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    • 专利摘要:
    The present invention relates to a method for controlling an automatic refractor (1) comprising a plurality of corrective lenses and at least one eyepiece (10) adapted to be placed facing an eye of a patient, the control method being characterized by steps of: determining (105) an accommodative profile indicating an ability of the eye to accommodate excessively or not, generating (106) at least one selection control (C) identifying corrective lenses to position successively in the eyepiece (10) in order to subject the eye to several successive refractive tests, the selection command (C) depending on the determined accommodative profile
    公开号:FR3050922A1
    申请号:FR1654033
    申请日:2016-05-04
    公开日:2017-11-10
    发明作者:Philippe Morizet
    申请人:Philippe Morizet；
    IPC主号:
    专利说明:

    FIELD OF THE INVENTION
    The present invention relates to the field of ocular subjective refractive tests. It particularly relates to an accommodative profiling process and a device for controlling an automatic refractor. The study of ocular refraction is the study of the position of the light rays entering the eye relative to the retina. This study aims to determine abnormalities of vision (ametropia). The ametropia of the eye are defined by the position of these light rays deviated from the retina. If these rays are located: • in front of the retina, the eye is said to be too long or short-sighted, • on the retina, the eye is said to be normal or emmetropic, • behind the retina, the eye is said too much short or hyperopic.
    If these rays converge in the eye at one point, the eye is said to be stigma or spherical. A suitable spherical corrective glass is enough to make this emmetropic eye if it was not already.
    In the opposite case, the light rays describe an image surface on the retina; the eye is then said to be astigmatic. A spherical corrective lens is not enough to make this emmetropic eye. It must obligatorily associate a corrective cylindrical glass to make it emmetropic.
    Reminders on the phenomenon of accommodation Accommodation is the set of focusing phenomena that allows an eye to see clearly at different distances. The accommodation is both reflex and automatic. She is also fatigable (this is called accommodative asthenopia). It is measured in diopters. The accommodation serves to: • focus (focus) the objects seen, at different distances, on the fovéola, which centers the retina; and • to maintain the convergence in order to merge two images seen by the two eyes thus allowing a vision of the relief (stereoscope). Accommodation is therefore essential to maintaining a good binocular vision that allows us to situate ourselves in our environment. It is the analysis of the fuzziness of the retinal image (circles of lesser diffusion) which triggers reflexively and automatically accommodation. The accommodation is never at rest, it varies by permanent micro-fluctuations. To these micro-fluctuations are added three types of psychic accommodation: proximity (acquired reflex), intellectual (comprehension of the clinical test) and apparatus (an infinitely adjusted pattern does not fool the eye). The convergence is voluntary and precedes by a few milliseconds the accommodation. The accommodation is the result of a set of physiological mechanisms whose starting point is the contraction of the (small) muscle of Rouget-Muller (which, with the imposing Brücke Wallace muscle, constitutes the circular ciliary muscle) and the point of arrival of the transformations on the crystalline lens (shape, refractive index and position) in order to focus or to maintain the object looked at on the retina.
    This active contraction of the Rouget-Muller muscle is followed by a series of passive events, leading to changes in the lens of the lens: a) in shape: the contraction of the Rouget-Muller muscle and the concomitant release of the Brücke antagonist muscle -Wallace cause relaxation of Zinn's Zoni fibrils that support the crystalline lens at 360 ° equator. The latter, thanks to its spontaneous elasticity (and all the more so as the subject is young) undergoes consecutive modifications of curvature, essentially of the anterior surface, (according to the theory of Young-Helmholtz). The crystalline lens thus passes from a biconvex form, constrained (so-called position of "accommodative rest") to a conoid form (in madeleine), unconstrained but natural (so-called "accommodation" position). Thus the anteroposterior diameter of the lens grows causing an increase in the power of the eye (we speak of a myopization of the eye) and an increase in the crystalline astigmatism (we say that the accommodation is thus astigmatogenic) . b) refractive index: due to the aforementioned changes in curvature, a consecutive sliding of the cortical crystalline cells leads to an increase in the refractive index of the crystalline lens (Gullstrand theory). c) position: the ciliary muscle is connected directly to the sclera, which is the shell of the eye, and more precisely to the scleral spur by a circular tendon. The contraction of this muscle causes an opening of the iridocorneal angle (at the bottom of which the aqueous humor of the eye flows) and a depression in the anterior chamber of the eye. As the relaxed fibrils of Zinn's zonule are longer at midday than at six o'clock, and because of the depression it follows, a postero-anterior lowering of the crystalline lens thus bringing its central optical axis (more powerful of 4 d - Cherning) naturally before the pupillary area.
    This phenomenon of accommodation is also accompanied by: • a miosis that both reduces optical aberrations due to lens deformity and increases the depth of field (facilitating the work of accommodation), and • accommodation / convergence synchrony (so as to guarantee uniqueness of the point seen).
    All these mechanisms aim, with a minimum of energy expended, to increase the power of the eye by making the lens curved so as to focus, as much as possible, the image of the object on the retina and see net . Optical mechanism of accommodation
    By convention and on an algebraic plane, any phenomenon going in the direction of the light beam entering the eye will be noted positively. The accommodation defocuses the image of the object seen by the eye in the opposite direction of the light beam entering the eye; it is therefore conventionally counted as negative diopters.
    In a stigmatic eye, the light rays from the two main corneal meridians (whose radius of curvature is identical) converge at one point. The accommodation defocuses this image point towards the front of the eye. Thus the myopic eye will be even more myopic, the emmetropic eye will become myopic and the hypermetropic eye will be less hypermetropic or emmetropic or will become myopic (depending on the accommodative capacities of the patient).
    In an astigmatic (regular) eye, the light rays from the two main corneal meridians (whose radius of curvature is different) converge in two focal lengths creating the Sturm conoid formed of three zones of lesser diffusion. The first zone is the focal length constructed by the convergence at one point of the radii coming from the most arched main corneal meridian, the second zone is the circle of less diffusion or CMD (rounded, passage of the net radii in an axis with the net radii in the against the axis) and the third zone is the focal length constructed by the convergence at one point of the rays coming from the flattened principal corneal meridian. Thus, if the horizontal corneal meridian is flatter than the vertical, the three zones are arranged in this order: the horizontal focal length, then the CMD, then the vertical focal length. There are as many Sturm conoids as there are different astigmatisms.
    In an astigmatic eye, if both focal lengths are in front of or behind the retina, astigmatism is said to be composed. If one of the two focal lengths is on the retina, we say that the astigmatism is simple and if the retina is between the two focal lengths we say that the astigmatism is mixed. The accommodation defocuses the Sturm conoid in the opposite direction of the light beam entering the eye. Thus the myopic astigmatic compound (AMC) eye will be even more AMC, the mixed astigmatic eye (AM) will be single myopic astigmate (AMS) or AMC and the compound hyperopic astigmatic eye (AHC) will be less AHC or single hyperopic astigmate ( AHS) or AM or AMS or AMC (depending on the accommodative capabilities of the patient). The accommodative excess
    An eye is never at rest, even in the dark where the tonic accommodation (zero point of the focus of the image on the retina in the emmetropic) is -1.00 diopters.
