Method and system for detecting, characterizing and monitoring optic nerve diseases

• US 4,826,308 A
• Filed: 12/31/1985
• Issued: 05/02/1989
• Est. Priority Date: 12/31/1985
• Status: Expired due to Fees

• Current Assignee: University of Southern California
• Original Assignee: University of Southern California
• Inventors: Sadun, Alfredo A.
• Primary Examiner(s): Kyle, Deborah L.
• Assistant Examiner(s): Carone, Michael J.
• Application Number:
  US06/815,216
• Time in Patent Office: 1,218 Days
• Field of Search: 351/49, 351/215, 351/232, 351/234, 351/235, 350/407
• US Class Current: 351/49
• CPC Class Codes: A61B 3/024 for determining the visual field, e.g. perimeter types
• CPC Class Codes: A61B 3/063 for testing light sensitivity, i.e. adaptation
• CPC Class Codes: A61F 2009/0043 by supporting the instrument on the patient's head, e.g. head bands

Abstract

A method and system are provided for detecting, characterizing and monitoring eye diseases and, particularly, optic nerve diseases, by determining the difference in relative brightness sensed by the two eyes. The method utilizes eyeglasses having a pair of cross-polarizing lenses selectively adjustable for blocking or admitting light into each eye. The patient observes an illuminated test object while looking through the eyeglasses at maximum luminance. By adjusting the relative polarization of the lenses for the eye in which the test object appears the brightest, while occluding the other eye, the amount of brightness sensed by that eye can be compared to the other eye. If there is a disparity in brightness-sense between the eyes within certain pre-established ranges, the nature of the eye disease can be detected and specifically characterized, and its progression or resolution can be monitored.

Claims

1. A method of detecting eye disease in a patient by determining the difference in relative brightness sensed by the two eyes, using eyeglasses of the type having a polarized inner lens mounted against rotation in front of the oculars of the eyeglasses, and a pair of polarized outer lenses mounted for rotation with respect to and in visual alignment with the oculars, the inner lens and outer lenses having their polarizing gratings in parallel for maximum light transmission when the outer lenses are at zero degrees rotation with respect to the inner lens, and the polarizing gratings being orthogonal for minimum light transmission when the outer lenses are at ninety degrees rotation with respect to the inner lens, said method comprising the steps of:

(a) providing an illuminated object for viewing;

(b) setting the outer lenses at zero degrees rotation with respect to the inner lens to permit maximum light transmission to the eyes;

(c) positioning the eyeglasses in front of the patient'"'"'s eyes;

(d) alternately occluding the eyes to identify the eye in which eye the illuminated object appears brighter, this eye being referred to as the unaffected eye and the other eye being referred to as the affected eye;

(e) rotating the adjacent outer lens for the unaffected eye away from zero degrees rotation with respect to the inner lens to decrease luminance until the illuminated object is sensed by the patient as being substantially equally bright in both eyes;

(f) quantifying the amount of rotation of the outer lens for the unaffected eye to thereby determine the amount of reduced brightness-sense of the affected eye as compared with the unaffected eye; and

(g) correlating the amount of reduced brightness-sense of the affected eye with one or more categories of eye disease in accordance with the following table as an indication of eye diseases afflicting the affected eye;

space="preserve" listing-type="tabular">______________________________________ AMOUNT OF RE- DUCED BRIGHT- NESS-SENSE OF TYPE OF AFFECTED EYE OTHER EYE DISEASE (%) CONSIDERATIONS ______________________________________ No disease 80-100 No significant inter-eye brightness-sense disparity Optic neuritis 2-40 Brightness-sense (recent onset) increase over next 4-8 months Optic neuritis 25-75 20/20 vision;

no change (old/resolved) in brightness-sense Anterior ischemic 15-45 Accompanied by optic neuropathy altitudnal visual field loss Compressive optic 1-35 Brightness-sense neuropathy reduction over next several months Retinal diseases 80-100 Accompanied by poor (non-macular) visual acuity Retinal diseases 35-85 Accompanied by poor (macular) visual acuity Cataracts 80-100 No significant inter-eye brightness-sense disparity ______________________________________

