JP7850082B2 - A patch-on device for treating progressive refractive errors using peripheral defocalization. - Google Patents

Description

(Cross-reference of related applications)
This application claims the benefit of U.S. Provisional Patent Application No. 63/036,234, filed on 8 June 2020, titled "STICK ON DEVICES USING PERIPHERAL DEFOCUS TO TREAT PROGRESSIVE REFRACTIVE ERROR," which is incorporated as a whole by this reference under 35 U.S.C. §119(e).

The subject matter of this application relates to PCT/US2019/043692, filed on 26 July 2019, titled "ELECTRONIC CONTACT LENS TO DECREASE MYOPIA PROGRESSION," published as WO2020028177A1, whose entire disclosure is incorporated herein by reference.

Previous approaches to treating refractive errors such as myopia may be sub-ideal in at least some respects. Eyeglass lenses, contact lenses, and refractive surgery can be used to treat refractive errors of the eye. However, lenses must be worn to correct the abnormality, and uncorrected refractive errors can affect a person's ability to achieve and fully participate in certain activities in school, sports, and other activities. While surgery can be performed to reduce refractive errors, surgery carries risks, including infection and vision loss, at least in some cases. Furthermore, these approaches do not address the underlying changes in axial length associated with refractive errors such as myopia.

Research related to this disclosure suggests that the retinas of many species, including humans, are repositioned through scleral remodeling in response to defocused images, reducing the blur caused by defocusing. While the mechanisms of growth signal generation remain under study, one observable phenomenon is an increase in choroidal thickness. Defocused images can alter choroidal thickness, which is related to the axial length of the eye. Changes in the axial length of the eye can alter refractive errors by altering the position of the retina relative to the cornea. For example, an increase in axial length increases myopia by increasing the distance between the cornea and the lens.

Image defocusing may play a role in changes in choroid thickness and axial length of the eye, but previous approaches are sub-ideal for addressing refractive errors of the eye related to axial length. Pharmaceutical treatments have been proposed to treat myopia associated with axial length growth, but these treatments may have sub-ideal results and, in at least some cases, have not been shown to safely treat refractive errors. Light has been proposed as a stimulus to modify eye growth, but at least some of the previous devices may provide sub-ideal results. Furthermore, treatment times may be longer than ideal, and at least some of the previous approaches may be more complex than ideal.

Therefore, a new approach is needed to treat refractive errors of the eye that improves at least some of the limitations of previous approaches.

A device for treating refractive errors of the eye comprises an optical system having an optical zone and a peripheral defocusing optical structure for forming images of multiple stimuli in front of or behind the peripheral portion of the retina of the eye. In some embodiments, the peripheral defocusing optical structure is located outside the optical zone. In some embodiments, the peripheral defocusing optical structure has refractive power to focus light to a different depth than the optical zone of the eye. In some embodiments, the optical system comprises one or more of lenses, optically transparent substrates, beam splitters, prisms, or optically transparent supports.
The present invention provides, for example, the following items:
(Item 1)
A device for treating refractive errors of the eye, wherein the device is
An optical system with an optical zone,
A peripheral defocusing optical structure for forming images of multiple stimuli in front of or behind the peripheral portion of the retina of the eye, wherein the peripheral defocusing optical structure is located outside the optical zone and
A device equipped with the following features.
(Item 2)
The apparatus according to item 1, wherein the peripheral defocusing optical structure has refractive power to focus light to a depth different from the optical zone of the eye.
(Item 3)
The apparatus according to item 1, wherein the optical system comprises one or more of a lens, an optically transparent substrate, a beam splitter, a prism, or an optically transparent support.
(Item 4)
The peripheral defocusing optical structure is the apparatus described in item 1, comprising a Fresnel lens.
(Item 5)
The apparatus according to item 1, wherein the peripheral defocusing optical structure comprises a plurality of lenslets.
(Item 6)
The apparatus according to item 5, wherein the plurality of lenslets are arranged in one or more circular arrays centered on the optical zone.
(Item 7)
The apparatus according to item 1, wherein the peripheral defocusing optical structure comprises one or more of a diffractive optical structure or an Echelet grating.
(Item 8)
The apparatus according to item 1, further comprising a filter within the optical zone to reduce light transmission through it.
(Item 9)
The apparatus according to item 8, wherein the filter is configured to reduce the intensity of the central image formed on the fovea of the eye and to provide the increased intensity of the plurality of stimuli in relation to the intensity of the central image.
(Item 10)
The apparatus according to item 8, wherein the filter extends within the peripheral defocusing optical structure.
(Item 11)
The apparatus according to item 8, wherein the filter comprises a neutral concentration filter.
(Item 12)
The filter is the apparatus described in item 8, which reduces the transmittance of visible light to 1/5 to 1/30.
(Item 13)
The device described in item 8, wherein the filter reduces the transmittance of visible light by an amount in the range of 5 percent to 99 percent.
(Item 14)
The apparatus according to item 1, further comprising a display configured to provide light through the optical zone to form a central image on the macula, and through the peripheral defocusing optical structure to provide the plurality of stimuli with defocusing on the peripheral portion of the retina.
(Item 15)
The apparatus according to item 14, wherein the plurality of stimuli are formed using the lenslet of the peripheral defocusing optical structure.
(Item 16)
The apparatus according to item 1, wherein the peripheral defocusing optical structure further comprises a plurality of stimulus generating structures.
(Item 17)
The apparatus according to item 16, further comprising a filter matched with one or more apertures of the aforementioned peripheral defocusing optical structures.
(Item 18)
The apparatus described in item 17, wherein the plurality of stimulus-generating structures are located within the opening.
(Item 19)
The apparatus according to item 18, wherein each of the plurality of stimulus-generating structures comprises a mask.
(Item 20)
The apparatus described in item 1, wherein each of the aforementioned multiple stimuli has a spatial frequency.
(Item 21)
The apparatus according to item 20, wherein the spatial frequency is within the range of 0.1 cycles/degree to 180 cycles/degree, and optionally within the range of 1 cycle/degree to 180 cycles/degree.
(Item 22)
The apparatus according to item 20, wherein the spatial frequencies include at least one line pair/mm (lp/mm) on the retina, and optionally, at least 50 lp/mm on the retina.
(Item 23)
The apparatus according to item 1, wherein the aforementioned multiple stimuli have contrast within the range of 99.9% to 2.5%.
(Item 24)
The apparatus according to item 1, wherein the peripheral defocusing optical structure has a refractive power in the range of -2D to -6D or in the range of +2D to +6D.
(Item 25)
The apparatus according to item 1, wherein the peripheral defocusing optical structure has a refractive power in the range of -3D to -5D or in the range of +3D to +5D.
(Item 26)
The apparatus according to item 1, further comprising a base, wherein the peripheral defocusing optical structure is coupled to the base.
(Item 27)
The apparatus according to item 26, further comprising an adhesive on the surface of the base.
(Item 28)
The apparatus according to item 27, wherein the optical system comprises an eyeglass lens and a filter, and the peripheral defocusing optical structure is coupled to the lens.
(Item 29)
The optical system is the apparatus described in item 1, comprising an adhesive.
(Item 30)
The optical system is the apparatus described in item 1, comprising multiple layers.
(Item 31)
The display and
A processor operably coupled to the display, the processor comprising instructions for providing the plurality of stimuli on the display at a plurality of locations and for forming the image at a plurality of locations in front of or behind the retina.
The apparatus described in item 1, further comprising the above.
(Item 32)
The apparatus according to item 31, wherein the peripheral defocusing structure comprises a plurality of lenslets, and each of the plurality of stimuli on the display is aligned with a corresponding lenslet to form an image in an anterior or posterior location in the peripheral portion of the retina.
(Item 33)
Multiple substantially transparent electrodes,
The liquid crystal material between the plurality of substantially transparent electrodes and
Furthermore,
The apparatus according to item 32, wherein the liquid crystal material and the plurality of lenslets are positioned between the plurality of electrodes, and the apparatus activates and deactivates the refractive power of the plurality of lenslets.
(Item 34)
The apparatus according to item 33, wherein the plurality of lenslets are substantially transparent in the deactivated configuration, and the plurality of lenslets are configured to provide the plurality of stimuli in the deactivated configuration.
(Item 35)
The apparatus according to item 33, wherein the plurality of electrodes are configured to change the refractive index of the liquid crystal material in response to the voltage between the electrodes.
(Item 36)
The apparatus according to item 33, wherein the processor is operably coupled to the plurality of electrodes, activates the plurality of lenslets, and provides the plurality of stimuli.
(Integrated by reference)

All patents, applications, and publications referenced and identified herein are incorporated herein by reference as a whole, and are deemed to be fully incorporated by reference wherever they are referenced.

A deeper understanding of the features, advantages, and principles of this disclosure will be obtained by referring to the following detailed description, which includes illustrative embodiments, and the accompanying drawings.

Figure 1 shows a side view of a visual device for treating refractive errors of the eye, according to several embodiments.

Figure 2 shows a device for treating refractive errors of the eye according to several embodiments.

Figure 3A shows the apparatus of Figure 2 in use according to several embodiments.