    During a conventional refraction examination, accommodation is maximally stimulated by the traditional monocular study of sight (acquired proximity reflex) and non-adaptation of the tests to the patient's accommodative habits (accommodation). intellectual psychic).
    This excess of accommodation is all the more important: • that the patient is young, • that he has not had his vision checked for a long time, • that he has bad or unstable binocular vision, • that his ametropia is weak or, on the contrary, important, • that his visual habits require a sustained and prolonged view in near or intermediate vision, and • that the retinal image is fuzzy (poorly adapted or not worn correction, convergence disorder).
    STATE OF THE ART
    Several devices used to carry out an examination of the ocular refraction are known from the state of the art.
    An automatic refractometer, or RA (also called an optometer) is a device adapted to measure an objective and theoretical correction adapted to the eye of a patient. It measures the following data (counted in diopters, 1 diopter being equal to 1 me1): • the distance that separates the retina from the image point in the stigmatic eye and from the farthest focal point in the astigmatic eye: this distance is called "sphere". • the distance between the two focal lengths corresponding to the two main corneal meridians, called the "cylinder". This distance is non-zero in case of astigmatism, because the radii of curvature of the two main corneal meridians are different.
    However, the state of the eye of a patient is likely to vary over time so that the results provided by an automatic refractometer about the same eye are variable in time. Therefore, a subjective study of the ocular refraction of a patient is conducted with his active participation, this subjective study aimed at a final prescription corrective lenses adapted to the patient.
    The determination of a comfortable and effective visual correction for the patient is the result of an adapted strategy comprising a series of clinical tests, chosen and well ordered in order to practice a review of the subjective refraction in a fast and rhythmic way.
    Such a subjective study is conventionally implemented by means of an automatic refractor. The automatic refractor is used by a vision professional (ophthalmologist, orthoptist or optician for example) to test the view of an individual (this individual is also called "refracted" in the following). It is conventionally equipped with corrective test lenses, an eyepiece intended to be placed in front of the eyes of the individual, means for positioning certain corrective test lenses in the eyepiece, and a control interface. used by the vision professional to control the positioning means. During this examination, different combinations (or "formulas") of corrective lenses are thus placed in the eyepiece, so as to verify whether they are adapted to the individual. During each test, the refracted is then invited to look at a target through the eyepiece to check if the presented lens (s) lead to a response adapted to the test or to a clear vision of the target. If this is not the case, either the trial corrective lenses are modified or a new test is implemented, or a new strategy is unveiled. The vision professional proceeds thus iteratively, to determine a visual correction adapted and comfortable to the sight of the individual.
    Such a test sequence postulates that the visual performance of the refracted to see the target clearly through the eyepiece is representative of the usual (not exaggerated) performance of the refracted.
    However, the results obtained by such a sequence of tests can be distorted if: • The selected tests are badly ordered or not adapted to the accommodative profile of the individual, • The refracted patient has a disorder (repeated or not, variable or no) affecting his ability to accommodate properly and normally, • the exam is not rhythmic and takes a long time.
    As a result, the examiner may have to give inadequate visual correction to the refracted.
    The vision professional must then implement a large number of successive tests before converging to a correction adapted to the individual and his visual comfort, which increases the duration of the examination.
    SUMMARY OF THE INVENTION The invention aims to shorten the duration of an examination of the subjective ocular refraction of an individual to avoid giving him an inappropriate and uncomfortable correction threatening his binocular vision and comfort of view.
    It is thus proposed according to a first aspect of the invention a method of controlling an automatic refractor comprising a plurality of corrective lenses and at least one eyepiece adapted to be placed opposite an eye of a patient, the method of control being characterized by steps of determining an accommodative profile indicating an ability of the eye to accommodate excessively or not, generating at least one selection control identifying corrective lenses to be positioned successively in the eyepiece in order to to submit the eye to several successive refractive tests, the selection control depending on the determined accommodative profile.
    The method thus proposed is advantageous for several reasons: an ideal visual correction for the individual under examination can be found by this method in a deterministic and reproducible manner. This correction will be in other words the same for each implementation of the control method of the automatic refractor, regardless of the examiner using this automatic refractor. • Thanks to this automation, it is possible to carry out remote view examinations by remote transmission (remote refraction or refraction) via a network such as the Internet. The practice of subjective refraction can be standardized and its results feed into a common database ("Big Data").
    The control method can be completed using the following features, taken alone or in combination when technically possible.
    The method may include: receiving ametropic data from at least one of the two eyes of the patient measured by a refractometer, the selection control being dependent on the measured ametropia data; Receiving visual correction data from at least one of the two eyes of the patient measured by a lensmeter, the selection control being dependent on the measured visual correction data.
    The corrective lenses to be successively positioned in the eyepiece can be adapted for implementing a method for determining the sphere at the landing, said sphere sphere determining method being: • of the red-green type, if the accommodative profile As the eye accommodates to a low or no level, • a descrambling method, if the accommodative profile measures that the eye accommodates to a high level.
    Said method of determination of sphere at the landing can also be: • a method of the Jackson cross type, if the accommodative profile measures that the eye accommodates according to an intermediate level comprised between the low level and the high level.
    The corrective lenses to be successively positioned in the eyepiece can be adapted for the implementation of a method of determination of the sphere at the landing, then a method of the auditory faces.
    The automatic refractor may comprise two eyepieces to be placed opposite the two eyes of the patient, and the corrective lenses to be positioned successively in the two oculars be adapted for the implementation of a monocular, biocular, binocular or biomonocular type examination, the type of examination depending on the determined accommodative profile.
    Which selection control can identify: • at least one spherical glass and at least one cylindrical glass to be positioned simultaneously in the eyepiece, if the accommodative profile measures that the eye accommodates at a low or zero level, • at least one glass spherical but no cylindrical glass, if the accommodative profile measures that the eye accomodates according to a higher level.
    The method may also include receiving visual correction data from at least one of the two eyes of the patient measured by a lensometer, the visual correction data including a cylinder value characteristic of a cylindrical deformity of the patient's eye, the cylindrical glass identified by the generated selection control constituting a visual correction adapted to said cylinder value.
    The automatic refractor may comprise two eyepieces to be placed simultaneously opposite the two eyes of the patient, and the selection control identify: at least one first spherical corrective lens to be positioned in the left eyepiece, the first corrective lens being adapted to scramble the left eye of the patient according to a predetermined distance from a maximum visual acuity value of the left eye; at least one second spherical corrective lens to be positioned simultaneously in the right ocular, the second corrective lens being adapted to scrambling the patient's right eye by the same deviation from a maximum visual acuity value of the right eye, the value of the predetermined deviation depending on the determined accommodative profile.
    Which of the following may be the subject of the selection command: • a frequency score at which the patient has undergone refractive tests in a past period, • a frequency score at which the patient is wearing visual correction means, • the age of the patient, • the patient's real or sensory monophthalmic character or not, • a score representative of the ability of the eyes to converge at a point.