2. A method of detecting eye disease in a patient by determining the difference in relative brightness sensed by the two eyes, using eyeglasses of the type having a polarized inner lens mounted against rotation in front of the oculars of the eyeglasses, and a pair of polarized outer lenses mounted for rotation with respect to and in visual alignment with the oculars, the inner lens and outer lenses having their polarizing gratings in parallel for maximum light transmission when the outer lenses are at zero degrees rotation with respect to the inner lens, and the polarizing gratings being orthogonal for minimum light transmission when the outer lenses are at ninety degrees rotation with respect to the inner lens, said method comprising the steps of:

(a) providing an illuminated object for viewing;

(b) setting the outer lenses at zero degrees rotation with respect to the inner lens to permit maximum light transmission to the eyes;

(c) positioning the eyeglass in front of the patient'"'"'s eyes;

(d) alternately occluding the eyes to identify the eye in which eye the illuminated object appears brighter, this eye being referred to as the unaffected eye and the other eye being referred to as the affected eye;

(e) rotating the adjacent outer lens for the unaffected eye away from zero degrees rotation with respect to the inner lens to decrease luminance until the illuminated object is sensed by the patient as being substantially equally bright in both eyes;

(f) quantifying the amount of rotation of the outer lens for the unaffected eye to thereby determine the amount of reduced brightness-sense of the affected eye as compared with the unaffected eye; and

(g) characterizing the amount of reduced brightness-sense of the affected eye in the range of approximately 80 to 100 percent of the unaffected eye as an indication for the absence of optic nerve disease.

3. A method of detecting eye disease in a patient by determining the difference in relative brightness sensed by the two eyes, using eyeglasses of the type having a polarized inner lens mounted against rotation in front of the oculars of the eyeglasses, and a pair of polarized outer lenses mounted for rotation with respect to and in visual alignment with the oculars, the inner lens and outer lenses having their polarizing gratings in parallel for maximum light transmission when the outer lenses are at zero degrees rotation with respect to the inner lens, and the polarizing gratings being orthogonal for minimum light transmission when the outer lenses are at ninety degrees rotation with respect to the inner lens, said method comprising the steps of:

(a) providing an illuminated object for viewing;

(b) setting the outer lenses at zero degrees rotation with respect to the inner lens to permit maximum light transmission to the eyes;

(c) positioning the eyeglasses in front of the patient'"'"'s eyes;

(d) alternately occluding the eyes to identify the eye in which eye the illuminated object appears brighter, this eye being referred to as the unaffected eye and the other eye being referred to as the affected eye;

(e) rotating the adjacent outer lens for the unaffected eye away from zero degrees rotation with respect to the inner lens to decrease luminance until the illuminated object is sensed by the patient as being substantially equally bright in both eyes;

(f) quantifying the amount of rotation of the outer lens for the unaffected eye to thereby determine the amount of reduced brightness-sense of the affected eye as compared with the unaffected eye; and

(g) characterizing the amount of reduced brightness-sense of the affected eye in the range of approximately 2 to 40 percent of the unaffected eye, when accompanied by an increase in the amount of brightness-sense of the affected eye over approximately the next 4 to 8 months, as an indication for optic neuritis of recent onset.

4. A method of detecting eye disease in a patient by determining the difference in relative brightness sensed by the two eyes, using eyeglasses of the type having a polarized inner lens mounted against rotation in front of the oculars of the eyeglasses, and a pair of polarized outer lenses for rotation mounted with respect to and in visual alignment with the oculars, the inner lens and outer lenses having their polarizing gratings in parallel for maximum light transmission when the outer lenses are at zero degrees rotation with respect to the inner lens, and the polarizing gratings being orthogonal for minimum light transmission when the outer lenses are at ninety degrees rotation with respect to the inner lens, said method comprising the steps of:

(a) providing an illuminated object for viewing;

(b) setting the outer lenses at zero degrees rotation with respect to the inner lens to permit maximum light transmission to the eyes;

(c) positioning the eyeglasses in front of the patient'"'"'s eyes;

(d) alternately occluding the eyes to identify the eye in which eye the illuminated object appears brighter, this eye being referred to as the unaffected eye and the other eye being referred to as the affected eye;

(e) rotating the adjacent outer lens for the unaffected eye away from zero degrees rotation with respect to the inner lens to decrease luminance until the illuminated object is sensed by the patient as being substantially equally bright in both eyes;

(f) quantifying the amount of rotation of the outer lens for the unaffected eye to thereby determine the amount of reduced brightness-sense of the affected eye as compared with the unaffected eye; and

(g) characterizing the amount of reduced brightness-sense of the affected eye in the range of approximately 25 to 75 percent of the unaffected eye, when accompanied by substantially normal vision for the patient and no substantial change in the amount of brightness-sense of the affected eye over approximately the next several months, as an indication for optic neuritis that is old or resolved.

