# US 9,039,182 B2 · Video game to monitor retinal diseases > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 9,039,182 B2 - Document ID: US9039182B2 - Status: Granted - Kind: B2 - Application number: 13/683,641 - Filed: 2012-11-21 - Published: 2013-05-23 - Granted: 2015-05-26 - Earliest claimed: 2011-11-21 - Assignees: ICHECK Health Connection, Inc. - Applicants: ICHECK Health Connection, Inc. - Inventors: David Huang - Web page: https://patentgrep.com/patent/US9039182B2 ## CPC - A61B 3/032: Devices for presenting test symbols or characters, e.g. test chart projectors (A61B3/036 takes precedence) - A61B 3/005: {Constructional features of the display} - A61B 3/02: Subjective types, i.e. testing apparatus requiring the active assistance of the patient - A61B 3/024: for determining the visual field, e.g. perimeter types - A61B 3/028: for testing visual acuity; for determination of refraction, e.g. phoropters - A61B 3/0033: {characterised by user input arrangements} - A61B 3/0041: {characterised by display arrangements} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) ## Abstract Systems and methods for providing a video game to map macular visual acuity comprising a multiple choice test where the fixation point is ensured by brief simultaneous presentation of both a central and pericentral targets. The game may be implemented on a hardware platform including a video display, a user input device, and a video camera. The camera is used to monitor ambient light level and the distance between the device and the eyes of the test subject. The game serves as a macular acuity perimeter that produces a map of the acuity of an eye that may be compared with normative data. The type of acuity tested is preferably Vernier acuity, but resolution acuity can also be tested. The test results are transmitted to a health care professional by telecommunications means to facilitate the diagnosis or monitoring of age-related macular degeneration or other relevant eye diseases. ## Claims ### Claim 1 A computer-implemented method for testing macular visual acuity, comprising: displaying a first set of objects on a display of a computing device, the first set of objects including at least three objects, exactly one object in the first set objects being different from the other of the objects in the first set, wherein recognition of the difference between the one different object and the other of the objects is indicative of a user's visual acuity; receiving input from the user via a user input device of the computing device indicating a selection of one of the objects in the first set of objects; determining whether the user correctly selected the one different object from the first set of objects; and assessing the user's visual acuity based on the selections of the user. ### Claim 2 (depends on 1) The computer-implemented method of claim 1, further comprising: capturing an image of the user using an image capture device of the computing device; determining the distance between the display of the computing device and the user based on the captured image; and providing an instruction to the user to either increase or decrease his or her distance from the display based on the determined distance. ### Claim 3 (depends on 1) The computer-implemented method of claim 1, further comprising: subsequent to displaying the first set of objects on the display, displaying a second set of objects on the display of the computing device, the second set of objects including at least three objects, exactly one object in the second set objects being different from the other of the objects in the second set, wherein recognition of the difference between the one different object in the second set and the other of the objects in the second set is indicative of a user's visual acuity; receiving input from the user via the user input device of the computing device indicating a selection of one of the objects in the second set of objects; and determining whether the user correctly selected the one different object from the second set of objects. ### Claim 4 (depends on 3) The computer-implemented method of claim 3, wherein a characteristic of one or more of the objects in the second set of objects displayed on the display is dependent on whether the user correctly selected the one different object from the first set of objects. ### Claim 5 (depends on 1) The computer-implemented method of claim 1, wherein the computing device comprises a tablet computer and the user input device comprises a touch screen of the tablet computer. ### Claim 6 (depends on 1) The computer-implemented method of claim 1, further comprising: measuring ambient light level; and adjusting a brightness level of the display dependent on the measured ambient light level. ### Claim 7 (depends on 1) The computer-implemented method of claim 1, further comprising: measuring ambient light level using the computing device; and providing a notification instructing the user to adjust the ambient light level. ### Claim 8 (depends on 1) The computer-implemented method of claim 1, further comprising: transmitting data relating to the user's visual acuity to an external computing device. ### Claim 9 (depends on 8) The computer-implemented method of claim 8, further comprising storing the data on the external computing device, and analyzing the data to detect presence of an eye condition. ### Claim 10 (depends on 9) The computer-implemented method of claim 9, further comprising sending a notification from the external computing device to a computing device over a network indicative of the detected eye condition. ### Claim 11 (depends on 1) The computer-implemented method of claim 1, wherein the objects in the first set of objects comprise Vernier acuity targets. ### Claim 12 (depends