at different depths by projecting beams 2338 from different depth planes. Changes in the accommodation status of the lens, as well as the size and accuracy of images formed on the retina and/or monitored to the wearer 2360 may be imaged to determine refractive errors. These measurements are useful in performing phoropter tests, monitoring the state of refraction of the eye, or assisting in performing tests that can correct refractive errors.

Various embodiments of one or more imager 2352 may allow the imager 2352 to selectively receive light in one or more desired wavelength ranges from the eye 2320 of the wearer 2260 while attenuating or filtering other wavelengths. It may include one or more wavelength filters configured to be there. For example, the imaging device 2352 may include one or more wavelength filters configured to enable the imaging device 2352 to selectively receive light in a visible spectral range, a near-infrared spectral range, a mid-infrared spectral range, and/or a far-infrared spectral range. may include. As another example, the imaging device 2352 may be between about 440 nm and about 12.0 micrometers; between about 500 nm and about 10.0 micrometers; between about 550 nm and about 8.5 micrometers; between about 600 nm and about 5.0 micrometers; between about 650 nm and about 3.0 micrometers; The imaging device 2352 can selectively receive light having any value between about 1.0 micrometer and about 2.5 micrometers, or any of the ranges and subranges described above, while attenuating or filtering wavelengths outside the selected range. It may include one or more wavelength filters configured to be there.

The information and/or images acquired by the one or more imaging devices 2352 may be processed in real time or thereafter. In various embodiments, the device 2350 may include a light source and a detector to track eye movement. The light source and detector for tracking the eye movement may have characteristics similar to those of the light source 26 and the camera 24 described with reference to FIG. 5 . Light sources and detectors that track the eye can be used to counteract any effect of eye movement. The wearable device 2350 configured as an OCT system may be used in one or more embodiments to provide a superior in vivo widefield microangiography imaging device.

The wearable device 2350 configured as an OCT system can be used to visualize topography, deep fundus imaging (ie, detection of lesions), retinal pigment epithelium (RPE) changes and other age-related macular degeneration, and to visualize the retinal vasculature. and visualizes blood flow in the fundus, and visualizes the shape and structure of blood vessels in the fundus. The wearable device 2350 may also be used to provide multispectral imaging comparisons, which may be beneficial for improving visual identification of retinal and subretinal features through spectral and depth-enhanced differential fields of view.

For example, the device 2350 may be configured to perform OCT angiography. Accordingly, the device 2350 may be used to visualize blood flow in a retinal and/or choroid capillary network. Visualizing blood flow in the retinal and/or choroidal capillary network may be advantageous in detecting abnormal blood vessel growth by using the movement of blood as a control. Visualization of blood flow in the retina and/or choroidal capillary network using OCT angiography techniques allows imaging of multiple levels of vascular branches in the retina, such as the radial optic disc capillary level, the superficial level, and the deep plexus level, without the use of fluorescent dyes. can do. The device 2350 may also be used to perform multicolor analysis of the retina and/or segmentation of the retinal layers.

As noted above, the wearable device 2350 can be configured to project light related to visible light (which is typically done via an RGB light source), as well as other multispectral components (e.g., laser light source, infrared light source). light source, LED light, etc.) may be configured to emit light having a wavelength range and spectral composition. Or, in other embodiments, a tunable laser capable of changing the wavelength of light over time on a frame-continuous basis, line-sequential basis, pixel-by-pixel basis, etc. (e.g., in a laser The length of the cavity can be varied or the grating can be modified) can be used.

Multi-spectral light emission can be advantageous for imaging purposes, as different parts of the eye respond better to different colors or light spectra, leading to more accurate imaging techniques. Accordingly, a wearable device 2350 configured with an OCT system may include additional components that enable the emission of multispectral light. For example, the apparatus 2350 may be configured to perform spectral (Fourier) domain OCT.

In one or more embodiments, the wearable device 2350 may transmit different wavelengths of light from different angles to penetrate the soft tissue at the back of the eye. The wearable device 2350 may include a light source capable of providing laser tomography as well as white light tomography. Similarly, ERG (Electroretinography) or EOG (Electrooculography), eye tracking and counting functions advantageously enable the wearable device 2350 to precisely collect light returning from retinal tissue; Can be allowed to de-noise and deal with. For example, detecting eye movement while measuring with ERG or eye tracking can cause the system to drop or filter the data, or process the data differently. Such treatment may enhance or enhance the image. Other sensors or sensing systems, such as accelerometers, motion sensors, head posture tracking devices, etc., may be employed to determine if the user has moved and vibrations may be introduced into the measured and/or captured images.

23C shows an exemplary flow diagram 2300 of a method of examining an eye using the wearable device 2350 . The method of examining the eye may be executed by an electronic hardware processor 2370 in conjunction with the wearable device 2350 . The device 2350 may be configured to perform an OCT examination of the eye upon detecting that the user 2360 is having difficulty with vision or focusing. Referring now to FIG. 23C , an exemplary process flow 2300 is provided. At block 2302, an OCT program may be initiated. At block 2304 , one or more beams of light may be projected onto a portion of the user's eye using light source 2354 . At block 2306 , the backscattered light 2356 and/or the reflected reference beam is employed as the light source 2354 to measure a set of parameters related to the backscattered light 2356 emitted back from the eye. It may be collected by the optical fiber 2354 of the FSD, or by another imager 2352 (eg, a photodetector). At block 2308 , the system can be configured to infer an image of the user's eye 2320 portion based on a set of measured parameters associated with backscattered light 2356 . At block 2310, eye movements may be measured and used to denoise the inferred image and generate a more accurate image. At block 2312 , any abnormality of the eye 2320 may be detected from the acquired image and known to the clinician or physician. For example, the acquired image may be compared to a stored image accessible by the electronic hardware processor 2370 using a pattern matching algorithm to detect anomalies. The stored image may include an image of a healthy eye, an image indicating characteristics of an eye affected by a specific disease, and/or an image of a user's eye obtained from a past examination. The electronic hardware processor 2370 may be configured to obtain quantitative measurements (eg, volume measurements) of various portions of the acquired image of the user's eye. Quantitative measurements can be passed on to a clinician for further analysis. As another example, one or more parameters may be extracted from the acquired image to detect an abnormality. The obtained images and/or quantitative measurements can be used to monitor eye health or disease progression.

Referring now to FIG. 23A , a schematic diagram of a wearable device 2350 for performing OCT functions using a photo detector 2352 is shown. 23B , light source 2354 directs projection beam 2338 to user's eye 2320 . The light rays pass through the user's cornea and iris and reach the user's retina. It should be understood that the angle at which the light source 2354 projects light may vary based on the area of the retina or ocular space that needs to be imaged. 23A , some of the light rays (e.g., visible light, RGB light, infrared light, multispectral light) projected to eye 2320 are backscattered into light rays 2356 and the wearable device ( It is captured by photodetector 2352 , which may be located at various locations on 2350 . For example, as shown in FIG. 23B , the photo detector 2352 may be located around the rim of the wearable device 2350 , along the frame perimeter of the wearable device 2350 , or in any other suitable configuration. can be positioned as The reference beam generated by the light source 2354 reflected from the reflective reference may also be received at the photodetector 2352 and interfered with the backscattered light 2356 to obtain an OCT signal.

One or more parameters of the light received by the photodetector 2352 (eg, density, angle, intensity, spectral content, etc.) and/or the OCT signal are to be passed by the photodetector 2352 to the processor 2370 . and may use one or more algorithms to extrapolate the image from the data transmitted from the photodetector. In one or more embodiments, the photodetector is a photodiode (eg, silicon based, germanium (Ge) based for infrared light, photomultiplier tube (PMT), charge coupled device (CCD), CMOS based sensor, shark - Hartman (Shack-Hartman wavefront sensor, etc.) may be included. In one or more embodiments, multimode optical fibers may be used to receive backscattered light and channel them to a PMT or any other type of light detector.

Although the backscattered light 2356 is shown in FIG. 23A as being directed at the photodetector 2352 at a large angle for illustrative purposes, it should be understood that the backscattered light 2356 may be reflected back at the same angle as it was emitted. do. Accordingly, some embodiments may include a beam splitter to direct the backscattered light to one or more photodetectors (not shown).

The backscattered light 2356 may come from the retina as shown in FIG. 23A , but the light may also be a Purkinje image reflected from the cornea (eg, a corneal glare, etc.) or other glare of the eye. have. Different photodetectors may be more sensitive to different types of light or parametric parameters. For example, some photodetectors may be better at tracking corneal glare, and these sensors may be strategically positioned to detect corneal glare or Purkinje images. Alternatively, other light detectors may be better at distinguishing between the various angles at which light is backscattered from the retina, and may be positioned in such a way that they optically mate to the retina. Accordingly, the wearable device 2350 may include various light detectors configured to detect different types (or parameters) of the backscattered light 2356 .

The wearable device 2350 may be configured for OCT systems as well as non-health applications (eg, for entertainment such as watching movies or videos, playing games, for work, etc.). The wearable device 2350 may perform OCT scans periodically (eg, hourly, daily, weekly, biweekly, monthly, interactive, annual, etc.) or the device 2350 may ) can be configured to perform when detecting problems in vision or focusing. In various embodiments, the system 2350 may be configured to perform OCT scans of the eye 2320 at irregular time intervals. For example, the wearable device 2350 may be configured to perform OCT examinations several times an hour, several times a week, several times a month, several times a year, and the like. Accordingly, these tests may be performed 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24 or more times per year. These tests may be performed more frequently if the user has health problems. The system 2350 may also be configured for use in a physician's office or hospital as an OCT examination. In contrast to conventional over table/bench OCT systems, the wearable device 2350 can be worn by a user 2360 . The wearable device 2350 configured as an OCT system may be lighter, smaller, and less bulky than a conventional table/bench-top OCT system.

In certain embodiments, a doctor, nurse, technician, or other health care provider controls the system. Alternatively, the user controls the OCT system. In some embodiments, the system is automated and algorithmically controlled. For example, time parameters such as when OCT imaging is performed are determined by the system. The system may determine that the test should be initiated based on an indication resulting from one of the described diagnostic tests, for example, an indication that the health of the eye is impaired or a health problem has been found. Alternatively, the system may simply follow a protocol, such as a schedule for performing inspections periodically or aperiodically as described above.

Various embodiments of the device 2350 include components capable of providing audible, visual, pictorial and/or tactile alerts to the user 2360 prior to initiation of, during, and/or after completion of an examination. An alarm system may be included. The device 2350 may also include components capable of providing audible, visual and/or pictorial instructions to the user 2360 prior to initiation of, during, and/or after completion of the examination.

<u>aberration</u>

In one or more embodiments, the ophthalmic device may function similarly to an aberrometer. The aberrometer measures precise irregularities in the eye. These aberrations, like fingerprints, are very unique aberrations that are special to individuals. The device measures the wavefront as it passes through the eye. In an aberration-free eye, the wavefront is flat. In an imperfect eye, the wavefront exhibits bending and/or distortion. These subtle aberrations can distort light as it passes through the cornea and lens to the retina. The results can have a significant impact on vision quality and can affect depth perception, contrast, color perception, night vision, and more. If these abnormalities are identified, more accurate eyewear prescriptions are possible.

In order to check the refractive error, the aberrometer may send light in the laser band to the eye. The light passes through the cornea and the lens of the eye and is reflected by the retina. The reflected light may be measured by an aberrometer to generate a 3D image. The aberrometer is generally used during laser vision correction surgery. The aberrometer-generated map directs the delivery of laser beams that accurately reconstruct the cornea.

In one or more embodiments, the optical fiber scanning display (FSD) of the ophthalmic device may be used to generate light of a desired wavefront. As in the previous embodiment, the response of the applied stimulus can be measured. It should be understood that wavefronts of other frequencies may be applied. Similarly, visible or non-visible light can be projected onto the eye to produce accurate resolution for the resulting 3D image. In one or more embodiments, the acquired data may be processed to determine any anomalies similar to the process flow shown in FIG. 23C .

27 shows an exemplary embodiment of an augmented and/or virtual reality system 2700 configured with a wavefront aberrometer. In some embodiments, the system 2700 includes a stacked waveguide assembly 178, a variable focus element (VFE) (eg, a deformable mirror film whose shape is controlled by electrical signals applied to a plurality of electrodes); the same adaptive optical elements, or optical elements capable of changing other optical properties in a controlled manner, or any combination thereof. An example of this is disclosed herein with respect to FIGS. 10A-10D. The system 2700 may also include a beam splitter 2702 , a wavefront sensor 2710 , and a processor 2706 . The system 2700 may be mounted on the head to align with the user's eyes 58 . The system 2700 may include any other device or features described herein. In some cases, additional elements used in the wavefront aberrometer embodiment but not necessarily required for the other functions described herein may be provided as additional attachments to the augmented and/or virtual reality system.

The stacked waveguide assembly 178 may include multiple waveguides 182 , 184 , 186 , 188 , 190 and multiple lenses 192 , 194 , 196 , 198 . In some embodiments, the lenses 192 , 194 , 196 , 198 are negative lenses, but in other embodiments they may be positive lenses. As shown in FIG. 27 , the waveguide and the negative lens may be arranged in an alternately stacked configuration. The stacked waveguide assembly 178 also includes a plurality of light sources 200 , 202 , 204 , 206 , 208 . As discussed herein, these light sources may be optical fiber scanning displays, although other light sources may also be used. Each individual light source may inject light into a corresponding waveguide 182 , 184 , 186 , 188 , 190 , distributing the light substantially equally over its length and redirecting the light back to the eye 58 . . In some embodiments, the light sources 200 , 202 , 204 , 206 , 208 may inject collimated light into respective waveguides 182 , 184 , 186 , 188 , 190 , each waveguide having a different range of output angles. can output a collimated light beam. The light provided by the light sources 200 , 202 , 204 , 206 , 208 may be, for example, the visible or infrared spectrum. In other embodiments, still other wavelengths of light may be used.

As discussed herein in connection with other embodiments, the stacked waveguide assembly 178, alone or in combination with one or more additional lenses or adaptive optics elements, transmits light having a varying wavefront curvature to the eye 58 ) can be used to penetrate Wavefront aberrometer system 2700 may likewise use any such arrangement to create a wavefront of light having desired properties.

The stacked waveguide assembly 178 may also include a compensating lens layer 180 . This lens layer will compensate for the cumulative effect of the negative lenses 192 , 194 , 196 , 198 when the user otherwise views light originating from the outside world 144 on the other side of the stacked waveguide assembly 178 . can Further, the compensating lens layer 180 may be designed to compensate for any other optical element that may be provided between the stacked waveguide assembly 178 and the user's eye 58 .

Referring again to FIG. 27 , wavefronts of light output from the stacked waveguide assembly 178 propagate along the visual axis toward the user's eye. In some embodiments, the stacked waveguide assembly 178 outputs a probe beam of light having a planar wavefront as shown in FIG. 27 . The probe beam is transmitted through a beam splitter 2702 provided between the stacked waveguide assembly 178 and the eye 58 . The probe beam then enters the eye 58 and is eventually backscattered by the retina. As the probe beam propagates through the eye, its plane wavefront may be affected by irregularities or imperfections in the optics of the eye 58 . These irregularities or imperfections can also make the fracture surface irregular.

As the backscattered probe beam exits the eye, it is reflected by the beam splitter 2702 towards the wavefront sensor 2710 . 27 , the wavefront exiting the eye may be irregular. The specific shape of the aberrated wavefront depends on the irregularities or imperfections of the eye 58 . The system may include a relay lens system that relays the wavefront to the wavefront sensor 2710 at the approximate pupil plane of the eye. The wavefront sensor 2710 may measure and characterize the shape of the wavefront.

The illustrated wavefront sensor 2710 is a Shack-Hartmann type wavefront sensor (any other type of wavefront sensor may be used). This includes an array of lenses that spatially sample incoming wavefronts from different locations. The wavefront sensor 2710 also includes a detector, such as a CCD or CMOS array, located at one focal length from the miniature lens array. Each miniature lens focuses a point of light on the detector. The exact position of each point on the detector depends on the local curvature of the wavefront at the position of the corresponding miniature lens. Thus, the detector creates an image consisting of an array of points. This image may be analyzed by the processor 2706 to determine the exact location of each point, which in turn represents the wavefront curvature at the location of the corresponding miniature lens. In this way, the processor 2706 can determine the curvature of the wavefront at each spatial location sampled by the miniature lens array. Based on the shape of the measured wavefront, the processor can calculate eye aberrations, including low-order and high-order aberrations. Such aberrations can be numerically represented, for example, by Zernike coefficients.