5. A method of detecting eye disease in a patient by determining the difference in relative brightness sensed by the two eyes, using eyeglasses of the type having a polarized inner lens mounted against rotation in front of the oculars of the eyeglasses, and a pair of polarized outer lenses mounted for rotation with respect to and in visual alignment with the oculars, the inner lens and outer lenses having their polarizing gratings in parallel for maximum light transmission when the outer lenses are at zero degrees rotation with respect to the inner lens, and the polarizing gratings being orthogonal for minimum light transmission when the outer lenses are at ninety degrees rotation with respect to the inner lens, said method comprising the steps of:

(a) providing an illuminated object for viewing;

(b) setting the outer lenses at zero degrees rotation with respect to the inner lens to permit maximum light transmission to the eyes;

(c) positioning the eyeglasses in front of the patient'"'"'s eyes;

(d) alternately occluding the eyes to identify the eye in which eye the illuminated object appears brighter, this eye being referred to as the unaffected eye and the other eye being referred to as the affected eye;

(e) rotating the adjacent outer lens for the unaffected eye away from zero degrees rotation with respect to the inner lens to decrease luminance until the illuminated object is sensed by the patient as being substantially equally bright in both eyes;

(f) quantifying the amount of rotation of the outer lens for the unaffected eye to thereby determine the amount of reduced brightness-sense of the affected eye as compared with the unaffected eye; and

(g) characterizing the amount of reduced brightness-sense of the affected eye in the range of approximately 15 to 45 percent of the unaffected eye, when accompanied by an altitudinal visual field loss, as an indication for anterior ischemic optic neuropathy.

6. A method of detecting eye disease in a patient by determining the difference in relative brightness sensed by the two eyes, using eyeglasses of the type having a polarized inner lens mounted against rotation in front of the oculars of the eyeglasses, and a pair of polarized outer lenses mounted for rotation with respect to and in visual alignment with the oculars, the inner lens and outer lenses having their polarizing gratings in parallel for maximum light transmission when the outer lenses are at zero degrees rotation with respect to the inner lens, and the polarizing gratings being orthogonal for minimum light transmission when the outer lenses are at ninety degrees rotation with respect to the inner lens, said method comprising the steps of:

(a) providing an illuminated object for viewing;

(b) setting the outer lenses at zero degrees rotation with respect to the inner lens to permit maximum light transmission to the eyes;

(c) positioning the eyeglasses in front of the patient'"'"'s eyes;

(d) alternately occluding the eyes to identify the eye in which eye the illuminated object appears brighter, this eye being referred to as the unaffected eye and the other eye being referred to as the affected eye;

(e) rotating the adjacent outer lens for the unaffected eye away from zero degrees rotation with respect to the inner lens to decrease luminance until the illuminated object is sensed by the patient as being substantially equally bright in both eyes;

(f) quantifying the amount of rotation of the outer lens for the unaffected eye to thereby determine the amount of reduced brightness-sense of the affected eye as compared with the unaffected eye; and

(g) characterizing the amount of reduced brightness-sense of the affected eye in the range of approximately 1 to 35 percent of the unaffected eye, when accompanied by a reduction in the amount of brightness-sense of the affected eye over approximately the next several months, as an indication for compressive optic neuropathy (tumor).

7. A method of detecting eye disease in a patient by determining the difference in relative brightness sensed by the two eyes, using eyeglasses of the type having a polarized inner lens mounted against rotation in front of the oculars of the eyeglasses, and a pair of polarized outer lenses mounted for rotation with respect to and in visual alignment with the oculars, the inner lens and outer lenses having their polarizing gratings in parallel for maximum light transmission when the outer lenses are at zero degrees rotation with respect to the inner lens, and the polarizing gratings being orthogonal for minimum light transmission when the outer lenses are at ninety degrees rotation with respect to the inner lens, said method comprising the steps of:

(a) providing an illuminated object for viewing;

(b) setting the outer lenses at zero degrees rotation with respect to the inner lens to permit maximum light transmission to the eyes;

(c) positioning the eyeglasses in front of the patient'"'"'s eyes;

(d) alternately occluding the eyes to identify the eye in which eye the illuminated object appears brighter, this eye being referred to as the unaffected eye and the other eye being referred to as the affected eye;

(e) rotating the adjacent outer lens for the unaffected eye away from zero degrees rotation with respect to the inner lens to decrease luminance until the illuminated object is sensed by the patient as being substantially equally bright in both eyes;

(f) quantifying the amount of rotation of the outer lens for the unaffected eye to thereby determine the amount of reduced brightness-sense of the affected eye as compared with the unaffected eye; and

(g) characterizing the amount of reduced brightness-sense of the affected eye in the range of approximately 80 to 100 percent of the unaffected eye, when accompanied by poor visual acuity, as an indication for non-macular retinal disease.