on 1) The computer-implemented method of claim 1, further comprising, prior to displaying the first set of objects, displaying a set of differently-sized objects on the display, and receiving a selection of an object in the set of differently-sized objects via the user input interface indicating the smallest object in the set of differently-sized objects that is perceptible by the user, wherein the size of the objects in the first set of objects corresponds with the size of the selected object in the set of differently-sized objects. ### Claim 13 (depends on 1) The computer-implemented method of claim 1, further comprising displaying a score on the display based on the number of correct selections by the user. ### Claim 14 (depends on 1) The computer-implemented method of claim 1, wherein the one object in the first set objects is different in size from the other of the objects in the first set. ### Claim 15 A computer-implemented method for testing macular visual acuity, comprising: displaying a fixation location indicator on a display of a computing device configured for fixation thereon by a user; simultaneously and briefly displaying on the display a fixation pattern at the location of the fixation location indicator and at least two pericentral patterns spaced apart from the fixation pattern, wherein one of the pericentral patterns is a correct choice pericentral pattern that is different from the other of the pericentral patterns; receiving input from the user via a user input device indicating a selection of one of the pericentral patterns; determining whether the user selected the correct choice pericentral pattern; and recording whether the user selected the correct choice pericentral pattern in a data storage. ### Claim 16 (depends on 15) The computer-implemented method of claim 15, wherein the fixation pattern is positioned on the display near a periphery thereof. ### Claim 17 (depends on 15) The computer-implemented method of claim 15, further comprising: capturing an image of the user using an image capture device of the computing device; determining the distance between the display of the computing device and the user based on the captured image; and providing an instruction to the user to either increase or decrease his or her distance from the display based on the determined distance. ### Claim 18 (depends on 15) The computer-implemented method of claim 15, wherein the computing device comprises a tablet computer and the user input device comprises a touch screen of the tablet computer. ### Claim 19 (depends on 15) The computer-implemented method of claim 15, further comprising: measuring ambient light level; and adjusting a brightness level of the display dependent on the measured ambient light level. ### Claim 20 (depends on 15) The computer-implemented method of claim 15, further comprising: measuring ambient light level using the computing device; and providing a notification instructing the user to adjust the ambient light level. ### Claim 21 (depends on 15) The computer-implemented method of claim 15, further comprising: transmitting data relating to the user's visual acuity to an external computing device. ### Claim 22 (depends on 21) The computer-implemented method of claim 21, further comprising storing the data on the external computing device, and analyzing the data to detect presence of an eye condition. ### Claim 23 (depends on 22) The computer-implemented method of claim 22, further comprising sending a notification from the external computing device to a computing device over a network indicative of the detected eye condition. ### Claim 24 (depends on 15) The computer-implemented method of claim 15, wherein the fixation pattern and the at least two pericentral patterns comprise Vernier acuity targets. ### Claim 25 (depends on 15) The computer-implemented method of claim 15, wherein the correct choice pericentral pattern comprises the same pattern as the fixation pattern, and the other of the pericentral patterns comprises a different pattern than the fixation pattern. ### Claim 26 (depends on 15) The computer-implemented method of claim 15, wherein the correct choice pericentral pattern comprises a different pattern than the fixation pattern, and the other of the pericentral patterns comprises the same pattern as the fixation pattern. ### Claim 27 A system for testing macular visual acuity, comprising: a display; a user input device; and a computer coupled to the display and the user input device, and configured to: simultaneously and briefly display on the display a fixation pattern and at least two pericentral patterns, wherein one of the pericentral patterns is a correct choice pericentral pattern that is different from the other of the pericentral patterns; receive input from the user via the user input device indicating a selection of one of the pericentral patterns; and determine whether the user selected the correct choice pericentral pattern. ### Claim 28 (depends on 27) The system of claim 27, wherein the correct choice pericentral pattern comprises the same pattern as the fixation pattern, and the other of the pericentral patterns comprises a different pattern than the fixation pattern. ### Claim 29 (depends on 27) The system of claim 27, wherein the correct choice pericentral pattern comprises a different pattern than the fixation pattern, and the other of the pericentral patterns comprises the same pattern as the fixation pattern. ### Claim 30 (depends on 27) The system of claim 27, further comprising: a camera operatively coupled to the computer configured to monitor the ambient light level of the environment of the system, wherein the computer is configured to adjust the brightness of the display dependent on the monitored ambient light level. ### Claim 