Once the processor 2706 has determined the aberration of the eye 58 , the measurement may be output in numerical or graphical form, for example. The measurements can be used to determine a treatment regimen for the eye 58 , such as a corrective optics prescription. Aberration measurements of the eye 58 can also be used to control adaptive optics that can be used to project an optically corrected image onto the eye 58 to provide a sharper image to the user. For example, in some embodiments, the processor 2706 may be used to control the shape of the wavefront output by the stacked waveguide assembly when projecting virtual and/or augmented reality images to the eye 58 . In this way, the image presented to the user can be specifically corrected based on the aberrations of the user's eye. If the stacked waveguide assembly 178 is capable of correcting only the lower order aberrations of the eye 58 , different or additional adaptable optical elements may also be provided to correct higher order aberrations. For example, a deformable thin-film mirror whose shape is controlled by electrical signals applied to a plurality of electrodes can be used to correct higher-order aberrations. Such deformable thin film mirrors may be provided in the optical path between light sources 200 , 202 , 204 , 206 , 208 and waveguides 182 , 184 , 186 , 188 , 190 . Many other devices and/or adaptable optics may also be used to correct for lower and/or higher order aberrations of the eye 58 based on measurements from the wavefront sensor 2710 .

The augmented and/or virtual reality system 2700 shown in FIG. 27 may also be configured with a light field camera or bright field microscope that may be used to examine the wearer's eyes. As discussed further herein, this can be done by including lenses that focus the light at or near the miniature lens array shown in FIG. 27 . One advantage of such a device is that the capturing brightfield image can be refocused computationally in another plane at any time after the brightfield has been captured. For example, the device may capture a brightfield image of the wearer's eye. In post-processing, the brightfield image can be focused on the patient's retina to perform retinal examination. The same brightfield image can also be focused on any other anatomy of the eye in post-processing.

Prior art cameras reduce a three-dimensional object to a flat two-dimensional recording of light intensity, detected from object space within the camera field of view. This flattening effect is the result of imaging in which rays originating from different points on the target object within the camera field of view are focused by the lens to a corresponding point on the image plane. Angle information is lost in this process; For example, the light intensity recorded at a given pixel of a prior art image does not represent the intensity contribution of each light beam originating from a corresponding point in the field of view with a different angular orientation. Instead, the intensity measured at each point in the image plane represents the combined intensity of the various rays entering the camera at different angular orientations from the corresponding point in the field of view. Therefore, various characteristics such as depth of field cannot be quantitatively determined from conventional images.

The flattening from 3D to 2D in prior art cameras significantly limits the information content of images. Perhaps the simplest result of this flattening is an ambiguity of depth, in which objects behind and in front of the focal plane become blurred (out of focus).

One method of obtaining information about the angular intensities of light rays with different angular orientations within the field of view is, as shown in FIG. -Hartman) to provide an array-like wavefront sensor. Each miniature lens samples a spatially localized area of the light wavefront entering the instrument from the field of view and makes it possible to record local angular information into the sensor. In this way, the sensor can detect the intensity of each of the light rays reaching each miniature lens from different angular directions. This four-dimensional information of the light intensity at each position (x, y) for each angle (θx, θy) quantifies the brightfield in the field of view of the device.

As described above, the system 2700 shown in FIG. 27 can be configured as a brightfield camera or microscope by including a lens in the optical path of the instrument to focus light in the approximate plane of the wavefront sensor 2710. . The lens may be disposed, for example, between the beam splitter 2702 and the wavefront sensor 2710 , although other locations may also be suitable. The stacked waveguide assembly 178 may be used to provide one or more beams of light to illuminate the eye 58 . This light may be backscattered by the retina towards beam splitter 2702 . The lens may be positioned and configured such that its focal plane is at or near the wavefront sensor 2710 . The wavefront sensor 2710 may collect 4D information of light intensity at each position (x, y) for each angle (θx, θy). This brightfield information may be processed, for example, by the processor 2706 to provide an image focused on a desired plane.

<u>ultrasonic wave</u>

24A schematically illustrates a wearable device 2450 that can be worn by a user 2460 configured to perform an ultrasound examination of the user 2460's eye. The device 2450 includes a frame 2464 attached to a display system 2462 . The display system 2462 may be configured to be positioned in front of the user 2460 eye 2420 . Various embodiments of the wearable device 2450 may include an ultrasound stimulator module that generates an ultrasound-wavefront that provides stimulation to the user's eye 2420 . The ultrasound stimulator module may include a probe 2481 configured to contact a region of the eye (eg, upper eyelid, eye orbit, sclera, cornea, etc.). The probe 2481 may be configured to couple to an ultrasound transmitter 2477 configured to deliver ultrasound energy to the eye, and an ultrasound receiver 2479 configured to receive ultrasound energy reflected and/or scattered from various structures. In some embodiments, the probe 2481 may be configured to be coupled to an ultrasound transceiver 2475 that couples an ultrasound transmitter and receiver. In some embodiments, the ultrasound stimulator module may be configured to deliver ultrasound energy to various portions of the eye without contacting one or more portions of the eye. For example, the ultrasonic stimulator module may include an electromagnetic acoustic transducer (EMAT). The ultrasound stimulator module may include one or more ultrasound transducers configured to convert ultrasound energy reflected and/or scattered from various structures of the eye into electrical signals. The probe 2481 may be configured to receive ultrasound reflected from various regions of the eye as well as to transmit ultrasound to various regions of the eye.

Accordingly, the wearable device 2450 may be configured to measure a response to an applied stimulus and generate images of various structures of the eye. For example, in various embodiments, the probe 2481 may be movable to scan one or more directions. In some embodiments, for example, the probe 2481 may be directed in two or three other potentially orthogonal directions (such as x and y or possibly x, y and z) to produce a two-dimensional or three-dimensional image. can be scanned with In some embodiments, as another example, the probe 2481 may be moved to transmit and receive ultrasound energy at different angles to generate two-dimensional and/or three-dimensional images. Similarly, an ultrasonic sensor that detects ultrasonic energy can be moved or scanned. For example, the ultrasonic sensor may be scanned in two or three different potentially orthogonal directions (such as x and y or possibly x, y and z) to generate a two-dimensional image or a three-dimensional image. An electronic hardware processor 2470, having similar characteristics to the local processing and data module 70 of FIGS. 3A-3C , is configured to examine the various structures of the user's eye 2420 by using ultrasound received from the user's 2460 eye 2420. It can be used to analyze energy.

The wearable device 2450 may generate more accurate results by reducing noise that may be generated due to movement or interference of a clinician. In some embodiments, ultrasound energy may be continuously applied for a given period of time to perform an ultrasound examination. Alternatively, in some embodiments, ultrasound energy may be applied in a predetermined pattern or protocol unique to user 2460 .

The wearable device 2450 may obtain images of various parts of the eye, including the lens, retina, and other structures of the eye, for diagnostic and therapeutic use. For example, low power (e.g. 2 W/cm² Ultrasound energy with less than ultrasound power) and/or low frequency (eg, ultrasound frequency of about 40 kHz or less) may be used to treat glaucoma and/or reduce intraocular pressure (IOP). As another example, about 2 W/cm²High-intensity focused ultrasound (HIFU) with an energy of As another example, 1 W/cm²with a fraction of about 5 W/cm²Ultrasonic energy with a fraction of and a frequency between about 1 MHz and about 5 MHz can be used for cosmetic purposes (eg, promoting collagen production and/or reducing the exposure of fat under the eyes). Ultrasound stimulation can elicit a response in the retina that qualitatively resembles a strong visual response but appears to have a short delay. Various ultrasound frequencies, including high-frequency ultrasound, can be used to accurately identify various ocular pathologies, including retinal detachment. For example, an ultrasound frequency of about 8 MHz can be used to obtain an A-scan of the eye. As another example, an ultrasound frequency of about 10 MHz to 15 MHz may be used to obtain a B-scan of the eye.

24B shows an exemplary flow diagram 2400 of a method of examining an eye using the apparatus 2450 . The method of examining the eye may be executed by an electronic hardware processor 2470 in conjunction with the device 2450 . If the device 2450 detects that the user 2460 has difficulty with vision or a problem with focusing, the device 2450 may be configured to perform an ultrasound examination of the eye. Referring now to FIG. 24B , an exemplary process flow 2400 is disclosed. At block 2402, an ultrasound mode may be initiated. As described above, in various embodiments, a separate ultrasound generator may be connected to the AR device. For example, the ultrasound energy may be generated by an ultrasound stimulator module that includes one or more ultrasound transducers that are integrated with the augmented reality/virtual reality wearable device 2450 when the ultrasound mode is initiated. At block 2404 , an ultrasound protocol is determined for the user. For example, the ultrasound may be delivered continuously, or it may follow a special pattern specific to the user. At block 2406 , an ultrasound wavefront or front face is delivered to the user's eye. In one or more embodiments, the response of the eye is measured as shown in block 2408 . For example, ultrasound reflected from various structures of the eye may be received by a transducer of the ultrasound stimulator module and converted into an electrical signal. This information may be used by the device 2450 to generate or manufacture an ultrasound image. Any abnormality of the eye may be detected by a clinician from the generated ultrasound image or by an electronic processor that may use a pattern matching algorithm to detect the abnormality, as shown in block 2410 .

For example, the acquired ultrasound image may be compared with a stored image accessible by the electronic hardware processor 2470 using a pattern matching algorithm to detect anomalies. The stored image may include an image of a healthy eye, an image indicating characteristics of an eye affected by a specific disease, and/or an image of a user's eye obtained from a past examination. The electronic hardware processor 2470 may be configured to obtain quantitative measurements (eg, volume measurements) of various portions of the acquired image of the user's eye. Quantitative measurements can be passed to a clinician for further analysis. As another example, one or more parameters may be extracted from the acquired image to detect an abnormality. The obtained images and/or quantitative measurements may be used to monitor eye health or disease progression.

24A , the display system 2462 of the device 2450 may include a display lens 2476 mounted to a frame 2464 . In some embodiments, the display lens 2476 may be a single lens comprising two eyepiece areas, each eyepiece area located in front of the user's eye 2420 . In some embodiments, the display system 2462 may include two display lenses mounted to the frame 2464 , each display lens positioned in front of each eye 2420 of the user. includes the eyepiece area. The display device lens 2476 using illumination from the light source 2468 may project the generated ultrasound image to a specific position of the user's eye 2420 . The display lens 2476 may include a plurality of waveguides having characteristics similar to those of the waveguide stack 178 described above with reference to FIG. 10D . In various embodiments, the plurality of waveguides may include diffractive optics configured to couple optical power from the light source 2468 to one or more of the plurality of waveguides. The plurality of waveguides may further include a diffractive optical element and/or a variable focus element configured to out-couple light propagating therein. The diffractive optics and/or variable focus element may be configured to modify the direction of light projected from the focal plane and/or display lens 2476, such that the projected image is from different depth planes and different directions. see. In this way, the 2/3D image may be projected to a desired position of the user's eye. The display lens 2476 may be employed to display the ultrasound image result to the wearer. For example, as described herein, a 2D or 3D image corresponding to an ultrasound image may be provided by projecting light onto the wearer's eye to form an image on the retina.

In various embodiments, the light source 2468 includes a plurality of optical fibers configured to deliver light from a light emitter (eg, laser, LED, flash lamp, super light emitting diode, etc.) to the display lens 2476 . It may include a fiber optic scanning device (FSD). In various embodiments, the FSD may be scanned in various patterns (eg, raster scans, spiral scans, Lissajous patterns, etc.) and velocities. The 2/3D image may also be projected to a desired position of the user's eye by changing the scanning pattern and scanning speed of the FSD. As described above, in some embodiments, the 2D or 3D image projected on the eye of the wearer may correspond to an ultrasound image (eg, using a transducer) obtained using a wearable device.

In various embodiments, the device 2450 may be configured to perform ultrasonic shorthand. For example, the transducer or ultrasound source may be configured to produce high frequency ultrasound waves that are not reflected and absorbed by other structures of the eye and may be collected by the transducer or sensor or FSD.

In various embodiments, the system may be configured to perform auscultation. In various embodiments, for example, the system may include a transducer or sensor that detects and measures ultrasonic energy originating from the eye or the wearer. Such a configuration may be in contrast to a system that includes a transducer that generates ultrasound waves and directs the ultrasound waves to the eye or wearer, and a sensor that detects ultrasound waves reflected from the eye or wearer. The ultrasonic sensor detects or "listens" for ultrasonic energy emitted from the wearer, such as from blood flow through the vasculature of the wearer's eye. In various embodiments, the device 2450 may be configured to transmit and/or receive energy in an audible frequency range. Detecting ultrasound energy in the wearer's vasculature can be used, for example, to perform a complete analysis of blood flow in the fundus of the eye.

In various embodiments of the device 2450, ultrasound signals received from the eye may be analyzed to measure Doppler shifts to measure the velocity of blood flowing in the blood vessels of the retina. The velocity measurement of the prior art using ultrasound is based on the Doppler principle, in which sound emitted from a moving emission source or sound reflected from a moving target shifts the frequency of the sound. This so-called Doppler shift can be measured directly from a signal received via continuous wave ultrasonic emission, also called CW-Doppler, or sampled via radiation of several ultrasonic pulses, also called PW-Doppler.

One of the advantages of ultrasound imaging is that it can measure blood and tissue velocity with high precision and high frame rate. In a diagnostic setting, information on blood velocity can be used to identify abnormal blood flow associated with pathologies, such as jet flow patterns due to heart valve leaks. In addition, information about tissue velocity can be used to quantify the function of the heart through the identification of cardiac muscle regions with reduced contractility. Various embodiments of the device 2450 configured to perform ultrasound examination may include subarachnoid hemorrhage, stroke and carotid-cavernous fistula, ocular abnormalities or ocular murmurs that may be identified as symptomatic atherosclerotic vascular disease. can be detected. The device 2450 configured to perform an ultrasound examination may detect carotid or renal murmur seen in a user with high blood pressure.

The device 2450 may be configured for OCT systems as well as non-health applications (eg, for entertainment such as watching a movie or video, for gaming, for work, etc.). The device 2450 may be configured to perform an ultrasound examination periodically (eg, hourly, daily, weekly, biweekly, monthly, twice a year, annually, etc.). In various embodiments, the device 2450 may be configured to perform ultrasound examinations of the eye 2420 at irregular time intervals. For example, the device 2450 may be configured to perform ultrasound examinations several times an hour, several times a week, several times a month, several times a year, etc. Accordingly, such examinations may be performed 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24 or more times per year. These tests may be performed more frequently if the user has a health problem, or if the device detects that the user has difficulty focusing or has vision problems. The device 2450 may also be configured for use in a physician's office or hospital, such as an ultrasound scan.

<u>electric ophthalmology record</u><u>(</u><u>EOG</u><u>), </u><u>EEG recording test</u><u>(EEG), and </u><u>electroretinography test</u><u>(ERG)</u>

In various embodiments, the wearable augmented reality device may be integrated into a system comprising electrodes and electronic devices configured for EOG (Electrical Ophthalmography), EEG (EEG), and ERG (Retina Electrograms). . 24F, for example, the electrode 2450 may be positioned around the eye and/or over the person's head. In some embodiments, the electrode 2450 may be mounted on a frame of augmented reality head-mounted glasses, for example, glasses. One or more electrodes may be disposed on the inner surface of the glasses. Such electrodes may be located, for example, on the portion of the spectacles that supports the lens (eg, the rim) or temples or earrings, straps or other support members that support the head mounted assembly over the head. Thus, these electrodes may contact the forehead and/or the side of the head, for example above the ear. The electrodes may also be in contact with the eye or face or facial tissue around the eye.

The electrode 2450 may be connected to a wire or lead supported by the frame or body of the eyeglasses and/or may be configured to communicate with the device via wireless technology. Accordingly, the electrode 2450 may be in direct contact with a part of the user's body. The electrode 2450 may also be disposed at a distance from the user's body, and may have a portion of a particular material or device disposed between the electrode 2450 and the user's body, or other suitable for measuring an electrical potential. may be placed in position.