8. A method of detecting eye disease in a patient by determining the difference in relative brightness sensed by the two eyes, using eyeglasses of the type having a polarized inner lens mounted against rotation in front of the oculars of the eyeglasses, and a pair of polarized outer lenses mounted for rotation with respect to and in visual alignment with the oculars, the inner lens and outer lenses having their polarizing gratings in parallel for maximum light transmission when the outer lenses are at zero degrees rotation with respect to the inner lens, and the polarizing gratings being orthogonal for minimum light transmission when the outer lenses are at ninety degrees rotation with respect to the inner lens, said method comprising the steps of:

(a) providing an illuminated object for viewing;

(b) setting the outer lenses at zero degrees rotation with respect to the inner lens to permit maximum light transmission to the eyes;

(c) positioning the eyeglasses in front of the patient'"'"'s eyes;

(d) alternately occluding the eyes to identify the eye in which eye the illuminated object appears brighter, this eye being referred to as the unaffected eye and the other eye being referred to as the affected eye;

(e) rotating the adjacent outer lens for the unaffected eye away from zero degrees rotation with respect to the inner lens to decrease luminance until the illuminated object is sensed by the patient as being substantially equally bright in both eyes;

(f) quantifying the amount of rotation of the outer lens for the unaffected eye to thereby determine the amount of reduced brightness-sense of the affected eye as compared with the unaffected eye; and

(g) characterizing the amount of reduced brightness-sense of the affected eye in the range of approximately 35 to 85 percent of the unaffected eye, when accompanied by poor visual acuity, as an indication for macular retinal disease.

9. A system for detecting eye disease eye disease in a patient by determining the difference in relative brightness sensed by the two eyes, comprising:

(a) an illuminated object for viewing;

(b) a pair of eyeglasses for mounting in front of the patient'"'"'s eyes, said pair of eyeglasses including,

a substantially transparent polarized mounted against rotation with respect to said frame, said inner lens being mounted in visual alignment with the patient'"'"'s eyes;

a pair of substantially transparent polarized outer lenses mounted for rotating with respect to said frame, with one outer lens in visual alignment with and rotatable with respect to one eye and the other outer lens in visual alignment with and rotatable with respect to the other eye;

rotation of said pair of outer lenses with respect to said inner lens over a ninety degree angle varying the amount of brightness sensed by the eyes when viewing said illuminated object, selective independent rotation of one of said pair of outer lenses with respect to the other causing the amount of brightness sensed by one eye to be substantially the same as the amount of brightness sensed by the other eye; and

means for quantifying the amount that the outer lens of one eye has rotated relative to the inner lens and the amount that the outer lens of the other eye has rotated with respect to the inner lens when the amount of brightness sensed by each eye is substantially equal, to thereby determine the relative sense of brightness of the two eyes; and

(c) means for characterizing the amount of reduced brightness-sense of one eye as compared to the other eye as an indication of eye disease in the eye for which said illuminated object appeared less bright according to the following table;

space="preserve" listing-type="tabular">______________________________________ AMOUNT OF RE- DUCED BRIGHT- NESS-SENSE OF TYPE OF AFFECTED EYE OTHER EYE DISEASE (%) CONSIDERATIONS ______________________________________ No disease 80-100 No significant inter-eye brightness-sense disparity Optic neuritis 2-40 Brightness-sense (recent onset) increase over next 4-8 months Optic neuritis 25-75 20/20 vision;

no change (old/resolved) in brightness-sense Anterior ischemic 15-45 Accompanied by optic neuropathy altitudnal visual field loss Compressive optic 1-35 Brightness-sense neuropathy reduction over next several months Retinal diseases 80-100 Accompanied by poor (non-macular) visual acuity Retinal diseases 35-85 Accompanied by poor (macular) visual acuity Cataracts 80-100 No significant inter-eye brightness-sense disparity ______________________________________