31 (depends on 27) The system of claim 27, further comprising: a camera operatively coupled to the computer configured to monitor the ambient light level of the environment of the system, wherein the computer is configured to display a message on the display providing an instruction to the user to adjust the ambient light level of the environment. ### Claim 32 (depends on 27) The system of claim 27, further comprising: a communications interface coupled to the computer and configured to communicate with an external computer system using wired or wireless communication. ### Claim 33 (depends on 27) The system of claim 27, further comprising: a camera operatively coupled to the computer configured to capture an image of the user, wherein the computer is configured to determine the distance between the display and the user based on the captured image, and to provide an instruction to the user to either increase or decrease his or her distance from the display based on the determined distance. ### Claim 34 (depends on 27) The system of claim 27, wherein the system comprises a tablet computer and the user input device comprises a touch screen of the tablet computer. ### Claim 35 (depends on 27) The system of claim 27, wherein the fixation pattern and the pericentral patterns comprise Vernier acuity targets. ### Claim 36 (depends on 27) The system of claim 27, wherein the computer is further configured to, prior to displaying the fixation pattern and the pericentral patterns, display a set of differently-sized patterns on the display, and receive a selection of one of the differently-sized patterns via the user input interface indicating the smallest patterns in the set of differently-sized patterns that is perceptible by the user, wherein the size of the fixation pattern and the pericentral patterns corresponds with the size of the selected pattern in the set of differently-sized patterns. ### Claim 37 (depends on 27) The system of claim 27, wherein the fixation pattern is positioned on the display near a periphery thereof. ### Claim 38 A non-transitory computer-readable medium encoded with computer executable instructions, which when executed, performs a method comprising: displaying a first set of objects on a display of a computing device, the first set of objects including at least three objects, exactly one object in the first set objects being different from the other of the objects in the first set, wherein recognition of the difference between the one different object and the other of the objects is indicative of a user's visual acuity; receiving input from the user via a user input device of the computing device indicating a selection of one of the objects in the first set of objects; determining whether the user correctly selected the one different object from the first set of objects; and assessing the user's visual acuity based on the selections of the user. ### Claim 39 (depends on 38) The non-transitory computer-readable medium of claim 38, wherein the method further comprises: capturing an image of the user using an image capture device of the computing device; determining the distance between the display of the computing device and the user based on the captured image; and providing an instruction to the user to either increase or decrease his or her distance from the display based on the determined distance. ### Claim 40 (depends on 38) The non-transitory computer-readable medium of claim 38, wherein the method further comprises: subsequent to displaying the first set of objects on the display, displaying a second set of objects on the display of the computing device, the second set of objects including at least three objects, exactly one object in the second set objects being different from the other of the objects in the second set, wherein recognition of the difference between the one different object in the second set and the other of the objects in the second set is indicative of a user's visual acuity; receiving input from the user via the user input device of the computing device indicating a selection of one of the objects in the second set of objects; and determining whether the user correctly selected the one different object from the second set of objects. ### Claim 41 (depends on 40) The non-transitory computer-readable medium of claim 40, wherein a characteristic of one or more of the objects in the second set of objects displayed is dependent on whether the user correctly selected the one different object from the first set of objects. ### Claim 42 (depends on 38) The non-transitory computer-readable medium of claim 38, wherein the computing device comprises a tablet computer and the user input device comprises a touch screen of the tablet computer. ### Claim 43 (depends on 38) The non-transitory computer-readable medium of claim 38, wherein the method further comprises: measuring ambient light level; and adjusting a brightness level of the display dependent on the measured ambient light level. ### Claim 44 (depends on 38) The non-transitory computer-readable medium of claim 38, wherein the method further comprises: measuring ambient light level using the computing device; and providing a notification instructing the user to adjust the ambient light level. ### Claim 45 (depends on 38) The non-transitory computer-readable medium of claim 38, wherein the method further comprises: transmitting data relating to the user's visual acuity to an external computing device. ### Claim 46 (depends on 45) The non-transitory computer-readable medium of claim 45, wherein the method further comprises storing the data on the external computing device, and analyzing the data to detect presence of an eye condition. ### Claim 47 (depends on 46) The non-transitory computer-readable