Systems and methods for vision assessment

1. A system for assessment of a visual field of a user, the system comprising: computing hardware configured to perform operations comprising:

displaying, on the virtual reality environment on a virtual reality display of a head-mountable virtual reality device, a first fixation target, the virtual reality environment comprising a pointer that is controlled by the user wearing the head-mountable virtual reality device, the first fixation target being one of a plurality of fixation targets;

determining whether a fixation task associated with the first fixation target has been completed by the user;

based at least on determining that the fixation task associated with the first fixation target is not completed, displaying at least one additional fixation target until an indication is received, wherein the indication indicates the fixation task is completed, and wherein the fixation task is completed when the pointer overlaps at least a portion of the first fixation target;

based at least on determining that the fixation task associated with the first fixation target is completed when the indication is received and when the pointer overlaps at least the portion of the first fixation target, identifying a position of at least a portion of at least one eye of the user;

based at least on the identifying the position, displaying, on the head-mountable display, a first test target, the first test target being one of a plurality of test targets, the first test target displayed at a first location, the first location corresponding to one of a plurality of locations in the visual field of the user, others of the plurality of test targets each corresponding to at least one other of the plurality of locations;

determining whether the user has detected the first test target at the first location;

collecting data related to the determining of whether the user has detected the first test target at the first location;

automatically iteratively performing a plurality of assessment steps for each of at least a portion of the plurality of fixation targets and corresponding ones of the plurality of test targets until a certain termination condition is met, wherein the plurality of assessment steps includes the displaying the first fixation target, the determining whether the fixation task associated with the first fixation target has been completed by the user, the displaying the at least one additional fixation target until the indication is received, the identifying the position of at least the portion of the at least one eye of the user, the determining whether the user has detected the first test target at the first location, and the collecting data; and

providing information related to a result of the visual field assessment of the user based at least on the collected data from the iterative performance of the plurality of assessment steps.

2. The system of claim 1 , wherein the user input indicating that the user has detected the test target at the first location comprises determining whether the user input indicates that the pointer is moving towards the first location.

3. The system of claim 1 , wherein the user input indicating that the user has detected the test target at the first location comprises determining whether the user input indicates that a head of the user is moving towards the first location.

4. The system of claim 1 , wherein the user input indicating that the user has detected the test target at the first location comprises determining whether the user input comprises a pupil response.

5. The system of claim 1 , wherein the user input indicating that the user has detected the test target at the first location comprises determining whether the user input comprises a button press.

6. The system of claim 1 , wherein the operations that the computing hardware is configured to perform further comprise determining a position of the eye and/or pupil when it is determined that the eye is fixating on the fixation target.

7. The system of claim 1 , wherein the iterative performance of the displaying, determining, displaying, receiving, and acquiring steps continues until all test targets of the plurality of test targets have been displayed.

8. The system of claim 1 , wherein the iterative performance of the displaying, determining, displaying, receiving, and acquiring steps continues until a predetermined period of time has passed.

9. The system of claim 1 , wherein the iterative performance of the displaying, determining, displaying, receiving, and acquiring steps continues until a predetermined level of statistical confidence in an assessment has been reached.

10. The system of claim 1 , wherein the test target is displayed at least partially simultaneously with displaying the fixation target when it is determined that the eye is fixating on the fixation target.

11. The system of claim 1 , wherein determining whether the eye is fixating on the fixation target comprises determining whether the patient's fovea is fixated on the fixation target.

12. The system of claim 1 , further comprising comparing a stability of the patient's binocular fixation to a stability of the patient's monocular fixation in each eye to determine whether to display the fixation target one eye at a time or to both eyes simultaneously.

13. The system of claim 1 , wherein the user input comprises an indication of movement of the pointer in the virtual reality environment.

14. The system of claim 1 , wherein acquiring the indication that the test target has been detected by the user comprises determining that the pointer is positioned within a predetermined distance from the first location.

15. The system of claim 1 , wherein acquiring the indication that the test target has been detected by the user comprises acquiring an indication that the location of the test stimulus has been detected by the user.

16. The system of claim 1 , wherein acquiring the indication that the test target has been detected by the user comprises determining a movement of one or both eyes, a head, facial muscles, one or both pupils, and/or body of the user.

17. The system of claim 1 , wherein the iterative performance of the displaying, determining, displaying, receiving, and acquiring steps comprises:

displaying, in a second location on the virtual reality environment corresponding to a second location of the visual field of the user that is different from the first location of the visual field of the user, a subsequent test target of the plurality of test targets.

