Technological enhancements to optometric clinical tests

A sizeable amount of the testing in eye care, requires either the identification of targets such as letters to assess functional vision, or the subjective evaluation of imagery by an examiner. Computers can render a variety of different targets on their monitors and can be used to store and analyse ophthalmic images. However, existing computing hardware tends to be large, screen resolutions are often too low, and objective assessments of ophthalmic images unreliable. Recent advances in mobile computing hardware and computer-vision systems can be used to enhance clinical testing in optometry. High resolution touch screens embedded in mobile devices, can render targets at a wide variety of distances and can be used to record and respond to patient responses, automating testing methods. This has opened up new opportunities in computerised near vision testing. Equally, new image processing techniques can be used to increase the validity and reliability of objective computer vision systems. Three novel apps for assessing reading speed, contrast sensitivity and amplitude of accommodation were created by the author to demonstrate the potential of mobile computing to enhance clinical measurement. The reading speed app could present sentences effectively, control illumination and automate the testing procedure for reading speed assessment. Meanwhile the contrast sensitivity app made use of a bit stealing technique and swept frequency target, to rapidly assess a patient’s full contrast sensitivity function at both near and far distances. Finally, customised electronic hardware was created and interfaced to an app on a smartphone device to allow free space amplitude of accommodation measurement. A new geometrical model of the tear film and a ray tracing simulation of a Placido disc topographer were produced to provide insights on the effect of tear film breakdown on ophthalmic images. Furthermore, a new computer vision system, that used a novel eye-lash segmentation technique, was created to demonstrate the potential of computer vision systems for the clinical assessment of tear stability. Studies undertaken by the author to assess the validity and repeatability of the novel apps, found that their repeatability was comparable to, or better, than existing clinical methods for reading speed and contrast sensitivity assessment. Furthermore, the apps offered reduced examination times in comparison to their paper based equivalents. The reading speed and amplitude of accommodation apps correlated highly with existing methods of assessment supporting their validity. Their still remains questions over the validity of using a swept frequency sine-wave target to assess patient’s contrast sensitivity functions as no clinical test provides the range of spatial frequencies and contrasts, nor equivalent assessment at distance and near. A validation study of the new computer vision system found that the authors tear metric correlated better with existing subjective measures of tear film stability than those of a competing computer-vision system. However, repeatability was poor in comparison to the subjective measures due to eye lash interference. The new mobile apps, computer vision system, and studies outlined in this thesis provide further insight into the potential of applying mobile and image processing technology to enhance clinical testing by eye care professionals.

Proposing a systems vision of knowledge management in emergency care

This paper makes a case for taking a systems view of knowledge management within health-care provision, concentrating on the emergency care process in the UK National Health Service. It draws upon research in two casestudy organizations (a hospital and an ambulance service). The case-study organizations appear to be approaching knowledge (and information) management in a somewhat fragmented way. They are trying to think more holistically, but (perhaps) because of the ways their organizations and their work are structured, they cannot ‘see’ the whole of the care process. The paper explores the complexity of knowledge management in emergency health care and draws the distinction for knowledge management between managing local and operational knowledge, and global and clinical knowledge.

A review of current knowledge on Electronic Vision Enhancement Systems for the visually impaired

Magnification can be provided to assist those with visual impairment to make the best use of remaining vision. Electronic transverse magnification of an object was first conceived for use in low vision in the late 1950s, but has developed slowly and is not extensively prescribed because of its relatively high cost and lack of portability. Electronic devices providing transverse magnification have been termed closed-circuit televisions (CCTVs) because of the direct cable link between the camera imaging system and monitor viewing system, but this description generally refers to surveillance devices and does not indicate the provision of features such as magnification and contrast enhancement. Therefore, the term Electronic Vision Enhancement Systems (EVES) is proposed to better distinguish and describe such devices. This paper reviews current knowledge on EVES for the visually impaired in terms of: classification; hardware and software (development of technology, magnification and field-of-view, contrast and image enhancement); user aspects (users and usage, reading speed and duration, and training); and potential future development of EVES. © 2003 The College of Optometrists.

Benefits of electronic vision enhancement systems (EVES) for the visually impaired

PURPOSE: To examine whether objective performance of near tasks is improved with various electronic vision enhancement systems (EVES) compared with the subject's own optical magnifier. DESIGN: Experimental study, randomized, within-patient design. METHODS: This was a prospective study, conducted in a hospital ophthalmology low-vision clinic. The patient population comprised 70 sequential visually impaired subjects. The magnifying devices examined were: patient's optimum optical magnifier; magnification and field-of-view matched mouse EVES with monitor or head-mounted display (HMD) viewing; and stand EVES with monitor viewing. The tasks performed were: reading speed and acuity; time taken to track from one column of print to the next; follow a route map, and locate a specific feature; and identification of specific information from a medicine label. RESULTS: Mouse EVES with HMD viewing caused lower reading speeds than stand EVES with monitor viewing (F = 38.7, P < .001). Reading with the optical magnifier was slower than with the mouse or stand EVES with monitor viewing at smaller print sizes (P < .05). The column location task was faster with the optical magnifier than with any of the EVES (F = 10.3, P < .001). The map tracking and medicine label identification task was slower with the mouse EVES with HMD viewing than with the other magnifiers (P < .01). Previous EVES experience had no effect on task performance (P > .05), but subjects with previous optical magnifier experience were significantly slower at performing the medicine label identification task with all of the EVES (P < .05). CONCLUSIONS: Although EVES provide objective benefits to the visually impaired in reading speed and acuity, together with some specific near tasks, some can be performed just as fast using optical magnification. © 2003 by Elsevier Inc. All rights reserved.