medium of claim 46, wherein the method further comprises sending a notification from the external computing device to a computing device over a network indicative of the detected eye condition. ### Claim 48 (depends on 38) The non-transitory computer-readable medium of claim 38, wherein the objects in the first set of objects comprise Vernier acuity targets. ### Claim 49 (depends on 38) The non-transitory computer-readable medium of claim 38, wherein the method further comprises, prior to displaying the first set of objects, displaying a set of differently-sized objects on the display, and receiving a selection of an object via the user input interface indicating the smallest object in the set of differently-sized objects that is perceptible by the user, wherein the size of the objects in the first set of objects corresponds with the size of the selected object in the set of differently-sized objects. ### Claim 50 (depends on 38) The non-transitory computer-readable medium of claim 38, wherein the method further comprises displaying a score on the display based on the number of correct selections by the user. ### Claim 51 (depends on 38) The non-transitory computer-readable medium of claim 38, wherein the one different object in the first set objects differs from the other of the objects in the first set of objects in one of color and gray level. ### Claim 52 A computer-implemented method for providing a video game for testing macular visual acuity, the method comprising: testing central visual acuity by executing a plurality of central visual acuity rounds of the video game, each central visual acuity round comprising: displaying at least three central acuity targets on a display of a computing device, one of the at least three central acuity targets being different from the other of the central acuity targets, wherein recognition of the difference between the one different central acuity target and the other central acuity targets is indicative of a user's central visual acuity; receiving a selection of one of the central acuity targets from the user via a user input device of the computing device; determining whether the user correctly selected the one different central acuity target from the central acuity targets; and assessing the user's central visual acuity based on the selection of the user; testing pericentral visual acuity by executing a plurality of pericentral visual acuity rounds of the video game, each pericentral visual acuity round comprising: displaying a fixation location indicator on the display of the computing device configured for fixation thereon by a user; simultaneously and briefly displaying on the display a fixation target at the location of the fixation location indicator and at least two pericentral acuity targets spaced apart from the fixation target, wherein one of the pericentral acuity targets is a correct choice pericentral acuity target that is different from the other of the pericentral acuity targets, the correct choice pericentral acuity target being positioned relative to the fixation target such that perception of the correct choice pericentral acuity target is indicative of the user's visual acuity at a location on an acuity map; receiving a selection of one of the pericentral acuity targets from the user via the user input device; determining whether the user selected the correct choice pericentral acuity target; and recording whether the user selected the correct choice pericentral acuity target in a data storage; and generating a visual acuity map based on the user's selections during the plurality of central acuity and pericentral acuity rounds, wherein in the visual acuity map is divided into a plurality of locations, and each of the plurality of locations is tested by at least one of the central acuity or pericentral acuity rounds of the video game. ### Claim 53 (depends on 52) The computer-implemented method of claim 52, wherein, during each of the central acuity rounds, a characteristic of the central acuity targets displayed on the display is dependent on the user's selection of a central acuity target in a previous central acuity round. ### Claim 54 (depends on 52) The computer-implemented method of claim 52, wherein, during each of the pericentral acuity rounds, a characteristic of the fixation target and the pericentral acuity targets displayed on the display is dependent on the user's selection of a pericentral acuity target in a previous pericentral acuity round. ### Claim 55 (depends on 52) The computer-implemented method of claim 52, wherein a characteristic of the central acuity targets and the pericentral acuity targets is initially selected based on the user's previous visual acuity test results. ### Claim 56 (depends on 52) The computer-implemented method of claim 52, wherein a characteristic of the central acuity targets and the pericentral acuity targets is initially selected based on visual acuity information of a normal population. ### Claim 57 (depends on 52) The computer-implemented method of claim 52, further comprising: capturing an image of the user using an image capture device of the computing device; determining the distance between the display of the computing device and the user based on the captured image; and providing an instruction to the user to either increase or decrease his or her distance from the display based on the determined distance. ### Claim 58 (depends on 52) The computer-implemented method of claim 52, wherein the computing device comprises a tablet computer and the user input device comprises a touch screen of the tablet computer. ### Claim 59 (depends on 52) The computer-implemented method of claim 52, wherein the central acuity targets and the pericentral acuity targets comprise Vernier acuity targets.