The electrodes may be electrically connected to the local processing and data module 70 , the remote processing module 72 and/or the remote data store 74 in any combination or configuration. A voltage measurement may be taken from electrode 2450 and the potential difference to electrode 2450 may be determined by either the local processing data module 70 or the remote processing module 72 . Alternatively, the potential difference may come directly from the plurality of electrodes 2450 . Additional circuitry may or may not be included on the electrode or between the electrode and the local processing and data module 70 .

The remote processing module 72 may be configured to receive measurements from the electrode 2450 and/or transmit control signals to the electrode either directly or via the local processing and data module 70 . In some embodiments, the local processing and data module 70 may perform some or all of the transmission of control signals and the reception of measurements. Likewise, signal processing of RF signal conditioning and measurement may occur in whole or in part in local processing and data module 70 and/or remote processing module 72 . The measurements and derived parameters of the electrode 2450 may be stored in whole or in part in a local processing and data module 70 and/or a remote data store 74 .

Based on the measurement of the electrical signal originating from electrode 2450, the position of the eye may be determined, and thus the pattern of the eye may be detected. In one or more embodiments, the ophthalmic device and system may be used and configured for electro-ophthalmoscopy (EOG). EOG measures the potential voltage between the Bruchmembrane at the back of the eye and the cornea. One basic application program is to record eye movements. In the case of EOG, a pair of electrodes may be placed on the left and right of the eye and/or above and below the eye, as shown in the example shown in FIG. 24F. In some embodiments, for example, the patient may be placed in a well-lit room such that the pupil of the patient's eye is dilated. When the eye moves towards the electrodes, a potential difference is created between the electrodes and the position of the eye can be determined, thus a measurement of eye movement can be determined. These electrodes may in various embodiments be placed on the inward facing surface of the spectacles or head mounted device. In some cases, such electrodes may be mounted to the cushioned surface of the eyewear. This cushioning surface may be facing inward. These surfaces may allow the electrodes to make contact with the face (front or side), such as the cheek, forehead, or temple. In some cases, electrodes can be attached to the same side (front or side) on the cheek, forehead, or temple and connected to a head-mounted device with a wire or lead. Wireless connections to electronic devices are also possible, as discussed above. For example, any configuration or other electronic device discussed above may be adapted to receive and/or process EOG signals to determine eye movement or other conditions.

In one or more embodiments, the ophthalmic device may also include an EEG sensor for mapping brain activity. Electrodes 2450 may be placed around the user's head and/or over the user's head to measure and compare the potential in this region. Electrode 2450 may be disposed on a helmet, rimmed hat, cap, net, or other housing, frame, or overhead or surrounding surface to facilitate placement on the user's head. can be positioned to do so. In some embodiments, for example, a strap may be placed on the portion of the head and electrode mounted inwardly or underneath to contact the user's head. Electrodes 2450 may be connected via wireless or wired technology, which is then connected to the ophthalmic device. In a particular embodiment, electrode 2450 is disposed on the back of the wearer's head closer to the optic nerve. A strap, frame, or other flexible or rigid member may enable support for one or more electrodes, and the electrodes may be disposed on an interior surface of these members to face and contact the head.

The EEG sensor can detect abnormal activity or patterns in the brain and report it to the user and/or the clinician. This may be particularly useful immediately after brain surgery or in patients at risk. The ophthalmic device can be pre-programmed with an EEG detection module to analyze the data collected by the EEG sensor. For example, the electronic device having the above-described configuration or other configuration may be used to receive and/or process an EEG signal and analyze data collected by an EEG sensor.

In one or more embodiments, the ophthalmic device may be configured with electrodes 2450 disposed around and/or over the user's eye to measure and compare the resting potential of the retina. Electroretinography (ERG) is the retina's bulk electrical response to light stimuli, and can measure the potential of various cell types in the retina. Examples include photoreceptors, inner retinal cells, and ganglion cells. For example, electrode 2450 may be placed over the cornea through a contact lens, between the cornea and the lower eyelid, or inserted into the skin near the eye. However, electrode 2450 may also be placed to record ERG from the skin. The ERG may be placed just above or below the eye, or under the eye next to the outer corner of the eye. Since the skin electrodes are not in contact with the eye, there may be an attenuation of the ERG signal amplitude and may be significant. In various embodiments, averaging and other signal processing techniques may be used to increase the signal-to-noise ratio. The patient's eye can be exposed to stimuli, and electrodes placed on the cornea measure the electrical response of light-sensing cells in the retina located behind the eye. Normally, when light enters the eye, the light is converted into electrical energy by special cells in the retina. Stimuli to the ERG can be flashes or patterns, with or without background lighting or changing colors. Examples include dim blinking (measures photopic and/or scotopic rod cell activity), blinking (measures cone cell activity) and/or pattern stimulation (measures retinal ganglion cell activity). The ERG electrode measures the electrical activity associated with this process. Other recording methods may also be used.

This information can be combined with optical ophthalmography to detect abnormalities in the eye. Such imaging techniques may include those described herein.

This padded surface may be facing inward. These surfaces may allow the electrodes to come into contact with the face (front or side) of the eye or orbital or eye socket, cheek, forehead or temple, or other area. In some cases, the electrode may be attached to the face (front or side) of the eye or orbital or eye socket, cheek, forehead or temple or other area, and may be connected to a head-mounted device by wire. As mentioned above, a wireless connection to an electronic device is also possible. For example, any one or other electronic device of the above-described configuration may be employed to receive and/or process an ERG signal to analyze the signal.

Accordingly, treatment devices as described herein, as well as other imaging and diagnostic devices, may also be included in the system. The wearable augmented reality device may include a virtual reality device and/or an augmented reality device. Electrodes may be included in systems with augmented or virtual reality systems.

Although electrodes have been disclosed, other types of sensors may be used for EEG, EOG and/or ERG. Electrodes 2450 may be electrical conductors capable of measuring a potential and/or may be a special set of electrodes specific for a particular test as described above.

<u>Light Therapy</u>

In one or more embodiments, light therapy may be selectively administered to one or more regions of the user's eye. Phototherapy refers to the selective administration of light (eg, multispectral light, blue light, IR, etc.) for a variety of applications. In some embodiments, the amount of light of one or more wavelengths projected by or transmitted through the display 62 ( FIGS. 3A-3D ) to the user's eyes may be decreased or increased depending on the application.

In some embodiments, the decrease or increase in the amount of light of one or more wavelengths propagating from or through the display to the user's eye may be dynamically adjusted and based on the wavelength of light propagating from the surrounding environment towards the user's eye. and/or may occur in real time based on the content of the image to be displayed to the viewer. Additionally or alternatively, the decrease or increase may be determined based on temporal considerations including time of day, date, time of year, season, and the like. For example, blue light has been found to affect sleep, and display 62 is programmed to adjust the output of blue light at night, or depending on when the user approaches the user's expected time to reach sleep cycle. can be programmed.

As another example, overexposure to blue light has been monitored to specifically damage retinal cells. The ophthalmic system may, in one or more embodiments, be programmed to detect overexposure of blue light through one or more sensors and selectively filter blue light to prevent damage to retinal cells. The one or more sensors may be the camera 16 of FIG. 5 . In some other embodiments, one of the sensors may be a dedicated color sensor facing outward from the frame 108 . Filtering out the blue light reduces the amount of blue light projected by the display system 62 to the user's eyes and/or reduces the amount of blue light that propagates through the display 62 from the surrounding environment to the user's eyes. 62) to filter or block. "Blue light" refers to light of one or more wavelengths perceived as blue by a viewer, and reducing blue light refers to reducing the amount of such one or more wavelengths reaching a user's eyes.

In some embodiments, reducing the amount of light of a particular color projected by display system 62 may be accomplished using a wavelength selective filter (eg, color filter) disposed in the light path to the user's eye. . For example, a filter may be provided at a location where the waveguides 182 , 184 , 186 , 188 , 190 ( FIG. 10D ) receive light from the plurality of displays 200 , 202 , 204 , 206 , 208 . In some embodiments, the filter may be a coating on the surface of the waveguide that receives blue light from the plurality of displays 200 , 202 , 204 , 206 , 208 . In some embodiments, filters can be selectively coupled or uncoupled.

In some embodiments, the amount of light of a particular wavelength (eg, blue light) directed by the display system 62 to the user's eye may be reduced by reducing the intensity of the light source generating the light in these waveguides. For example, in some embodiments, the display device 62 is configured to display a color image using a light source that outputs light of wavelengths corresponding to different component colors (eg, red, green, and blue light). can be configured. When the colors of the different components are combined, a full range color image is formed. In some embodiments, the display device 62 may be configured to reduce the output of the blue light source, for example when the blue light is reduced. For example, local processing module 82 (FIGS. 3A-3C) and/or remote processing module 72 (FIGS. 3A-3D) may cause a blue light source to output less blue light than if it were specified to form a full gamut color image. (eg, by reducing the power supplied to the light source). In some embodiments, the amount of light at other wavelengths may be actively and similarly reduced as desired by using filters and/or reducing light emission of desired wavelengths from the light source.

It will be understood that the decrease in the amount of light of some wavelengths reaching the user's eye may be caused by intensity analysis of the light wavelength of the image content to be projected on the user's eye. The display 62 may be programmed to a threshold, above which the display 62 is programmed to decrease the output level of the selected wavelength. In some other embodiments, the display 62 may simply be programmed to reduce any output of a particular wavelength by a set amount. The specific wavelength and power level may be user selectable or, in some embodiments, programmed by a third party (eg, a health care provider) as part of a treatment protocol.

In addition to or as an alternative to reducing the output of certain wavelengths by the display device 62 , in some embodiments, the display device 62 may include one or more wavelengths of one or more wavelengths transmitted through the display device 62 from the surrounding environment to the user. You can reduce the amount of light. For example, the display 62 may selectively block or occlude certain portions of the user's field of view to reduce the amount of one or more wavelengths reaching the viewer's eye from the surrounding environment. A method and apparatus for blocking a portion of a user's field of view can be found in US Patent Application Publication No. 2015/0205126, which is incorporated herein by reference. In some embodiments, a light sensor, such as camera 16 ( FIG. 5 ), may be used to detect the level and origin direction or location of one or more wavelengths of light incident on display device 62 . This information can then be used to block light from that direction (eg, by activating a switchable element in display 62 ) to reduce the amount of light from that direction reaching the user's eye. In some embodiments, the blocked portion of the user's field of view may be replaced with an image projected by the display device 62 into the user's eye. These projected images may be images of the blocked portion of the user's field of view, but may be wavelengths of light reduced to a lower level than those present in the surrounding environment.

Compared to overexposure, some studies have found that underexposure to general or specific wavelengths of light has a significant impact on patients' circadian rhythms and is associated with depression, sleep disturbances and other psychological problems. To this end, the ophthalmic system may be similarly programmed to detect light of a particular wavelength, for example white light, blue light, or other spectrum of light, via one or more sensors, and put into the user's eye to correct for imbalance. Light may be optionally administered (eg, regular treatment, etc.). Many other similar applications are envisioned. As noted above, the underexposed wavelength of light may be detected using one or more cameras 16 or a dedicated color sensor.

The light may be emitted by any light source (eg, LED, FSD, multicore optical fiber, DLP, OLED, IR light source, etc.). For example, enhancement of one or more wavelengths of light may be achieved by increasing the light output of the light source for light of these wavelengths (eg, by increasing the power supplied to the light source, such as blue light, blue light, etc.). In one or more embodiments, an ophthalmic system including a display device 62 may provide a light emitting module 27 (eg, polypolarized polarized light, laser, light emitting diode) to selectively administer light based on a treatment protocol. , fluorescent lamps, dichroic lamps, full spectrum light, etc.). The light emitting module 27 may function as an auxiliary light source for outputting light of a desired wavelength.

It should be understood that various forms of phototherapy may be administered via an ophthalmic system. Such phototherapy may consist of exposing the eye (or region of the eye) to sunlight or light associated with a specific wavelength. Depending on the patient's symptoms, location, environment (external parameters such as time of day, time of year, date and season), mood, input, or other symptoms of depression or anomalies, the ophthalmic system can determine an appropriate treatment protocol. It will be appreciated that in some embodiments, mood and/or insanity may be detected by an inward facing camera 24 and/or EEG sensor, as disclosed herein.

As for the treatment protocol, light may be administered periodically or continuously for a period of time. In some embodiments, the ophthalmic system may also be configured to determine the wavelength of light to be administered to achieve a desired result. For example, if it is determined that there is a need for cell growth and repair, the ophthalmic system may be configured to administer light of a wavelength corresponding to the red color determined to promote cell growth and repair. Other treatment parameters can similarly be used to determine an effective treatment protocol. For example, in order to treat depression, seasonal affective disorder, treatment and/or reset the day/night jet lag (eg due to jet lag), the display 62 may display a set duration and/or a specific time (eg, due to jet lag). For example, it may be configured to provide the user with full-range spectral light or blue and/or green light for the morning, including before sunrise. Preferably, because the mobility of the display device 62 allows the user to wear it all day long, the user's perception of the length of the day and the timing and duration of night and daylight can be as desired using the system 62 . can be changed. For example, full spectrum and/or blue light may be generated in the morning and/or at night to enhance light from the surroundings to provide the effect of days of different lengths or different hours of daylight. In one or more embodiments, the ophthalmic system may be stored with a phototherapy program to determine an appropriate protocol.

In one or more embodiments, the ophthalmic system may be used to prevent or ameliorate age-related macular degeneration (AMD). AMD is a common eye disease that can cause severe visual loss in a patient's eyes. AMD can affect patients in either a dry form or a wet form. The dry form usually causes gradual loss of vision due to deterioration of the retina. The wet form involves abnormal blood vessel growth under the retina called choroidal neurovascularization (CNV). These abnormal blood vessels can leak fluid and/or blood and adversely affect the visual appearance.

To this end, the ophthalmic system may include one or more components for laser photodynamic therapy to combat AMD and other related diseases. Laser treatment has been proven to be helpful in treating AMD. The ophthalmic system may be configured to localize macular degeneration and to apply laser treatment or laser photodynamic therapy to the areas most affected by AMD or other related conditions. Lasers can be administered to moderate the growth of abnormal blood cells, and in some cases the laser can close or reduce excess blood cells in the wet form of AMD.

In one or more embodiments, photodynamic therapy (PDT) may be used to occlude abnormal blood vessels due to AMD without damaging the overlying retina. The ophthalmic system may include a separate module that injects a photosensitizer (Visudyne) into a vein, which may travel through the bloodstream and collect in abnormal blood vessels under the retina.

The ophthalmic system can then be configured to administer a low-energy laser (eg, via a laser module of the ophthalmic system) to activate the photosensitizer. The activated photosensitizer triggers a chemical reaction that closes the leaking blood vessel.

macular degeneration

In one or more embodiments, the ophthalmic system may be configured to detect, diagnose, and/or compensate for a macular defect. Macular defects (e.g. cavities, cysts, degenerative diseases, etc.) are damage to the tissues in the macula and central part of the retina, resulting in mutations, blind spots, or areas of reduced or insensitivity to light in the user's field of vision. . Common forms of macular degeneration include age-related macular degeneration (AMD), Stargardt's disease, Best's disease and other degenerative conditions. Age-related macular degeneration includes "dry" AMD, characterized by atrophy of the retinal pigment epithelium, and "wet" AMD, characterized by loss of vision due to abnormal blood vessel growth in the retina. A macular defect can lead to a loss of contrast or color sensitivity, as well as an area of reduced sensitivity to light in variations, blind spots, or various parts of the field of vision. Often, anomalies, blind spots, or areas of reduced sensitivity occur near the center of the field of view rather than at the periphery.

The ophthalmic system may be configured to detect or diagnose a macular defect by determining the ability of a portion of the retina to detect an image. In some embodiments, the ophthalmic system may be a user display 62 as shown in FIG. 5 , which is a projection subsystem configured to project light 38 into the wearer's eye to form an image in the eye ( 18). The user indicator 62 includes a display lens 106 that can be mounted to the user's head or eyes by a housing or frame 108 . The display lens 106 may include one or more transparent mirrors or reflective features positioned by the housing 108 in front of the user's eye 20 , reflecting light 38 projected onto the eye 20 . (and also potentially promotes beamforming). These reflective surfaces may be partially transmissive to allow transmission of at least some light from the local surroundings. 10D shows a display device including a plurality of display devices 200, 202, 204, 206, 208 that can be used to inject image information into a plurality of respective waveguides 182, 184, 186, 188, 188, 190. A further illustration of an embodiment, wherein each waveguide may be configured to distribute incident light over the entire length of each waveguide for emission downward toward the eye, as described above. The display devices 200 , 202 , 204 , 206 , and 208 may include an optical fiber scanning device (FSD) for forming an image. Such a device may be configured to project an image onto a portion of the retina.

