IlluminatedZoom: spatially varying magnified vision using periodically zooming eyeglasses and a high-speed projector.

Spatial zooming and magnification, which control the size of only a portion of a scene while maintaining its context, is an essential interaction technique in augmented reality (AR) systems. It has been applied in various AR applications including surgical navigation, visual search support, and human behavior control. However, spatial zooming has been implemented only on video see-through displays and not been supported by optical see-through displays. It is not trivial to achieve spatial zooming of an observed real scene using near-eye optics. This paper presents the first optical see-through spatial zooming glasses which enables interactive control of the perceived sizes of real-world appearances in a spatially varying manner. The key to our technique is the combination of periodically fast zooming eyeglasses and a synchronized high-speed projector. We stack two electrically focus-tunable lenses (ETLs) for each eyeglass and sweep their focal lengths to modulate the magnification periodically from one (unmagnified) to higher (magnified) at 60 Hz in a manner that prevents a user from perceiving the modulation. We use a 1,000 fps high-speed projector to provide high-resolution spatial illumination for the real scene around the user. A portion of the scene that is to appear magnified is illuminated by the projector when the magnification is greater than one, while the other part is illuminated when the magnification is equal to one. Through experiments, we demonstrate the spatial zooming results of up to 30% magnification using a prototype system. Our technique has the potential to expand the application field of spatial zooming interaction in optical see-through AR.

Optical performance of progressive addition lenses (PALs) with astigmatic prescription.

The progressive addition lens (PAL) is a spectacle lens design with progressive refractive power changes across the lens surface to provide sharp vision at different viewing distances for patients with reduced accommodative strength. It has gained in popularity not just for presbyopic patients, but also patients with occupational (office, driving, or digital device) and therapeutic (e.g., myopia control) needs. However, despite the increasing prevalence of astigmatism in adults > 40 years old who rely on PAL correction, no metric is available to reflect the optical variation in PALs with astigmatic prescriptions. Based on recent studies, four novel optical metrics sensitive to variation of refractive power across the lens surface of PALs have been developed. These metrics were used to compare the optical performance of PALs of various prescriptions, designs, and manufacturers. For each lens, the refractive power profile was first measured with a Moire-deflectometry-based instrument.The data was then exported and analyzed using a two-dimensional error map for each of the four metrics. The results revealed significant impacts of astigmatic prescription, providing evidence for the usefulness of these metrics in quantifying the optical performance of PALs for patients with astigmatic prescriptions.

Indicators for Assessing the Quality of Refractive Error Care.

SIGNIFICANCE: Quality refractive error care is essential for reducing vision impairment. Quality indicators and standardized approaches for assessing the quality of refractive error care need to be established. PURPOSE: This study aimed to develop a set of indicators for assessing the quality of refractive error care and test their applicability in a real-world setting using unannounced standardized patients (USPs). METHODS: Patient outcomes and three quality of refractive error care (Q.REC) indicators (1, optimally prescribed spectacles; 2, adequately prescribed spectacles; 3, vector dioptric distance) were developed using existing literature, refraction training standards, and consulting educators. Twenty-one USPs with various refractive errors were trained to visit optical stores across Vietnam to have a refraction, observe techniques, and order spectacles. Spectacles were assessed against each Q.REC indicator and tested for associations with vision and comfort. RESULTS: Overall, 44.1% (184/417) of spectacles provided good vision and comfort. Of the spectacles that met Q.REC indicators 1 and 2, 62.5 and 54.9%, respectively, provided both good vision and comfort. Optimally prescribed spectacles (indicator 1) were significantly more likely to provide good vision and comfort independently compared with spectacles that did not meet any indicator (good vision: 94.6 vs. 85.0%, P = .01; comfortable: 66.1 vs. 36.3%, P < .01). Adequately prescribed spectacles (indicator 2) were more likely to provide good comfort compared with spectacles not meeting any indicator (57.7 vs. 36.3%, P < .01); however, vision outcomes were not significantly different (85.9 vs. 85.0%, P = .90). Good vision was associated with a lower mean vector dioptric distance (P < .01) but not with comfort (P = .52). CONCLUSIONS: The optimally prescribed spectacles indicator is a promising approach for assessing the quality of refractive error care without additional assessments of vision and comfort. Using USPs is a practical approach and could be used as a standardized method for evaluating the quality of refractive error care.