Figure 3B shows a display with multiple stimuli according to several embodiments, and the corresponding dimensions of the defocused stimuli on the retina in degrees.

Figure 4 shows a cross-sectional perspective view of the apparatus of Figure 2 according to several embodiments.

Figure 5 shows an assembly of the device shown in Figure 2 on a lens, according to several embodiments.

Figure 6 shows a device for treating refractive errors of the eye according to several embodiments.

Figure 7 shows the apparatus of Figure 6 in use according to several embodiments.

Figure 8 shows perspective views of the apparatus of Figure 6 according to several embodiments.

Figure 9 shows a cross-sectional perspective view of the apparatus of Figure 6 according to several embodiments.

Figure 10 shows an assembly of the device of Figure 6 on a lens, according to several embodiments.

Figure 11 shows a device for treating refractive errors of the eye according to several embodiments.

Figure 12 shows the apparatus of Figure 11 in use according to several embodiments.

Figure 13 shows a perspective view of the apparatus of Figure 11 according to several embodiments.

Figure 14 shows a cross-sectional perspective view of the apparatus of Figure 11 according to several embodiments.

Figure 15 shows an assembly of the device of Figure 11 on a lens, according to several embodiments.

Figure 16 shows a device for treating refractive errors of the eye according to several embodiments.

Figure 17 shows an apparatus comprising a device that is coupled to the display of a user device and provides retinal stimulation to the user.

Figure 18 shows multiple lenslets with liquid crystal material between electrodes.

Figure 19 shows a therapeutic device comprising a display coupled to a lenslet array, according to several embodiments.

Detailed Description The following detailed description provides a deeper understanding of the features and advantages of the invention as described herein, through the embodiments disclosed herein. The detailed description includes many specific embodiments, which are provided only as examples and should not be construed as limiting the scope of the invention as disclosed herein.

The methods and apparatus of this disclosure can be configured in many ways to provide membrane stimulation, as described herein. The methods and apparatus of this disclosure are particularly well-suited for use with many prior devices, such as ophthalmic devices, TV screens, computer screens, virtual reality ("VR") displays, augmented reality ("AR") displays, handheld and mobile computing devices, tablet computing devices, smartphones, wearable devices, spectacle lens frames, spectacle lenses, eyepiece displays, head-mounted displays, goggles, contact lenses, implantable devices, corneal onlays, corneal inlays, corneal prostheses, or intraocular lenses, one or more of these. While specifically referring to spectacles and contact lenses, the methods and apparatus of this disclosure are particularly well-suited for use with any of the aforementioned devices, and those skilled in the art will readily understand how one or more of the components of this disclosure can be interchangeable between devices based on the teachings provided herein.

The methods and apparatus of this disclosure can be used to treat many types of refractive errors, but they are particularly well-suited, for example, to treat the progression of myopia.

Figure 1 shows a cross-section of a device 100 for treating refractive errors of the eye. The device 100 may include any suitable visual device, such as a VR headset. The components of the device may be arranged relative to the user's eye. The device 100, such as a VR headset, may include a display 110. The display 110 provides visual content, such as video games and movies, for viewing by the user. The image from the display 110 is transmitted through an optical system 112 to the user's eye, represented by the cornea 114 and pupil 116. The optical system 112 may include refractive lenses that change the focus of light before it enters the user's eye. Alternatively, the optical system may include, for example, a beam splitter or a flat surface such as a prism. The optical system 112 may include a rear optical structure 122 that can be curved or otherwise shaped to adjust the focus of the image projected from the display 110 onto the user's eye. For example, in the device 100, such as a VR device, the rear optical structure 122 may include a Fresnel lens. In other devices, such as eyeglasses, the optical system 112 may include prescription lenses to correct the refractive error of the patient's eye, using a rear optical surface 122 that is shaped to correct one or more of the following refractive errors of the eye: myopia, hyperopia, astigmatism, and other refractive errors of the eye. While referring to Fresnel lenses, the lenses may comprise any preferred lens structure, such as curved lenses, annular lenses, Fresnel lenses, diffractive or holographic elements, and one or more of these combinations.

The defocusing treatment device 124 may be attached to or part of the surface of the optical system 112. For example, in Figure 1, the defocusing treatment device 124 may be part of or attached to the front surface of the optical system 112. In some embodiments, the treatment device 124 is bonded to the optical system 112 using an adhesive. In some embodiments, the defocusing treatment device 124 comprises a peripheral defocusing optical structure 120 arranged around a central optical zone 118. In some embodiments, the central optical zone is configured to provide a clear field of view of an object such as a display 110. The optical zone can be configured in many ways and may include an optical zone with correction to provide the eye with an image focused on the macula of the eye's retina that is not obstructed by the display. In some embodiments, the defocusing optical structure 120 alters the focus of light. The defocusing optical structure can be configured to form an image of the stimulus in front of the retina to treat refractive errors of the eye, such as myopia. Alternatively, the image of the stimulus can be formed behind the retina of the eye. The image of the stimulus may, for example, be displayed on a screen. While referring to a therapeutic defocusing device bonded to the lens 112, in some embodiments, the defocusing optical structure 120 is formed directly on the surface of the lens 112, or, for example, the structure is etched into the surface of the lens 112.

The dimensions of the optical zone 118 and the peripheral defocusing optical structure 120 zone can be configured in many ways. In some embodiments, the peripheral defocusing optical structure 120 is sized and shaped to transmit light at angles ranging from 12 to 40 degrees or from 15 to 35 degrees relative to the entrance pupil of the eye. In some embodiments, the angles include half angles, such as the angle between the boundary of the optical zone and a line formed through the center of the optical zone and the center of the entrance pupil. In some embodiments, the peripheral defocusing optical structure 120 is sized to be at angles ranging from 15 to 50 degrees relative to the entrance pupil of the eye. In some embodiments, the peripheral defocusing optical structure 120 comprises an inner boundary and an outer boundary. The inner boundary corresponds to an inner boundary angle 125 ranging from 15 to 20 degrees relative to the entrance pupil of the eye, and the outer boundary corresponds to an outer boundary angle 126 ranging from 25 to 70 degrees relative to the entrance pupil of the eye. In some embodiments, the lens is at a certain distance from the eye. The distance, medial boundary, and lateral boundary may be precisely measured to provide the internal and external angles relative to the entrance pupil of the eye.

The peripheral defocusing optical structure 120 may have an annular shape with inner and outer diameters, selected so that the peripheral defocusing is applied to a portion of the patient's retina that is eccentric with respect to the fovea. For example, the inner diameter may be at an angle of about 7.5 degrees with respect to the optical axis of the optical system 112 and the pupil, and this angle may be referred to as the inner boundary angle 125. The outer diameter of the peripheral defocusing optical structure 120 may be at an outer boundary angle 126 with respect to the optical axis of the patient's eye and pupil, for example, 17.5 degrees. Such an arrangement results in the peripheral defocusing optical structure 120 being located within the periphery of the user's visual field, with corresponding defocusing of light projected into the peripheral region of the user's retina that is eccentric with respect to the fovea.

While referring to an annular shape, the peripheral defocusing optical structure 120 can be configured with other shapes such as polygons, squares, and triangles, and may comprise multiple discrete optical structures positioned around the optical zone at appropriate locations.

In some embodiments, the peripheral defocusing optical structure 120 may include an optical system or optical structure that alters the focus of the projected light in the patient's eye. The peripheral defocusing optical structure 120 may include one or more of the following: a diffractive optical system, a lenslet, a gradient refractive index ("GRIN") lenslet, a crossed cylindrical rod, a mask, or an Eschlett grating, which modifies the focus of the light passing through the defocusing optical structure 120.

In some embodiments, the peripheral defocusing optical structure 120 is sized to provide a defocused image to the peripheral portion of the retina. In some embodiments, the defocusing optical structure 120 is configured to provide stimulation to the peripheral portion of the retina constituting the area of the retina outside the fovea or macula, so as to provide clear vision to the fovea and macula when the user looks forward and the peripheral defocusing optical structure 120 provides a defocused image to the peripheral retina. The image may be defocused myopically or hyperopically relative to the retina within a range of 2.0 to 6.0 diopters ("D"). For example, the defocusing may be 3.5 to 5D in front of the retina (e.g., myopic defocusing) or behind the retina (e.g., hyperopic defocusing). The defocusing is preferably 2.5 to 5.0D, more preferably 3.0 to 5.0D.

In some embodiments, the defocusing treatment device may be used to treat refractive errors of the eye in combination with localized stimuli projected into a peripheral zone by a display. In the defocusing treatment device 124, the stimuli are projected through a peripheral defocusing optical structure 120 along with video content projected by a display, and therefore, images of both the video content and the stimuli are defocused by the peripheral defocusing optical structure.

For the treatment of spherical refractive errors of the eye, such as myopia, the stimulus projected onto the retina may be uniform around the periphery of the central optical zone 118. For the treatment of cylindrical refractive errors of the eye, such as astigmatism, the stimulus projected onto the retina may be non-uniform around the periphery of the central optical zone 118. For example, the stimulus may be larger along a meridian corresponding to or aligned with the first astigmatism axis of the eye, and symmetrically mirrored around the second astigmatism axis of the eye.