18. The system of claim 1 , wherein the iterative performance of the displaying, determining, displaying, receiving, and acquiring steps comprises:

displaying, on the virtual reality environment, a subsequent fixation target;

determining whether the eye is fixating on the subsequent fixation target;

when it is determined that the eye is fixating on the subsequent fixation target, displaying, in a second location on the virtual reality environment corresponding to a second location of the visual field of the user that is different from the first location of the visual field of the user, a subsequent test target of the plurality of test targets;

receiving user input comprising an indication that the user has detected the subsequent test target at the second location;

acquiring, based on the received user input, a second indication of whether the subsequent test target has been detected by the user, and storing the second indication.

19. The system of claim 18 , wherein the subsequent test target has at least one property that is different from at least one property of the test target that was displayed in the first location.

20. The system of claim 1 , wherein determining whether the eye is fixating on the fixation target comprises determining whether the pointer has moved such that the pointer at least partially overlaps with the fixation target.

21. The system of claim 1 , wherein the fixation target comprises a representation of at least one movable object.

22. The system of claim 1 , wherein the fixation target is displayed in the vicinity of the first location.

23. The system of claim 1 , wherein receiving user input further comprises acquiring eye tracking information using a sensor monitoring at least one of the eyes of the user wearing the head-mountable virtual reality device.

24. The system of claim 1 , wherein the head-mountable virtual reality device comprises glasses.

25. The system of claim 1 , wherein the user input is further received from at least one input device selected from the group consisting of a mouse, a joystick, a keyboard, a hand-held gesture and motion tracking device, a gesture and motion device that is not hand-held, a microphone, at least one camera, an omnidirectional treadmill, a head tracking device, a body tracking device, a facial muscle sensor, and a game pad.

26. The system of claim 1 , comprising a mobile computing device including the computing hardware.

27. The system of claim 1 , wherein the pointer comprises a head pointer.

28. The system of claim 1 , wherein the pointer comprises a hand pointer.

29. The system of claim 1 , wherein physical characteristics of the fixation target or test targets and the rules for whether and how they are displayed are described within a spread sheet or data file that can be altered by a person-conducting the test.

30. The system of claim 1 , wherein physical characteristics of the fixation target or test targets and the rules for whether and how they are displayed are configured on a separate computing device and received on the device that administers the test through a network connection.

31. The system of claim 1 , wherein the results and data collected during the testing are sent to a separate computing device.

32. The system of claim 1 , wherein one or more properties of the test stimulus are at least in part determined by prior test results from the current patient and/or other patients.

33. The system of claim 1 , wherein acquiring the indication that the test stimulus has been detected by the user comprises determining that the pointer is positioned within one of at least two sectors surrounding the location of the fixation target.

34. The system of claim 1 , wherein the assessment of a condition of the visual field includes information on the identification, status, and/or progression of at least one of glaucoma, multiple sclerosis, macular degeneration, diabetic retinopathy, neurological function, retinitis pigmentosa, color vision, binocular vision including suppression scotomas, and a vascular disease.

35. A system for assessment of a visual field of a user, the system comprising: computing hardware configured to perform operations comprising:

displaying, on a user interface rendered on a display associated with a computing device, a first fixation target, the user interface comprising a pointer that is controlled by the user viewing the user interface, the first fixation target being one of a plurality of fixation targets;

determining whether a fixation task associated with the first fixation target has been completed by the user;

based at least on determining that the fixation task associated with the first fixation target is not completed, displaying at least one additional fixation target until an indication is received, wherein the indication indicates the fixation task is completed, and wherein the fixation task is completed when the pointer overlaps at least a portion of the first fixation target;

based at least on determining that the fixation task associated with the first fixation target is completed when the indication is received and when the pointer overlaps at least the portion of the first fixation target, identifying a position of at least a portion of at least one eye of the user;

displaying a first test target, the first test target being one of a plurality of test targets the first test target displayed at a first location, the first location corresponding to a one of a plurality of locations in the visual field of the user, others of the plurality of test targets each corresponding to at least one other of the plurality of locations;

determining whether the user has detected the first test target at the first location;

collecting data related to the determining of whether the user has detected the first test target at the first location;

automatically iteratively performing a plurality of assessment steps for each of at least a portion of the plurality of fixation targets and corresponding ones of the plurality of test targets until a certain termination condition is met, wherein the plurality of assessment steps includes the displaying the first fixation target, the determining whether the fixation task associated with the first fixation target has been completed by the user, the displaying the at least one additional fixation target until the indication is received, the identifying the position of at least the portion of the at least one eye of the user, the determining whether the user has detected the first test target at the first location, and the collecting data; and

providing information related to a result of the visual field assessment of the user based at least on the collected data from the iterative performance of the plurality of assessment steps.