    According to a second aspect of the invention there is provided a computer program product comprising program code instructions for performing the steps of the control method according to the first aspect of the invention, when this program is executed by at least one processor.
    According to a third aspect of the invention, there is provided a device for controlling an automatic refractor comprising a plurality of corrective lenses and at least one eyepiece adapted to be placed opposite an eye of a patient, the device for command comprising: at least one processor configured to generate at least one selection command identifying correcting lenses to be successively positioned in the eyepiece in order to subject the eye to several successive refraction tests, a communication interface for sending the autorefractive generated selection control, wherein: • the processor is configured to determine an accommodative profile indicating an ability of the eye to accommodate excessively or not, and to generate the selection command based on the determined accommodative profile.
    According to a fourth aspect of the invention, there is provided an ocular refraction test system comprising an automatic refractor and a control device according to the third aspect of the invention for controlling the automatic refractor.
    This test system may further comprise a refractometer configured to measure ametropia data of an eye and transmit the measured data to the controller, the accommodative profile determined by the processor depending on said measured data and transmitted to the controller.
    This test system may further comprise a control terminal, the control terminal comprising: data input means; a network communication interface with the control device for transmitting to the control device data according to which the accommodation profile is determined.
    DESCRIPTION OF THE FIGURES Other characteristics, objects and advantages of the invention will emerge from the description which follows, which is purely illustrative and nonlimiting, and which should be read with reference to the appended drawings in which:
    FIG. 1 represents a refraction test system according to one embodiment of the invention.
    FIG. 2 is a flowchart of steps of a method for controlling an automatic refractor, according to an embodiment of the invention.
    In all the figures, similar elements bear identical references.
    DETAILED DESCRIPTION OF THE INVENTION 1. Eye refraction test system
    With reference to FIG. 1, an ocular refraction test system comprises an automatic refractor 1.
    The automatic refractor 1 comprises a reserve in which are housed a plurality of corrective lenses.
    The automatic refractor 1 also comprises two eyepieces 10, one being designed to be placed opposite the left eye of the individual, the other being intended to be placed simultaneously opposite the right eye of the same. individual.
    The automatic refractor 1 a further comprises means for taking one or more corrective lenses in the reserve and position them in the two eyepieces. These means, known to those skilled in the art, comprise for example at least one articulated arm.
    The sampling and positioning means are actuated by means of a selection control C.
    The automatic refractor 1 also comprises a reception interface for receiving a selection command C, when the said command is sent by another device.
    The automatic refractor 1 further comprises a processor configured to drive the sampling and positioning means according to the selection command C received.
    Can be placed in an eyepiece 10 of the automatic refractor 1 one or more corrective glasses superimposed. By convention, hereinafter called "set of corrective lenses" a set of several glasses superimposed in the same eyepiece.
    The two eyepieces 10 can be solicited simultaneously or alternately. In particular, the automatic refractor 1 may comprise means for closing each eyepiece 10 independently of the other eyepiece. These sealing means may comprise, for example, an opaque glass which has previously been taken from the reserve of the automatic refractor 1.
    Finally, we distinguish several types of elements present in the reserve of the automatic refractor 1: • spherical corrective lenses, adapted to defocus the image of the object looked in the eye (jamming) then on the retina of the eye (descrambling), and therefore adapted to correct simple hyperopia or simple myopia; • cylindrical corrective lenses, adapted to correct cylindrical deformations of the cornea (for example), and therefore adapted to correct a hypermetropic or myopic astigmatic eye; Opaque glasses for closing off one or other of the eyepieces of the automatic refractor 1.
    Some glasses called test glasses (colored or polarized or prisms, for example) can be superimposed in front of one or both eyes.
    The ocular refraction test system 10 further comprises a control device 2 for controlling the automatic refractor 1.
    The controller 2 comprises at least one processor for processing data, a memory for storing data, and a command sending interface adapted to communicate with the receiving interface of the automatic refractor 1.
    The processor is more specifically adapted to generate a selection command C to be sent via the sending interface, and which identifies corrective lenses to be positioned in the two eyepieces 10 of the automatic refractor 1.
    The memory of the control device 2 is provided for storing a database of configurations of the eyepieces 10 of the automatic refractor 1.
    Each corrective lens selectable in the reserve of the automatic refractor 1 is identified by a unique identifier in the database.
    The two eyepieces 10 are also identified by two different eyepiece identifiers 10 in the database (e.g. "left" and "right").
    A configuration of the automatic refractor 1 is for example defined in the database in the form of an input comprising, for each of the two eyepieces 10: an identifier of the eyepiece, and a list of unique element identifiers (s). ) to be positioned in the recipient eyepiece (these elements may be one or more corrective lenses taken from the reserve or an opaque element adapted to close an eyepiece).
    A sequence of ocular refraction tests is defined in the database as an input comprising a configuration configuration of the eyepieces of the automatic refractor (the number of configurations of this series may vary).
    In such a sequence, the order of a configuration of the automatic refractor 1 is identified by an index i (by convention, it is considered in the following that the index configuration 1 is the first configuration to use).
    The database stores a plurality of different ocular subjective refraction test sequences.
    Furthermore, the control device comprises a communication interface with a control terminal 5.
    The control terminal 5 comprises a communication interface with the control device 2 and with the automatic refractor, a screen 50, and data acquisition means.
    The control terminal 5 is for example a touch pad.
    The control terminal 5 is configured to execute a computer program whose main function is to enable an operator to control the execution of refraction tests by means of the automatic refractor 1.
    Thus, this computer program may comprise a graphical interface that can be displayed on the screen 50 of the control terminal 5.
    Alternatively, it can be provided that the control device 2 is the control terminal 5 form a single computer equipment.
    In the embodiment illustrated in FIG. 1, the control device 2 communicates with the control terminal 5 via a wireless link, for example a Wi-Fi type link. Furthermore, the control device 2 communicates with the refractor automatic 1 by a wired link.
    In a variant, the control terminal 5 and the control device 2 communicate via a network such as the Internet. In this case, the system will advantageously be used at a distance (it is called remote refraction or refraction); indeed, an operator can control the system via the control terminal 5 from a first location, the other elements of the system (including the control device 2 and the automatic refractor 3 being in another location where the individual to be examined .
    The automatic refractometer 3 is configured to perform objective refraction measurements on each eye. The means of the automatic refractometer 3 for carrying out such measurements are conventional.
    The automatic refractometer 3 comprises a communication interface with the control device 2.
    In the embodiment illustrated in FIG. 1, the automatic refractometer 3 communicates with the control device 2 via a wire link.
    The refraction test system may also include a lensometer 4 (or "lens meter" in English). In a manner known per se, the frontofocometer 4 is configured to analyze the geometry of a corrective glass (typically a spectacle lens) and to deduce from it optical data characterizing the visual correction delivered by this lens.
    The frontofocometer 4 comprises a communication interface for communicating with the control device 2.
    In the embodiment illustrated in FIG. 1, the frontofocometer 4 communicates with the control device 2 via a wire link.