Figure 2 depicts a defocusing therapy device 124, comprising a hardware-based defocusing structure and stimuli provided by software, such as software that modifies the image projected from the display so that the image contains appropriate stimuli. The defocusing therapy device 124 includes a central optical zone 118 and a peripheral defocusing optical structure 120. The central optical zone 118 may be flattened to have a substantially planar surface, or otherwise shaped to provide little to no change in the angle of incident light passing through the central optical zone 118. Referring to a central optical zone with a substantially planar surface, the central optical zone may have refractive power to correct refractive errors of the eye, or may be combined with optical correction such as eyeglasses. The central optical zone 118 may also include a filter 130, such as a neutral density filter or mask.

In some embodiments, a neutral density filter is provided to increase the intensity of stimulation relative to the central clear visual zone so as to provide increased stimulation to the outer portion of the retina, e.g., the peripheral retina. In some embodiments, the neutral density filter comprises a filter that substantially equally reduces or modifies the intensity of light within the visible wavelength without inducing any change in the hue or color of the light passing through the filter. The neutral density filter can reduce the illumination of light by 80% to 99%, preferably 90 and 95%, more preferably about 97%. The neutral density filter 130 may provide an illumination difference of at least 5 times, preferably at least 10, 20, or 30 times, between the central optical zone 118 or other filtered area and the outer zone or other unfiltered area. In some embodiments, the illumination difference provided by the neutral density filter and unfiltered area of the defocusing treatment device 124 may be about 5, 10, 20, or 30 times. In some embodiments, the illumination difference may be 5 to 30 times, more preferably 10 to 20 times. While a neutral concentration filter is mentioned, in some embodiments, filter 130 comprises a colored filter.

In some embodiments, the outer area of the defocusing treatment device 124 includes a peripheral defocusing optical structure 120. The peripheral defocusing optical structure 120 may be provided by a Fresnel lens as shown in Figures 2, 3A, 3B, 4, and 5, or by any preferred optical structure as described herein. The Fresnel lens is sized to provide a defocused image to the peripheral portion of the retina. In some embodiments, the peripheral portion of the retina constitutes a region of the retina outside the fovea or macula, and defocusing is provided to this area, while the central area is not defocused to provide clear vision to the fovea and macula when the user looks forward. The Fresnel lens of the defocusing optical structure 120 may have a refractive power in the range of 2.0 D to 6.0 D myopically or hyperopically. For example, the refractive power may be in the range of 3.5 D to 5 D myopically or hyperopically. In some embodiments, the refractive power is preferably in the range of 2.5D to 5.0D, more preferably in the range of 3.0D to 5.0D.

The peripheral defocusing optical structure 120 may have an annular shape with inner and outer diameters, selected so that the peripheral defocusing is applied to a portion of the patient's retina that is eccentric with respect to the fovea. For example, the inner diameter may be selected to be at an angle of approximately 7.5 degrees with respect to the optical axis of the optical system 112 and the pupil. The outer diameter of the peripheral defocusing optical structure 120 may be at an outer boundary angle, e.g., 17.5 degrees, with respect to the optical axis of the patient's eye and pupil. Such an arrangement results in the peripheral defocusing optical structure 120 being located within the user's peripheral field of vision, with corresponding defocusing of light projected into the peripheral region of the user's retina that is eccentric with respect to the fovea.

In some embodiments, a defocusing treatment device may be used in combination with localized stimulation within a peripheral zone to treat refractive errors of the eye. The localized stimulation may be, for example, a portion of an image projected from a display, or provided by a structure within the defocusing treatment device or a portion thereof.

For example, Figure 3A depicts a defocusing therapy device 124 in front of a display 110. The display 110 may provide video or other image content for projection into the user's eye through the defocusing therapy device 124. As discussed above, the defocusing therapy device 124 may be positioned in front of an optical system 112, such as the lenses of a virtual reality headset, glasses, or other device worn by the user.

Figure 3B shows a display 110 with multiple stimuli and the corresponding dimensions of the defocused stimuli on the retina in degrees. The size of the stimuli on the display is related to the distance between the user and the display, and the dimensions can be varied according to the viewing distance to provide an appropriate viewing angle to the retina. Those skilled in the art can easily perform calculations to determine the size and location of the stimuli on the display in order to provide an appropriate angular size of the defocused projected image. Each stimulus has a transverse distance corresponding to an angular illumination on the retina, for example, 3.3 degrees. The stimuli are arranged to provide a clear central field of view, which can be, for example, 15 degrees. Multiple stimuli have a maximum transverse distance, for example, 70 mm, which corresponds to a viewing angle of 35 degrees.

In the embodiments shown in Figures 3A and 3B, the video content or other image provided by the display 110 may be modified to include a stimulus 136. The stimulus 136 may be provided in the form of increased luminosity or brightness at an eccentric location relative to the center of the image on the display. When the stimulus 136 is positioned on the display 110 and passes through the defocusing optical structure 120, it provides the stimulus to the peripheral region of the retina. In some embodiments, the processor is configured with instructions to position the stimulus 136 at a location on the display corresponding to a location on the retina. The display 110 can be positioned at an appropriate distance from the defocusing optical structure 120 to form the image stimulus 136 in front of or behind the retina, as described herein.

The stimuli may be located within a range from a fixed location on the display 110 or its center. In some embodiments, such a spatial arrangement of stimuli within the display can deliver stimuli to substantially fixed locations on the user's retina, because the display in the user's eye, i.e., the defocusing therapy device, is maintained in a substantially fixed arrangement by the mounting of the headset on the patient's head, for example, with a VR or AR headset. In some embodiments, the headset may include an eye tracker that tracks the location and/or orientation of the user's eyes. The location of the stimuli on the display may be updated based on the location and/or orientation of the user's eyes. In some embodiments, peripheral stimuli may be turned on or off based on the position of the user's eyes. For example, in some embodiments, the user's eyes may be at a point of fixation so that the stimuli may appear within the user's central vision. In such embodiments, stimuli that would otherwise appear within the user's central vision may be deactivated when the eye tracker detects that the stimuli may be within the user's central vision.

The stimuli may be sized so that they are located at approximately 0.5 to 5 degrees, more preferably about 2 to 3 degrees, and most preferably about 2.3 degrees, within the apparent diameter of the user's field of view.

One or more stimuli may include images, which are constructed in many ways, and may include image structures corresponding to information or content associated with spatial frequencies. In some embodiments, one or more images projected within a stimulus comprise, for example, spatial frequencies in the range of 1 cycle/degree to 180 cycles/degree and contrasts in the range of 99.9% to 2.5%. In some embodiments, the projected image comprises image structure content configured to provide a spatial frequency range, for example, in the range of 2 cycles/degree to approximately 60 cycles/degree. In some embodiments, the image is projected onto the retina with an optical transfer function coefficient equal to or better than 0.3 at a spatial frequency of 50 lp/mm or greater.

In some embodiments, the stimulus may include a darker area within a brighter area or a brighter area within a darker area. For example, as shown in Figures 3A and 3B, each of the multiple stimuli may include a bright circular area with a dark cross shape inscribed within it. The cross shape may include, for example, two dark lines that intersect perpendicularly to each other at its midpoint and the center of the bright circle. In some embodiments, the stimulus may include a single line extending across the diameter of the circle.

In the defocusing therapy device 124, the stimulus 136 is projected through the peripheral defocusing optical structure 120 along with the video content projected by the display 110. Therefore, both the image of the video content and the stimulus 136 are defocused by the peripheral defocusing optical structure 120.

Figure 4 shows a cross-section of the defocusing treatment device 124, including a flattened central area 118 and a peripheral defocusing optical structure 120. As shown in Figure 4, the peripheral defocusing optical structure 120 may be a Fresnel lens or other suitable optical structure, comprising a first curved surface having a shape according to the desired diopter of the lens, and a second surface that may be tilted with respect to the optical axis of the lens or perpendicular to the optical axis of the lens, as shown in Figure 4. The peripheral defocusing optical structure may have other shapes or structures. For example, the peripheral defocusing optical structure may be a diffractive optical structure, an Eschlett grating, or a series of concentric annular lenses having a curved surface of the desired diopter.

As further shown in Figure 4, the defocusing treatment device 124 may include a filter 130 or one or more of a filter or mask layer 142. In some embodiments, the layer 142 comprises a neutral density layer, but the layer may be, for example, colored or clear. The neutral density layer 142 may include a neutral density filter within the area of the lens, where it is desired to have darker and lower illumination. The neutral density filter may be located on the rear surface of the defocusing treatment device 124, opposite the front surface on which the peripheral defocusing optical structure 120 is located. The neutral density filter layer 142 may be centered on the flattened central optical zone 118 such that light passing through the flattened central optical zone 118 also passes through the neutral density filter. In some embodiments, the neutral density filter layer 142 may extend around the peripheral defocusing optical structure 120 such that a portion of the light passing through the peripheral defocusing optical structure 120 is filtered by the neutral density filter layer 142. As further shown in Figure 4, peripheral stimulation may be provided by one or more locations on the defocusing therapeutic device 124 that are not filtered by the neutral density filter layer 142, at least partially. Structure 410 may be formed in or through the neutral density filter layer 142 to allow unfiltered light to pass through it. For example, in Figure 4, the defocusing therapeutic device 124 includes a stimulation location with the neutral density filter layer 142 and structure 410 formed to allow unfiltered light to pass through it. Structure 410 may be any preferred shape, such as forming a bright circular area with a dark cross shape engraved therein, as described herein. Structure 410 may comprise, for example, one or more of a transparent material or an opening. The cross shape may include two dark extensions formed by neutral concentration filters that intersect perpendicularly with each other at its midpoint and the center of the circle. In some embodiments, the stimulus may include a single line formed by a neutral concentration filter layer 142 extending across the diameter of the circle. While referring to the cross shape, the structure 410 may have any preferred shape for providing the stimulus as described herein.