The system can then detect the user's response. For example, an image may be clearly visible when projected onto a healthy portion of the retina, but not visible when projected onto a defective portion of the retina. In some embodiments, the wearer may automatically or triggered by another user, such as a medical professional, indicate whether the wearer has viewed the image. The user may input a reaction of the wearer through the user interface. In some embodiments, the ophthalmic system uses eye tracking camera 24 or similar detection methods to detect unintended reactions with changes in focus or gaze, or changes in continued eye scanning, without requiring conscious input. Accuracy can be increased by monitoring whether it occurs in response to projections of the same image. The eye tracking camera 24 may be an inward facing (ie, facing the user's eye) camera as shown in FIG. 5 . In some embodiments, the ophthalmic system may prompt the wearer directly to indicate whether the image has been monitored, either by manual input or by consciously directing the wearer's gaze to the image or to a projected virtual button image. The virtual button image may be projected by the display lens 106 and the wearer's button selection may be detected by the eye tracking camera 24 or through gesture recognition.

In some embodiments, the aforementioned tests may be repeated with different images in different parts of the retina or in the same part of the retina to detect areas of macular defects. For example, a specific portion of the retina where the wearer can see an image may be determined to be healthy, but a portion of the retina where the same image cannot be seen may be determined to be deficient. In another example, an image mainly composed of long-wavelength visible light such as red light may be projected first. An image composed of shorter wavelength visible light, such as blue light, can be projected on the same part of the retina, and the wearer's visibility imbalance can indicate the wearer's loss of color sensitivity. In some embodiments, a plurality of images differing in contrast, saturation, hue, intensity, periodicity, or spatial frequency, or any other characteristic, are presented to the wearer at different locations on the wearer's retina to diagnose various loss of sensitivity due to macular defects. can be presented. In order to improve the reliability of the diagnosis of macular defects, retinal images of the wearer may be used in addition to the test results described above. Such images may be obtained by, for example, an ophthalmoscope or funduscope, optical coherence tomography, or various imaging techniques discussed herein.

Examination for macular defects may be performed as individual examinations as needed, or may be performed periodically and/or repeatedly over time. Repeat analyzes can track age-related or other progressive macular defects such as macular degeneration. Thus, the macular defect diagnosis function may be incorporated into a device worn only for ophthalmic diagnosis, or it may be part of a device worn regularly for, for example, entertainment, work or other purposes, so that the examination is automatically performed at regular intervals and/or It can be performed at various times of the day, week, month, year, etc. In some embodiments, the wearer may be notified in advance, such as by an audible alarm and/or a visually displayed message, before an automatic test is performed. The results of the macular defect examination may be evaluated in real time on the device for evaluation and/or diagnosis, or transmitted via the cloud or other network for remote evaluation. A remote assessment and/or diagnosis of a mutation or other macular defect can be transmitted back to the device to enable the treatment or compensation method described below. The unique characteristics of the wearer's eyes can be recorded on the device and used for identification to ensure the security and privacy of the transmitted data. For example, the camera may photograph the iris, and the processor may perform pattern recognition to determine whether the wearer's identity matches the identity of the corresponding person in the test result. The system may display the test result only if the person for whom the test result is displayed is the wearer.

An ophthalmic system could help compensate for macular degeneration by projecting light directly onto the retina and targeting healthy cells, particularly around the macula. By changing the location where the light is projected, the device can selectively direct healthy cells and improve the user's vision. In one or more embodiments, the projection light source comprises a fiber optic scanning device (FSD), such as a fiber optic scanning display, that may be configured to project an image through a waveguide to another portion of the user's eye. The system may include other types of displays that may be configured to selectively project light to different portions of the retina. This technique can be utilized to selectively project pixels of an image onto healthy retinal cells and to reduce, minimize or alter the nature of light projected onto damaged areas. For example, the pixel projected on the abnormal part may be enlarged or brightened. Also, it should be understood that this technique may require correction of the projected image data itself, and that the processor may change the characteristics of the image so that the user does not feel any difference when viewing the image.

In embodiments involving augmented reality devices, the system modifies the wearer's field of view of light from the outside world. Augmented reality systems can detect light entering the device in real-time or near real-time, and can correct some of the light or project additional light to correct the wearer's macular defects. For example, the system can image the outside world using an outward-facing camera. The system may project additional light to project an image of the outside world onto the wearer. A pixel may be selectively projected onto healthy retinal cells, but a pixel projected to a transitional area may be reduced, minimized, enlarged, brightened, or otherwise altered in magnification, intensity, hue, saturation, spatial frequency or other quality. can be The system may also be used to darken a normally bright room and/or to brighten the wearer's night vision when it is difficult to adapt to changes in light conditions due to macular degeneration.

A similar method may be used in a virtual reality system. The virtual reality system may have forward and outward looking cameras that image the outside world in front of the wearer and determine the color of the object. As described above, the virtual reality system may reproduce an image of the external world to the wearer based on the output of the camera looking outward through some modification of brightness, magnification, color, and/or other parameters. For example, the virtual reality system may selectively project image pixels from the outside world to at least partially alleviate the wearer's macular defect.

In an augmented or virtual reality system, the system may use an outward-facing camera to alert the wearer. Alerts may be based on the detection of a hazardous condition that is not visible to the wearer due to a macular defect. The system may determine the presence of an unseen hazard based on a correlation of images, originating from an outward-facing camera, with known macular defect data of the wearer, such as the location of an abnormality on the retina. The system can alert the wearer when a blind spot hazard is detected, such as an incoming object, a hole in the ground, or some other condition. Alerts may include visual, audio or tactile notifications. In case of complete blindness, the system may be configured to detect the presence of the desired item (eg, chair, table, bed, etc.) and provide proximity information to the wearer with an audible notification.

In one or more embodiments, the ophthalmic system may diagnose or evaluate the anatomy of the user's eye to determine the location of macular degeneration. Referring now to FIG. 13 , an exemplary process flow 1300 is provided for diagnosing, detecting, and/or identifying any area of macular degeneration. At block 1302, a macular degeneration diagnosis/assessment program may be initiated. As in many of the embodiments described above, the program may be pre-coded or downloaded into the ophthalmic system. At block 1304, an image is projected via one or more FSDs to a particular portion of the user's eye. For example, an image (eg, a small round dot, a small shape, etc.) is directed to the center of the user's eye (eg, formed in the center of the retina).

At block 1306, the system may receive input regarding the quality of the image via any type of user interface. For example, a user may be asked to rate the quality of an image on a scale of 1 to 10. Or, in other embodiments, an image may be projected with an increase or decrease in the visual stimulus, and the user identifies when the image will appear or disappear from the user's vision, whether the visual stimulus is decreasing, and/or representing movement. Should be. In some embodiments, the system may detect the time required for the wearer to answer, as the wearer may have difficulty viewing the stimulus for a long time to answer. Similarly, many techniques can be used, such as Pelli Robson or sinusoidal grating tests. At block 1308 , based on the received user's input, the system may determine the health of that portion of the user's eye.

At block 1310 , the system may determine if other parts of the eye should be similarly diagnosed and/or evaluated. If the answer is yes, blocks 1304-1308 are repeated. After various other portions of the eye have been similarly examined, at block 1312, the health outcomes for the various portions of the user's eye may be analyzed and any abnormalities may be identified.

In one or more embodiments, the AR system operates like a visuscope that includes a small grid line target for measurement of eccentric fixation. A projection light source (eg, FSD) projects an image onto the patient's retina, and the patient may be asked to monitor the center of the target. The location of the fovea reflex relative to the center of the grid target may indicate whether, and to the extent that the patient has a specific fixation. Similarly, the direction and angle of the eccentric fixation can be determined through the above process.

If it is determined that the user has one or more mutations, the ophthalmic system may be configured to project the modified image onto the user's eye, such that the majority of the image is viewed through healthy surrounding retinal cells and any pixels projected on the mutation are adjusted. can It should be noted that the image to be projected needs to be modified through a predetermined algorithm so that the user sees the image through a healthy cell but does not perceive any change in the image itself.

<u>Contrast test</u>

In one or more embodiments, the ophthalmic system may be configured to test the contrast sensitivity of the wearer. Contrast sensitivity tests can be used to assess the wearer's ability to distinguish different luminances of an image. Controlled sensitivity tests may indicate the presence of conditions such as age-related macular degeneration, amblyopia and/or cataracts.

The ophthalmic system may be configured to perform a contrast sensitivity test by projecting a static or changing image. In some embodiments, the ophthalmic system may be a user display 62 , as shown in FIG. 5 , which is a projecting sub configured to project light 38 to the wearer's eye to form an image in the eye. system 18 . The user indicator 62 includes a display lens 106 that can be mounted to the user's head or eyes by a housing or frame 108 . The display lens 106 may include one or more transparent mirrors or reflective features positioned by the housing 84 in front of the user's eye 20 and configured to reflect the light 38 projected to the user's eye 20 . (also potentially facilitating beamforming). These reflective surfaces may be partially transmissive to allow transmission of at least some light from the local environment. 10D shows a display device including a plurality of display devices 200, 202, 204, 206, and 208 that can be used to inject image information into each of the plurality of waveguides 182, 184, 186, 188, 188, 190. , wherein each waveguide may be configured to distribute incident light over the entire length of each waveguide for emission downward toward the eye, as described above. The display devices 200 , 202 , 204 , 206 , and 208 may include a fiber optic scanning device (FSD) for forming an image. Such a device may be configured to project a static image or a changing image of various contrasts to test the wearer's contrast sensitivity. Such a device may also be configured to simulate foreground and background portions of an image for purposes of contrast sensitivity testing. Foreground and background can be projected from different depth planes or simulated into a single plane. For example, various dark foreground planes may be provided along with a light background plane.

The system can then detect the user's response. For example, the image may be a high-contrast image in which the contrast gradually increases or decreases. In some embodiments using changing images, the wearer automatically or by another user, such as a healthcare professional, indicates when images appear or disappear, and/or whether the wearer can distinguish images of different luminance. can represent In another embodiment using static images, the user may be prompted to display the monitored content of the image, such as visual letters, numbers, shapes or other patterns. The user may input a reaction of the wearer through the user interface. In some embodiments, the ophthalmic system may increase accuracy by using an eye tracking camera 24 or similar detection method to monitor if an involuntary response to image projection, such as a change in focus or gaze or blink, occurs. . Eye tracking and/or head posture measurement may be used to ensure that the image is actually projected onto the desired part of the retina, as well as noise filtering of the measured data. The eye tracking camera 24 may be an inward facing (ie, facing the user's eye) camera as shown in FIG. 5 . In some embodiments, the ophthalmic system may trigger directly on the wearer to indicate when the image was monitored or when the image disappeared, either by manual input or by consciously directing the wearer's gaze to the image or to a projected virtual button image. can The virtual button image may be projected by the display lens 106 and the wearer's button selection may be detected by the eye tracking camera 24 or through gesture or voice recognition. In some embodiments, a combination of eye tracking and gesture recognition may be used to detect a wearer response, eg, the wearer may indicate a response by looking at a button and blinking one or both eyes to select the button.

In some embodiments, the system may use the changing image to evaluate the contrast sensitivity of the wearer. A relatively high contrast image may be projected to the wearer, and the contrast of the image may be gradually reduced. For example, a dark gray image displayed on a white background may gradually lighten until the image becomes white or almost white. The wearer may be prompted to point out when the image can no longer be discerned due to the similarity to the background color. The test may be repeated multiple times with the same or different images to more accurately estimate the wearer's contrast sensitivity. For example, the image may change to a different number/letter/shape each time the image is brightened, and the wearer may be asked to report the number/letter/shape of the image after each change. Color shift and/or glare testing between images (discussed in more detail below) may also be included.

In some embodiments, the system may use static images to evaluate the contrast sensitivity of the wearer. For example, the system may use an image such as a Pelli-Robson contrast sensitivity table. In the Pelli-Robson table, uppercase letters are displayed in multiple lines on a white background. The upper left character is printed in black, each successive line and/or character is printed in a light gray shade, and the lower row and right character are printed in a near white shade. The system may project a pattern of increasing or decreasing Pelli-Robson tables or similar letters, numbers, shapes, or other patterns. The wearer may be asked to provide a response via one of the response methods described above by reading a series of letters or numbers or describing a shape or pattern. The system may then determine the contrast sensitivity of the wearer based on the lowest contrast at which the wearer can accurately detect the presence of letters, numbers, shapes, or other patterns.

Similarly, the system can use a sinusoidal grating image as a static image for contrast sensitivity testing. A sine wave grid image contains a series of blurred parallel bars with lighter and darker shades. The bar may vary in width (ie spatial frequency) along an axis perpendicular to the bar. A series of sine wave gratings with varying contrast amplitudes (ie, the difference in light intensity between the darkest and brightest portions of the image) can be viewed by the wearer. The wearer may be prompted to point out which bars are visible in each image and, if so, which bars are visible. Thus, the system can determine the contrast sensitivity of the wearer to various spatial frequencies. In some embodiments, a sinusoidal grating test may be combined with a glare test. For example, the device may include at least one inward-facing light source directed directly at the eye to simulate a condition of glare to determine the effect of glare on the wearer's contrast sensitivity.

Contrast sensitivity tests may be performed in individual tests as needed, or may be performed periodically or repeatedly over time. Iterative analysis can track progressively decreasing or increasing contrast sensitivity through monitoring or detecting anomalies as well as historical analysis of previous results. Thus, the control sensitivity test function may be integrated into a device worn only for ophthalmic diagnosis, or it may be part of a device worn regularly for, for example, entertainment, work or other purposes, so that the test is performed at regular intervals and/or days, weeks, and/or intervals. , month, year, etc. can be performed automatically at various times. In some embodiments, the frequency of regularly scheduled tests may be automatically adjusted based on trends in control sensitivity test results. If the system detects that the wearer's contrast sensitivity has decreased, the system may initiate further testing or contact the clinician. For example, the system may contact the clinician if it discovers that the wearer has difficulty seeing in dark conditions, or exhibits accommodative/visual instability related to focusing. In augmented or virtual reality systems, the system may use an outward facing camera to alert the wearer. Alerts may be based on detection of hazardous conditions that are not visible to the wearer due to deficiencies in contrast sensitivity. The system may determine the presence of an unseen hazard based on correlation to images from an outwardly looking camera with known wearer's contrast sensitivity data, such as light conditions at a contrast sensitivity reduced by the wearer. During the darkened night state, if a hazard that the wearer may not be able to see, such as an approaching dark object or a hole in the ground, is detected, the system can alert the wearer. Alerts may include visual, audio or tactile notifications.

The system may further provide therapeutic functionality based on detected control sensitivity deficits. For example, after detecting/diagnosing reduced contrast sensitivity, display 62 may simulate contrast-enhanced tinted glasses, such as yellow-tinted glasses. Color simulations may be performed in augmented reality systems by color augmentation or other processing as described elsewhere herein. In a virtual reality system, an outward-facing camera or camera may be used to image the outside world, and a yellow-tint filter may be applied before projecting an image of the outside world to the wearer through a display device.

<u>Visual Fields</u>

In one or more embodiments, the ophthalmic system may be configured to detect, diagnose, and/or compensate for visual field deficits. Visual field testing can be used to detect visual defects in central and/or peripheral vision by analyzing a subject's ability to see fixed and/or moving objects and/or images at various locations in the subject's field of view. Visual field examination may indicate the presence of various conditions such as scotoma, trauma to the cornea, vitreous tears, traumatic cataracts, retinal hemorrhage, retinal detachment, macular degeneration, or retinal hemorrhage (Torsion's syndrome).