    In particular, it can be provided that the test system further comprises a routing device 6 between, on the one hand, the control device 2, and on the other hand, the refractometer 3 and the frontofocometer 4, as represented in FIG.
    The test system may also include a display device (not shown) of targets on a screen, the targets having a content adapted to test the visual acuity of the refracted. The control device may be configured to control the display, by the display device, of a predetermined target, for example chosen by means of the control terminal 5. The display device may for example comprise an overhead projector. 2. Control method of the automatic refractor
    We will now detail the steps of a method implemented by means of the eye refraction test system 10 according to the figure for testing the view of an individual.
    In a preliminary step, the control terminal 5 displays on its screen 50 a questionnaire comprising closed questions relating to the individual and his or her visual habits. The purpose of this questionnaire is to determine an adaptive profile (level or state) specific to the refracted.
    A user of the control terminal 5 (the individual himself or a qualified professional) uses the input means of the control terminal 5 to enter response data to this questionnaire.
    The response information captured by the input means is transmitted by the control terminal 5 to the control device 2, and is stored in the memory of the control device 2.
    In one embodiment, the information entered includes: • the age of the individual; • a number of individual submissions to subjective refractive testing by a vision specialist over a predetermined period of time (for example, a number of visits per year); • whether the individual is consulting the vision specialist for the first time or not; • information determining whether the individual has a real monophthalmia (the individual sees only one eye) or sensory (the individual uses only one eye); • information indicating whether the individual wears visual correction means such as glasses, supplemented if necessary by information indicative of the regularity with which the individual wears these means of visual correction; • information about the ability of the individual's eyes to converge properly at one point; • information about the individual's visual habits.
    This information is stored in the memory of the control device 2.
    In a next step, the processor calculates from each information a score counted in number of points. From the age of the individual, the processor calculates a first score representative of the youth of the individual. The first score is even higher than the individual is young.
    The processor also calculates a second score representative of the regularity of the individual's visit to an ophthalmologist or other vision specialist.
    The second score increases with the number of visits of the individual per time unit (eg per year). The consultation score may also be increased when the individual first consults the practitioner using the device according to the invention.
    The processor also calculates a third score indicating whether the individual is monophthalmic or not.
    The processor calculates a fourth score representative of the frequency of wearing of visual correction means by the individual. This fourth score can take three different values, depending on whether the wearing of visual correction means is systematic, "frequent", or "rare to nonexistent".
    The processor further calculates a fifth score relating to the ability of the individual's eyes to converge. The fifth score can thus take three different values for the following three cases: • decompensated phoria absent or infrequent, • decompensated phorie moderately frequent, • decompensated phorie very frequent.
    The processor calculates a sixth score representative of the individual's visual habits. The sixth score can take three different values corresponding to the following three cases: • varied visual habits (near and far vision), • visual habits by far, • close visual habits.
    The value of each of the first, second, third, third, fourth, fifth and sixth scores is stored in the memory.
    The processor of the controller 2 calculates an overall score based on at least two of the first, second, third, third, fourth, fifth and sixth scores in a step 102. The overall score is for example the sum of at least two of the first, second, third, third, fourth, fifth and sixth scores.
    In a step 103, the automatic refractometer 3 measures ametropia data from at least one of the two eyes of the patient.
    The IR ametropia data may comprise a sphere value, a cylinder value and an axis value of the cylinder, these values being descriptive of the geometry of the eye as already mentioned in the introduction.
    The measured ametropia IR data are transmitted by the automatic refractometer to the control device 2. In addition, the lensometer 4 analyzes the possible corrective lenses worn by the individual in a step 104 and deduces the data which may include a value of sphere, a cylinder value and an axis value of the cylinder. These data are also transmitted to the control device 2. The measurement step of ametropia data by the lensometer 4 can be performed for the two glasses of the glasses of the individual.
    The ametropia data received by the control device 2 from the automatic refractometer 3 and / or the frontofocometer 4 are stored in the memory of the control device 2.
    The processor determines an accommodative profile for the individual, from the overall score in a step 105.
    In one embodiment, three accommodative profiles are predetermined: • a "normal" profile 1 (Pa1), characteristic of an eye that accommodates normally and without excess; • a profile 2 (Pa2) "intermediate" characteristic of an eye that accommodates a little excessive intermittently; • a "difficult" profile 3 (Pa3), characteristic of an eye that accommodates excessively and almost permanently.
    Is assigned by the device 2 to the eye of the patient one of the three predetermined profiles according to the value of the overall score, for example: • the normal profile Pa1 if the overall score is in a first range of values, • the intermediate profile Pa2 if the overall score is comprised in a second interval of values greater than those of the first interval, • the difficult profile Pa3 if the overall score is in a third interval of values greater than those of the second interval.
    The accommodative profile assigned to the eye is stored in the memory of the controller 2 as a code.
    The processor of the control device 2 selects a sequence of tests to be implemented present in the database, which sequence depends on the accommodative profile (Pa) determined during the step 105.
    The test sequence may also depend on the data collected by the automatic refractometer 3 and / or by the lensometer 4.
    In one embodiment, a test sequence is identified by a 5-digit code: • the first digit corresponds to the numbered ametropia of the right eye, • the second digit corresponds to the numbered ametropia of the left eye • the third digit is the fact that the person first or regularly consults, • the fourth digit represents the accommodative profile of the interviewee to be examined, • the fifth digit represents the type of strategy (the shorter and less accommodating) proposed by default.
    The processor of the device 2 transmits to the control terminal 5 instructions for displaying the test sequence on its screen 50.
    For example, the test sequence is displayed on the screen 50 of the control terminal 5 as a chronological frieze (or phrase) with N boxes, each box corresponding to a possible test and consequently to a particular configuration of the eyepieces 10 of the Automatic refractor 1. The examiner is then informed of the test sequence proposed by the control device 2, and therefore corrective lenses that will be successively presented to the eyes of the individual in the eyepieces 10 of the refractor 1. The individual places his eyes next to the eyepieces 10 of the automatic refractor 1. The eyepieces are arranged so that the individual can see one or more targets displayed by the display device.
    The control device 2 generates a first selection command C adapted to configure the eyepieces 10 of the automatic refractor 1 according to the configuration of the first test of the test sequence.
    A test is triggered by the examiner by means of an appropriate button displayed on the control terminal 5 (for example by clicking on an element of the corresponding frieze, or on a "next" button).
    The selection command C is sent by the control device 2 and / or by the control terminal 5 to the automatic refractor 1.
    Upon receipt of said selection command C, the processor of the automatic refractor 1 analyzes the contained configuration of the selection command and controls the positioning means in accordance therewith.
    The positioning means of the automatic refractor 1 take the glasses to position in the left eyepiece 10 and in the right eyepiece 108 (identified in the selection command C). The examined individual is then subjected to a test comprising for example the projection of a target on a screen 50 arranged next to the eyepieces 10 of the automatic refractor 1. The examiner invites the individual to read the contents of the target ( or to answer other questions) while the individual's eyes are in front of the eyepieces 10.