In some embodiments, the neutral density filter 130 may extend beyond the central flattened region of the defocusing therapy device 124. For example, the neutral density filter 130 may extend to encompass the peripheral defocusing optical structure 120. In some embodiments, the region of the defocusing therapy device 124, including the peripheral defocusing optical structure 120, may include a portion masked by the neutral density filter 130 and a portion not masked by the neutral density filter 130. The unmasked or clear portion of the outer area may be clear and optically matched with the stimuli provided in the image or video content of the display 110. When optically matched, the unmasked portion of the outer area and the stimuli appear superimposed across each other from the user's viewpoint. By combining the increased luminosity from the stimuli in the projected image with the difference in luminosity between the masked and unmasked regions of the defocusing therapy device, a greater difference in luminosity between the stimuli compared to the non-stimulating region may be provided.

Referring to Figures 4 and 5, the defocusing treatment device 124 may include a clear base 140 on the rear side of the defocusing treatment device 124. The base 140 may include a lens interface surface 144 for bonding the defocusing treatment device 124 to a lens such as lens 112. In some embodiments, the lens interface surface 144 may include an adhesive to further facilitate bonding the defocusing treatment device 124 to the lens or other structure. In some embodiments, the defocusing treatment device 124 may be formed directly on or within the lens. In such embodiments, the defocusing treatment device 124 may not have the base 140 on the front surface, or the base 140 may be an optical structure such as lens 112.

Figure 6 depicts a defocusing therapy device 124 with a hardware-based defocusing structure, and a stimulus provided by software, such as software, which modifies the image projected from the display to include the stimulus, at will by the hardware. The defocusing therapy device 124 includes a central optical zone 118. The central optical zone 118 may be flattened to have a substantially planar surface, or otherwise shaped to provide little or no change in the angle of incident light passing through the central optical zone 118. The central optical zone 118 may also include a neutral density filter 130 or a mask 150. The defocusing therapy device 124 may have a substantially flattened anterior surface within a non-stimulation area, for example, an area not including the lenslet 146.

The defocusing treatment device 124 may also include a neutral concentration filter 130. The neutral concentration filter 130 filters light passing through the flattened region of the defocusing treatment device 124. In some embodiments, the neutral concentration filter 130 filters light passing through the defocusing treatment device 124 within the non-stimulating region of the defocusing treatment device 124.

The outer area of the defocusing treatment device 124 includes the peripheral defocusing optical structure 120. The peripheral defocusing optical structure 120 may include one or more lenses within the outer region of the device 124. For example, the peripheral defocusing optical structure 124 may include an array of lenslets 146, as shown in Figures 6, 7, 8, 9, and 10. Multiple lenslets 146 may be shaped and arranged to provide a defocused image to the peripheral portion of the retina while providing clear vision to the fovea and macula when the user looks forward. Each lenslet 146 of the defocusing optical structure 120 may have a refractive power in the range of 2.0 D to 6.0 D myopically or hyperopically. For example, the refractive power may be in the range of 3.5 D to 5 D myopically or hyperopically. The curvature is preferably 2.5 to 5.0 D, more preferably 3.0 to 5.0 D.

The lenslets 146 of the peripheral defocusing optical structure 120 may be arranged in one or more circular arrays centered around the central optical zone 118 of the defocusing treatment device 124. One or more circular arrays may form an annular shape with inner and outer diameters, selected so that the peripheral defocusing is applied to a portion of the patient's retina that is eccentric with respect to the fovea. For example, the inner diameter may be selected to be at an angle of about 7.5 degrees with respect to the optical axes of the optical system 112 and the pupil. The outer diameter of the peripheral defocusing optical structure 120 may be at an outer boundary angle, e.g., 17.5 degrees, with respect to the optical axes of the patient's eye and pupil.

In some embodiments, the lenslet 146 and the unfiltered area of the defocusing treatment device 124 may be positioned relative to each other such that unfiltered light passes through the unfiltered area of the device 124 so as to be defocused to the patient's retina, and light also passes through the lenslet 146. The defocusing treatment device may be used in combination with localized stimulation in a peripheral zone to treat refractive errors of the eye. The localized stimulation may be, for example, a part of an image projected from a display, or may be provided by a structure within the defocusing treatment device or a part thereof.

For example, Figure 7 depicts a defocusing therapy device 124 in front of a display 110. The display 110 may provide video or other image content for projection into the user's eye through the defocusing therapy device 124. As discussed above, the defocusing therapy device 124 may be positioned in front of an optical system 112, such as the lenses of a virtual reality headset, eyeglasses, or other device worn by the user. In the embodiment shown in Figure 7, the video content or other image provided by the display 110 may be modified to include a stimulus 136. The stimulus 136 may be provided in the form of increased luminosity or brightness at a location eccentric with respect to the center of the image on the display.

The stimuli may be located in a fixed location on the display 110, or within a range from its center. Such a fixed array of stimuli within the VR headset display can deliver stimuli to a substantially fixed location on the user's retina, because the display in the user's eye, i.e., the defocusing therapy device, is maintained in a substantially fixed array by the mounting of the VR headset on the patient's head. In some embodiments, the VR headset may include an eye tracker that tracks the location and/or orientation of the user's eyes. The stimuli and associated lenslets may be sized such that they are about 0.5 to 5 degrees, more preferably about 2 to 3 degrees, and most preferably about 2.3 degrees, within the apparent diameter of the user's field of view.

One or more stimuli may include images, which are constructed in many ways, and may include image structures that correspond to information or content associated with spatial frequencies. In some embodiments, a stimulus may include a darker area within a brighter area or a brighter area within a darker area. For example, as shown in Figure 7, a stimulus may include a bright circular area with a dark cross shape inscribed within it. The cross shape may include, for example, two dark lines that intersect perpendicularly to each other at its midpoint and the center of the bright circle. In some embodiments, a stimulus may include a single line extending across the diameter of the circle.

In the defocusing therapy device 124, the stimulus 136 is projected through the peripheral defocusing optical structure 120 along with the video content projected by the display 110. Therefore, both the image of the video content and the stimulus 136 can be defocused by the peripheral defocusing optical structure 120.

Figures 8 and 9 show oblique and cross-sectional views of the defocusing treatment device 124, respectively, and include a flattened central area 118 and a peripheral defocusing optical structure 120. The peripheral defocusing optical structure 120 may include a plurality of lenslets 146, each having a curved surface shaped according to the desired diopter in the defocusing of the lenslet. The lenslets may have other shapes or structures. For example, a lenslet may be formed from one or more of the following: a diffractive optical structure, a GRIN lens, an Eschlet grating, a holographic lens, or a Fresnel lens, having a shape or structure for creating the desired optics. In some embodiments, the lenslet may be an electrically adjustable lens that allows for dynamic variation in the defocusing provided by the lenslet 146. For example, in some embodiments, the lenslet may provide no defocusing during one period, while providing 2-6D defocusing during other periods.

The defocusing treatment device 124 may include a filter 130, such as a neutral density filter or a mask layer 142. The layer 142 may include a neutral density filter within the lens area, where darker and lower illumination is desired. The neutral density filter may be located on the rear surface of the defocusing treatment device 124, opposite the front surface on which a peripheral defocusing optical structure 120, such as a lenslet 146, is located. In some embodiments, the neutral density filter layer 142 may extend from the flattened center 118 to the flattened region of the peripheral defocusing optical structure 120, such that some of the light passing through the flattened region of the peripheral defocusing optical structure 120 is filtered by the neutral density filter layer 142. In some embodiments, the neutral density filter layer 142 may not cover the location of the defocusing treatment device 124 corresponding to the location of the lenslet 146. The peripheral stimulation 136 may be provided by one or more locations on the defocusing therapeutic device 124 that are not filtered by the neutral density filter layer 142, at least partially. Structures such as openings or transparent materials may be formed within or through the neutral density filter layer 142, allowing unfiltered light to pass through. For example, as shown in the cross-sectional view of Figure 9, the defocusing therapeutic device 124 includes a neutral density filter layer 142 and stimulation locations with structures formed to allow unfiltered light to pass through. The structures may be shaped as discussed above, such that they form bright circular areas, with or without dark cross shapes etched within them.

The peripheral boundary of the aperture formed through the filter 130 may include an optical barrier or baffle 152 that helps prevent light passing through one aperture toward an associated lenslet from entering or scattering through the filter into a different lenslet not associated with the aperture. In some embodiments, the baffle or barrier may extend into or through the optical layer 142 to the lenslet on the front surface of the peripheral defocusing optical structure 120.