36. The system of claim 35 , wherein the computing device comprises a smartphone.

37. The system of claim 35 , wherein the computing hardware is included in the computing device.

38. The system of claim 35 , wherein the display is part of the computing device.

39. The system of claim 35 , wherein the computing device comprises a smart television.

40. The system of claim 35 , wherein the computing device comprises a personal computer.

41. The system of claim 35 , wherein the user interface comprises a virtual reality environment on a virtual reality display of a head-mountable virtual reality device.

42. The system of claim 35 , wherein the user input is further received from at least one input device selected from the group consisting of a mouse, a joystick, a keyboard, a gesture and motion tracking device, a microphone, at least one camera, an omnidirectional treadmill, and a game pad.

43. A method for assessment of a visual field of a user, the method comprising:

displaying, on a virtual reality environment on a virtual reality display of a head-mountable virtual reality device, a first fixation target, the virtual reality environment comprising a pointer that is controlled by the user wearing the head-mountable virtual reality device, the first fixation target being one of a plurality of fixation targets;

determining whether a fixation task associated with the first fixation target has been completed by the user;

based at least on determining that the fixation task associated with the first fixation target is not completed, displaying at least one additional fixation target until an indication is received, wherein the indication indicates the fixation task is completed, and wherein the fixation task is completed when the pointer overlaps at least a portion of the first fixation target;

based at least on determining that the fixation task associated with the first fixation target is completed when the indication is received and when the pointer overlaps at least the portion of the first fixation target, identifying a position of at least a portion of at least one eye of the user;

based at least on the identifying the position, displaying, on the head-mountable display, a first test target, the first test target being one of a plurality of test targets, the first test target displayed at a first location, the first location corresponding to one of a plurality of locations in the visual field of the user, others of the plurality of test targets each corresponding to at least one other of the plurality of locations;

determining whether the user has detected the first test target at the first location;

collecting data related to the determining of whether the user has detected the first test target at the first location;

automatically iteratively performing a plurality of assessment steps for each of at least a portion of the plurality of fixation targets and corresponding ones of the plurality of test targets until a certain termination condition is met, wherein the plurality of assessment steps includes the displaying the first fixation target, the determining whether the fixation task associated with the first fixation target has been completed by the user, the displaying the at least one additional fixation target until the indication is received, the identifying the position of at least the portion of the at least one eye of the user, the determining whether the user has detected the first test target at the first location, and the collecting data; and

providing information related to a result of the visual field assessment of the user based at least on the collected data from the iterative performance of the plurality of assessment steps.

44. The method of claim 43 , further comprising determining whether the user input indicates that the pointer is moving towards the first location.

45. The method of claim 43 , further comprising determining whether the user input indicates that a head of the user is moving towards the first location.

46. The method of claim 43 , further comprising determining whether the user input comprises a pupil response.

47. The method of claim 43 , further comprising determining whether the user input comprises a button press.

48. The method of claim 43 , further comprising determining a position of the eye and/or pupil when it is determined that the eye is fixating on the fixation target.

49. The method of claim 43 , wherein the iterative performance of the displaying, determining, displaying, receiving, and acquiring steps continues until all test targets of the plurality of test targets have been displayed.

50. The method of claim 43 , wherein the iterative performance of the displaying, determining, displaying, receiving, and acquiring steps continues until a predetermined period of time has passed.

51. The method of claim 43 , wherein the iterative performance of the displaying, determining, displaying, receiving, and acquiring steps continues until a predetermined level of statistical confidence in an assessment has been reached.

52. The method of claim 43 , wherein the test target is displayed at least partially simultaneously with displaying the fixation target when it is determined that the eye is fixating on the fixation target.

53. The method of claim 43 , wherein determining whether the eye is fixating on the fixation target comprises determining whether the patient's fovea is fixated on the fixation target.

54. The method of claim 43 , further comprising comparing a stability of the patient's binocular fixation to a stability of the patient's monocular fixation in each eye to determine whether to display the fixation target one eye at a time or to both eyes simultaneously.

55. The method of claim 43 , wherein the user input comprises an indication of movement of the pointer in the virtual reality environment.

56. The method of claim 43 , further comprising determining that the pointer is positioned within a predetermined distance from the first location.

57. The method of claim 43 , further comprising acquiring an indication that the location of the test stimulus has been detected by the user.