    If the corrective lens or combination of corrective lenses positioned in at least one of the two eyepieces 10 is unsuitable for the test or for an accurate reading of the target's content, steps 106 to 109 are repeated: the examiner triggers the second test of the test sequence previously determined on the basis of the accommodative profile, which generates a new selection command C comprising a second configuration of the eyepieces 10 of the automatic refractor 1. This new command is sent to the latter, the positioning means replace the glass or the glass combination of the first test of the sequence with the glass or glass combination of the following test of the sequence, and the patient is subjected to this test under this new reconfiguration of the refractor automatic 1.
    Steps 106 to 109 are implemented at most N times. The examination of the patient's eyes is terminated when a test of the sequence concludes with a satisfactory and comfortable reading of a target by the patient (this conclusion may occur before arriving at the N and last test of the sequence ).
    The N selection commands can be generated simultaneously, or sequentially, each time the examiner decides to launch a new test via the control terminal 5.
    There are several types of refractive examination known: "monocular", "biocular", "binocular" and "biomonocular".
    Monocular examination is performed one eye at a time. During each test, one of the two eyes is masked by means of a shutter element positioned in one of the two eyepieces.
    Binocular examination is performed simultaneously for both eyes. Both eyes are subjected to the same tests, that is to say that they are presented the same target via the display device.
    A biocular examination is performed simultaneously for both eyes. During such a biocular examination, it is ensured that the two eyes are subjected to two different tests, that is to say that they are presented with different content targets via the display device. This can be implemented by positioning in the two orifices polarized corrective lenses having different polarizations. It can be positioned in the left eyepiece a polarized lens with a polarization of +45 degrees, and in the right eyepiece a polarized lens a polarized lens with a polarization of +135 degrees.
    In addition, a biomonocular examination is implemented as follows. • unpolarized corrective lenses are positioned in one of the eyepieces 10, these have a common sphere value - that is to say unchanged for the N successive tests. The common sphere value selected for the N is adapted to scramble the patient's eye at a predetermined distance from a maximum visual acuity value of that eye. • Non-polarized corrective lenses are positioned in the other eyepiece 10. These glasses have variable sphere values for the N successive tests. 3. Level Sphere Focusing Tests 3.1. Swaine's Rule
    The rule of Swaine, known to those skilled in the art, aims to determine a spherical correction to the stage based on a simple direct reading of a naked eye or simply provided with its only refractometric astigmatism. The reading can be that of a scale of far-sighted visual acuity of Swaine (method called Swaine direct). This sphere at the hypothetical stage, deduced can be verified by this same rule in return by adding +1.25 d (so-called inverse Swaine method or interference sphere to 0.2). This rule has the advantage of not over-correcting a nearsighted one if it is well practiced, in the rules of the art and in adequate premises. It is always practiced in monocular, that is to say by placing in one of the two eyepieces 10 a shutter element.
    This rule is advantageously used in myopes (simple or not) • whose sphere power is in the range of -2.50 to -0.25 d, whatever their accommodative profile (Swaine direct ) • whose sphere power is less than +2,50 d (inverse Swaine), and having an accommodative profile Pa3.
    The Swaine rule is also implemented advantageously for the emmetropic and hyperopic (simple or not) having an accommodative profile Pa2. In this case, it is preferable to use the inverse Swaine method or determination of the interference sphere at 0.2 in order to find the sphere at the bearing.
    Dr. W. Swaine's formula for the correspondence between distance visual acuity (AVL) measured in tenths and the power of myopia (DL) measured in diopters is as follows:
    Then simply replace AVL by the different values between 0.1 and 1.0 and we have the corresponding myopia DL back. Thus an AVL of 0.2 corresponds to a myopia of -1.25 d. 3.2. "Descrambling" or "fogging" method
    This second method, improved by Swaine and known to those skilled in the art, also aims to determine a spherical correction at the landing. This method is advantageously implemented for an eye in case of hyperopia (simple or not) having an accommodative profile Pa3.
    It can be performed during a monocular examination but is particularly effective during a bio-monocular examination.
    The descrambling method consists in presenting to the patient corrective lenses having ordered value spheres, starting from a first sphere whose value exceeds the assumed accommodative power of the examined eye by several diopters. This starting sphere is obtained by adding to the value of the sphere measured by the refractometer or the frontofocometer a value of positive (or convex) sphere. In other words, the focal length (s) of the eye is displaced towards the bottom of the the eye (in the opposite direction to the direction of propagation of a light signal entering the eye) by the succession of corrective lenses successively placed in the eyepiece.
    A typical curve of visual acuity (in tenths on the ordinate) of a human eye as a function of the sphere values (in diopters on the abscissa) presents an increasing portion, then a plateau where the visual acuity is maximal, then a decreasing portion .
    During the first test of this descrambling method, is positioned in the eyepiece 10 of the automatic refractor 1 the first interference corrector glass. A target is projected on the screen arranged next to the eyepieces 10 but the patient, scrambled, does not see its content clearly. At each new test of the method, is positioned in the eyepiece 10 of the automatic refractor 1 a new corrective glass (or a set of corrective lenses) whose sphere value is less convex than that of the previous game. This brings us closer and closer to the plateau where the patient's acuity is maximal. The art of this test is to know when to unravel the sphere in the eyepiece 10.
    Advantageously, the manner in which the individual reads the target presented to him is taken into account. The following are used as parameters: • reading speed: slow and reflected reading ("turtle reading") or fast and spontaneous reading ("rabbit reading"), • the number of letters (or optotypes) read by the patient: less of 3, equal to 3 or greater than 3. Knowing that 3 read letters validate a distance visual acuity line (AVL).
    When less than 3 letters are read and the sphere in the eyepiece 10 is descrambled by 0.25 d, the line of AVL is kept identical,
    When 3 letters are read and the sphere in the eyepiece 10 is descrambled by 0.25 d, and the line of AVL is changed as to its contents,
    When more than 3 letters are read at slow speed and the sphere in the eyepiece 10 is unscrambled, the AVL line is changed in content but identical in level,
    When more than 3 letters are read at high rabbit speed and the sphere in the eyepiece 10 is the same, the AVL line is changed as to its level which becomes higher.
    If the patient claims to see the target with a first set of corrective lenses as well as with a previous set of corrective lenses, then, in subsequent tests, assert the target with a second set of corrective lenses as well as with the first set of corrective lenses, then the sphere value of the first set of corrective lenses is selected as the one most suitable for correcting the patient's eye: this sphere value is commonly called the "sphere at the landing". This sphere value at the bearing is very advantageously verified by the so-called "verification faces" test, known to those skilled in the art. 3.3. Jackson's Cross Method "(or fixed cross)
    This third method, known to those skilled in the art, aims to determine a spherical correction at the landing or check. It is useful in the hyperopic (simple or not) of PA = 2, even in the myopic where we prefer the rule of Swaine. This test can be practiced in monocular or binocular and consists of: - projecting on a screen arranged next to the eyepieces 10 a fixed cross with two branches and each branch orthogonal to the other consists of 4 black lines on a white background. - To place in the eyepieces 10 a cross cylinder of Jackson whose negative axis is at 90 ° - to scramble the refractometric starting sphere or the frontofocometer of + 0.50d.
