Abstract: A selectively marked contact lens having, in one aspect, marks in an optical zone region on a surface thereof and, in another aspect, different marks outside an optical zone region of the lens, for an in-vivo lens. With the lens in-vivo, the subject's eye is illuminated and the lens is imaged. A fast algorithm is used to determine the mark coordinates in relation to a measured pupil coordinate to determine position and/or orientation of the contact lens. A wavefront aberration measurement can also be obtained simultaneously with the contact lens position measurement, as well as pupil size. A fast algorithm provides for online measurements; i.e., at a repetition rate of 10 Hz or greater, over a selected time interval. Blinking periods are determined and anomalous lens position and/or wavefront information is discarded. A most frequently occurring wavefront and/or contact lens position/orientation is determined over the selected time interval.

Abstract: The invention is directed to a system and methods for automatically determining a multiple number of viable treatment plans for correcting a patient's vision via photoablative refractive surgery. Embodiments of the invention rely on selected various diagnostic input about the patient's eye to classify the eye as being particularly suitable for treatment by several different treatment algorithms. The invention is further directed to the simultaneous presentation of various treatment plans based upon selected input data and available treatment algorithms that can be reviewed, modified, and ultimately selected for application.

Abstract: A customized corneal profile is provided by combining corneal topography data with captured wavefront aberration data to form a course of refractive treatment of the eye. In one embodiment, the captured wavefront data is employed within the area of a pupil, while the corneal topography data is employed in the area outside of the pupil. In other embodiments, the topography data is adjusted based on the wavefront data, a course of refractive treatment is simulated and displayed upon the topography data, and an initial evaluation of the suitability of a patient for treatment is performed based on the topography data.

Abstract: A system and method are provided in which an iris or eye image is taken during a refractive diagnostic analysis. The image is employed for aligning data from the analysis with data from other refractive analysis instruments, as well as aligning a refractive surgical tool, such as a laser, with the eye for treatment. Further, the stored iris image is compared with the patient's iris before treatment, verifying that the correct eye is to be treated with a developed treatment pattern. A variety of refractive instruments can be used, such as corneal topography systems and wavefront aberration systems.

Abstract: In an ophthalmic laser system preferably intended for photoablative refractive surgery, a component apparatus that is preferably an optical coherence tomography device for measuring corneal pachymetry makes its measurement when the First and Second Purkinje reflections of the OCT probe beam are detected, otherwise, the reflection signal is not strong enough to enable the OCT measurement. The beam axis of the therapeutic laser of the system is co-aligned with the OCT-prbbe beam. When the First and Second Purkinje reflections of the OCT probe beam are detected, a signal is generated by the OCT device and sent to the eye tracker component of the system to engage the eye tracker operation. This allows for objective, automatic engagement of the eye tracker and alignment of the patient's optical axis to the treatment axis or a diagnostic beam axis.

Abstract: A system and method are provided in which an iris or eye image is taken during a refractive diagnostic analysis. The image is employed for aligning data from the analysis with data from other refractive analysis instruments, as well as aligning a refractive surgical tool, such as a laser, with the eye for treatment. Further, the stored iris image is compared with the patient's iris before treatment, verifying that the correct eye is to be treated with a developed treatment pattern. A variety of refractive instruments can be used, such as corneal topography systems and wavefront aberration systems.

Abstract: A system and method for providing a predictive outcome in the form of a predictive best instruction for a therapeutic ophthalmic correction of a patient's vision defects. The predictive best instruction is derived from prospective therapeutic-outcome-influencing, new information that is analyzed in conjunction with optimized, historical therapeutic-outcome information. The instruction is preferably an optimized, custom, photoablative algorithm for driving a photoablative, excimer laser. The instruction can be provided on a fee basis.

Abstract: An improved wavefront sensor is provided that enhances the initial focus and precision of imaged spots used to determine the monochromatic wave aberrations of the eye. The wavefront sensor includes an adjustment camera that is independent of a lenslet camera. A laser in a lower power mode is projected onto the retina of the eye and is brought into more precise or sharp focus by a control system employing data from the adjustment camera, which aids in focusing the imaged spots. “Trombone”-type optics are used to adjust the focus of the light projected onto the retina and the imaged spots onto a sensor. The laser has a higher power mode used when acquiring data of the imaged spots from the sensor.

Abstract: An improved wavefront sensor is provided that enhances the initial focus and precision of imaged spots used to determine the monochromatic wave aberrations of the eye. The wavefront sensor includes an adjustment camera that is independent of a lenslet camera. A laser in a lower power mode is projected onto the retina of the eye and is brought into more precise or sharp focus by a control system employing data from the adjustment camera, which aids in focusing the imaged spots. “Trombone”-type optics are used to adjust the focus of the light projected onto the retina and the imaged spots onto a sensor. The laser has a higher power mode used when acquiring data of the imaged spots from the sensor.

Abstract: An method for providing an objective manifest refraction of a patient's eye includes obtaining at least fourth-order Zernike wavefront aberration information, fitting a second-order only polynomial to the at least fourth-order data, and using this information to predict the patient's manifest refraction with an accuracy approaching the patient's subjective manifest refraction. A method is also described for prescribing an accurate vision correction based upon the objective manifest refraction. A display according to the invention includes higher-order wavefront aberrations, lower order wavefront aberrations, numerical indicia of predicted manifest refraction, and images of qualitative assessments of a patient's vision quality. A device for obtaining an objective manifest refraction is described.