Referring to Figure 8-10, the defocusing treatment device 124 may include a clear base 140 on the rear side of the defocusing treatment device 124. The base 140 may include a lens interface surface 144 for bonding the defocusing treatment device 124 to a lens such as lens 112. In some embodiments, the lens interface surface 144 may contain an adhesive to further facilitate bonding the defocusing treatment device 124 to the lens or other structure. In some embodiments, the defocusing treatment device 124 may be formed directly on or within the lens. In such embodiments, the defocusing treatment device 124 may not have the base 140 on the front surface, or the base 140 may be an optical structure such as lens 112.

Figure 11 depicts a defocusing therapy device 124 with a hardware-based defocusing structure provided by a plurality of lenslets 146, and a stimulus 136 provided by software, such as software, which optionally modifies the image projected from a display to include the stimulus. The defocusing therapy device 124 includes a central optical zone 118 and a peripheral defocusing optical structure 120. The central optical zone 118 may be flattened to have a substantially planar surface, or otherwise shaped to provide little or no change in the angle of incident light passing through the central optical zone 118. The central optical zone 118 may also include a neutral density filter 130 or a mask 150. The defocusing therapy device 124 may have a substantially flattened front surface in a non-stimulation area, for example, an area that does not include the lenslets 146. The neutral density filter 130 filters light passing through the flattened region of the defocusing therapy device 124. In some embodiments, the neutral concentration filter 130 filters light passing through the defocusing treatment device 124 within the non-stimulating area of the defocusing treatment device 124.

The peripheral area of the defocusing treatment device 124 includes the peripheral defocusing optical structure 120. The peripheral defocusing optical structure 120 may include one or more lenses within the outer region of the device 124. For example, the peripheral defocusing optical structure 124 may include an array of lenslets 146, as shown in Figure 11-15. Multiple lenslets 146 may be shaped and arranged to provide a defocused image to the peripheral portion of the retina while providing clear vision to the fovea and macula when the user looks forward.

The lenslets 146 of the peripheral defocusing optical structure 120 may be arranged in one or more circular arrays centered on the central optical zone 118 of the defocusing treatment device 124. One or more circular arrays may form an annular shape with inner and outer diameters, selected so that the peripheral defocusing is applied to a portion of the patient's retina that is eccentric with respect to the fovea. For example, the inner diameter may be selected to be at an angle of about 7.5 degrees with respect to the optical axes of the optical system 112 and the pupil. The outer diameter of the peripheral defocusing optical structure 120 may be at an outer boundary angle, e.g., 17.5 degrees, with respect to the optical axes of the patient's eye and pupil. Such an arrangement results in the peripheral defocusing optical structure 120 being located within the user's peripheral field of vision, with corresponding defocusing of light projected into the peripheral region of the user's retina that is eccentric with respect to the fovea.

In some embodiments, the lenslet 146 and the unfiltered area of the defocusing treatment device 124 may be positioned relative to each other such that light passing through the unfiltered area of the device 124 also passes through the lenslet 146, so that unfiltered light is defocused relative to the patient's retina. In some embodiments,

Defocusing therapeutic devices may be used in combination with localized stimulation within a peripheral zone to treat refractive errors of the eye. The localized stimulation may be, for example, a portion of an image projected from a display, or it may be provided by a structure within the defocusing therapeutic device or a portion thereof.

The stimulus 136 shown in Figures 7 and 11 includes a brighter area within a darker area, as described herein. The stimulus 136 includes a circular area having an unfiltered cross shape engraved therein. The cross shape may include, for example, two unfiltered lines that intersect perpendicularly to each other at its midpoint and the center of the circle. The stimulus may also include a wedge-shaped neutral concentration filter 130 or mask 150. Each wedge-shaped neutral concentration filter or mask 150 may fill a quadrant of the circular stimulus formed by the unfiltered area of the cross shape. In some embodiments, the stimulus may filter the same, larger, or smaller range of light as the neutral concentration filter 130 on the non-stimulated area of the defocusing therapeutic device 124. For example, the stimulus 136 may further reduce the light transmittance by at least 5 times, preferably at least 10, 20, or 30 times, compared to the unfiltered area of the stimulus. In some embodiments, the light transmittance difference provided by the neutral concentration filter compared to the unfiltered area of the defocusing treatment device 124 may be about 5, 10, 20, or 30 times. In some embodiments, the illumination difference may be 5 to 30 times, more preferably 10 to 20 times. In some embodiments, the stimulus 136 may not include the neutral concentration filter.

In some embodiments, the molded mask 150 may provide stimuli. For example, the stimuli of the mask 150 may include images, which are configured in many ways, and may include image structures corresponding to information or content associated with spatial frequencies. In some embodiments, one or more images projected within the stimuli have, for example, spatial frequencies in the range of 0.1 cycles/degree to 180 cycles/degree and optionally, contrast in the range of 99.9% to 2.5%. In some embodiments, one or more images projected within the stimuli have, for example, spatial frequencies in the range of 1 cycle/degree to 180 cycles/degree and contrast in the range of 99.9% to 2.5%. In some embodiments, the projected images include image structure content configured to provide a spatial frequency in a range, for example, 2 cycles/degree to about 60 cycles/degree. In some embodiments, the images are projected onto the retina with an optical transfer function coefficient equal to or better than 0.3 at a spatial frequency of 50 lp/mm or greater. In some embodiments, the image projected onto the retina has a spatial frequency of at least one line pair/mm ("lp/mm") or higher on the retina.

Referring again to Figures 3A and 3B, the display 110 may provide video or other image content for projection into the user's eye through a defocusing therapeutic device 124. As discussed above, the defocusing therapeutic device 124 may be positioned in front of an optical system 112, such as the lenses of a virtual reality headset or glasses or other device worn by the user. In the embodiment shown in Figure 12, the video content or other image provided by the display 110 may be modified to provide a stimulus 136. The stimulus 136 may be provided in the form of increased luminosity or brightness at a location eccentric with respect to the center of the image on the display.

In some embodiments, the stimuli and associated lenslets are sized such that they are approximately 0.5 to 5 degrees, more preferably approximately 2 to 3 degrees, and most preferably approximately 2.3 degrees, within the apparent diameter of the user's field of view. In the embodiment shown in Figure 12, video content or other images provided by light from the display 110 may be modified by the defocusing therapeutic device 124 to provide stimuli. Hardware stimuli can provide crossing either as an alternative to stimuli on the display or in combination with video stimuli on the display.

In the defocusing therapy device 124, video content provided by the display 110 is projected through the lenslet 146 and the stimulus 136 of the mask 150 within the peripheral defocusing optical structure 120; therefore, both the image of the video content and the stimulus 136 are defocused by the peripheral defocusing optical structure 120. In some embodiments, the display may include bright areas that are aligned with the stimulus 136 and lenslet 146 of the peripheral defocusing optical structure 120, providing additional brightness and contrast to the stimulus compared to other areas of the defocusing therapy device 124.

Figures 13 and 14 show oblique and cross-sectional views, respectively, of the defocusing treatment device 124, and include a central optical zone 118 with a flattened central area 128, and a peripheral defocusing optical structure 120 and its associated lenslet 146 and mask 150. The peripheral defocusing optical structure 120 may include a plurality of lenslets 146, each having a desired refractive power to provide defocusing to the lenslet. The lenslet may have other shapes or structures. For example, the lenslet may be formed from a diffractive optical structure, an Eschlett grating, a GRIN lens, or a Fresnel lens having a shape or structure for creating a desired diopter. In some embodiments, the lenslet may be an electrically adjustable lens that allows for dynamic variation of the defocusing provided by the lenslet 146. For example, in some embodiments, the lenslet may provide no defocusing during one period, while providing 2–6D of defocusing during other periods.

The defocusing treatment device 124 may include a neutral density filter 130 or a mask layer 148. The mask layer 148 may include a neutral density filter 130 within the area of the lens, where it is desired to have darker and lower illumination. The neutral density filter may be located on the rear surface of the defocusing treatment device 124, opposite the front surface on which a peripheral defocusing optical structure 120, such as a lenslet 146, is located. In some embodiments, the neutral density filter 130 may extend from the flattened center 128 to the flattened region of the peripheral defocusing optical structure 120, such that a portion of the light passing through the flattened region of the peripheral defocusing optical structure 120 is filtered by the neutral density filter 130. In some embodiments, the neutral density filter 130 may not cover the location of the defocusing treatment device 124 corresponding to the location of the lenslet 146. The peripheral stimulation 136 may be provided by one or more locations on the defocusing therapeutic device 124 that are not filtered by the neutral concentration filter 130, at least partially. Structures may be formed within or through the neutral concentration filter 130, allowing unfiltered light to pass through. For example, as shown in the cross-sectional view of Figure 14, the defocusing therapeutic device 124 includes a neutral concentration filter 130 and stimulation locations with structures formed to allow unfiltered light to pass through. The structures may be shaped as discussed above, such that they form bright circular areas, with or without an optic cross shape engraved therein.