Respuestas evocadas visuales mediante estimulación con diodos emisores de luz montados en gafas / Visual evoked responses to light-emitting diodes in goggles

Introducción: El potencial evocado visual es una técnica que permite la evaluación de la integridad funcional de la vía visual; su aplicación en niños pequeños resulta de gran dificultad. Objetivo: Caracterizar desde el punto de vista fisiológico el potencial evocado visual en niños menores de 5 años. Métodos: Estudio descriptivo transversal, donde se registran respuestas visuales obtenidas con diodos (montados en gafas) en 112 niños sanos (65 varones, 47 hembras) con rango de edad entre 3 meses y 5 años. Se calcularon los valores medios y desviación estándar de latencias y amplitudes de cada componente de la respuesta y se estimaron sus dinámicas madurativas en función de la edad. Se utilizó un análisis de componentes principales para explicar la variabilidad morfológica (complejo N1-P1-N2) y, se calculó una ecuación discriminante (con indicadores de replicación y relación señal/ruido), para evaluar la contribución en su mejor detección. Resultados: La morfología típica encontrada resultó consistente, replicable y mostró un nivel de detección visual > 90 por ciento (para cada componente), con 85 por ciento de acierto global (clasificaciones correctas) mediante la ecuación discriminante. El complejo N1-P1-N2, consigue explicar > 70 por ciento de la varianza de esta respuesta. Se demostró un acortamiento significativo de latencia con la edad (regresión, p≤ 0,05) para los componentes N1, P1 (marginal, N2). Los valores de amplitud resultaron de mayor dispersión y su tendencia al incremento no alcanzó significación. Conclusiones: El registro del potencial evocado visual mediante diodos/gafas demuestra la obtención de respuestas fisiológicas consistentes y replicables (alta detectabilidad) con una variabilidad morfológica controlable(AU)

Introduction: The Visual Evoked Potentials is a neurophysiological technique to provide an objective assessment of the functional integrity of the visual pathway. However, the young children population is a particularly difficult (uncooperative) group to obtain visual responses. Objective: The purpose of this study was to describe electrophysiological characteristics of the visual response in children. Methods: Descriptive, cross-sectional study. Transient visual evoked potentials with goggles were recorded from 112 healthy children (65 males, 47 females) aged between 3 months to 5 years old. The mean (and standard deviations) for latencies and amplitudes of each component was calculated and both statistical significance in function of age was analyzed (linear regression model). Principal component analysis is use to explain the visual waveform variability. A discriminant equation (with indicators of reliability and noise/signal ratio) is calculate to evaluate contribution in detectability. Results: The typical waveform of (N1, P1, N2, components) is consistent and reliable and showed a visual detection level >90 percent (for each component) and 85 percent of global success (good classifications) with the discriminant equation. N1-P1-N2 complex is able to explain >70 percent of the visual response variance. A significant reduction of N1, P1 (N2, marginal) latencies with increasing age is demonstrated (linear regression, p≤0.05). There was no significant difference for age-dependent increased pattern of amplitude data (high variability). Conclusions: The visual evoked potentials/goggles obtained in infants and young children are consistent and reliable physiological responses (high detectability) with recognizable morphological variability(AU)

Reliability Testing of Augmented Reality Glasses Technology: Establishing the Evidence Base for Telewound Care.

PURPOSE: To test the fidelity and feasibility of using augmented reality glass (ARG) telehealth technology for comprehensive wound, ostomy, and continence (WOC) service delivery to underserved rural practice settings. DESIGN: Intrarater reliability design focusing on treatment integrity. SAMPLE AND SETTING: Adult patients in a tertiary care hospital and a rural long-term care setting who were scheduled for routine wound care consults. METHODS: Intra- and interrater reliability were assessed using a documentation-based wound assessment tool comprising 6 discrete assessment points. The wound teleassessment was first conducted by the telehealth "hub" WOC nurse remotely in collaboration with a bedside nurse wearing the ARG. The same hub WOC nurse then conducted an assessment at the bedside. Initial assessment points and treatment plans were compared to establish assessment and treatment intrarater reliability. A different WOC nurse, blinded to the first assessment, also conducted a bedside assessment and provided treatment recommendations, which were then compared to the hub WOC nurse's initial remotely ARG-generated treatment plan to establish treatment interrater reliability. RESULTS: Sixteen patients with 21 wounds were assessed. Six wound assessment components were included, yielding a total of 126 total observation points. Intrarater assessment reliability was 98%. Treatment plan interrater reliability was 100%. CONCLUSIONS: Results support further evaluation of ARG technology as a tool to enhance the delivery of wound care services in remote underserved settings. Implementation and evaluation of this technology on clinical and financial outcomes in multiple wound care delivery environments should be determined moving forward. Successful implementation should serve as a template to expand evidence-based WOC nursing care across the globe.