    The patient is then asked to answer specific questions asked by the examiner about the sharpness of the horizontal and vertical lines constituting the test of Jackson's cross. As long as the expected response is not obtained by the examiner, is positioned in the eyepiece 10 of the automatic refractor 1 a new corrective glass (or a set of corrective lenses) whose value of the sphere is lower than that of the game previous. This brings us closer and closer to the plateau where the patient's acuity is maximal. 3.4. "Red-Green" test
    The "Red-Green" method, also known to those skilled in the art, is intended to determine a spherical correction at the landing or to verify it. This method can be performed in monocular (RVS), binocular (RGB) or biocular (polarized or prismed RV). In all cases, the rules governing this method are the same.
    The following is a simple green red test in monocular (abbreviated as RVS). This test is useful in the search for the sphere at the landing only in the case of hyperopia (simple or not) for accommodative profiles Pa1 or Pa2.
    According to this RVS test, are positioned opposite the right eyepiece 10 black optotypes on a red background (for example) and are positioned opposite the left eyepiece black optotypes on a green background (for example).
    At the start of the RVS test, each eye is scrambled with a value ranging from +0.75 to +0.50 d. on the refractometric sphere or from the frontofocometer. The patient is then invited to answer specific questions asked by the examiner on the sharpness of the black optotypes seen by the right eye on a red background and seen by the left eye on a green background. As long as the expected response is not obtained (switching from the red response to green) by the examiner, is positioned in the eyepiece 10 of the automatic refractor 1 a new corrective glass (or a set of corrective lenses) whose value of the sphere is lower than that of the previous game. This brings us closer and closer to the plateau where the patient's acuity is maximal.
    This test can be advantageously used without prior interference in a myopic, astigmatic patient and having an accommodative profile Pa1 or Pa2. 3.5. Verification faces method
    The method of the verification faces, abbreviated FV (+0.25 d / -0.25 d) also known to those skilled in the art aims to verify a spherical correction at the landing.
    The verifying faces are actually two pairs of corrective lenses: one of +0.25 d and the other of -0.25 d. The face of +0.25 d is placed in front of the sphere at the landing (and this longer than the face of -0.25 d in order not to solicit the reflex accommodation) and the refracted one is invited to read the contents of a target displayed by the display device. This face is removed, and the refracted is invited again to read the target with the so-called sphere alone. The same manipulation is implemented by reading with the sphere at the landing then the concave face in front.
    The FV method can be performed during a monocular ("mono FV") or binocular ("FV bino") examination. In all cases, the rules are the same.
    The following is a detailed FV monocular method. This test is advantageously used to check the sphere at the landing in all farsighted (simple or not).
    The previously determined bearing sphere is considered to be correct if the following conditions are met: • the patient sees better the highest AVL line obtained (after a ball sphere focus test) with the sphere present in the eyepiece 10 with this same sphere added +0,25 d, • and after informing the patient that a different added glass was going to be presented to him, if the latter sees this same line of AVL with the sphere present in the eyepiece 10 with this same sphere added -0.25 d.
    As long as these two conditions are not met, VFs are again practiced. So if the patient sees similarly with +0.25 d, this value is added to the sphere in the eyepiece 10. If the patient sees better with -0.25 d this value is added to the sphere in the eyepiece 10.
    This way of doing things must quickly lead to the ideal answer; If this is not the case, use a new method to focus the sphere at the landing or change the strategy by modifying the accommodative profile.
    In all cases, is presented first before the sphere at the theoretical level in the eyepiece 10 the convex face of the FV and the concave face with a time ratio of presentation that will always be twice as long for the convex than for the concave not to stimulate the accommodation too much in the patient.
    Unconventionally, this test can be performed fully automatically using the control device 2 described above.
    In the nearsighted, the concave face of the FV can be used alone, knowing that -0.25 d must at least gain 3 letters read on the same line of AVL.
    It will be noted that the sphere at the landing can be accompanied or named by a cylinder (in other words, a cylindrical glass can be superimposed on a spherical glass to correct a myopic astigmatic or hyperopic astigmatic eye).
    It may also be noted that verification of cylinder power can change the value of the sphere at the landing (under the rule of equilibrium and dioptric imbalance).
    By convention, the sphere at the landing is called "emmetropying sphere" if, if it is verified as being correct and it is not accompanied by a cylinder, or if it is verified as being correct in combination with a cylinder also considered correct after a proper check. The effectiveness of the sphere-level development (or approach) methods described in sections 3.1.1 to 3.1.5 depends on the measured ametropia data and the patient's accommodative profile.
    If, for example, the ametropia data provided by the frontofocometer or the automatic refractometer identify the eye as hyperopic (simple or not), and if the accommodative profile is Pa1: then the successive selection commands C identify advantageously games corrective lenses adapted for the implementation of the "Red Simple Green" method then the method of the auditory faces. If the accommodative profile is Pa3: then the successive selection commands C advantageously identify corrective lens sets adapted to the implementation of the descrambling method followed by the verification faces; this is indeed a better strategy to quickly reach the emmetropic sphere than the strategy of implementing the "Red Simple Green" method and the method of the auditory faces. • If the accommodative profile is Pa2: then the successive selection commands C advantageously identify sets of corrective lenses adapted to implement the method of the "Jackson cross" then the auditory faces, this method offering a good compromise between speed of implementation and partial neutralization of accommodation of the patient's eye.
    The control device 1 therefore selects in the successive selection commands C corrective lenses adapted to implement one of these strategies by means of the automatic refractor 1, as a function of the previously determined accommodative profile.
    If the automatic refractometer measures a sphere and a cylinder, the first thing to do is to look at the power of the cylinder and the accommodative profile of the patient. • If the accommodative profile is Pa1: whatever the value of the refractometric cylinder, place it as it is in the eyepiece 10 and superimpose the modified refractometric sphere according to the development test of the sphere at the chosen step. • If the accommodative profile is Pa2 or Pa3 (score <12): it is only legitimate to conceal at first a refractometric cylinder value of -0.25 d. This procedure must be verified by a reading "rabbit" of 5 letters out of 5 of the eye considered. In the opposite case, a Freeman method can be implemented to find this cylinder (initially obscured) and to develop it. As for the sphere, the attitude to hold is the same as before (we start with a sphere whose initial scrambling is a function of the accommodative profile and the first test chosen to go to the sphere at the landing). • If the accommodative profile is Pa3 (score> 12): it is legitimate to conceal at first a refractometric cylinder value of -0.25 or 0.50 d. This procedure must be verified by a reading "rabbit" of 5 letters out of 5 of the eye considered. In the opposite case a method of Freeman must find this cylinder and develop it. As for the sphere, the attitude to hold is the same as before (we start with a sphere whose initial scrambling is a function of the accommodative profile and the first test chosen to go to the sphere at the landing). - In all other cases of cylinder power it is placed as it is in the eyepiece 10. This verification will be done after verification of the sphere at the landing. 4. Cylinder Focusing Method
    Once the sphere at the stage determined for a given eye of the patient, is determined using the automatic refractor 1 a cylinder value adapted to correct the eye, if it is astigmatic.
