Wavefront Guided Spectacle Lenses For Emmetropes and Myopes

1
IMPROVEMENT OF NIGHT DRIVING
VISIBILITY DETECTION WITH WAVEFRONT GUIDED
SPECTACLE LENSES J.A. Kensick1 M.C. Brown2, A.
Ginsburg3, A.W. Dreher1, N. Gomez1, C.
James1 1Ophthonix Inc., San Diego, CA 2Gordon
Binder Weiss Vision Institute, San Diego, CA
3Vision Sciences Research Cooperation, San Ramon,
CA.
2781 B964
Introduction Traffic deaths are three times
greater at night than during the daytime and 90
of drivers reaction time is visually based.
Considering that nighttime (mesopic) refractive
myopic shifts can lead to poorer night vision,
the drivers at night are dependent on artificial
sources of light, and are more sensitive to
bright lights. Night driving vision was the
single highest challenge (77) from a survey of
1,300 people aged 18 years and older. Other
challenges were managing street light glare
(70), seeing objects in low light conditions
(70), and driving at sunset (64). Many patients
complained of double images, distorted field of
view, low contrast, lack of color perception,
glare sensitivity, night driving problems include
halos, star burst patterns, and comet tails
around lights at night.
Ophthonix launched their single vision
wavefront guided iZon High Resolution lenses in
April 2005 and consumer surveys found 91 of the
respondents highly rated the iZon spectacles for
night driving. In order to correlate this data
with objective information, Ophthonix set out to
clinically evaluate the effects of wavefront
guided iZon lenses with regards to improved
reaction time while driving at night with an
outside institution.

• Methods
• Subjects
• 27 subjects
• Age 18 64 years
• Refraction range 1.20 D to -5.75 D with up to
  -2.50 D astigmatism
• Study was conducted at the US Navy Refractive
  Surgery Center, San Diego CA
• Procedure
• Wavefront measurements were collected on a
  holographic grating wavefront aberrometer
  (Z-View, Ophthonix Inc.) (Fig. 1). All subjects
  underwent an independent manifest refraction and
  Z-View refraction.
• A double masked study was designed where
  subjects, clinical coordinators and investigators
  were masked from the type of lenses being tested.
• Identical frames were used for making both pairs
  of spectacles one pair made using Z-View
  Refraction and second pair made using Manifest
  Refraction.
• The wavefront guided iZon lenses are composite
  lenses made of 1.6 index lenses with a
  photopolymer sandwiched between them.
• Both sets of lenses (based on Z-View and Manifest
  Refractions) are made of 1.6 index material and
  possess identical antireflective (AR) coating.
• The order the lenses being tested in the study
  was randomized and tested in identical room
  conditions.
• Subjects were tested using the FDA validated
  Night Driving Simulator (NDS, Vision Sciences
  Research Corporation, San Ramon, CA)
• During the NDS test, subjects are tested
  simulating driving at 55 mph on a rural road
  environment. The subjects were given 15 minutes
  adaptation period prior to taking the NDS tests.
• Subjects were first trained to use the NDA system
  by viewing all 6 objects for detection and
  running through a practice sequence.
• The objects to detect and identify during the
  tests consisted of Green Business Sign stating
  either to Take Right Exit or Take Left Exit,
  a Yellow 3-way or 4-way Intersection Sign, and a
  Pedestrian on both sides of the road either
  Walking Right or Left.
• Subjects were tested in both detecting the object
  followed by identifying the object.

• Discussion
• The Z-View Aberrometer uses a proprietary
  wavefront technology obtaining over 17,000
  measurement points over a 7mm pupil. The exam is
  taken by a monocular measurement in binocular
  fixation conditions. The dynamic measurement
  range for sphere is -12D to 11D for cylinder is
  /- 8D.
• The iZon Wavefront Guided lenses were
  prescribed directly from the Z-View Aberrometer
  which creates the subjects wavefront
  prescription called the iPrint, while the
  conventional lenses were made from the
  Optometrists manifest refraction.
• The iZon Wavefront Guided lenses is a unique
  3-layer composition which addesses the vision
  problems associated with higher order
  aberrations.
• Through additional feedback retained from
  surveys of patients who purchased the iZon
  glasses, 91 of SV wearers (N530) and 91 of PAL
  wearers (N617) rate the iZon glasses good or
  excellent for Night Driving use.
• Conclusions
• iZon Wavefront Guided lenses improve reaction
  time over traditional lenses in detecting and
  identifying normal road signs and pedestrian
  hazards while driving in simulated night time
  driving situations under glare and non glare
  conditions.
• The average reaction time of a quarter of a
  second faster at 55 mph was observed with iZon
  Wavefront Guided lenses over conventional lenses.

Results Discussions Statistically Significant
Differences were found favoring the iZon Lens
versus the Conventional Lenses.
Ten of the twelve tests were found to be
statistically significant when compared with the
t-test for paired data, p lt .05, as shown in
Table 1. The largest improvement was seen when
identifying the pedestrian in nighttime glare
conditions. The average improvement during this
test was 20.2 feet at 55 mph, which equates to
.25 seconds. 20 subjects showing improved
reaction time ranging from 5 to 100 feet while
wearing the iZon wavefront guided lenses (74 of
subjects). .25 or a quarter of a second at 55
mph means Distance across a typical
intersection. Just under the reaction time
improvement of the Federally mandated third
taillight.
Table 1. t-Test, Paired two samples of means
Common Night Driving Complaints
Halos and Ghost Images
Starbursts

• References
• P. Binder, A. Dreher. Visual Acuity and Contrast
  Sensitivity in Patients Using Wavefront
  Customized Spectacles, 2003 Annual AAO Meeting,
  Anaheim, CA.
• Dreher, A. Custom Eyeglass Manufacturing Method,
  US Patent 6,682,195, 2004.
• Dreher, A. Eyeglass Manufacturing Method using
  Variable Index Layer, US Patent 6,712,466, 2004.
• Kaupp, S, Brown, M.C., Visual Performance In A
  Night Driving Simulator using Spectacles With
  Wavefront Guided Correction, 2006 ARVO Meeting,
  Fort Lauderdale, FL.

Ophthonixs Z-View Aberrometer
Night Driving Simulator
Figure 1. Z-View Aberrometer, Wavefront System
used to measure the eyes Low and High Order
Aberrations.
Equipment set up
Contact Info Ophthonix Inc. 10455 Pacific Center
Court San Diego, CA 92121 877-FOR-IZON www.ophthon
ix.com
Hypothesis The purpose of this study is to
evaluate the improvement in wearers visual
performance under night driving conditions while
wearing iZon Wavefront Guided lenses
Green Business Sign
Yellow 4-way Street Sign