Abstract: An aperture card is provided for insertion into a laser refractive ablation system for use in laser ablating the cornea. The aperture card is designed for single surgical use for surgical precautionary considerations and to achieve the highest quality ablations, in addition to reproducibility. The aperture card is loaded into the laser refractive ablation system in a path between the laser system and the eye. The aperture card is precisely located by positioning means and ablative lasing action is inhibited if the card is not positioned within tolerance. Alternatively, the laser system can determine the position of the aperture card and adjust a computed ablation profile or otherwise adjust the optical system to adapt for any misalignment of the apertures in the aperture card. The card contains a “soft spot” aperture capable of shaping a spatial intensity distribution with a unique profile.

Abstract: This invention is directed to a method for providing a LASIK or a LASEK myopia vision correction, and to a medium that has stored therein an instruction for directing a laser vision correcting laser platform to deliver a controlled biodynamic ablation according to the invention. A known biodynamic response of the eye is induced by performing a controlled laser ablation in a cornea of the eye outside of an optical zone for the nominal ablation in a laser vision correction surgery. An ablation ring, or portion thereof, outside of the optical zone produces a biodynamic flattening of the central region of the cornea which in turn provides for a decreased depth of volumetric ablation to correct a myopic refractive defect of the eye. Such controlled biodynamic flattening may provide the opportunity for laser vision correction in patients whose corneas would otherwise be too thin post-operatively to warrant laser vision correction.

Abstract: Methods and apparatus for improving vision incorporate the effects of biodynamical and biomechanical (biological) responses of the eye. The eye produces a biological response to trauma, such as a LASIK keratectomy or other necessary traumatic procedure in preparation for refractive surgery. By observing the biological response, a prospective treatment to correct higher order aberrations is adjusted to compensate for the biological effects. An improved photorefractive surgery system incorporates one or more suitable diagnostic devices that provide biological response information in such a manner that the patient need not change position from that assumed for the surgical procedure.

Abstract: Methods and apparatus for improving vision incorporate the effects of biodynamical and biomechanical (biological) responses of the eye. The eye produces a biological response to trauma, such as a LASIK keratectomy or other necessary traumatic procedure in preparation for refractive surgery. By observing the biological response, a prospective treatment to correct higher order aberrations is adjusted to compensate for the biological effects. An improved photorefractive surgery system incorporates one or more suitable diagnostic devices that provide biological response information in such a manner that the patient need not change position from that assumed for the surgical procedure.

Abstract: An method for providing an objective manifest refraction of a patient's eye includes obtaining at least fourth-order Zernike wavefront aberration information, fitting a second-order only polynomial to the at least fourth-order data, and using this information to predict the patient's manifest refraction with an accuracy approaching the patient's subjective manifest refraction. A method is also described for prescribing an accurate vision correction based upon the objective manifest refraction. A display according to the invention includes higher-order wavefront aberrations, lower order wavefront aberrations, numerical indicia of predicted manifest refraction, and images of qualitative assessments of a patient's vision quality. A device for obtaining an objective manifest refraction is described.

Abstract: A device readable medium for use in controlling a laser vision correction system includes a storage structure having stored therein a pre-programmed first, readable, corrective instruction reference that corresponds to an encoded customized corrective instruction determined by a calculation module external to the medium. The encoded customized corrective instruction is executable by a laser vision correction laser platform for correction of a refractive defect when the corrective instruction reference is properly recognized. A laser vision correction system including the device readable medium is described. A remunerative model relating to the device readable medium is disclosed.

Abstract: An method for providing an objective manifest refraction of a patient's eye includes obtaining at least fourth-order Zernike wavefront aberration information, fitting a second-order only polynomial to the at least fourth-order data, and using this information to predict the patient's manifest refraction with an accuracy approaching the patient's subjective manifest refraction. A method is also described for prescribing an accurate vision correction based upon the objective manifest refraction. A display according to the invention includes higher-order wavefront aberrations, lower order wavefront aberrations, numerical indicia of predicted manifest refraction, and images of qualitative assessments of a patient's vision quality. A device for obtaining an objective manifest refraction is described.

Abstract: A system and method for providing a predictive outcome in the form of a predictive best instruction for a therapeutic ophthalmic correction of a patient's vision defects. The predictive best instruction is derived from prospective therapeutic-outcome-influencing, new information that is analyzed in conjunction with optimized, historical therapeutic-outcome information. The instruction is preferably an optimized, custom, photoablative algorithm for driving a photoablative, excimer laser. The instruction can be provided on a fee basis.

Abstract: A device readable medium for use in controlling a laser vision correction system includes a storage structure having stored therein a pre-programmed first, readable, corrective instruction reference that corresponds to an encoded customized corrective instruction determined by a calculation module external to the medium. The encoded customized corrective instruction is executable by a laser vision correction laser platform for correction of a refractive defect when the corrective instruction reference is properly recognized. A laser vision correction system including the device readable medium is described. A remunerative model relating to the device readable medium is disclosed.

Abstract: A laser vision correction ablation algorithm relies upon the central radius of curvature and a biconic shape factor of a pre-operative and a post-operative anterior corneal surface. The post-operative shape factor is selected to provide a spherical aberration value that is optimized for a particular patient or for a particular patient population group. The algorithm is embodied as a readable, executable instruction in a device readable medium. The algorithm further sets forth a method for laser vision correction.