The mask 150, which includes the stimulus, may be an image or structure formed within a wedge-shaped area within the neutral density filter 130, either on the base 140 or at the location of the corresponding lenslet 146.

Referring to Figure 13-15, the defocusing treatment device 124 may include a clear base 140 on the rear side of the defocusing treatment device 124. The base 140 may include a lens interface surface 144 for bonding the defocusing treatment device 124 to a lens such as lens 112. In some embodiments, the lens interface surface 144 may contain an adhesive to further facilitate bonding the defocusing treatment device 124 to the lens or other structure. In some embodiments, the defocusing treatment device 124 may be formed directly on or within the lens. In such embodiments, the defocusing treatment device 124 may not have the base 140 on the front surface, or the base 140 may be an optical structure such as lens 112.

Figure 16 shows eyeglasses 200 incorporating a defocusing therapy device 124 with a hardware-based peripheral defocusing optical structure 120, and stimuli provided by hardware such as a mask, as discussed above with reference to the mask 150. The defocusing therapy device includes a central optical zone 118 and the peripheral defocusing optical structure 120.

The peripheral defocusing optical structure 120 may be implemented in many ways, including any of the structures discussed herein, such as a Fresnel lens, lenslet, diffractive optical system, or Echelet grating. The central optical zone 118 and non-stimulating region of the peripheral defocusing optical structure may also include a neutral density filter or mask, as discussed herein. The defocusing structure device may be incorporated into the lens 112 of the eyeglasses, or it may be a separate structure that can be coupled to another part of the eyeglasses, such as the lens 120 or the eyeglass frame.

Figure 17 shows a therapeutic device that provides retinal stimulation to a user, comprising a device 124 coupled to a display 110 of a user device or the like. In some embodiments, the display 110 comprises a protective layer 1720 and a pixel layer 1730. Multiple lenslets 146 are spaced 1710 apart from the pixel layer 1730. The distance 1710 and the refractive power of the lenslets can be configured to focus multiple stimuli in front of or behind the retina with an appropriate amount of defocusing.

In some embodiments, the base 140 and layer 142 each have a thickness that is sized to position a plurality of lenslets 146 at a distance of 1710 from the pixel layer 1730. In some embodiments, the defocusing therapeutic device 124 includes a clear base 140 for bonding to a display using an adhesive. Layer 142 may include a filter. Alternatively, layer 142 may include, for example, a substantially clear layer and a display configured to provide a dark background around the stimulus. In some embodiments, layer 142 has a thickness that positions the lenslet array at a suitable distance 1710 from the pixel layer 1730. Alternatively, or in combination, the clear base 140 has a thickness that positions the lenslet array at a suitable distance 1710. Although the base 140 and layer 142 are shown, in some embodiments, the lenslet array has a thickness that is sized to position the lenslets 146 at a distance of 1710 from the pixel 1730 without the base 140 and layer 142. For example, the adhesive layer 1740 can directly bond the lenses of the lenslet array 146 to the protective layer 1720 of the display 138, with the lenslets positioned at a distance of 1710 from the pixel layer 1730.

In some embodiments, the device 124 is bonded to the display using an adhesive layer 1740. Alternatively, the device 124 can be mounted within a support such as a holder to position the lenslet array at a distance 1710 from the display. In some embodiments, the device 124 is provided to the user with a peelable cover on the adhesive layer for the user to peel off the cover and place the device 124 on the display. While referring to layer 1740 comprising an adhesive layer, in some embodiments, layer 1740 comprises a weak adhesive that allows the user to remove the device 124 from the display.

In some embodiments, the lenslet is provided with refractive power, and the distance 1710 is sized to provide an appropriate magnification to the stimulus, so as to provide a suitable distance across each of the multiple stimuli.

In some embodiments, the processor provides instructions for providing retinal stimuli, including multiple stimuli 136 on the display with appropriate sizes and locations, as described herein. Those skilled in the art of optics can determine the focal length of the lenslet 146 and the distance 1710 between the lenslet and the pixel layer, for example, as described herein with reference to Figure 3B, and provide appropriate angular sizes for the stimuli 136 on the display.

In some embodiments, each of the lenslets is separated from adjacent lenslets by a certain gap to reduce optical interference between stimuli, so that each stimulus can be delivered to a region of the retina substantially without light from nearby stimuli. For example, multiple stimuli on a display can be separated from each other, as well as the spacing between lenses in a lenslet array. The display may have a substantially dark background with gaps between stimuli, as shown in Figure 3B. Alternatively, layer 142 may comprise an optically opaque material that defines an aperture or window of a transparent material corresponding to the location of the lens to reduce optical interference.

Figure 18 shows multiple lenslets with liquid crystal material between electrodes. In some embodiments, the peripheral defocusing structure comprises multiple lenslets of a lenslet array 146, electrodes, and liquid crystal ("LC") material for activating and deactivating the refractive power of the lenslets. In the active configuration, the lenslets possess refractive power and generate multiple stimuli. In the deactivated configuration, the refractive power of the lenslets is reduced so that the user can typically view the display through, for example, a substantially inactive lenslet, and it appears substantially transparent to the user.

In some embodiments, the peripheral defocusing structure comprises a first electrode 1710 and a second electrode 1720, which are separated using a liquid crystal material 1730 and lenslets 1740 between a plurality of substantially transparent electrodes. The liquid crystal material and the plurality of lenslets are positioned between the plurality of electrodes and activate and deactivate the refractive power of the plurality of lenslets.

In some embodiments, multiple lenslets between electrodes can be optically coupled to a display, and a mobile device processor is operably coupled to the display. The processor provides multiple stimuli on the display at multiple locations and includes instructions for forming images at multiple locations in front of or behind the retina. In some embodiments, each of the multiple stimuli on the display is matched with a corresponding lenslet to form an image at either the front of or behind the peripheral portion of the retina.

The electrodes, liquid crystal ("LC") material, and lenslet can be constructed in many ways. In some embodiments, the lenslet comprises one or more of the following: a diffraction optical system, a refractive optical system, a holographic optical system, or an Eschlett grating. In some embodiments, the potential difference (voltage) is delivered by a transparent electrode, for example, indium tin oxide (ITO). The electrode may have a thickness in the range of 20 nm to 200 nm. The metal may be deposited on a matched layer of a substrate, such as a _SiO2 layer, having a thickness in the range of 5 nm to 30 nm. In some embodiments, the matching of the _SiO2 layer is achieved by oblique deposition. In some embodiments, the matching of the _SiO2 layer drives the matching of LC molecules at a lower voltage.

The coating thickness can be configured in many ways, but in some embodiments, the thickness is determined using optimization. For example, simulations can be performed to optimize transmission with the ITO- _SiO2 coating. With respect to the ITO-SiO2 _layer on a glass substrate, studies related to this disclosure suggest that thicknesses of 20 nm and 230 nm, respectively, can provide maximum transmittance for light at 550 nm with normal incidence. The transmittance can be any preferred amount, for example, 80% or more, but the calculated transmittance can be, for example, about 93.35% with respect to the air/ITO interface with normal incidence. _SiO2 (glass) is referred to as the substrate material having a refractive index of 1.67, but the substrate material may include any preferred material such as glass or plastic.

In some embodiments, the liquid crystal material comprises a substantially transparent material with a glass transition temperature below -10°C and a melting point above 100°C. The liquid crystal material may comprise one or more of the nematic phase, cholesteric phase, or smectic phase. The liquid crystal material may comprise a cholesteric liquid crystal with a dichroic dye. The dichroic dye may have an orientation-dependent absorptivity or an orientation-dependent mean refractive index. Both such properties of the dichroic dye may be used within the structure of the electroactive elements disclosed herein.

In some embodiments, the liquid crystal material comprises a substantially transparent material with a glass transition temperature below -10°C and a melting point above 100°C. The liquid crystal material may comprise one or more of the nematic phase, cholesteric phase, or smectic phase. The liquid crystal material may comprise a cholesteric liquid crystal with a dichroic dye. The dichroic dye may have an orientation-dependent absorptivity or an orientation-dependent mean refractive index. Both such properties of the dichroic dye may be used within the structure of the electroactive elements disclosed herein.

The electroactive component can be configured in many ways. For example, the electroactive component may comprise an assembly configured for installation on the lens at a suitable time during lens manufacturing. For example, the component may comprise a standalone component configured for installation on the lens either before or after the curved refractive surface is polished onto the lens. The circuit network can be coupled to the electroactive component using suitable connectors, as described herein, and mounted on a support such as an eyeglass frame at a suitable location.

Table 1 shows commercially available liquid crystal formulations from Merck and their material properties, such as refractive index.

While specific liquid crystal materials are referenced, those skilled in the art will recognize that many adaptations and variations are possible.

Those skilled in the art can identify lenslet materials suitable for use with LC materials, which provide appropriate switching of refractive power in lenslet arrays. Many materials can be used, but examples of lenslet materials include one or more of the following: ion-doped glass, polyacrylate, polymethacrylate, polycyclic aromatics, polysulfone, polyimide, polyamide, polyether, polyetherketone, or polycyclic olefin.