Technical Report: Solar Ultraviolet Protection from Sunglasses.

SIGNIFICANCE: There is substantial scientific uncertainty about the necessary levels of protection in sunglasses to avoid delayed health effects from solar ultraviolet radiation in the ultraviolet A (UV-A) band. The longer-wavelength limit for UV-A and the inclusion of the spectral effectiveness function in the calculation of solar UV-A transmittance are questionable. PURPOSE: There has been a wide range of informed opinion with regard to the level-or even need for-near-ultraviolet filtration (by absorption or reflection) in sunglasses. Many current sunglass filter lenses transmit very little near-ultraviolet radiant energy, whereas others transmit a significant fraction. There also are opposing commercial interests that argue either for strong filtration or for minimal protection. We review the evidence for potential risks and the challenge for the designer of any sunglass lens. It is shown that current standards are not at all cautious in their requirements for near-ultraviolet protection and do not meet a philosophical approach of minimizing needless exposure to optical energy that does not benefit vision. METHODS: The arguments for and against various factors in eye protection from ultraviolet radiation are discussed. The solar UV-A transmittance of some sunglass and clear spectacle lens materials has been calculated using the formulae and methods used in the International Standards Organization sunglass standard. The Annex gives results of the calculations both with and without the S(λ) erythemal weighting function and up to 380 or 400 nm. RESULTS: The solar UV-A transmittance calculated with the S(λ) function and only up to 380 nm gives numerical results that are lower than taking either the upper limit for UV-A as 400 nm or without the S(λ) function. CONCLUSIONS: Most sunglass lenses will still pass the requirements with the more stringent requirements, but some spectacle lens materials will need extra treatment.

Technical Support by Smart Glasses During a Mass Casualty Incident: A Randomized Controlled Simulation Trial on Technically Assisted Triage and Telemedical App Use in Disaster Medicine.

BACKGROUND: To treat many patients despite lacking personnel resources, triage is important in disaster medicine. Various triage algorithms help but often are used incorrectly or not at all. One potential problem-solving approach is to support triage with Smart Glasses. OBJECTIVE: In this study, augmented reality was used to display a triage algorithm and telemedicine assistance was enabled to compare the duration and quality of triage with a conventional one. METHODS: A specific Android app was designed for use with Smart Glasses, which added information in terms of augmented reality with two different methods-through the display of a triage algorithm in data glasses and a telemedical connection to a senior emergency physician realized by the integrated camera. A scenario was created (ie, randomized simulation study) in which 31 paramedics carried out a triage of 12 patients in 3 groups as follows: without technical support (control group), with a triage algorithm display, and with telemedical contact. RESULTS: A total of 362 assessments were performed. The accuracy in the control group was only 58%, but the assessments were quicker (on average 16.6 seconds). In contrast, an accuracy of 92% (P=.04) was achieved when using technical support by displaying the triage algorithm. This triaging took an average of 37.0 seconds. The triage group wearing data glasses and being telemedically connected achieved 90% accuracy (P=.01) in 35.0 seconds. CONCLUSIONS: Triage with data glasses required markedly more time. While only a tally was recorded in the control group, Smart Glasses led to digital capture of the triage results, which have many tactical advantages. We expect a high potential in the application of Smart Glasses in disaster scenarios when using telemedicine and augmented reality features to improve the quality of triage.

Reevaluation of Current Prism Standards With Recommendations to Increase Accuracy in the Measurement of Strabismus.