The ophthalmic system may be configured to administer visual field examinations by determining the subject's ability to detect images at various locations within the field of view. In some embodiments, the ophthalmic system may be a user display 62 as shown in FIG. 5 , which is a projection subsystem configured to project light 38 to the wearer's eye to form an image in the eye ( 18). The user indicator 62 includes a display lens 106 that may be mounted to the user's head or eye by a housing or frame 108 . The display lens 106 may include one or more transparent mirrors or reflective features positioned by the housing 84 in front of the user's eye 20 , reflecting light 38 projected onto the eye 20 . (and also potentially promotes beamforming). These reflective surfaces may be partially transmissive to allow transmission of at least some light from the local environment. 10D shows a display device including a plurality of display devices 200, 202, 204, 206, and 208 that can be used to inject image information into a plurality of respective waveguides 182, 184, 186, 188, 188, 190. A further illustration of an embodiment is included, wherein each waveguide may be configured to distribute incident light over the entire length of each waveguide for emission downward toward the eye, as described above. The display devices 200 , 202 , 204 , 206 , and 208 may include an optical fiber scanning device (FSD) for forming an image. Such devices may be configured to project still or moving images in a portion of the field of view, such as in the surroundings.

The system can then detect the user's response. For example, an image may be clearly visible when projected onto a healthy part of the field of view, but not visible when projected onto a defective part. In some embodiments, it may be automatically or triggered by another user, such as a healthcare professional, to indicate whether and/or when the wearer viewed the image. The user may input a reaction of the wearer through the user interface. In some embodiments, the ophthalmic system uses eye tracking camera 24 or similar detection methods to detect unintended reactions with changes in focus or gaze, or changes in continued eye scanning, without requiring conscious input. Accuracy can be increased by monitoring whether it occurs in response to projections of the same image. Eye tracking and/or head posture measurements may be used to filter out the noise of the measured data as well as ensure that the image is actually projected onto the desired part of the retina. The eye tracking camera 24 may be an inward facing (ie, facing the user's eye) camera as shown in FIG. 5 . In some embodiments, the ophthalmic system may prompt the wearer directly to indicate whether the image has been monitored, either by manual input or by consciously directing the wearer's gaze to the image or to a projected virtual button image. In some embodiments, the system may require the user to verify characteristics of the image (eg, number, color, letter, shape, etc.) to confirm that the wearer has viewed the image. The virtual button image may be projected by the display lens 106 and the wearer's button selection may be detected by the eye tracking camera 24 or through gesture recognition. The wearer's reaction can also be detected by voice recognition. For example, the system may detect a video, or an audio indication of a wearer viewing one or more features in the video, as described above.

In some embodiments, the system may be used to assess the wearer's perception of vision in the vicinity of the field of view. For example, the system may provide a stationary target stationary near the optical axis. While the wearer's gaze is fixed on the fixed target, the image may be projected onto an outer portion of the display that is outside the wearer's field of view. It can then move inward towards a stationary target until the image comes into view. The wearer may be induced when the target becomes visible, for example by any of the reaction methods described above. In some embodiments, the wearer may be instructed to describe characteristics of the image, such as shape, number of objects appearing, or other characteristics. The test may be repeated in various quadrants or locations around the wearer's field of view, such as left, right, top and/or bottom of the field of view. In embodiments where the ophthalmic system includes an augmented reality system, a physical object, such as a finger or other suitable object, may be used instead of a projected image with a display providing a fixed target.

The visual field examination may be performed as an individual examination as needed, or may be performed periodically and/or repeatedly over time. Repeat analyzes can track the progression of visual field deficits through past analyzes of previous outcomes. Thus, the visual field test function may be integrated into a device worn only for ophthalmic diagnosis, or it may be part of a device worn regularly for, for example, entertainment, work or other purposes, so that the test is automatically performed at regular intervals and/or days. , can be performed at various times of the week, month, year, etc. In some embodiments, the frequency of regularly scheduled exams may be automatically adjusted based on trends in visual field exam results.

In an augmented or virtual reality system, the system may use an outward-facing camera to alert the wearer. Alerts may be based on the detection of a hazardous condition that is not visible to the wearer due to a lack of vision. The system may determine the presence of an unseen hazard based on a correlation of images from the outward looking camera with known visual field data of the wearer, such as the quadrant in which the wearer has reduced peripheral vision. The system can alert the wearer when a hazard is detected in a faulty quadrant, such as an incoming object, a hole in the ground, or other condition. Alerts may include visual, audio or tactile notifications.

<u>laser photodynamics</u><u> cure</u>

In one or more embodiments, the ophthalmic system may be configured to administer laser treatment to the eye of a wearer to treat various eye conditions. For example, the ophthalmic system may include a laser (eg, laser 27; FIG. 5 ), wherein the wearer's eye is exposed to laser light of a selected wavelength and intensity for a specific duration selected to alter ocular tissue. may be exposed.

As an example of a condition that can be treated with laser treatment, an ophthalmic system can be used to prevent or alleviate age-related macular degeneration (AMD). AMD is a common eye disease that can cause severe visual loss in a patient's eyes. AMD can affect patients in either a dry or wet form. The dry form usually causes gradual loss of vision due to deterioration of the retina. The wet form involves abnormal blood vessel growth under the retina called choroidal neuroangiogenesis (CNV). These abnormal blood vessels can leak fluid and/or blood, causing adverse visual effects.

In some embodiments, the ophthalmic system may include one or more components for laser photodynamic therapy to combat AMD and/or other diseases related thereto. Laser treatment has been proven to be helpful in treating AMD. The ophthalmic system may be configured to localize macular degeneration and to apply laser treatment or laser photodynamic therapy to the areas most affected by AMD or other related conditions. In some embodiments, by imaging of the eye (eg, using camera 24 ; FIG. 5 ), and/or by choroidal neurovascularization, which may include imaging of the retina surrounding the retina and tissue surrounding the retina. The location of the macular degeneration can be determined by visual field examination to determine the presence and location of the formation. Once the location of the choroidal neuroangiogenesis is determined, laser light may be selectively applied to that location. Lasers can be administered to alleviate abnormal blood vessel growth, and in some cases, lasers can close or reduce excess blood vessels in addition to removing or destroying other tissues or blood cells in the case of wet-forming AMD.

It should be understood that abnormal blood vessel growth can occur in wet AMD (eg, in the choroid behind the retina, due to choroidal neovascularization or CNV). Abnormal vessels can leak blood/body fluids (including blood cells) into the central visual field. Preferably, exposing the abnormal blood vessel to the laser causes clotting at the exposed site to reduce leakage of fluid from the blood vessel, which in turn can help keep the macula uncovered. Coagulation using a laser can be referred to as laser photocoagulation. Without wishing to be bound by theory, it is believed that the light energy provided by the laser may heat tissue and/or fluid within the blood vessel, which may seal and/or destroy the tissue and/or fluid comprising the blood vessel.

Laser light coagulation can take many forms and can treat a variety of conditions. In some embodiments, the photocoagulation treatment treats retinoblastoma. For example, a laser beam can be aimed through the pupil and focused on the blood vessels that surround and supply the retinoblast tumor, destroying the blood vessels with heat from the beam. As a result, tumor-forming cancer cells starve for nutrients and the tumor can shrink in size or be destroyed.

In some embodiments, laser light coagulation may be a focal photocoagulation in which specific leaking blood vessels in a small area of the retina are identified and sealed, usually near the macula. In some other embodiments, the laser light coagulation method may be a scattering (pan-retinal) light coagulation method. This scattering treatment can be used to slow the growth of new abnormal blood vessels that occur over large areas of the retina. Hundreds of laser burns or exposures can be applied to the retina to prevent blood vessels from growing over relatively large areas.

In one or more embodiments, photodynamic therapy (PDT) may be used to occlude abnormal blood vessels due to AMD without damaging the overlying retina. The ophthalmic system may include a separate module for intravenous infusion of the photosensitizer (Visudyne), or the photosensitizer may be administered separately (eg, by a medical professional). The photosensitizer can then travel through the bloodstream and collect in abnormal blood vessels under the retina.

The ophthalmic system can then be configured to administer a low-energy laser (eg, via a laser module of the ophthalmic system) to activate the photosensitizer. Activated photosensitizers cause a chemical reaction that occludes leaking blood vessels.

In one or more embodiments, the ophthalmic system may include one or more laser modules for selectively administering laser treatment to a user's eye. By determining the presence and/or location of the disease or use, the area in need of treatment can be determined, the treatment protocol can be determined, and the laser can be activated to specifically deliver the laser treatment to a specific area of the eye.

In some embodiments, the ophthalmic system may be configured to deliver visual and/or auditory information to the wearer as part of laser treatment. It will be appreciated that visual information may be displayed on display 62 (FIG. 5) and audible information may be conveyed using speaker 66 (FIGS. 3A-3D).

For example, the ophthalmic system may be configured to provide visual and/or audible instructions to the wearer prior to exposing the laser light to the wearer. In some embodiments, the ophthalmic system is configured to display an image to the wearer as part of laser treatment. In some treatments it may be desirable to direct the viewer's eye in a particular direction, eg, light from a laser may facilitate access to a particular part of the eye and/or maintain the eye in a desired orientation. In such embodiments, the ophthalmic system may be configured to orient the eye by showing an object for the wearer's eye to focus on. The subject may be held in one stable position to facilitate holding the wearer's eyes in a particular orientation. In some other embodiments, the viewed object is movable to facilitate eye movement, such that the eye tracks a predetermined pattern. In some embodiments, the ophthalmic system may issue instructions after the wearer is exposed to light from a laser. For example, the ophthalmic system may display instructions and/or provide audible instructions that the wearer may take various actions, such as to facilitate recovery after laser treatment. As an example, the instruction may include closing the eyelid one or more times for a set duration and blinking a set number of times.

<u>drug administration</u>

As discussed herein, in one or more embodiments, the ophthalmic device may include an augmented or virtual reality system, such as system 62 ( FIG. 5 ) including drug release module 21 . The drug release module 21 may be configured to advantageously deliver a predetermined drug to a user or a wearer of the display system 62 . Dispensing of the drug may optionally be performed based on a predetermined treatment protocol.

For example, the ophthalmic system may be configured to dispense a liquid, such as saline, to the wearer. In some embodiments, the liquid solution may be delivered as a mist furnace (eg, using the outlet 22 in embodiments where one or more of the outlets is a nebulizer), as a mist, as droplets, and/or as a stream of liquid. The size and shape of the opening in the outlet 22, and/or the velocity and pressure of the liquid solution exiting the opening, may be selected to output as a mist, spray, droplet, or flow of liquid as desired for a particular application. In one example, the ophthalmic device may be configured to detect whether the wearer's eyes are dry, and actually discharges the liquid out of the outlet 22 upon detection that the wearer's eyes are dry. For example, the ophthalmic system may be configured to output a haze, such that the haze may be delivered to a patient or a wearer suffering from dry eye.

It should be understood that applying a liquid, such as saline, to the eye may help in the treatment or alleviation of dry eye syndrome associated with a variety of conditions. For example, patients with rheumatoid arthritis may benefit from such fluids, as dryness of the cornea and conjunctiva may be found in such patients. Without wishing to be bound by theory, it is believed that lymphocyte infiltration disrupts the tear-producing glands and causes dryness. As a result, the patient may experience blurred vision and/or a foreign body sensation in or around the eye. Also, severe dryness can permanently damage the cornea. Regular application of a liquid, such as normal saline, to the eye may help alleviate or prevent dryness, thus mitigating the effects of dryness mentioned above. More generally, as discussed herein, application of a liquid can be used to treat the "keratitis sicca" syndrome, which is also present in other connective tissue diseases, such as Sjogren's syndrome and scleroderma. can also be found.

In some embodiments, the degree of dryness can be detected using a fluorescein dye applied to the eye, for example the cornea. It is believed that this dye stains and appears green in areas where eye tissue is damaged by drying, which lacks epithelial cells. In some embodiments, the ophthalmic system is configured to apply a dye to the eye, and a camera on the ophthalmic system can be used to detect staining of ocular tissue, for example, to detect green color of the cornea. The amount of staining detected (eg, the intensity of green) can be correlated with and determined using the amount of liquid applied to the eye, eg, the amount of saline solution applied to address dry eye.

In general, in some embodiments, dry eye can be detected by imaging the eye and detecting signs of dryness or the presence of water. Once the detected parameter reaches a threshold value, the ophthalmic system may be configured to apply a liquid to the eye. For example, multispectral imaging and fuduscope examination of cellular composition and characteristics of the eye can be used. In some other embodiments, dry eye may be detected by using an inwardly-facing camera to detect glare of ocular tissue. When the eye is wet, light is reflected back, and when the eye is dry, there is less reflection. In some embodiments, a camera and eye color sensor may be used to detect redness of the eye or redness of the eye. A level of redness in the eye, or a congested eye, may be interpreted by the ophthalmic system as dry. In some other embodiments, the level of blinking may be used to determine that the user's eyes are dry. For example, a rate or frequency of blinking above a threshold may indicate dryness or other eye irritation, which may cause fluid supply to the eye. In some embodiments, multiple tests or indicators related to drying may be detected together to increase the accuracy of drying decisions.

It will be appreciated that, as disclosed herein, delivery of a drug may be triggered by one or more conditions detected in or around the wearer. In some embodiments, the ophthalmic system comprises one or more sensors that measure one or more of temperature of the wearer and/or the environment, duration since immediately prior delivery of the liquid to the eye, ambient humidity, and number of pollen or particulates. can do. The ophthalmic system can also be programmed with thresholds for various measurements. The ophthalmic system may be further programmed to deliver the appropriate liquid to the eye of the wearer when a certain threshold is exceeded. For example, the presence of a foreign body above a certain threshold (e.g., counting pollen or particulates, or examining a camera of the eye to detect a foreign body in the eye) may be considered an eye irritant, and the irritant by adding saline or water to the eye can be washed off In some cases, a remote database or a database such as a calendar may be referred to confirm or determine the possibility of the existence of a foreign object. For example, pollen from different types of plants may be present at different times of the year, and a user's known sensitivity to a particular type of pollen sets a threshold for drug administration to the eye when that particular pollen is known to be present. It should be understood that the timing can be lowered. At other times of the year, the threshold may be raised by the ophthalmic system. In some embodiments, the presence of chemicals or liquids, such as other irritants, such as chlorine, can be detected or inferred. For example, a user may be determined to be in a chlorinated pool by imaging his/her surroundings and/or detecting the user's location. Upon exiting the pool, the ophthalmic system may be configured to flush the eye to remove the chlorinated water. In another example, a treatment protocol may specify delivery of a liquid a given number of times over a period of time, and the ophthalmic system may be configured to deliver liquid at regular time intervals within that period of time.

In some embodiments, the liquid may be delivered with other types of treatment. For example, phototherapy or laser treatment may be assisted by applying a photosensitive liquid, such as a photosensitive dye, to the wearer. In some embodiments, UV-activated riboflavin treatment for myopia can be performed using vitamin B2 (riboflavin) applied on the cornea, which is applied to the cornea and then UVA (UVA) light is applied to the cornea. Guided into the eye (eg, from an ophthalmic system or an external world light source) for a period of time (eg, 20 minutes) to strengthen, stiffen, and flatten the twisted cornea. The photosensitive liquid may react with applied light to enhance contrast and/or ability to image features of the eye. For example, dyes may selectively accumulate on or in certain materials or structures, such as blood vessels, thereby enhancing the ability of an imager (eg, camera 24 ) to image blood vessels within the eye. . As another example, eye diagnostics may benefit from application of a pupil-dilating liquid to the eye. Dilation may be utilized to better see the interior of the eye.

<u>Other therapeutic platforms</u>

Preferably, the proximity of the ophthalmic system to the user enables the ophthalmic system to administer different types of treatment to the user based on the treatment protocol. Examples of these other types of treatment may include vibration (e.g., facial or cranial massage), sound (e.g. stereophonic sound, etc.), temperature (e.g. cooling, warming means) at specific times, to name a few. have.

To activate these other therapies, referring back to FIG. 5 , in some embodiments, the display device may include an actuator 30 coupled to the distal end 30a configured to contact the wearer to apply vibration therapy to the wearer. have. As shown, the actuator 30 may be mounted on the frame 108 , and the terminal portion 30a may be positioned to contact the wearer's face or skull. The actuator 30 may be configured to move the terminal portion 30a back and forth to provide vibration to the wearer, for example by applying and removing pressure at the point of contact with the wearer. Although a single actuator 30 is shown, the ophthalmic system may include multiple actuators 30 mounted to the frame 108 and/or otherwise attached to the wearer in electronic communication with the ophthalmic system.