In some embodiments, the liquid crystal material is switchable from a first refractive index, in a first configuration, which substantially refracts light using a lenslet array, to a second refractive index, in a second configuration, which substantially transmits light transparently through the lenslet array with virtually no refractive power. In the second configuration, the second refractive index is closer to that of the lenslet array in order to reduce the refractive power from the lenslet array.

In some embodiments, the first refractive index differs from the refractive index of the lenslet array by at least 0.05, providing substantial refractive power to the lenslet array, and the second refractive index differs from the refractive index of the lenslet array by 0.02 or less, providing substantial reduction in refractive power, allowing light to pass through the lenslet array substantially transparently, so that the presence of the lenslet array is imperceptible to the user.

In some embodiments, the liquid crystal material is configured to provide a change in refractive index within the range of 0.10 to 0.25.

Figure 19 shows a therapeutic device 100, comprising a display 110 coupled to a lenslet array 146 of a therapeutic device 124, as described herein. The device 100 can be configured in many ways and may include a user device comprising one or more of the following: an ophthalmic device, a TV screen, a computer screen, a VR display, an AR display, a handheld, a mobile computing device, a tablet computing device, a smartphone, a wearable device, an eyeglass lens frame, an eyeglass lens, an eyepiece display, a head-mounted display, goggles, a contact lens, an implantable device, a corneal onlay, a corneal inlay, a corneal prosthesis, or an intraocular lens. In some embodiments, the therapeutic device comprises a user device such as, for example, a smartphone or a tablet. The display of the user device can be configured to provide a plurality of stimuli 136, as described herein. In some embodiments, the user device comprises a lenslet array 146, positioned across the plurality of stimuli to provide images of the stimuli in front of or behind the retina. In some embodiments, each lenslet of the lenslet array is matched with one of the plurality of stimuli. The user device may include a zone 118 with a clear viewing area, for example, without a lenslet array extending within the clear viewing area, as described herein. The clear viewing area can be configured to allow the user to view images such as videos and to use the device in a substantially normal manner, such as using a web browser, playing video games, sending and receiving texts and emails. The lenslet array can be positioned at a certain distance from the pixels to provide an appropriate amount of defocusing, as described herein.

As described herein, the computing devices and systems described and/or illustrated herein broadly represent any type or form of computing device or system capable of executing computer-readable instructions, such as those contained within the modules described herein. In their most basic configurations, each of these computing devices may comprise at least one memory device and at least one physical processor.

As used herein, the terms “memory” or “memory device” generally refer to any type or form of volatile or non-volatile storage device or medium capable of storing data and/or computer-readable instructions. In one embodiment, a memory device may store, load, and/or maintain one or more of the modules described herein. Embodiments of memory devices include, but are not limited to, random-access memory (RAM), read-only memory (ROM), flash memory, hard disk drives (HDDs), solid-state drives (SSDs), optical disk drives, caches, variations or combinations of one or more of the same, or any other suitable storage memory.

In addition, the terms “processor” or “physical processor” as used herein generally refer to any type or form of hardware implementation processing unit capable of interpreting and/or executing computer-readable instructions. In one embodiment, the physical processor may access and/or modify one or more modules stored in the memory devices described above. Embodiments of the physical processor include, but are not limited to, microprocessors, microcontrollers, central processing units (CPUs), field-programmable gate arrays (FPGAs) implementing soft-core processors, application-specific integrated circuits (ASICs), parts of one or more of the same, variations or combinations of one or more of the same, or any other suitable physical processors. The processor may also include distributed processor systems, such as a startup of parallel processors or remote processors such as servers, and combinations thereof.

Although illustrated as separate elements, the method steps described and/or illustrated herein may represent parts of a single application. In addition, in some embodiments, one or more of these steps may represent, or correspond to, one or more software applications or programs that, when executed by a computing device, cause the computing device to perform one or more tasks, such as the method steps.

In addition, one or more of the devices described herein may convert data, physical devices, and/or representations of physical devices from one form to another. In addition, or alternatively, one or more of the modules enumerated herein may convert processors, volatile memory, non-volatile memory, and/or any other parts of a physical computing device from one form of computing device to another form of computing device by executing on a computing device, storing data on a computing device, and/or otherwise interacting with a computing device.

As used herein, the term “computer-readable medium” generally refers to any form of device, carrier, or medium capable of storing or carrying computer-readable instructions. Examples of computer-readable mediums include, but are not limited to, transmission media such as carrier waves, magnetic storage media (e.g., hard disk drives, tape drives, and floppy disks), optical storage media (e.g., compact discs (CDs), digital video discs (DVDs), and Blu-ray® discs), electronic storage media (e.g., solid-state drives and flash media), and non-transient media such as other distributed systems.

Those skilled in the art will recognize that any process or method disclosed herein can be modified in many ways. The process parameters and sequence of steps described and/or illustrated herein are given only as examples and can be varied as desired. For example, the steps illustrated and/or described herein are shown or discussed in a specific order, but these steps do not necessarily have to be performed in the order illustrated or discussed.

The various exemplary methods described and/or illustrated herein may also omit one or more of the steps described or illustrated herein, or may include additional steps in addition to those disclosed. Furthermore, any step of any method disclosed herein may be combined with any one or more steps of any other method disclosed herein.

A processor as described herein may be configured to perform one or more steps of any of the methods disclosed herein. Alternatively, or in combination, a processor may be configured to combine one or more steps of one or more of the methods disclosed herein.

Unless otherwise stated, the terms “connected to” and “combined with” (and their derivatives) as used herein and in the claims shall be interpreted as enabling both direct and indirect (i.e., through other elements or components) connections. In addition, the terms “a” and “an” as used herein and in the claims shall be interpreted as meaning “at least one of.” Finally, for ease of use, the terms “including” and “having” (and their derivatives) as used herein and in the claims shall be synonymous with and have the same meaning as the word “comprising.”

A processor as disclosed herein may be configured with instructions for performing one or more steps of any of the methods disclosed herein.

Please understand that the terms “First,” “Second,” “Third,” etc., may be used herein to describe various layers, elements, components, regions, or divisions without referring to any particular order or sequence of events. These terms are simply used to distinguish one layer, element, component, region, or division from another. A first layer, element, component, region, or division as described herein may be referred to as a second layer, element, component, region, or division without departing from the teachings of this disclosure.

As used herein, the term "or" is used comprehensively to refer to an item, both as an alternative and in combination.

As used herein, numbers and other letters refer to similar elements.

The generally accepted unit of refractive power is the diopter ("D"), which relates to the reciprocal of the focal length of the lens in metric units. In some embodiments, a defocusing optical structure comprises a refractive power for altering the focus of light on the retina. The defocusing optical structure may comprise a positive refractive power for forming an image of the stimulus in front of the retina, or a negative refractive power for forming an image of the stimulus behind the retina. In some embodiments, myopic defocusing corresponds to a positive refractive power and can be expressed using a positive value in diopter units, while hyperopic defocusing corresponds to a negative refractive power and can be expressed using a negative value in diopter units.

This disclosure includes the following numbered annotations:

Note 1. A device for treating refractive errors of the eye, comprising an optical system having an optical zone, and a peripheral defocusing optical structure for forming images of multiple stimuli in front of or behind the peripheral portion of the retina of the eye, wherein the peripheral defocusing optical structure is located outside the optical zone.

Note 2. The peripheral defocusing optical structure is the device described in Note 1, which possesses refractive power to focus light to a depth different from the optical zone of the eye.

Note 3. The apparatus described in Note 1, wherein the optical system comprises one or more of the following: a lens, an optically transparent substrate, a beam splitter, a prism, or an optically transparent support.

Note 4. The peripheral defocusing optical structure is the apparatus described in Note 1, which includes a Fresnel lens.

Note 5. The peripheral defocusing optical structure is the apparatus described in Note 1, comprising multiple lenslets.

Note 6. The apparatus described in Note 5, wherein multiple lenslets are arranged in one or more circular arrays centered on the optical zone.

Note 7. The apparatus described in Note 1, wherein the peripheral defocusing optical structure comprises one or more of the following: a diffractive optical structure or an Echelett grating.

Note 8. The apparatus described in Note 1, further comprising a filter within the optical zone to reduce light transmission through it.

Note 9. The apparatus described in Note 8, wherein the filter is formed on the fovea of the eye, and is configured to reduce the intensity of the central image and provide increased intensity of multiple stimuli in relation to the intensity of the central image.

Note 10. The filter is the device described in Note 8, extending within the peripheral defocusing optical structure.

Note 11. The apparatus described in Note 8 includes a neutral concentration filter.

Note 12. The filter is the device described in Note 8, which reduces the transmittance of visible light to 1/5 to 1/30 of its original value.

Note 13. The filter is the device described in Note 8, which reduces the transmittance of visible light by an amount ranging from 5 percent to 99 percent.

Appendix 14. The apparatus according to Appendix 1, further comprising a display configured to provide light through an optical zone to form a central image on the macula, and through a peripheral defocusing optical structure to provide multiple stimuli with defocusing on the peripheral portion of the retina.

Note 15. The apparatus described in Note 14, wherein multiple stimuli are formed using a lenslet with a peripheral defocusing optical structure.