PURPOSE: To critically evaluate the traditional standards for holding single prisms in measuring strabismus, with the specific goal being to increase the overall accuracy of clinical measurements. DESIGN: Reliability and validity analysis. METHODS: Using an analysis involving geometric optics, the effective prism power (EPP), measured in prism diopters (PD), was calculated for glass and acrylic prisms and was the main outcome measure. These results were also validated using optical bench measurements. No patients were involved. RESULTS: Plotting the calculated effective prism power as a function of rotational angle produced curves demonstrating that the frontal plane position lies along the flatter portions of the curves, while the Prentice position lies along the steeper portions of the curves. Calculated values of prism power for the standard clinical positions as well as the percentage errors from accepted standards were compared. Acrylic prisms can be held in the frontal plane position with acceptable amounts of error (<5%) for prisms up to 50 PD. Glass prisms are capable of producing significant errors for measurements much greater than 10 PD. CONCLUSIONS: The use of glass prisms as currently calibrated should be abandoned or at least limited to small measurements. Acrylic prisms produce acceptable errors if careful attention is given to their position.

Using motion capture technology to measure the effects of magnification loupes on dental operator posture: A pilot study.

BACKGROUND: Motion analysis has great potential for quantitatively evaluating dental operator posture and the impact of interventions such as magnification loupes on posture and subsequent development of musculoskeletal disorders. OBJECTIVE: This study sought to determine the feasibility of motion capture technology for measurement of dental operator posture and examine the impact that different styles of magnification loupes had on dental operator posture. METHODS: Forward and lateral head flexion were measured for two different operators while completing a periodontal probing procedure. Each was measured while wearing magnification loupes (flip up-FL and through the lens-TTL) and basic safety lenses. RESULTS: Operators both exhibited reduced forward flexion range of motion (ROM) when using loupes (TTL or FL) compared to a baseline lens (BL). In contrast to forward flexion, no consistent trends were observed for lateral flexion between subjects. CONCLUSIONS: The researchers can report that it is possible to measure dental operator posture using motion capture technology. More study is needed to determine which type of magnification loupes (FL or TTL) are superior in improving dental operator posture. Some evidence was found supporting that the quality of operator posture may more likely be related to the use of magnification loupes, rather than the specific type of lenses worn.

Healthcare professionals' views of smart glasses in intensive care: A qualitative study.

OBJECTIVE: The aim of this study was to describe healthcare professionals' views of smart glasses before their implementation in an intensive care unit, both regarding quality of use of the glasses and to identify possible intensive care situations where the glasses could be used to increase patient safety. METHODS: Data were generated through focus group interviews and analysed using thematic content analysis. FINDINGS: The findings describe participants' views of smart glasses divided into three categories; Smart glasses to facilitate work at intensive care unit; Quality of use and Utilisation. Participants assumed smart glasses to cause both effect and affect in intensive care. Participants' concern for patients arose recurrently and through their concern intention to work to promote patient safety. CONCLUSION: Smart glasses are suggested as a complement to existing monitoring and routines and cannot replace human presence in intensive care.

[Spectacle Glasses - an Overview]. / Brillengläser ­ eine Übersicht.

This paper will give some support to choose the right spectacle lens. The question "what is the proper spectacle lens" cannot be answered exactly, the answer depends on many parameters. Depending on the visual task, the right spectacle lens is a compromise between lens properties. These properties are pointed out in the paper.

[Glasses as Relevant Factor in Expert Opinions]. / Die Brille als Bewertungsfaktor im Gutachten.

Optical correction is an independent factor in expert opinions. It is outlined how this should be considered in different legal areas.

The Effect of Magnification Loupes on Dental Hygienists' Posture while Exploring.

Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation.Methods: A convenience sample of 27 right-handed dental hygienists, with no prior history of injuries or disabilities of the head, neck, or trunk region, enrolled in the study. Baseline posture calibration was taken and tri-axial accelerometers were placed on four locations of the head and trunk (occipital region of head; cervical vertebrae C5; thoracic vertebrae T5; lumbar vertebrae L1) to measure acceleration and the orientation of the body to gravity. Participants were randomly assigned to wear self-supplied magnification loupes during either the first or second half of the session. Dental chair mounted typodonts, prepared with artificial calculus, were used to represent a simulated oral environment. Participants were asked to explore all areas of the mouth using an ODU 11/12 explorer. Mean accelerations of the three axes were used to compute average forward/backward (AP) and side to side (ML) tilt of each accelerometer recorded during the instrumentation sessions. An end-user opinion survey was completed by each participant at the conclusion of the session.Results: No statistically significant differences in posture were revealed between the sessions with the participants wearing their loupes and not wearing loupes. However, data from the end-user survey indicate that 74% of all the participants strongly agreed that magnification loupes made exploring easier and 67% strongly agreed that they felt that magnification loupes improved their posture.Conclusion: While the majority of participants perceived that their magnification loupes enhanced their posture and made exploring easier, data from this study provided little evidence to suggest that wearing loupes leads to improved body orientation. Future research needs to examine the declination angle of ergonomic loupes and its relationship to neck and trunk flexion.

Visual Performance and Optical Quality of Standardized Asymmetric Soft Contact Lenses in Patients With Keratoconus.

Purpose: To evaluate the visual performance and optical quality of a standardized asymmetric soft contact lens (SCL) used for correction of higher-order aberrations (HOAs) in eyes with keratoconus. Methods: We included 30 eyes (26 patients) with keratoconus (average K: 45.7 ± 2.3 diopters [D]). The patients were subjected to corneal tomography, aberrometry, measurements of manifest refraction and visual acuity (VA), and visual analog scale (VAS) assessments. The study lenses were made using a molding method and consisted of six standardized types, in which an asymmetric power distribution of approximately 2 to 12 D (2-D step) was used to correct HOAs. The lens type suitable for each eye was selected based on the corneal tomography and aberrometry data. The on-eye performance of the lens was evaluated using aberrometry (4-mm pupil), over refraction, VA, and VAS. Results: The standardized asymmetric SCL improved the best spectacle-corrected VA from -0.07 ± 0.09 to -0.11 ± 0.08 logMAR (P < 0.05) and the mean VAS score from 66.2 ± 21.8 to 75.4 ± 20.5 (P < 0.05). Vertical coma decreased significantly (-0.50 ± 0.36 µm without SCL; -0.36 ± 0.34 µm with SCL; P < 0.01). In subgroup analysis, subjects in the high VAS group (score ≥ 75) accounted for 70% of all subjects, and this was the group in which the vertical coma decreased significantly from the level without the lens. Conclusions: A standardized asymmetric SCL can reduce HOAs and improve vision quality when compared with spectacles in patients with keratoconus who wear rigid gas-permeable lenses.

Patient-Reported Spectacle Independence Questionnaire (PRSIQ): Development and Validation.

PURPOSE: To develop a questionnaire quantifying spectacle independence following cataract surgery. DESIGN: Questionnaire design and validation study. METHODS: A literature review, expert clinical interviews, and patient interviews were undertaken to develop a patient-reported questionnaire assessing spectacle independence. Draft items were assessed and revised in a series of cognitive interviews where the instructions, recall period, and response categories were evaluated for understandability and consistency. The final draft items were evaluated in 2 quantitative studies. Confirmatory factor analyses, including item response theory calibration, were performed; reliability estimates were obtained; and validity analyses of the resulting scores were carried out. RESULTS: Qualitative research demonstrated that patients often considered themselves spectacle independent yet, when probed, it was determined that the respondent actually wore correction for certain activities. Moreover, despite what the respondents claimed about needing to wear correction and their actual use of correction, there were various levels of function reported when carrying out activities at several different distances without the use of correction. Using the qualitative results, the Patient-Reported Spectacle Independence Questionnaire (PRSIQ) was developed to assess spectacle independence via items that assess what patients say and do, and how they function at various distances. All quantitative analyses (eg, discriminant and convergent validity correlations, known-groups analyses) conform to predictions and support the use of the PRSIQ as a measure of spectacle independence. CONCLUSIONS: The PRSIQ is a patient-reported measure assessing spectacle independence following cataract surgery. The analyses conducted provide evidence for the use of the PRSIQ total score as a measure of spectacle independence.

Smart-Glasses: Exposing and Elucidating the Ethical Issues.