Examples of suitable actuators include piezoelectric actuators, which can preferably be made small and capable of generating vibrations over a wide range of frequencies or intervals. Other examples of actuators include eccentric cams, eccentric rotating mass (ERM) vibrating motors (eg, pager motors), and linear resonant actuators (LNAs). In some embodiments, these actuators may be used to cause vibration of the frame 108 , thereby distributing the vibrations to multiple points of contact the frame 108 makes with the wearer, rather than one point of contact with the actuator. In some embodiments, actuator 30 may also be configured to move along two or more axes to provide, for example, brushing or kneading motion at the point of contact with the wearer.

In some embodiments, one or more actuators 30 ( FIG. 5 ) may provide tactile or vibrational therapy to the wearer. For example, the actuator 30 may move to provide vibration at the point of contact with the wearer and/or may vibrate the frame 108 to provide vibration to the wearer via the frame 108 . As another example, as described above, the actuator 30 may be configured to brush or move along the surface of the wearer's face or skull. In some embodiments, the ophthalmic system may be configured such that the actuator 30 applies pressure at a specific location for an extended duration, for example to provide acupressure treatment. In some embodiments, actuator 30 may be configured to emit ultrasound waves that vibrate at ultrasound frequencies to provide non-contact haptic ultrasound treatment.

In some embodiments, the ophthalmic system may be configured to provide thermal treatment to the wearer. With continued reference to FIG. 5 , the display may include a thermostat 29 in communication with a heating/cooling outlet 28 via a connection 28a. In some embodiments, the thermostat 29 may include a cooler having a cooling coil containing a resistive heating filament and/or a refrigerant. In some other embodiments, the thermostat 29 may be a thermoelectric heater or cooler that utilizes a thermoelectric effect to achieve a desired degree of heating or cooling. The thermostat 29 may also include a gas source (eg, compressed air) that delivers the gas to the heating/cooling outlet 28 through the connection 28a. In this configuration, the connection 28a may be a channel or tube and the heating/cooling outlet 28 may be an opening through which gas is evacuated and directed to the wearer, for example to one or more eyes of the wearer. do. The thermostat 29 heats or cools the gas as desired before it is sent to the viewer, such as for certain treatments.

In some embodiments, the connection 28a may be a heat pipe that provides and/or removes heat from the frame 108 , and the heating/cooling outlet 28 is simply a connection between the connection 28a and the thermostat 29 . It may be a point of contact. In such an arrangement, one or more heat pipes may also be arranged along the frame 108 . This arrangement can be used to regulate the temperature of the frame 108, which also allows a temperature-based therapy to be applied around the wearer's eyes. In some embodiments, the thermostat 29 may be integrated into the frame 108 .

In some embodiments, the ophthalmic system may be configured to perform thermotherapy using a heater and/or cooler 29 (FIG. 5). For example, as discussed herein, a stream of heated and/or cooled air (eg, through the heated/cooled outlet 28 ) may be applied to one or more eyes of the wearer. With another thermal treatment, the frame 108 may be heated and/or cooled to bring the viewer's eye and neighboring areas to different temperatures as part of the treatment protocol. In one or more embodiments, the ophthalmic device may also include an EEG sensor 31 ( FIG. 5 ) for mapping brain activity. The EEG sensor 31 may detect an abnormal activity or pattern of the brain and report it to a user and/or a clinician. This may be particularly useful for patients immediately after brain surgery or at risk. The ophthalmic device may be pre-programmed with an EEG sensing module to analyze the data collected by the EEG sensor 31 . Although a single EEG 31 sensor is shown, it will be appreciated that the ophthalmic device may include multiple EEG sensors in contact with the wearer at multiple locations.

In other embodiments, the ophthalmic system may be configured to dispense different types of drugs or therapeutics based on a treatment protocol. Advantageously, the proximity of the ophthalmic system to the wearer allows a variety of other types of treatments to be readily administered to the wearer, including, for example, treatments based on sound and/or temperature, direct physical contact with the wearer. Examples of these other types of treatment include tactile sensations, including vibration (eg, facial or cranial massage), sound (eg, stereophonic sound, etc.), temperature (eg, cooling, warming means) at specific times, to name a few. may include stimulation.

In some embodiments, the ophthalmic system may be configured to perform acoustic therapy on a user using a speaker, such as speaker 66 ( FIGS. 3A-3D ). For example, the ophthalmic system may be configured to deliver stereophonic sound to the wearer's ear via a speaker 66 . A pair of speakers 66 may be provided, one for each ear of the wearer. As another example of acoustic therapy, an ophthalmic system may be configured to direct sound waves into the eye of a wearer. For example, in some embodiments, the ophthalmic system may include one or more speakers or acoustic transducers 67 ( FIG. 5 ). A speaker 67 may be attached to the frame 108 and may be directed towards the wearer's eyes to provide a healthy stimulus to the eye.

It will be appreciated that such therapy may be applied based on a determination of the physical and/or mental state of the wearer. For example, the ophthalmic system may include an EEG sensor 31 , which may be used to detect the presence of a trigger to initiate one of the other therapies. In some embodiments, the EEG sensor 31 may be used to detect electrical activity of the brain indicative of stress. Upon sensing such activity, the ophthalmic system may be configured to apply massage therapy to the wearer for the purpose of reducing stress levels.

In some embodiments, the ophthalmic system may be configured to deliver an alert to a wearer (eg, a patient) as part of delivering a drug to the wearer or as part of another therapy. It should be appreciated that the alerts may be visual or based on other actions perceptible to the wearer, including sound-based alerts, pressure-based alerts and/or temperature-based alerts. For example, an alert may take the form of an audible notification, a tap/pressure on the user by the ophthalmic system, the application or removal of heat, or directing an air flow to the wearer. In one or more embodiments, the patient may receive an alert prompting them to keep their eyes open and/or focus on visual cues while the drug or any of the above therapies is being delivered. In some embodiments, eye opening may be facilitated by displaying the object or image(s) to enable the wearer to fixate. In some other embodiments, the alert may instruct or otherwise encourage the wearer to focus on displayed visual cues. Visual cues may be movable, and tracking of those movement signals by the wearer's eyes may be used to provide these eyes with different orientations and/or fields of view. It will be appreciated that the display system may set a visual alert in any desired plane of depth, such that the alert is clearly seen and/or read without the wearer having to change accommodation and/or viewing angles.

As disclosed herein, the ophthalmic device may be an augmented reality head-mounted ophthalmic system or a virtual reality head-mounted ophthalmic system. It will be appreciated that an augmented reality head-mounted ophthalmic system may be configured to pass light originating from the outside world to the eye of a wearer wearing the head-mounted ophthalmic system. On the other hand, a virtual reality head-mounted ophthalmic system would not be configured to pass light originating from the outside world in front of the head-mounted ophthalmic system into the eyes of a wearer wearing the head-mounted ophthalmic system. can In such a virtual reality system, light originating from the outside world will not form an image of the outside world to the wearer's eyes. Rather, in some embodiments, the image of the outside world visible to the wearer wearing the system is limited to the image displayed by the display of the ophthalmic system.

Referring now to FIG. 25 , an exemplary embodiment 2500 of an ophthalmic system is briefly described. It will be appreciated that other embodiments of the ophthalmic system may include additional components (eg, a light emitting module, an ultrasound module, an imaging module, an electrode, etc.). 25 illustrates the basic structure of an ophthalmic system, it will be understood that other components may be used with the ophthalmic system for other uses. The ophthalmic system generally includes an image generation processor 812 , at least one FSD (or any other spatial light modulator) 808 , a display or image processing circuitry 810 , coupling optics 832 , and at least one and an optical assembly 802 . The system may also include an eye tracking subsystem 808 .

As shown in FIG. 25 , the display circuit includes an image generating processor 812 , a behavior principle chip 818 , a temperature sensor 820 , a piezoelectric actuator/transducer 822 , a red laser 826 , and a blue laser 828 . ), and circuitry 810 in communication with a green laser 830 and a fiber coupler coupling all three lasers 826 , 828 and 830 .

The image generating processor ultimately serves to generate an image to be displayed to a user. The image generating processor may convert an image or video related to therapeutic or diagnostic content into a format that can be projected to a user in 3D. For example, when generating 3D content, it may be necessary to format the virtual content or image so that a part of a specific image is displayed on a specific depth plane and another image is displayed on a different depth plane. Alternatively, all images may be generated in a specific depth plane. Alternatively, the image generation processor may be programmed to feed slightly different images to the right and left eyes so that when viewed together the images are consistent and comfortable to the user's eyes.

In one or more embodiments, image generation processor 812 delivers images and/or light to the optical assembly in a time-sequential manner. A first portion of the virtual scene may be delivered first such that the optical assembly projects the first portion in the first depth plane. The image generation processor 812 may then transfer another portion of the same scene such that the optical assembly projects the second portion in the second depth plane.

The image generation processor 812 may further include a memory 814 , a CPU 818 , a GPU 816 , and other circuits for image generation and processing. The image generation processor may be programmed with desired virtual content to be presented to a user of the ophthalmic system. It should be understood that, in some embodiments, the image generation processor may be mounted on a wearable ophthalmic system. In another embodiment, the image generation processor and other circuitry may be mounted within a belt pack coupled to the wearable optics.

The ophthalmic system also includes coupling optics 832 that direct light from a light modulator (eg, FSD) to the optical assembly 802 . Coupling optics 832 may refer to one or more conventional lenses used to direct light into the DOE assembly. The ophthalmic system also includes an eye tracking subsystem 806 configured to track the user's eyes and determine the user's focus.

In one or more embodiments, software blurring may be used to induce blurring as part of a virtual scene. The blurring module may be part of the processing circuitry in one or more embodiments. The blurring module may blur one or more frame portions of the image data supplied to the DOE. In such an embodiment, the blurring module may blur portions of the frame that are not intended to be rendered at a particular depth frame, or blurring may be used to reduce transitions between depth planes.

<u>camera looking out</u>

As described herein, in some embodiments, the system may include one or more outwardly looking (eg, looking forward) cameras to capture imaging information from the surrounding environment, which imaging information is then may be displayed as an image presented to the wearer of the system. In some embodiments, the image provided to the wearer by the system may be re-rendered to provide a modified image relative to the image originally captured by the camera. The modification may be performed by a processor, eg, an image processor, that receives the image information captured by the camera and processes the image information to include changes that are later communicated to a light modulator that produces the displayed image. In some embodiments, the wearer's view of the world and particular features in that field of view may be modified as desired for diagnostic or therapeutic purposes.

Referring to FIG. 8 , as shown in FIG. 5 , the head-mounted medical system includes one or more outwardly looking cameras 16 (eg, two outwardly facing cameras 16 ) to image the outside world around the wearer. viewing camera). The system may process the image information (eg, image(s)) captured by the camera(s) 16 and re-render the image information for display to the wearer. In some embodiments, the device may project light from the display 108 into the wearer's eyes to project a re-rendered image of the outside world to the wearer.

In some embodiments, in the re-rendering step, the processor may be configured to selectively change characteristics of the image to be displayed to the wearer. For example, the processor may selectively alter a portion of the image based on the distribution of healthy and unhealthy cells in the wearer's retina, eg, such that the portion is projected onto healthy retinal cells, while unhealthy The portion of the image projected onto the retinal cells may be reduced, minimized, enlarged, brightened or otherwise altered in magnification, intensity, hue, saturation, spatial frequency or other quality. Similarly, a desired portion of the image may be modified with magnification, intensity, hue, saturation, spatial frequency, or any other quality necessary to alleviate and/or compensate for any known wearer's ophthalmic condition. The wavefront of the image may also be modified and/or reshaped to alleviate focus-related conditions in some embodiments. In another example, the system may also generally darken a bright room, and/or all or part of a user's view of the world with re-rendered content, which may, for example, reveal a darker or brighter view of the world as desired. By replacing the , it can be used to brighten the field of view of users who have difficulty adjusting to changing light conditions. In another example, the system may modify or shift colors to improve vision of a wearer, including a wearer who is colorblind. It will be appreciated that the system may include an augmented reality display or a virtual reality display, and the re-rendering of image information as disclosed herein can be applied to display content on either type of display.

5 , in some embodiments, the health system may have one or more forward and outward looking cameras 16 that image the outside world around (eg, in front of) the wearer. . The system may be configured to determine various characteristics of the image, such as intensity, color, saturation and/or spatial frequency of the image region. Based on the information captured by the outwardly looking camera 16 , the system may make some modifications to the brightness, magnification, color, wavefront and/or other parameters as described above to the wearer via the display 108 . Images can be processed, re-rendered and played back. In some embodiments, the display device may only project a partial image to the wearer's eyes, which augments the light passing through the display device to the wearer's eye to produce the desired correction. For example, the augmented reality system may shift some colors of the image based on the wearer's known color detection imperfections, as described elsewhere herein. In another example, the augmented reality system may enhance the difference in brightness between two or more portions of an image based on the wearer's known contrast sensitivity deficiencies.

In some embodiments, the display may be a light field display as described herein.

<u>Transmissive and Reflective </u><u>adaptable</u><u> Exemplary system with optics</u>

In one or more embodiments, the ophthalmic system may be configured to include reflective adaptive optics that provide correction for conditions such as spherical aberration, astigmatism, and/or higher order aberration. Some aberrations, such as nearsightedness, farsightedness, astigmatism and/or higher order aberrations, may be corrected by a system comprising transmissive adaptive optics, such as system 2900 shown in FIG. 29A. Treatment of myopia, farsightedness, astigmatism and/or higher order aberrations with transmissive adaptive optics is discussed in greater detail elsewhere herein. The system 2900 of FIG. 29A may be incorporated into any of the wearable augmented or virtual reality devices described elsewhere herein.

In an augmented reality device, system 2900 may include a transmissive variable focus element 2902 (VFE) positioned in the pupil conjugate plane for aberration correction and configured to modify incident light approaching the pupil 2906 of the eye. It may include an adaptable optical element. In some embodiments, light originating from the outside world may be transmitted from the outside world via a transmissive VFE 2902 to the pupil 2906 of the wearer's eye 2908 by a series of lenses 2910 , 2912 , 2914 , 2916 . . Each lens pair 2910/2912, 2914/2916 may form an afocal telescope, and the telescope's input and output may include collimated light. As shown, the transmissive VFE is between two infinitely focused telescopes. In some embodiments, the system includes a relay, and the system may be configured to be telecentric. The optical fiber scanning display 2918 may project additional light to form an augmented reality image in the eye 2908 . A corrective VFE 2902 is positioned between the beam splitter 2922 and the eye 2908 to couple the output beam 2920 of the fiber scanning display 2918 with light incident on the system 2900 from the outside world. Light originating from the optical fiber scanning display 2918 may be projected onto a beam splitter 2922 . Thus, both the light originating from the outside world and the light originating from the fiber scanning display 2918 are potentially to the wearer's aberrations, such as myopia, farsightedness, and/or astigmatism caused by the transmissive VFE 2902 or other adaptive optics. An image from two light sources calibrated with

The reflective system 2901 shown in FIG. 29B may provide the wearer with similar corrections with nearsightedness, farsightedness, astigmatism, and/or higher order aberrations. Rather than the transmissive VFE 2902 shown in FIG. 29A, an embodiment of a reflective system may include a reflective VFE 2926 (eg, a movable thin-film mirror or other deformable mirror). Treatment of myopia, farsightedness, astigmatism and/or higher order aberrations using reflective adaptive optics is discussed in more detail elsewhere herein.

A system that includes a reflective VFE 2926 (eg, a movable thin-film mirror or other deformable mirror) includes lenses 2910, 2912, 2914, and 2916, which may include an afocal telescope. may include many of the same elements as system 2900 of FIG. 29A. The output beam 2920 of the fiber scanning display 2918 may be coupled with light from the outside world at a beam splitter 2922 located in the image conjugate plane 2924 . In some embodiments, the system may include a relay and be configured to be telecentric. A second beam splitter 2928 may be included as shown in FIG. 29B . Light originating from the outside world may be incident on a beam splitter 2928 , where at least a portion is reflected back to a reflective VFE 2926 located at the pupil conjugate plane 2904 . The reflective VFE 2926 may include, for example, a MEMS device or a deformable mirror, as described herein. The corrected wavefront may be reflected through lenses 2914 , 2916 and enter the wearer's eye 2908 at pupil 2906 . The correction applied to the wavefront at the reflective VFE 2926 causes the wavefront to form a normal image of the light from the optical fiber scanning display 2918, although there are high-order aberrations and optics from the outside world, as described herein.