    The so-called "cross cylinder Jackson" method is for example adapted to develop the cylinder and check.
    The initial focus of the axis of the astigmatism is made by superimposing the axis of the rotating cross cylinder (CCT or cross cylinder of Jackson) in front of the axis of the cylindrical glass in the eyepiece 10. The axis cylindrical glass will be moved by x degrees depending on the refractometer cylinder power (x = 20 degrees for powers of <2.25 d, x = 10 degrees for powers of 2.50 to 4.50 d and x = 5 degrees for the powers> 4.50 d) and according to the patient's choice as to the position of the negative sign of the CCT with respect to the axis of the cylindrical lens in the eyepiece 10 (the axis of the refractometric cylinder is moved in the same meaning as the patient's response).
    A framing method is used for refractometric cylinders <4.50 d and comparative beyond. The axis is developed (or verified) when, in the comparative method, the patient reverses his preference and finally gives his last choice. In the comparative method it is the choice of the largest number of read optotypes that wins.
    The development of the refractometer cylinder power is done by superimposing on the cylinder axis previously checked or developed, sometimes the axis of the positive signs of the CCT, sometimes the axis of the negative signs of the CCT. If the choice of the patient is on the axis of the positives we add +0,25 d of power to the cylinder, on the negative axis, -0,25 d. This operation on the axis is repeated until the patient no longer sees a difference in sharpness between two proposed axis positions of the CCT in front of the cylinder axis previously verified.
    For this development of the cylinder power two rules already known by those skilled in the art can be used: • the rule of equilibrium (a cylinder power change of -0.50 d results in a power change of sphere of +0.25 d and vice versa). • The hesitant choice rule (keep the most convex cylinder power when hesitating between two powers on the part of the patient). Other unconventional rules can also be used: • The "RA" rule (the power of the refractometer cylinder is a power, theoretically, maximum not to exceed the prescription) • The "imbalance" rule (a change of refractometer cylinder power of 0.25 d must again control the power of the sphere, for example by using VFs for farsightedness or simple reading for nearsighted.) • The rule of "0.75 d "(Check the sphere with each cylinder power variation of 0.75 d and then resume focusing the cylinder).
    The "Jackson cross cylinder" method can be advantageously implemented automatically by means of the control device 2. 5. Other methods 5.1 Freeman method
    Freeman's method allows for unmeasured or neglected astigmatism with powers <1.25 d.
    It is performed in two stages where the patient is asked to choose between two axis positions of the CCT along orthogonal axes (0 ° and 90 ° then 45 ° and 135 °). Finally a cylinder (possibly, depending on patient responses) power -0.50 d is placed in the eyepiece 10 whose axis is between the first and second choice of the patient. Then a simple development of astigmatism follows, respecting all the rules. 5.2. Pinhole hole method
    This method makes it possible to judge the presence or absence of an astigmatic (placed in the eyepiece 10 it erases the errors due to a forgotten cylinder) or to check if it was correctly developed. 5.3. Test "red / green polarized or prismed".
    Preferably, this method is implemented at the end of the emmetropia of each eye of the patient. This method makes it possible to know if the eyes are dioptrically balanced. Its implementation rules are the same as those of the simple red / green test.
    In order to implement this method, the automatic refractor positioning means position polarized lenses (+45 degrees / + 135 degrees) in the manner indicated previously in the context of a biocular examination.
    Polarized lenses can be replaced by prismatic lenses. 5.4. Balance or balance test
    Preferably, this method is implemented at the end of the emmetropia of each eye of the patient, and following the red / green test polarized or prismed (see section 3.3.3).
    This systematic test is used to discover the dominance of an eye and to obtain, if possible, the co-dominance (in the blur) that allows sensory comfort to be achieved (and an equal distribution of accommodative influx for each eye) therefore a maximum visual performance.
    During an examination, it is possible that one eye did not have the same degree of accommodative relaxation as the other. Thus, the focus can not be exact simultaneously for both eyes. The "balance" or "balance bi-ocular" test, known in itself, can then be implemented to verify that the corrections determined for each of the two eyes are optimal.
    This test involves, initially, an initial scrambling of each eye. This initial interference is a function of the ametropia and the accommodative profile of the patient.
    More precisely, this interference, equal for each eye, is chosen all the greater as the patient accomodates strongly. For example, for a "normal" or poorly accommodative profile Pa1, the control device 2 selects a first interference gap, • for an "intermediate" profile Pa2, characteristic of an eye that accommodates excessively intermittently, the control device 2 selects a second interference gap greater than the first difference, • for a "highly accommodative" profile Pa3, the control device 2 selects a third interference gap greater than the second gap 3.
    The value of the initial deviation may also depend on other parameters, for example the degree of myopia / hyperopia of the eye.
    In one embodiment, the control device 2 selects the following initial interference gap values: • interference of +0.25 d in case of low or medium myopia (simple or not) and simple myopic astigmatism whatever the accommodative profile, • interference of +0.50 d in case of: o hyperopia (simple or not) and Pa1, o high myopia (whose Pa is 3) • interference from +0.75 to + 0.50 d in the case of an accommodative profile Pa1 or Pa2 and if the eye is hyperopic (simple or not), • interference from +1.00 to +0.75 d in case of accommodative profile Pa3 and if the eye is hyperopic (simple or not) or emmetropic.
    The best eye at the beginning of the test should be scrambled up to the same perception in the blur (co-dominance). If too few optotypes are seen at the beginning of the test both eyes will be cleared by the same amount (0.25 d) until the patient can at least see three out of five optotypes.
    Natural co-dominance does not have to be verified. Forced co-dominance (by scrambling an eye) should be like a dominance reversal proposed by the fact that the dominant eye is not the directing eye.
    This test can also be used, without interference, as a simultaneous double simultaneous Swaine in the sense that the polarized glasses are placed in the eyepieces; the refracted is then asked to read the target displayed by the display device. This amounts to a simple measure of gross visual acuity (if the eye is naked) by far to check if the sphere of each eye is sufficient to ensure emmetropia.
    Finally this test can be used to check if a myopic is on corrected or hyperopic under corrected (in both cases: possible reading of all the optotypes after jamming). 5.5. Examination of phoria (convergence). The study of phoria is advantageously carried out before the actual refraction tests. As examples: • The Schober test explores the first degree of binocular vision (VB): simultaneous vision. But he also explores heteroporia from afar. • The Worth test explores the second degree of BV: fusion. But he also explores the dominance of one eye. • The "stereo test" explores the third degree of VB: stereoscopy (relief).
    权利要求:
    Claims (16)
    [1" id="c-fr-0001]
    A method of controlling an automatic refractor (1) comprising a plurality of corrective lenses and at least one eyepiece (10) adapted to be placed facing an eye of a patient, the control method being characterized by steps of: • determination (105) of an accommodative profile indicating an ability of the eye to accommodate excessively or not, • generation (106) of at least one selection command (C) identifying corrective lenses to be positioned successively in the eyepiece (10) to subject the eye to several successive refractive tests, the selection control (C) depending on the determined accommodative profile.