58. The method of claim 43 , further comprising determining a movement of one or both eyes, a head, facial muscles, one or both pupils, and/or body of the user.

59. The method of claim 43 , wherein the iterative performance of the displaying, determining, displaying, receiving, and acquiring steps comprises:

displaying, in a second location on the virtual reality environment corresponding to a second location of the visual field of the user that is different from the first location of the visual field of the user, a subsequent test target of the plurality of test targets.

60. The method of claim 43 , wherein the iterative performance of the displaying, determining, displaying, receiving, and acquiring steps comprises:

displaying, on the virtual reality environment, a subsequent fixation target;

determining whether the eye is fixating on the subsequent fixation target;

when it is determined that the eye is fixating on the subsequent fixation target, displaying, in a second location on the virtual reality environment corresponding to a second location of the visual field of the user that is different from the first location of the visual field of the user, a subsequent test target of the plurality of test targets;

receiving user input comprising an indication that the user has detected the subsequent test target at the second location;

acquiring, based on the received user input, a second indication of whether the subsequent test target has been detected by the user, and storing the second indication.

61. The method of claim 18 , wherein the subsequent test target has at least one property that is different from at least one property of the test target that was displayed in the first location.

62. The method of claim 43 , further comprising determining whether the pointer has moved such that the pointer at least partially overlaps with the fixation target.

63. The method of claim 43 , wherein the fixation target comprises a representation of at least one movable object.

64. The method of claim 43 , wherein the fixation target is displayed in the vicinity of the first location.

65. The method of claim 43 , further comprising acquiring eye tracking information using a sensor monitoring at least one of the eyes of the user wearing the head-mountable virtual reality device.

66. The method of claim 43 , wherein physical characteristics of the fixation target or test targets and the rules for whether and how they are displayed are described within a spread sheet or data file that can be altered by a person conducting the test.

67. The method of claim 43 , wherein physical characteristics of the fixation target or test targets and the rules for whether and how they are displayed are configured on a separate computing device and received on the device that administers the test through a network connection.

68. The method of claim 43 , wherein the results and data collected during the testing are sent to a separate computing device.

69. The method of claim 43 , wherein one or more properties of the test stimulus are at least in part determined by prior test results from the current patient and/or other patients.

70. The method of claim 43 , wherein acquiring the indication that the test stimulus has been detected by the user comprises determining that the pointer is positioned within one of at least two sectors surrounding the location of the fixation target.

71. The method of claim 43 , wherein the assessment of a condition of the visual field includes information on the identification, status, and/or progression of at least one of glaucoma, multiple sclerosis, macular degeneration, diabetic retinopathy, neurological function, retinitis pigmentosa, color vision, binocular vision including suppression scotomas, and a vascular disease.

72. A non-transitory computer-readable medium storing instructions, which when executed by at least one data processor, result in operations comprising:

displaying, on the virtual reality environment on a virtual reality display of a head-mountable virtual reality device, a first fixation target, the virtual reality environment comprising a pointer that is controlled by the user wearing the head-mountable virtual reality device, the first fixation target being one of a plurality of fixation targets;

determining whether a fixation task associated with the first fixation target has been completed by the user;

based at least on determining that the fixation task associated with the first fixation target is not completed, displaying at least one additional fixation target until an indication is received, wherein the indication indicates the fixation task is completed, and wherein the fixation task is completed when the pointer overlaps at least a portion of the first fixation target;

based at least on determining that the fixation task associated with the first fixation target is completed when the indication is received and when the pointer overlaps at least the portion of the first fixation target, identifying a position of at least a portion of at least one eye of the user;

based at least on the identifying the position, displaying, on the head-mountable display, a first test target, the first test target being one of a plurality of test targets, the first test target displayed at a first location, the first location corresponding to one of a plurality of locations in the visual field of the user, others of the plurality of test targets each corresponding to at least one other of the plurality of locations;

determining whether the user has detected the first test target at the first location;

collecting data related to the determining of whether the user has detected the first test target at the first location;

automatically iteratively performing a plurality of assessment steps for each of at least a portion of the plurality of fixation targets and corresponding ones of the plurality of test targets until a certain termination condition is met, wherein the plurality of assessment steps includes the displaying the first fixation target, the determining whether the fixation task associated with the first fixation target has been completed by the user, the displaying the at least one additional fixation target until the indication is received, the identifying the position of at least the portion of the at least one eye of the user, the determining whether the user has detected the first test target at the first location, and the collecting data; and

providing information related to a result of the visual field assessment of the user based at least on the collected data from the iterative performance of the plurality of assessment steps.