What goes on your head? Head mounted devices

Bhavani Iyer OD, FAAO Director, Dan Arnold Center for Vision Rehabilitation Clinical Associate Professor, The University of Texas, McGovern Medical School Why head mounted systems?

• Ease of use- always available • Cosmesis- sleek look, better tolerance for “strangeness” • Hands free- allows other things to be done while system is in use • Portable • Traditional CCTVs too heavy to carry around Basic types of head mounted systems

Optical systems Electronic systems • Use system of lenses • Use a heads up display separated by a • Automatic focusing certain distance capability • Manual focusing • Multiple magnification capability options • Fixed magnification options Optical systems

Beecher binocular- upto 8x

Pros: great for watching games Cons: bulky Ocutech- 4.0x to 6.0x Ocutech sightscope- 2.2x

Pros: good field of view Pros: flips out, binocular, Cons: expensive, cosmesis, easy to use monocular Cons: cosmesis, low magnification BITA Designs for vision

Pros: Small, discreet, great for students Pros: good field view, upto 4.0x, great for bioptic driving Cons: low magnification, small field of view Cons: cosmesis, weight JORDY™ (Joint Optical Reflective Display) Where we are now ORCAM

Nueyes

Future? Three major systems currently available

• Esight- uses digital magnification technology- utilizes sight- VR • Nueyes- uses digital magnification technology and OCR- VR and OCR • ORCAM- OCR technology- utilizes speech eSight

• Goggle style- Headset • Custom prescribed lenses • Controller The technology behind the device-

• An HD camera on the Headset takes a live video from the environment • This is sent to a controller • The image is processed and sent back to the viewer • Image seen on 2 LED displays Diseases and acuity ranges

• macular degeneration, Stargardt’s disease, ocular albinism, diabetic retinopathy, Leber’s optic neuropathy, cone-rod dystrophy • acuity ranges from 20/60 and 20/400 • age ranges: 8 to 88; best for those under 75. Pros and cons

Pros: Cons: • Wide viewing field- • Bulky equivalent to a 60” • Cannot really walk screen. around with it • Ability to zoom • Immersive, no real life feel • Reversible contrast • Cost- $10,000 • Color display • Not good for tunnel • Weight: 6oz vision • ? Weight- 6oz Choosing the candidates-

• cognition • ability to tolerate the weight of device • Eye hand coordination • Dexterity of fingers Rehabilitation involved- have to work with low vision OD

• a. Pre- device training • b. Post- device training ORCAM

• Head unit- • Spectacle frame with custom Rx • a High resolution camera • A speaker that uses bone conduction The technology behind the device

• Uses real time immediate processing- all-inclusive system; OCR technology • Finger gestures- pointing- recognizes the nail bed and reads what’s pointed; hand in front of the page stops it from reading • Face recognition capabilities • Recognizes familiar objects, common daily items in the fridge for example Pros

• Superior cosmesis- looks like Google glasses, “cool factor” • Face recognition – great for working age population, elderly. • Light weight- about 20gms, base unit clips to pocket • Highly portable • Mobility is not impaired- can walk around with the device • Teachable- has the ability to “learn” new objects and faces- up to 100 • Replaces dependence on vision • Able to read even if paper is held upside down • Costs $4500 for the full version (with face recognition, reading and object recognition) Cons

• Hearing impaired cannot use it • Not consistent with face recognition- confuses people sometimes • Does not read curved surfaces- cans/ labels • Does not do well with small objects- eye drops; does not have a wide enough field to search for the object of interest • Does not read handwriting/ cursive print • “Does not improve vision any” Diseases and acuity ranges that can benefit from this device

• All diseases- central and peripheral vision loss • All acuity ranges- from 20/60 to NLP; however, best for 20/400 to CF from personal experience. Less expensive options available for the better acuity ranges that amplify vision. Since this does not amplify vision in anyway, some patients feel they are “wasting their vision” • Some vision is actually good for using the device since patients do need to be able to point to what they want to read. This helps to avoid reading fluff- material that the person did not intend to read NuEyes Features

• Variable Magnification from 1x-12x- • Digital camera with a stereoscopic HUD • Various contrast and color changes • Voice Activated • Wireless • Lightweight Design • Text-to-Speech (OCR) • Stream TV and Movies to the Glasses Technology behind the system

• NuEyes uses an HD (High Definition) digital camera mounted on the center bridge of the glasses to stream images to the built-in 3D stereoscopic HD display lenses. The full HD camera can shoot 1080p resolution at 60 frames per second. The camera image is projected onto the frame-mounted displays. NuEyes enlarges and enhances images captured by the camera on the inside of the glasses’ lenses to help people with vision loss see better. • NuEyes uses Osterhout Design Group’s ‘curved mirror’ technology. Small projectors in the lenses over each eye project the image down onto a light blocking lens display. Pros Cons • Cosmesis: certainly • Cosmesis- has not better than prior eliminated the systems “strangeness • Lighter than prior factor” systems • Head piece can get • Wireless hot • Cost is lower • Battery discharges • 60 degree field of rather quickly view