Variations of this design are also possible.

<u>conclusion</u>

As discussed herein, the disclosed head-mounted display may preferably form part of a user wearable diagnostic or health system, which may be used to perform health-related diagnostics, monitoring and treatment for a user. . In some embodiments, health-related diagnosis, monitoring, and treatment may include ophthalmic diagnostics, monitoring, and treatment. However, in the context of the present application, a diagnostic or health system is not limited to ophthalmic applications and may be applied to health-related diagnosis, monitoring and treatment in general.

As discussed herein, a user wearable diagnostic system is provided. The user wearable diagnostic system may include a frame configured to be mounted on a user and an augmented reality display device attached to the frame and configured to indicate an image to the user's eyes. The photo detector may be attached to the frame and configured to detect light reflected from the user's eye. The user wearable diagnostic system also includes a processor configured to perform a health analysis of the user based on the light or other detectable parameters detected by the light detector. Various details of the features mentioned above have been described above, and some of the descriptions are restated below to aid the reader.

In some embodiments, a frame may correspond to frame 64 ( FIGS. 3A-3D ) and the augmented reality display may correspond to display device 62 ( FIGS. 3A-3D ). The augmented reality display device may include a waveguide configured to allow a view of the outside world through the waveguide and form an image by directing light to the user's eye outside the waveguide. The waveguides may be part of a stack of waveguides, and each waveguide of the stack may be configured to output light with a different amount of divergence compared to one or more other waveguides in the stack of waveguides. In some embodiments, waveguides and waveguide stacks may correspond to each waveguide 182 , 184 , 186 , 188 , 190 and stacked waveguide assembly 178 of FIGS. 10D-10E , 27 , and 28A-28G.

It should be appreciated that the display device may be configured to output light to the user or output image information from the user, and to block light originating from the outside world. In some embodiments, the diagnostic system may be configured to perform a health analysis by occluding a specific area of the user's field of view.

In some embodiments, the processor may correspond to a local processing and data module 70 or a remote processing module 72 ( FIGS. 3A-3D ). It will be appreciated that the processor may be configured or programmed to perform any health analysis disclosed herein.

In some embodiments, the photo detector may be an inward-facing (user-facing) image capture device, such as an inward-facing camera. In some cases, the camera may be an infrared camera. The camera may correspond to camera 24 of FIG. 5 in some embodiments. Another example of a photodetector includes the photodetector 2352 of FIGS. 23A and 23B.

The processor may be configured to perform a health analysis using data provided by the light detector, the data derived from detecting light reflected from one or both eyes of the user. For example, the light detector may be configured to track movement of the user's eye. In some embodiments, the user wearable diagnostic system may include a light source configured to emit light toward the user, and the light detector may be configured to detect all or a portion of the emitted light reflected by the user. The light source may be configured to emit light of multiple wavelengths, and the diagnostic system may be configured to change the emitted wavelengths based on characteristics of the user to be imaged. In some applications, the light source may be configured to emit infrared or invisible light, which may have the advantage of allowing imaging of the eye or surrounding tissue without the user seeing it. The light source may correspond to light source 26 of FIG. 5 and/or light source 2354 of FIGS. 23A and 23B in some embodiments. It will be appreciated that a light source may include a plurality of separate illuminators, for example, configured to emit light of different wavelengths if the illuminators are different, and which may be emitted by selectively powering the illuminators.

In some embodiments, the augmented reality display is a fiber optic scanning display comprising optical fibers configured to project light in a pattern to form an image in the user's eye. In some applications, at least some fibers of a fiber optic scanning display may be used as part of a light detector to receive or capture light to image a user's eye. Preferably, light propagation within the optical fiber can occur in multiple directions, and the same optical fiber of a fiber scanning display can be configured to project light into the eye (eg, from a spatial light modulator or directly from a light source) and , receives the reflected portion of the light during health analysis and directs the light, for example, to an image sensor. In some embodiments, the optical fiber scanning display may be configured to vary the wavelength of light projected to the eye, for example by selectively powering a light emitter that projects light into a scanning optical fiber that propagates light to be projected onto the eye. can This change in wavelength and subsequent reflection and detection of these wavelengths of light can preferably be used to provide depth information about the tissue from which the light is reflected. In some embodiments, the optical fiber scanning display may correspond to the display using the optical fibers 352 and 362 of FIGS. 28A and 28B.

The processor may be configured to perform various health analyzes based on reception of the light by the light detector. For example, the photo detector may be configured to monitor the user's eyelids, and the processor may be configured to perform a health analysis based on the eyelid monitoring. As another example, the photo detector may be configured to monitor the pupil of the user, and the processor may be configured to perform a health analysis based on the pupil monitoring.

In some embodiments, the photo detector may be configured to image the fundus of the user's eye. In some health assays, the photodetector may be configured to image microcirculation of the fundus. As mentioned herein, microcirculation abnormalities can represent a variety of health problems that can be detected using information derived from microcirculation imaging. For example, the processor may be configured to analyze brain health and heart health based on information from such microcirculation imaging. In another example, the processor may be configured to detect hypertension based on the imaged microcirculation.

In some embodiments, the processor is configured to: eye movement, eye movement pattern, blinking pattern, eye gaze, fatigue, eye color change, depth of focus of the eye, eye focal length change, eye movement captured by the photodetector, in some embodiments. and may be configured to perform a health analysis using one or more information in fatigue, dry eye syndrome, and hypertension. In some embodiments, pattern recognition may be applied to information received from a photo detector as part of a health analysis.

In some embodiments, the processor may be configured to perform a health analysis by detecting intraocular pressure in the eye. This can be achieved, for example, by projecting light into the eye and using a photodetector to detect the pattern, density or amount of backscattered light received from the eye.

As discussed herein, a user wearable health or diagnostic system may be, for example, a display (eg, display 62 ( FIGS. 3A-3D )) or other light source (eg, light emitting module 27 ). ) (FIG. 5)) can provide light to the user's eyes. In some embodiments, the processor may be configured to perform health analysis by inducing the augmented reality display to provide optical stimulation to the user's eyes.

As discussed herein, the display device may preferably be configured to display an image in another depth plane and/or other location within the user's field of view, which may cause the display device to view the eye in a given depth plane and/or in a given direction. This is what causes the focus and allows it to converge. Some health analyzes may utilize this ability to focus and converge the eye in different depth planes as desired for diagnostic purposes. One or more images may be displayed at various depths and images of one or both eyes focused at these various depths may be captured for health analysis. Additionally or alternatively, an image may be displayed that results in focusing and convergence of the eye in a particular direction and/or plane of depth. This can be used, for example, to obtain a desired field of view of the eye without moving the photo detector.

In some embodiments, the photodetector may include a plurality of photodetectors and the photodetectors may be arranged at different angles to the user. This configuration can be used to capture different fields of view of the eye for health analysis, eg, different simultaneous fields of view. Examples of such photo detectors include photo detector 2352 of FIGS. 23A and 23B.

It should be appreciated that signal noise and/or visual artifacts may be present in images captured by the light detector. The diagnostic system may be configured to track eye movements and reduce signal noise in these images based on the tracked eye movements and/or other body movements such as head movements. For example, eye movement can be used to determine whether a monitored feature is an optical artifact that is only present in a particular field of view or whether a monitored feature is actually present in the eye (and thus present in multiple different visual fields of view). do). It will be appreciated that head movement may be tracked using an accelerometer attached to a head-mounted display system.

It will be understood that, as used herein, imaging and light detection can occur at visible and invisible wavelengths. Examples of invisible wavelength light include infrared light.

It will be appreciated that a variety of other sensors may be provided in the user wearable health system or diagnostic system to perform non-eye diagnostics of the user. Examples of such other sensors include EEG sensors. The processor may be configured to perform a health analysis by detecting brain activity using data obtained from the EEG sensor. In some embodiments, the system is configured to issue an alert triggered by detection of brain activity. Alerts can be issued to either or both the user and the clinician.

In some other embodiments, the other sensor may include one or more sensors selected from the group consisting of a temperature sensor, a pressure sensor, a light sensor, a non-invasive blood glucose sensor, and an ETCO2 sensor.

Other sensors may also include one or more sensors configured to monitor one or more conditions of the user's surrounding environment, and the system may be configured to perform health analysis using data collected by the one or more sensors. For example, the one or more sensors may include a camera configured to image the surrounding environment. The processor may be configured to use information from the camera to identify and analyze food, drugs, nutrients and toxins consumed by the user. In some embodiments, the processor may be configured to associate the identified food, drug, nutrient or toxin with other user health data. In some embodiments, the processor may be configured to determine the head posture of the user based on information received from the camera. The camera may correspond to camera 16 of FIG. 5 in some embodiments.

In some embodiments, other sensors may include one or more of a position and orientation sensor. Examples of position and orientation sensors include accelerometers, GPS sensors, compasses, gyroscopes, inertial measurement devices, and cameras. In some applications, the processor may be configured to perform health analysis by determining ambient information based on the user's location. The processor may be configured to access information characterizing the location and perform state analysis. Examples of information characterizing a location include one or more of pollen count, demographics, air pollution, environmental toxins, lifestyle statistics information from a smart thermostat, or proximity to a health care provider. In some embodiments, the processor may be configured to access a cloud-based database to obtain information characterizing the location. The information characterizing the location may be combined by the processor with information obtained from one or more sensors of the diagnostic system to arrive at a result for a health analysis.

In some embodiments, other sensors may include microphones that may be used to collect information about the surrounding environment and/or information about the user's activities. For example, the microphone may pick up sounds indicative of chewing by the user, and the processor may be configured to determine that the user is actually chewing food. It will be appreciated that food intake may be associated with various changes in physiological status, and the timing of food intake may be a useful variable to consider when diagnosing the various health conditions disclosed herein. In some embodiments the microphone may correspond to the microphone 55 of Figures 3A-3D.

The diagnostic system may also include one or more outputs for providing non-optical stimulation to the user. An example of such an output device includes a speaker, through which the processor may be configured to perform a health analysis by providing an auditory stimulus to the user. As another example, the one or more output devices may include a heater and/or a cooler. The speaker may in some embodiments correspond to the speaker 66 of FIGS. 3A-3D and the heater and/or cooler may correspond to the thermostat 29 of FIG. 5 .

It will be appreciated that the processor is programmable and preferably allows ample room for how the health analysis is performed. For example, the processor may be configured to spontaneously perform health analysis without requiring user or clinician input. Health analysis may optionally be performed in the background while the user is roaming around the day. For example, the diagnostic system may detect a condition (eg, a mental condition and/or a physiological condition) that triggers a health analysis. The system may then perform a health analysis and provide analysis results to the user and/or clinician. Preferably, the automatic detection, analysis and routing of results can provide a biofeedback loop to help address the health condition in real time or with little delay. In some cases, a health analysis may be performed semi-automatically as input from a clinician or user may be useful to guide the health analysis. In another instance, the diagnostic system performs health analysis under the control of a clinician. Such control may be advantageous, for example, if the analysis requires the clinician to obtain judgments or other data about the user independent of the parameters the user wearable diagnostic system can measure. Whether the diagnostic system is configured to perform a health analysis autonomously, semi-automatically, or under the control of a clinician, the system may be configured to provide results of the health analysis to a clinician. Clinicians can then review the results, provide users with additional diagnostic information, and develop treatment protocols.

In addition to performing a one-time health analysis based on current health data, the diagnostic system may be configured to track health data over time. The diagnostic system may be configured to perform a health analysis based on this tracked health data. In some embodiments, the diagnostic system may be configured to compare health data that is now being generated with historical health data. The diagnostic system may be configured to compare the now-generated health data with historical health data and send an alert to the user and/or clinician. In some embodiments, the diagnostic system may be configured to send an alert indicating initiation of a health analysis.

In some embodiments, the diagnostic system may be configured to compare user health data with data obtained from other users or individuals within a population. For example, the diagnostic system may be configured to compare the user's health data to standard data for individuals of a particular age group.

In some embodiments, as disclosed herein, a diagnostic system may include an acoustic emitter configured to emit sound waves to a user, and an acoustic detector attached to the frame and configured to detect sound waves reflected from the user. However, the photo detector may be omitted in some embodiments, and may be retained in other embodiments. The processor may be configured to perform a health analysis of the user based on information detected by the sound detector alone or in conjunction with another sensor such as a light sensor. In some embodiments, the acoustic emitter may be configured to provide ultrasonic stimulation to the user's eye. In some embodiments, the sound emitter may be configured to emit ultrasonic waves, and the sound detector may be configured to detect ultrasonic waves reflected from the user.

As disclosed herein, a user wearable system may be a user wearable health system for performing health treatment protocols on a user in addition to or as an alternative to health analysis. The user wearable health system includes: a frame configured to be mounted on a user; an augmented reality display device attached to the frame and configured to transmit an image to the user's eyes; and a processor instructing the augmented reality display device to perform a user's health treatment protocol. It will be appreciated that the processor may be configured or programmed to perform any health treatment protocol disclosed herein.

As described above, a frame may correspond to frame 64 ( FIGS. 3A-3D ), and the augmented reality display may correspond to display device 62 ( FIGS. 3A-3D ). As also mentioned above, the augmented reality display may include a stack of waveguides configured to provide a view of the outside world and to guide image information to the user's eyes. The processor may also correspond to a local processing and data module 70 or a remote processing module 72 ( FIGS. 3A-3D ).

In some embodiments, the health treatment protocol includes providing health treatment image information to the user through the augmented reality display device. For example, the health treatment image information may include a health alert. In providing such health alerts, in some instances, the user wearable health system may include sensors configured to monitor the physiological response of the user. The processor may receive information from the sensor regarding such physiological response and may be configured to select a health alert based on the information received from the sensor, which may be any of the sensors mentioned herein.

It will be appreciated that the augmented reality display may be configured to display information across multiple depth planes, and the user's eye may focus on one of these depth planes. As a result, the user may not easily see the alert on a plane of depth different from the plane on which the user's eyes are focused. To provide an alert that is more noticeable to the user and does not require the user to refocus the eye to a different depth plane, the health system may include an image sensor configured to detect the depth of focus of the user's eye. Further, the system may be configured to display a health alert on a depth plane corresponding to that depth of focus.

In some cases, the ability of the augmented reality display to project images from the variable focal plane and/or from other directions in the user's field of view may be used as part of a health treatment protocol. In some embodiments, as discussed herein, the augmented reality display may be configured to project an image to the eye to focus the eye in a variable direction or focal plane while a health treatment protocol is being performed.

It will be appreciated that the augmented reality display may have optical power and may modify the path of light incident on the user's eye. In some embodiments, health treatment performed by the health system may include altering the path of light incident to the user's eye based on a prescription for the user's eye.

In some embodiments, the health treatment protocol includes providing ocular stimulation to the user via an augmented reality display. It will be appreciated that some users may have relatively weak and relatively strong eyes. The processor may be configured to provide increased eye irritation to the weak eye as compared to the strong eye of the user. In some embodiments, eye stimulation may include health treatment image information that is selectively directed to the periphery of the user's retina.

As described above, the health system may include an image sensor configured to detect the depth of focus of the user's eye. In connection with providing an eye stimulus, the detected depth of focus may be used by the system to provide the eye stimulus on a depth plane corresponding to the detected depth of focus.

In some embodiments, the health treatment protocol includes providing phototherapy to the user via an augmented reality display. For example, a health system may include a light sensor configured to detect the user's exposure to different wavelengths of light, and the system may be configured to administer light to the user based on the wavelength of light detected by the sensor. . In some cases, the system may be configured to reduce an amount of blue light propagating to the user's eye in response to detecting the overexposure for the blue light, the overexposure corresponding to an amount of blue light that is greater than or equal to a threshold value. The threshold may be set by the user or clinician, or in some embodiments may be determined by an analysis performed by the health system. In some other cases, rather than addressing overexposure, the system may be configured to administer one or more wavelengths of light to the user in response to detecting underexposure to one or more wavelengths of light. As discussed herein, exposure to different wavelengths of light at different times or for different durations can affect a user's circadian rhythm. In some embodiments, the system may be configured to modify the user's circadian rhythm by administering or reducing the amount of light of one or more wavelengths of light propagating to the user's eye. Administering or reducing the amount of light of a specific wavelength may include changing the amount of light of some wavelengths output by the display device and/or changing the amount of light of some wavelengths transmitted to the user's eyes through the display device.