The objective of this study is to provide an overview over the ethical issues relevant to the assessment, implementation, and use of smart-glasses. The purpose of the overview is to facilitate deliberation, decision making, and the formation of knowledge and norms for this emerging technology. An axiological question-based method for human cognitive enhancement including an extensive literature search on smart-glasses is used to identify relevant ethical issues. The search is supplemented with relevant ethical issues identified in the literature on human cognitive enhancement (in general) and in the study of the technical aspects of smart-glasses. Identified papers were subject to traditional content analysis: 739 references were identified of which 247 were regarded as relevant for full text examinations, and 155 were included in the study. A wide variety of ethical issues with smart-glasses have been identified, such as issues related to privacy, safety, justice, change in human agency, accountability, responsibility, social interaction, power and ideology. Smart-glasses are envisioned to change individual human identity and behavior as well as social interaction. Taking these issues into account appears to be relevant when developing, deliberating, deciding on, implementing, and using smart-glasses.

Equivalence between solar irradiance and solar simulators in aging tests of sunglasses.

BACKGROUND: This work is part of a broader research that focuses on ocular health. Three outlines are the basis of the pyramid that comprehend the research as a whole: authors' previous work, which has provided the public to self-check their own sunglasses regarding the ultraviolet protection compatible to their category; Brazilian national survey in order to improve nationalization of sunglasses standards; and studies conducted on revisiting requirements of worldwide sunglasses standards, in which this work is inserted. It is still controversial on the literature the ultraviolet (UV) radiation effects on the ocular media, but the World Health Organization has established safe limits on the exposure of eyes to UV radiation based on the studies reported in literature. Sunglasses play an important role in providing safety, and their lenses should provide adequate UV filters. Regarding UV protection for ocular media, the resistance-to-irradiance test for sunglasses under many national standards requires irradiating lenses for 50 uninterrupted hours with a 450 W solar simulator. This artificial aging test may provide a corresponding evaluation of exposure to the sun. METHODS: Calculating the direct and diffuse solar irradiance at a vertical surface and the corresponding radiant exposure for the entire year, we compare the latter with the 50-h radiant exposure of a 450 W xenon arc lamp from a solar simulator required by national standards. RESULTS: Our calculations indicate that this stress test is ineffective in its present form. CONCLUSIONS: We provide evidence of the need to re-evaluate the parameters of the tests to establish appropriate safe limits for UV irradiance. SIGNIFICANCE: This work is potentially significant for scientists and legislators in the field of sunglasses standards to improve the requirements of sunglasses quality and safety.

A Comparison of Spectacles Purchased Online and in UK Optometry Practice.

PURPOSE: To compare spectacles bought online with spectacles from optometry practices. METHODS: Thirty-three participants consisting of single vision spectacle wearers with either a low (N = 12, mean age 34 ± 14 years) or high prescription (N = 11, mean age 28 ± 9 years) and 10 presbyopic participants (mean age 59 ± 4 years) wearing progressive addition lenses (PALs) purchased 154 pairs of spectacles online and 154 from UK optometry practices. The spectacles were compared via participant-reported preference, acceptability, and safety; the assessment of lens, frame, and fit quality; and the accuracy of the lens prescriptions to international standard ISO 21987:2009. RESULTS: Participants preferred the practice spectacles (median ranking 4th, IQR 1-6) more than online (6th, IQR 4-8; Mann-Whitney U = 7345, p < 0.001) and practice PALs (median ranking 2nd, IQR 1-4) were particularly preferred (online 6.5th, IQR 4-9, Mann-Whitney U = 455, p < 0.001). Of those deemed unacceptable and unsafe, significantly more were bought online (unacceptable: online 43/154 vs. practice 15/154, Fisher's exact p = 0.0001; unsafe: online 14/154 vs. practice 5/154, Fisher's exact p = 0.03). CONCLUSIONS: Participants preferred spectacles from optometry practice rather than those bought online, despite lens quality and prescription accuracy being similar. A greater number of online spectacles were deemed unsafe or unacceptable because of poor spectacle frame fit, poor cosmetic appearance, and inaccurate optical centration. This seems particularly pertinent to PAL lenses, which are known to increase falls risk. Recommendations are made to improve both forms of spectacle provision.