Note 16. The peripheral defocusing optical structure further comprises multiple stimulus-generating structures, as described in Note 1.

Appendix 17. The apparatus according to Appendix 16, further comprising a filter matched with one or more apertures of the peripheral defocusing optical structure.

Note 18. The apparatus described in Note 17 contains multiple stimulus-generating structures located within the opening.

Note 19. The apparatus described in Note 18, wherein each of the multiple stimulus-generating structures is equipped with a mask.

Note 20. The apparatus described in Note 1, wherein each of the multiple stimuli possesses a spatial frequency.

Note 21. The apparatus described in Note 20 has spatial frequencies ranging from 0.1 cycles/degree to 180 cycles/degree, and optionally ranging from 1 cycle/degree to 180 cycles/degree.

Note 22. The apparatus described in Note 20, wherein the spatial frequencies include at least one pair of lines/mm (lp/mm) on the retina, and optionally, at least 50 lp/mm on the retina.

Note 23. The apparatus described in Note 1, wherein multiple stimuli provide contrast within the range of 99.9% to 2.5%.

Note 24. The peripheral defocusing optical structure is the apparatus described in Note 1, having a refractive power in the range of -2D to -6D or +2D to +6D.

Note 25. The peripheral defocusing optical structure is the apparatus described in Note 1, having a refractive power in the range of -3D to -5D or +3D to +5D.

Appendix 26. The apparatus described in Appendix 1, further comprising a base, wherein the peripheral defocusing optical structure is coupled to the base.

Appendix 27. The apparatus described in Appendix 26, further comprising an adhesive on the surface of the base.

Note 28. The optical system comprises spectacle lenses and filters, and the peripheral defocusing optical structure is coupled to the lenses, as described in Note 27.

Note 29. The optical system is the apparatus described in Note 1, comprising an adhesive.

Note 30. The optical system is the apparatus described in Note 1, comprising multiple layers.

Appendix 31. The apparatus according to Appendix 1, further comprising a display and a processor operably coupled to the display, the processor comprising instructions for providing multiple stimuli on the display at multiple locations and for forming images at multiple locations in front of or behind the retina.

Appendix 32. The apparatus according to Appendix 31, wherein the peripheral defocusing structure comprises multiple lenslets, and each of the multiple stimuli on the display is aligned with the corresponding lenslet to form an image in the anterior or posterior location of the peripheral portion of the retina.

Appendix 33. The apparatus according to Appendix 32, further comprising a plurality of substantially transparent electrodes and a liquid crystal material between the plurality of substantially transparent electrodes, wherein the liquid crystal material and the plurality of lenslets are positioned between the plurality of electrodes, and the apparatus activates and deactivates the refractive power of the plurality of lenslets.

Note 34. The apparatus according to Note 33, wherein the multiple lenslets are substantially transparent in the deactivated configuration, and the multiple lenslets are configured to provide multiple stimuli in the deactivated configuration.

Note 35. The apparatus described in Note 33, wherein the multiple electrodes are configured to change the refractive index of the liquid crystal material in response to the voltage between the electrodes.

Note 36. The apparatus according to Note 33, wherein the processor is operably coupled to multiple electrodes, activates multiple lenslets, and provides multiple stimuli.

Embodiments of this disclosure, as illustrated and described herein, are provided only as examples. Those skilled in the art will recognize numerous adaptations, modifications, variations, and substitutions without departing from the scope of this disclosure. Several alternatives and combinations of the embodiments disclosed herein may be utilized without departing from the scope of this disclosure and the inventions disclosed herein. Therefore, the scope of the inventions of this disclosure may only be defined by the scope of the appended claims and their equivalents.

Claims (34)

A device for treating refractive errors of the eye, wherein the device is
An optical system with an optical zone,
A peripheral defocusing optical structure located outside the optical zone comprises multiple lenslets for forming images of multiple stimuli in front of or behind the peripheral portion of the retina of the eye,
A display coupled to the peripheral defocusing optical structure, configured to provide light through the optical zone to form a central image on the macula, and through the peripheral defocusing optical structure to provide the plurality of stimuli with defocusing on the peripheral portion of the retina,
A device comprising: a processor operably coupled to the display, the processor comprising instructions for forming the image at multiple locations in front of or behind the retina by providing the multiple stimuli on the display at multiple locations, each of the multiple stimuli on the display being matched with a corresponding lenslet to form the image at a location in front of or behind the peripheral portion of the retina. The apparatus according to claim 1, wherein the peripheral defocusing optical structure has refractive power to focus light to a depth different from the optical zone of the eye. The apparatus according to claim 1, wherein the optical system comprises at least one of a lens, an optically transparent substrate, a beam splitter, a prism, or an optically transparent support. The apparatus according to claim 1, wherein the peripheral defocusing optical structure comprises a Fresnel lens. The apparatus according to claim 1, wherein the plurality of lenslets are arranged in one or more circular arrays centered on the optical zone. The apparatus according to claim 1, wherein the peripheral defocusing optical structure comprises at least one of a diffractive optical structure or an Eschlett grating. The apparatus according to claim 1, further comprising a filter within the optical zone to reduce light transmission through it. The apparatus according to claim 7, wherein the filter is configured to reduce the intensity of the central image formed on the fovea of the eye and to provide an increased intensity of the plurality of stimuli in relation to the intensity of the central image. The apparatus according to claim 7, wherein the filter extends within the peripheral defocusing optical structure. The apparatus according to claim 7, wherein the filter comprises a neutral concentration filter. The apparatus according to claim 7, wherein the filter reduces the transmittance of visible light to 1/5 to 1/30 of its original value. The apparatus according to claim 7, wherein the filter reduces the transmittance of visible light by an amount within the range of 5 percent to 99 percent. The apparatus according to claim 1, wherein the plurality of stimuli are formed using the lenslet of the peripheral defocusing optical structure. The apparatus according to claim 1, wherein the peripheral defocusing optical structure further comprises a plurality of stimulus generation structures. The apparatus according to claim 14, further comprising filters matched with one or more apertures of the peripheral defocusing optical structure. The apparatus according to claim 15, wherein the plurality of stimulus-generating structures are located within the opening. The apparatus according to claim 16, wherein each of the plurality of stimulus-generating structures comprises a mask. A device for treating refractive errors of the eye, wherein the device is
An optical system with an optical zone,
A peripheral defocusing optical structure located outside the optical zone comprises multiple lenslets for forming images of multiple stimuli in front of or behind the peripheral portion of the retina of the eye,
A display coupled to the peripheral defocusing optical structure , configured to provide light through the optical zone to form a central image on the macula, and through the peripheral defocusing optical structure to provide the plurality of stimuli with defocusing on the peripheral portion of the retina,
A processor operably coupled to the display, the processor comprising instructions for forming the image in a plurality of locations in front of or behind the retina by providing the plurality of stimuli on the display at a plurality of locations, each of the plurality of stimuli on the display being aligned with a corresponding lenslet to form the image in a location in front of or behind the peripheral portion of the retina.
The aforementioned multiple stimuli each possess a spatial frequency, and the device comprises these multiple stimuli. The apparatus according to claim 18, wherein the spatial frequency is within the range of 0.1 cycles/degree to 180 cycles/degree. The apparatus according to claim 19, wherein the spatial frequency is within the range of 1 cycle/degree to 180 cycles/degree. The apparatus according to claim 18, wherein the spatial frequency comprises a frequency of at least one line pair/mm (lp/mm) on the retina. The apparatus according to claim 21, wherein the spatial frequency comprises a frequency of at least 50 lb/mm on the retina. The apparatus according to claim 1, wherein the plurality of stimuli have contrasts within the range of 99.9% to 2.5%. The apparatus according to claim 1, wherein the peripheral defocusing optical structure has a refractive power in the range of -2D to -6D or in the range of +2D to +6D. The apparatus according to claim 1, wherein the peripheral defocusing optical structure has a refractive power in the range of -3D to -5D or +3D to +5D. The apparatus according to claim 1, further comprising a base, wherein the peripheral defocusing optical structure is coupled to the base. The apparatus according to claim 26, further comprising an adhesive on the surface of the base. The apparatus according to claim 27, wherein the optical system comprises an spectacle lens and a filter, and the peripheral defocusing optical structure is coupled to the spectacle lens. The apparatus according to claim 1, wherein the optical system comprises an adhesive. The apparatus according to claim 1, wherein the optical system comprises multiple layers. Multiple transparent electrodes,
The liquid crystal material between the plurality of transparent electrodes further comprises
The apparatus according to claim 1, wherein the liquid crystal material and the plurality of lenslets are positioned between the plurality of transparent electrodes, and the refractive power of the plurality of lenslets is activated and deactivated. The apparatus according to claim 31, wherein the plurality of lenslets are transparent in the deactivated configuration, and the plurality of lenslets are configured to provide the plurality of stimuli in the deactivated configuration. The apparatus according to claim 31, wherein the plurality of transparent electrodes are configured to change the refractive index of the liquid crystal material in response to the voltage between the plurality of transparent electrodes. The apparatus according to claim 31, wherein the processor is operably coupled to the plurality of transparent electrodes, activates the plurality of lenslets, and provides the plurality of stimuli.