In addition to the circadian rhythm, exposure to light can affect the user's mental state. In some embodiments, the health system may be configured to modify the user's mental state by administering or reducing the amount of light in one or more wavelengths of light propagating to the user's eyes. It will be understood that administering light includes increasing the amount of light of one or more wavelengths and propagating it to the user's eye. Dosing or reducing light may be performed according to parameters sensed by the health system. For example, a health system may be configured to monitor a user's physical condition, environment, mood, or to detect signs of depression or psychosis. Phototherapy may be selected according to the results of detection or monitoring.

In addition to the display providing image information, the user wearable system may include one or more peripheral output devices for providing non-optical stimuli to the user. For example, the one or more peripheral output devices may include a vibrator, and the processor may be configured to perform a health treatment protocol comprising instructing the vibrator to provide a massage to the user. In some embodiments, the vibrator may massage the face or skull. In some other embodiments, the system may be configured to provide haptic feedback or tactile alerts to the user using a vibrator. The vibrator may correspond to the vibrator 30 of FIG. 5 .

In some other embodiments, the one or more peripheral output devices may include a speaker. The processor may be configured to provide instructions to the speaker to perform a health treatment protocol. For example, a stereophonic sound may be provided to the user through two or more speakers, at least one of which may be provided for each ear.

As noted herein, the ability of a health system to be worn periodically for extended periods of time and/or over extended intervals of time may provide the benefit of increasing the efficacy of health treatment protocols. In some embodiments, the health system may be configured to track health data over time. The health system may also be configured to perform an analysis of health data now generated with historical health data and adjust a treatment protocol based on the analysis.

As discussed herein, the health system may be coupled to a remote database. Preferably, such a connection enables adaptation of an existing health treatment protocol and/or acquisition of a new health protocol. For example, the system may be configured to download a health treatment protocol based on the user's condition. The remote database may correspond to the remote data store 74 of Figures 3A-3D.

As discussed herein, a wearable diagnostic system may be worn by a clinician to diagnose a patient. In some embodiments, the wearable diagnostic system includes a frame configured to be mounted to a clinician; an augmented reality display device attached to the frame and configured to transmit an image to the eyes of a clinician; an outwardly looking image capture device configured to image the patient's eye; and a processor configured to perform a health analysis of the patient based on the image of the eye captured by the image capturing device. The diagnostic system may be configured to provide a diagnosis using a stimulus-response-measurement analysis process in which a stimulus is applied to elicit a response in a patient and a response to the stimulus is measured by the diagnostic system. In some embodiments, the outward looking camera is configured to image the interior of the patient's eye.

It will be appreciated that the user wearable diagnostic or health system disclosed herein may provide one or more of the following advantages. In some embodiments, the head-mounted display may display the image in a manner that follows the user's natural accommodative-visual reflex. This may facilitate long-term wear of the device by reducing eye strain and/or discomfort that existing augmented or virtual reality systems may cause. The proximity of the user, particularly the user's eye, and the ability to gather information over an extended period of time of a head-mounted display device may continue to facilitate diagnostic testing and procedures. In some cases, diagnostic tests and treatments may occur continuously or periodically throughout the time the user wears the head-mounted display, which may be several hours or most of a day, spanning multiple days, weeks, months. Or it could be years. Preferably, the ability to collect diagnostic or therapeutic information over an extended period of time can increase the accuracy of diagnosis and efficacy of treatment. In some embodiments, a health or diagnostic system may be further improved by providing a more dynamic analysis of his/her diversification in different environments than when the user is sitting statically or stressed in the clinician's office. This is because the data was collected while walking around performing activities during the day.

In some embodiments, the head-mounted display system provides more information about a particular parameter (e.g., by detecting this information multiple times over an extended time frame of days, weeks, months, or years as noted above). ), and more diverse information. For example, as disclosed herein, a head-mounted display system may include a plurality of sensors including a sensor for monitoring a user and a sensor for monitoring a surrounding environment. It will be appreciated that a sensor that monitors the surroundings may include an outward looking camera (eg, camera 16 ( FIG. 5 )). In addition, the health or diagnostic system may include the ability to communicate electronically with external information sources such as location sensors (eg, GPS sensors) and remote data storage 74 . In some embodiments, the remote data store 74 may be a cloud-based database and communication may be performed over a network, such as over the Internet. As discussed herein, the system may detect the user's location, eg, obtain information characterizing the surrounding environment from a remote data repository. This information may include pollen counts, pollution, demographics, environmental toxins, indoor climate and air quality conditions, lifestyle statistics, proximity to health care providers, and the like.

The head-mounted display system relates to any type of diagnostic information and/or other information, such as information about other physiological parameters of the user, information about the surrounding environment, or temporary information such as time or date; The results of the various diagnostic assays disclosed herein may be accepted. For example, this other information may be analyzed locally by the system or remote processing device to determine whether the results of the diagnostic analysis depend on some of this other information. In some other embodiments, the occurrence of a particular diagnostic outcome may be correlated with the occurrence of a particular ambient condition. This correlation can be used to develop treatment protocols. When a particular environment and/or an object or condition within the environment is known to cause an adverse physiological response, the head-mounted display system may warn of possible adverse effects and/or recommend an environment, condition, and/or object to be avoided. may be configured to display. For example, a camera on a head-mounted display system may be configured to detect restaurant menu items (eg, using text recognition to read the menu), which in the past have caused a deleterious physiological response to the user. It can display warnings about items known to be known or related to. Additionally, the system can recognize items ingested by the user (eg, through image recognition, through recognition of identifiers such as words or symbols on a food package, etc.), and the user's subsequent It can be configured to correlate with a physiological response. In another example, an inward-facing camera may detect eye fatigue at the end of prolonged eye strain and alert the user to eye irritation associated with causing eye strain. can do.

Further, the local system or remote processing device may have access to diagnostic information and/or results for multiple users, wherein the user's diagnostic results are compared to other users' diagnostic results to link or link to any such other piece of information. The correlation can be further verified.

It will be appreciated that the user wearable health or diagnostic system disclosed herein may provide a user with access to sensitive personal health information. In addition, any misattribution of user information may adversely affect the efficacy of the treatment provided to the user and the accuracy of the user's future health analysis results, particularly where such health results are derived from historical data analysis. For example, when the system obtains data about the current user of the system, but relates this information to other users' historical data, for example through system errors or impersonation of a particular user by another user, personal information misattribution of may occur. Consequently, in some embodiments, the user wearable health or diagnostic system is configured to determine or authenticate the identity of the user prior to performing any of the monitoring, diagnosis or treatment disclosed herein. Such authentication may include entering a simple password or entering other security information by the user.

In some other embodiments, in addition to, or in lieu of, entry of security information by the user, authentication may be performed using biometric data. Such biometric data may include, for example, fingerprint scanning, iris scanning, or pupil scanning.

In some embodiments, an inwardly facing camera, such as one or both of cameras 24 (FIG. 5), may be used as an iris scanner for iris recognition of one or more eyes of a user. Preferably, the iris comprises a unique set of features that are stable over time and unique to each individual. As a result, a set of features that can define a unique pattern can be used to identify an individual, often with greater accuracy than fingerprints. This set of features may be captured by an inward-facing camera, for example as part of a captured iris image, and the health or diagnostic system may be used to detect if there is a unique set of iris features matching the user's set of iris features. You can analyze the video. If the user's unique set of iris features is found to exist, the health or diagnostic system records the match, and it is determined that the user is actually wearing the health or diagnostic system. The system can then perform monitoring, diagnosis or treatment related to that user.

In some other embodiments, the facing camera may be used as a retina scanner for one or more eyes of a user. Such retinal scans may include an infrared emitter (eg, light source 2668; FIG. 24C) configured to direct light to the user's eye. It should be understood that the pattern of blood vessels in the user's retina is unique and typically does not change over time, and that blood vessels reflect a different amount of infrared light than the surrounding tissue. The unique pattern formed by the different light reflections can be detected by the camera. If the detected retinal pattern is found to match the user's stored retinal pattern, the health or diagnostic system provides a signal indicative of the match, and it is determined that the user is actually wearing the health or diagnostic system. As above, the system may perform monitoring, diagnosis or treatment related to its user.

In some embodiments, multiple authentication protocols may be performed prior to performing monitoring, diagnosis or treatment to provide an enhanced level of security. For example, both iris and retina scanning can be performed. Preferably, the user wearable health or diagnostic system may already include the necessary ophthalmic hardware (eg, light source and eye imager) to perform the desired eye-based authentication.

The user wearable health or diagnostic systems disclosed herein may provide a variety of other benefits. For example, the integration of a single display configured for medical diagnosis and treatment may provide a user with a feedback loop that facilitates treatment. In some cases, real-time alerts may be displayed to facilitate treatment protocols by continuously monitoring the user's health and/or environment, and to increase the likelihood that protocols based on behavior modification will be successfully implemented.

Each of the processes, methods, and algorithms described herein and/or depicted in the drawings may be embodied, and may be embodied in one or more physical computing systems, hardware computer processors, special purpose circuits (ASICs), and/or specific and specific computer instructions. It will be understood that may be fully or partially automated by code modules executed by electronic hardware configured to execute For example, a computing system may include a general-purpose computer (eg, a server) programmed with specific computer instructions or special-purpose computers, special-purpose circuitry, and the like. Code modules can be compiled and linked into executable programs, installed in dynamic link libraries, or written in an interpreted programming language. In some embodiments, certain acts and methods may be performed by circuitry specific to a given function.

Further, certain embodiments of the functionality of the present disclosure are sufficiently mathematically, computationally or technically complex to provide substantial results, for example, due to the amount or complexity of the computations involved, or in real time; Special purpose hardware or one or more physical computing devices (with appropriate special executable instructions) may be required to perform the functions. For example, a video may include many frames with millions of pixels, requiring specially programmed computer hardware to process the video data to provide the desired image processing task or application in a commercially reasonable amount of time.

A code module or data of any type may be a hard drive, solid state memory, random access memory (RAM), read-only memory (ROM), optical disk, volatile or non-volatile storage, combinations of the foregoing and/or the like. and the like. In some embodiments, the non-transitory computer readable medium may be part of one or more of the local processing and data module 70 , the remote processing module 72 , and the remote data store 74 . The methods and modules (or data) may also include data signals (eg, carrier waves) or other analog or digital propagated signals generated on various computer-readable transmission media, including wireless-based and wired/wireless communications. as part), includes wireless-based and wired/cable-based media, and can take a variety of forms (e.g., as part of a single or multiplexed analog signal, or as multiple individual digital packets or frames). ). The results of the disclosed processes or process steps may be stored on a tangible computer storage device, non-transitory in any form, permanently or otherwise, or communicated via a computer-readable transmission medium.

Any process, block, state, step or function of the flowcharts described herein and/or illustrated in the accompanying drawings is one or more steps for implementing a particular function (eg, logical or arithmetic) or process. It should be understood as potentially representing a code module, segment, or portion of code that contains executable instructions. Various processes, blocks, states, steps or functions may be combined, rearranged, added, deleted, modified or otherwise altered from the example provided herein. In some embodiments, additional or other computing systems or code modules may perform some or all of the functions described herein. The methods and processes described herein are not limited to any particular sequence, and the blocks, steps, or states related thereto may be performed in any other sequence as appropriate, for example, in series, parallel, or otherwise. Tasks or events may be added to or removed from the disclosed exemplary embodiments. Also, the separation of various system components in the embodiments described herein is for illustrative purposes and should not be construed as requiring such separation in all embodiments. It should be understood that the program components, methods, and systems described may generally be integrated together in a single computer product or packaged into multiple computer products.

In the foregoing specification, the present invention has been described with reference to specific embodiments. However, it will be apparent that various changes and modifications can be made therein without departing from the broader spirit and scope of the invention. For example, in addition to scanning a fiber optic display (FSD), it will be appreciated that the projected light and image for the embodiments disclosed herein may be provided by other types of displays. Examples of these other types of displays include liquid crystal displays, micro-mirror-based displays (eg, DLP displays), and OLED displays.

In some embodiments, in addition to or as an alternative to applying a liquid to the eye, a solid state material, such as a powder or powdered drug, may also be delivered to the eye by the ophthalmic system.

Accordingly, the specification and drawings are to be regarded in an illustrative rather than a restrictive sense.

Indeed, it will be appreciated that the systems and methods of the present disclosure each have innovative aspects, no single one of which is solely responsible or required for the desirable attributes disclosed herein. The various features and processes described above may be used independently of one another, or may be combined in various ways. All possible combinations and subcombinations fall within the scope of this disclosure.

Certain features that are described herein in the context of separate embodiments may also be implemented in combination in a single embodiment. Conversely, various features that are described in the context of a single embodiment may also be implemented in a complex embodiment individually or in any suitable subcombination. Moreover, although features may be described and even initially claimed to work in a particular combination, one or more features resulting from a claimed combination may in some cases be eliminated from the combination, wherein the claimed combination is a sub-combination or sub-combination or sub-combination. It can be induced by variants of combinations. No single feature or group of features is necessary or essential for each and every embodiment.

Headings are used as organizational aids for the reader throughout this application. These headings may group together examples of methods, devices, and structures that may be generally related to the particular subject matter recited in the heading. However, while various features discussed under a heading may relate to a particular subject, it is understood that a feature discussed under a given heading indicates that its applicability is limited to only one or several subjects listed in that heading, It should be recognized that no For example, the heading may be labeled "Myopia/ Farsightedness/ Astigmatism". However, the topics contained under this heading are equally applicable to the topics contained in any other section, such as those contained under the headings of "Presbyopia," "Retinoscopy", "Automated Refractive Inspector" and other sections. Alternatively, the topics of other sections may also apply to the "Myopia/Farsightedness/Astigmatism" section.

Indeed, as shown in various shapes (eg, FIG. 5 ), structures for various health analysis and/or treatment may coexist in the same health system. Also, as disclosed herein, the same features may be applied to facilitate multiple health analyzes and/or treatments. For example, constructs used for drug administration can also be used for a variety of diagnostics as disclosed herein. Consequently, health systems in accordance with some embodiments may include various combinations of structural features disclosed herein, including combinations of features disclosed under different headings. In addition, the health system may be configured to perform various combinations of health analyzes and treatments disclosed herein, including those disclosed under other headings.

There are others, but among others "can", "could", "might", "may", "for example (eg, )" as used herein, unless specifically stated otherwise, or understood differently from usage in context, generally particular embodiments include particular features, elements, and/or steps while other embodiments It should be recognized that we are trying to convey that we do not include Accordingly, such conditional language indicates that a feature, element and/or step is in any way required for one or more embodiments, or that one or more embodiments, with or without input or prompting from the author, indicate such features, elements and/or steps. Whether a step is included or implemented in any particular embodiment is not intended to generally imply that it necessarily includes logic for determining. The terms "comprising," "including," "having," and the like, are synonymous and are used in an inclusive manner in an unrestricted manner and do not exclude additional elements, features, acts, acts, and the like. Also, the term "or" is used in an inclusive sense (not in an exclusive sense), e.g., when used to link a list of elements, the term "or" means one, some, or all of the elements in the list. element means. Also, as used herein and in the appended claims, the phrases "a, an" and "the" should be construed to mean "one or more" or "at least one," unless otherwise specified. do. Similarly, although various acts may be shown in the figures in a particular order, it is understood that such acts need not be performed in the specific order or sequential order shown, or that not all acts shown need be performed in order to achieve the desired acts. that should be recognized Furthermore, the drawings may schematically depict one or more example processes in the form of flow diagrams. However, other operations not shown may be incorporated into the exemplary methods and processes shown schematically. For example, one or more additional operations may be performed before, after, concurrently with, or between any operations shown. Also, the operations may be rearranged or rearranged in other embodiments. Multitasking and parallel processing can be advantageous in certain situations.

Moreover, the separation of various system components in the above-described embodiments should not be construed as requiring such separation in all embodiments, and the described program components and systems are generally not to be integrated together into a single software product or multiple software products. It should be understood that possible Also, other embodiments are within the scope of the claims below. In some cases, the actions recited in the claims may be performed in a different order, in which case the desired results may still be obtained.

Accordingly, the claims are not intended to be limited to the embodiments shown herein, but are to be accorded the widest scope consistent with this disclosure, the principles and novel features disclosed herein.