    [2" id="c-fr-0002]
    2. Method according to the preceding claim, further comprising receiving ametropia (IR) data from at least one of the two measured patient's eyes (103) by a refractometer (3), the selection control (C) dependent Ametropia (IR) data measured.
    [3" id="c-fr-0003]
    The method according to one of the preceding claims, further comprising receiving visual correction (IF) data from at least one of the two measured patient's eyes (103) by a lensometer (4), the selection control ( C) dependent on the measured visual correction data.
    [4" id="c-fr-0004]
    4. Method according to one of the preceding claims, wherein the corrective lenses to be successively positioned in the eyepiece (10) are adapted for the implementation of a sphere sphere determination method, said sphere determination method at the landing being: • of the red-green type, if the accommodative profile measures that the eye accomodates according to a low or no level, • a descrambling method, if the accommodative profile measures that the eye accomodates according to a high level.
    [5" id="c-fr-0005]
    5. Method according to the preceding claim, wherein said method of determination of sphere at the landing is: a method of the Jackson cross type, if the accommodative profile measures that the eye accommodates at an intermediate level between the low level and the high level.
    [6" id="c-fr-0006]
    6. Method according to one of the preceding claims, wherein the corrective lenses to be successively positioned in the eyepiece (10) are adapted for the implementation of a sphere sphere determination method, then a method of auditory faces.
    [7" id="c-fr-0007]
    7. Method according to one of the preceding claims, wherein the automatic refractor comprises two eyepieces (10) to be placed opposite the two eyes of the patient, and wherein the corrective lenses to be positioned successively in the two eyepieces (10) are adapted for the implementation of a monocular, biocular, binocular or biomonocular type examination, the type of examination depending on the determined accommodative profile.
    [8" id="c-fr-0008]
    8. Method according to one of the preceding claims, wherein the selection control (C) identifies: • at least one spherical glass and at least one cylindrical glass to be positioned simultaneously in the eyepiece, if the accommodative profile measures that the eye accomodates according to a low or no level, • at least a spherical glass but no cylindrical glass, if the accommodative profile measures that the eye accomodates according to a higher level.
    [9" id="c-fr-0009]
    The method of the preceding claim, further comprising receiving visual correction (IF) data from at least one of the two measured patient's eyes (103) by a lensometer (4), the visual correction data including a value of cylinder characteristic of a cylindrical deformation of the patient's eye, and wherein the cylindrical lens identified by the selection control (C) generated constitutes a visual correction adapted to said cylinder value.
    [10" id="c-fr-0010]
    10. Method according to one of the preceding claims, wherein the automatic refractor comprises two eyepieces (10) to be placed simultaneously opposite the two eyes of the patient, and wherein the selection control (C) identifies: • at least one first spherical corrective lens to be positioned in the left eyepiece, the first corrective lens being adapted to scramble the patient's left eye at a predetermined distance from a maximum visual acuity value of the left eye, • at least one second spherical corrective lens to be positioned simultaneously in the right eyepiece, the second corrective lens being adapted to scramble the patient's right eye by the same deviation from a maximum visual acuity value of the right eye, the value of the predetermined distance depending on the determined accommodative profile.
    [11" id="c-fr-0011]
    The method according to one of the preceding claims, wherein the selection control (C) further depends on at least one of the following data: • a frequency score at which the patient has been subjected to refraction tests in a past period, • a frequency score at which the patient wears visual correction means, • the age of the patient, • the actual or sensory monophthalmic or non-sensory nature of the patient, • a score representative of the ability of the eyes to converge in one point.
    [12" id="c-fr-0012]
    A computer program product comprising program code instructions for executing the steps of the method according to one of the preceding claims, when this program is executed by at least one processor.
    [13" id="c-fr-0013]
    13. Control device (2) for an automatic refractor (1) comprising a plurality of corrective lenses and at least one eyepiece (10) adapted to be placed facing an eye of a patient, the control device comprising At least one processor configured to generate at least one selection command (C) identifying corrective lenses to be positioned successively in the eyepiece (10) in order to subject the eye to several successive refraction tests, communication for sending the selection command (C) generated to the automatic refractor, the controller (2) being characterized in that: • the processor is configured to determine an accommodative profile indicating an ability of the eye to accommodate excessively or not, and to generate the selection command (C) according to the determined accommodative profile.
    [14" id="c-fr-0014]
    14. An ocular refraction test system comprising: an automatic refractor (1), a control device (2) according to the preceding claim for controlling the automatic refractor (1).
    [15" id="c-fr-0015]
    15. System according to the preceding claim, further comprising: a refractometer (3) configured to measure ametropia (IR) data of an eye and transmit the measured data to the control device, the accommodative profile determined by the processor dependent on said measured data and transmitted to the control device (2).
    [16" id="c-fr-0016]
    16. The ocular refraction test system according to one of claims 14 to 15, further comprising a control terminal (5), the control terminal (5) comprising: • data acquisition means, • an interface of network communication with the control device (2) for transmitting to the control device data according to which the accommodative profile is determined.
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    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    US4105302A|1976-06-23|1978-08-08|Tate Jr George W|Automatic refraction apparatus and method|
    CA2214260A1|1997-08-29|1999-02-28|Eyelogic Inc.|Method and device for testing eyes|
    FR2868170A1|2004-03-24|2005-09-30|Damien Gatinel|Test glass manufacturing method for correcting e.g. coma aberration, involves cutting and polishing surface of glass to provide test glass having thickness in each point according to equation|
    WO2010065475A2|2008-12-01|2010-06-10|Junzhong Liang|Methods and devices for refractive correction of eyes|
    US20150305619A1|2008-12-01|2015-10-29|Perfect Vision Technology Ltd.,|Systems and methods for remote measurement of the eyes and delivering of sunglasses and eyeglasses|
    WO2012054651A2|2010-10-20|2012-04-26|Krypton Vision, Inc.|Methods and systems for customizing refractive corrections of human eyes|
    WO2014083392A1|2012-11-28|2014-06-05|Perfect Vision Technology, Ltd.|Methods and systems for automated measurement of the eyes and delivering of sunglasses and eyeglasses|WO2019162476A1|2018-02-23|2019-08-29|Essilor International|Method for altering the visual performance of a subject, method for measuring the spherical refraction correction need of a subject and optical system for implementing these methods|
    WO2019220023A1|2018-05-17|2019-11-21|Costantini Florent|Device, method and booth for automatic determination of the subjective ocular refraction of a patient|
    WO2020254239A1|2019-06-19|2020-12-24|SiVIEW|Method for automatically assessing the near vision accommodative state of a non-presbyopic individual and associated device|
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    优先权:
    申请号 | 申请日 | 专利标题
    FR1654033A|FR3050922B1|2016-05-04|2016-05-04|METHOD FOR CONTROLLING AN AUTOMATIC REFRACTOR|
    FR1654033|2016-05-04|FR1654033A| FR3050922B1|2016-05-04|2016-05-04|METHOD FOR CONTROLLING AN AUTOMATIC REFRACTOR|
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