Optics: eye examining – vision testing and correcting – Eye examining or testing instrument – Eye exercising or training type
Reexamination Certificate
2001-04-25
2002-10-15
Manuel, George (Department: 3737)
Optics: eye examining, vision testing and correcting
Eye examining or testing instrument
Eye exercising or training type
Reexamination Certificate
active
06464356
ABSTRACT:
The present invention concerns a process and device for the training of human vision. In particular, the invention relates to a process and apparatus by which a change of the visual performance of persons in need of a training for improvement or completion of their vision can be affected by stimulating their visual system with optical stimuli.
Impairments of a human's visual system may either result from an incomplete or impaired development of the visual system during infancy or from a deterioration either continuously and naturally due to ageing of the person or more or less abruptly due to diseases or accidents more or less severely influencing the visual system. It was, for example, found that the vision of children can substantially be improved by regular sessions of training their visual system, e. g. in cases of squinting. On the other hand, persons whose vision was deteriorated for any reason may either stop the deteriorating development or even improve their vision by a specific training adapted to the cause of deterioration of their visual system. The present invention intends to provide a process and device for training and improving a human's vision in all conceivable cases of impairment where the presentation of optical stimuli to the visual system of a person having need for an improvement of the vision may promise a successful removal of the cause of impairment and/or increase his/her performance.
In recent years computer-technology has been utilized to train mental functions of the human brain. For example, the prior art reports on methods to treat temporal processing deficits of language-learning impaired children using computer-training as a paradigm (M. M. Merzenich et al., Temporal processing deficits of language-learning impaired children ameliorated by training; Science 271, 77-81 (1996)). It is not clear, however, whether computer-based training can facilitate other sensory modalities such as visual functions after damage to the brain.
Brain injury, which may result from stroke or trauma, often impairs visual functions. Patients typically loose sight in one half of the visual field while the other side often remains unimpaired. This partial blindness is generally considered untreatable because it is the long-held belief that proper vision requires a highly specific neuronal organization (D. H. Hubel, T. N. Wiesel, Receptive fields, binocular interaction and functional architecture in the cat's visual cortex, J. Physiol. 106-154 (1962)). Despite this specificity in neuronal organization, there is, however, a considerable degree of plasticity in the injured visual system (U. Eysel, O. J. Gruesser, Increased transneuronal excitation of the lateral geniculate nucleus after acute differentiation, Brain Res. 158, 107-128 (1978); J. H. Kaas et al., Reorganization of retinotopic cortical maps in adult mammals after lesions of the retina, Science 248, 229-231(1990); C. D. Gilbert, T. N. Wiesel, Receptive field dynamics changes in adult cerebral cortex, Nature 356,150-152 (1992)). Lost visual functions can recover spontaneously to some extent in animals (J. Sautter, B. A. Sabel, Recovery of vision despite progressive loss of retrogradely labelled retinal ganglion cells after optic nerve crush, Europ. J. Neurosci. 5,680-690 (1993); B. A. Sabel, E. Kasten, M. R. Kreutz, Recovery of vision after partial visual system injury as a model of post-lesion neuroplasticity, Adv. Neurol. 73, 251-276 (1997); T. N. Wiesel, D. H. Hubel, Extent of recovery from the effects of visual deprivation in kittens, J. Neurophysiol. 28, 1060-1072 (1965); K. L. Chow, D. L. Steward, Reversal of structural and functional effects of long-term visual deprivation in cats, Exp. Neurol. 34, 409-433 (1972)) and man (H. - L. L. Teuber, W. S. Battersby, M. B. Bender, Visual field defects after penetrating missile wounds of the brain, Cambridge, Mass., Harvard University Press (1960)). At least some of this spontaneous post-lesion neuroplasticity of the adult visual system is due to extensive receptive field reorganization following lesions in retina or cortex (U. Eysel, O. Gruesser, loc. cit.; J. H. Kaas et al.. loc. cit.).
In the prior art, training methods have been disclosed that can be used to improve visual functions of brain damaged monkeys (A. Cowey, Perimetric study of field defects in monkeys after cortical and retinal ablations, Quart. J. Exp. Psychol. 19, 232-245 (1967)) and of men (J. Zihl, Zur Behandlung von Patienten mit homonymen Gesichtsfeldstörungen, Z. Neuropsychol. 2, 95-101 (1990); E. Kasten, B. A. Sabel, Visual field enlargement after computer training in brain damaged patients with homonymous deficits: an open pilot trial, Restor. Neurol. Neurosci. 8, 113-127 (1995)). However, in humans it has not generally been accepted that training can improve vision. Nevertheless, several observations were made that suggest that humans with visual system damage may benefit from visual training.
The first observation that visual training may be effective in humans is the study by Zihl et al. (loc. cit.), who found that repeated presentation of visual stimuli and measurements of incremental thresholds in the same retinal location results in small expansions of visual field borders in persons with visual field defects. Repeated testing in this situation requires, however, an experimenter to carry out the training with the person to be trained, i.e. this method cannot be used by the person independently. Thus, it is extremely time consuming for both the person and the experimenter.
To overcome this manual approach of presenting visual stimuli, several devices have been disclosed in the prior art with which automated testing can be achieved. Although their efficacy has only been shown in a few individual persons and a strictly planned clinical trial was never carried out, there have been claims that these methods may improve visual functions. However, because these prior art devices have been too complicated to use and inefficient in their application, they have not been widely accepted in clinical practice.
In the document No. DE-U 93 05 147 issued to Schmielau, for example, a device for training the visual system of humans is described consisting of a large size hemispheric half bowl. Here, arrays of small light bulbs are positioned in a large diameter semicircle. Light stimuli are presented by illuminating sequences of said light bulbs arranged closely to each other such that they may stimulate the visual field in different excentricities from the center which has to be visually fixed. While this device does allow assessment and training of the entire visual field in its full extent, it has several disadvantages which preclude its widespread use. The disadvantages are (1) its size, (2) the inflexible position with which visual stimuli can be presented, and (3) the absence of any teaching of orienting the training according to the residual visual functions. Due to the lack of presentation strategy, the use of the Schmielau prior art device requires extended time periods. In addition, the half bowl used for training is inpracticable for home use.
The limitation of the Schmielau invention is apparent from the
FIG. 4
of said document: There, as also described in the classical text books, the visual system of a human is shown by areas which are either intact or deficient. There is no mention of areas of impaired, residual visual functions based on which a visual field training may be performed.
One may presume that computers might be useful to replace such a large size, unpracticable device, but Schmielau (loc. cit.) states that this is not possible.
Therefore, since it is clearly stated that computer controlled training is not useful for purposes of visual field training, the use of computers was always refused in the prior art by those skilled in the art.
In contrast to the general expectations in the art, we have surprisingly found that a computer-controlled training procedure for visual functions of a human can contribute considerably to an improvement of the training effect.
Kasten Erich
Sabel Bernhard A.
Manuel George
Novavision AG
Oblon & Spivak, McClelland, Maier & Neustadt P.C.
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