Binocular contrast vision at and above threshold

A fundamental problem for any visual system with binocular overlap is the combination of information from the two eyes. Electrophysiology shows that binocular integration of luminance contrast occurs early in visual cortex, but a specific systems architecture has not been established for human vision. Here, we address this by performing binocular summation and monocular, binocular, and dichoptic masking experiments for horizontal 1 cycle per degree test and masking gratings. These data reject three previously published proposals, each of which predict too little binocular summation and insufficient dichoptic facilitation. However, a simple development of one of the rejected models (the twin summation model) and a completely new model (the two-stage model) provide very good fits to the data. Two features common to both models are gently accelerating (almost linear) contrast transduction prior to binocular summation and suppressive ocular interactions that contribute to contrast gain control. With all model parameters fixed, both models correctly predict (1) systematic variation in psychometric slopes, (2) dichoptic contrast matching, and (3) high levels of binocular summation for various levels of binocular pedestal contrast. A review of evidence from elsewhere leads us to favor the two-stage model. © 2006 ARVO.

Understanding policy implementation processes as self-organizing systems

Implementation studies and related research in organizational theory can be enhanced by drawing on the field of complex systems to understand better and, as a consequence, more successfully manage change. This article reinterprets data previously published in the British Journal of Management to reveal a new contribution, that policy implementation processes should be understood as a self-organizing system in which adaptive abilities are extremely important for stakeholders. In other words, national policy is reinterpreted at the local level, with each local organization uniquely mixing elements of national policy with their own requirements making policy implementation unpredictable and more sketchy. The original article explained different paces and directions of change in terms of traditional management processes: leadership, politics, implementation and vision. By reinterpreting the data, it is possible to reveal that deeper level processes, which are more emergent, are also at work influencing change, which the authors label possibility space. Implications for theory, policy and practice are identified.

Biology of sensory systems

Since publication of the first edition, huge developments have taken place in sensory biology research and new insights have been provided in particular by molecular biology. These show the similarities in the molecular architecture and in the physiology of sensory cells across species and across sensory modality and often indicate a common ancestry dating back over half a billion years. Biology of Sensory Systems has thus been completely revised and takes a molecular, evolutionary and comparative approach, providing an overview of sensory systems in vertebrates, invertebrates and prokaryotes, with a strong focus on human senses. Written by a renowned author with extensive teaching experience, the book covers, in six parts, the general features of sensory systems, the mechanosenses, the chemosenses, the senses which detect electromagnetic radiation, other sensory systems including pain, thermosensitivity and some of the minority senses and, finally, provides an outline and discussion of philosophical implications. New in this edition: - Greater emphasis on molecular biology and intracellular mechanisms - New chapter on genomics and sensory systems - Sections on TRP channels, synaptic transmission, evolution of nervous systems, arachnid mechanosensitive sensilla and photoreceptors, electroreception in the Monotremata, language and the FOXP2 gene, mirror neurons and the molecular biology of pain - Updated passages on human olfaction and gustation. Over four hundred illustrations, boxes containing supplementary material and self-assessment questions and a full bibliography at the end of each part make Biology of Sensory Systems essential reading for undergraduate students of biology, zoology, animal physiology, neuroscience, anatomy and physiological psychology. The book is also suitable for postgraduate students in more specialised courses such as vision sciences, optometry, neurophysiology, neuropathology, developmental biology.

Run-time connector synthesis for autonomic systems of systems

A key objective of autonomic computing is to reduce the cost and expertise required for the management of complex IT systems. As a growing number of these systems are implemented as hierarchies or federations of lower-level systems, techniques that support the development of autonomic systems of systems are required. This article introduces one such technique, which involves the run-time synthesis of autonomic system connectors. These connectors are specified by means of a new type of autonomic computing policy termed a resource definition policy, and enable the dynamic realisation of collections of collaborating autonomic systems, as envisaged by the original vision of autonomic computing. We propose a framework for the formal specification of autonomic computing policies, and use it to define the new policy type and to describe its application to the development of autonomic system of systems. To validate the approach, we present a sample data-centre application that was built using connectors synthesised from resource-definition policies.

Mach bands and multiscale models of spatial vision:the role of first, second, and third derivative operators in encoding bars and edges

Ernst Mach observed that light or dark bands could be seen at abrupt changes of luminance gradient in the absence of peaks or troughs in luminance. Many models of feature detection share the idea that bars, lines, and Mach bands are found at peaks and troughs in the output of even-symmetric spatial filters. Our experiments assessed the appearance of Mach bands (position and width) and the probability of seeing them on a novel set of generalized Gaussian edges. Mach band probability was mainly determined by the shape of the luminance profile and increased with the sharpness of its corners, controlled by a single parameter (n). Doubling or halving the size of the images had no significant effect. Variations in contrast (20%-80%) and duration (50-300 ms) had relatively minor effects. These results rule out the idea that Mach bands depend simply on the amplitude of the second derivative, but a multiscale model, based on Gaussian-smoothed first- and second-derivative filtering, can account accurately for the probability and perceived spatial layout of the bands. A key idea is that Mach band visibility depends on the ratio of second- to first-derivative responses at peaks in the second-derivative scale-space map. This ratio is approximately scale-invariant and increases with the sharpness of the corners of the luminance ramp, as observed. The edges of Mach bands pose a surprisingly difficult challenge for models of edge detection, but a nonlinear third-derivative operation is shown to predict the locations of Mach band edges strikingly well. Mach bands thus shed new light on the role of multiscale filtering systems in feature coding. © 2012 ARVO.

Surface roughness after excimer laser ablation using a PMMA model:profilometry and effects on vision

PURPOSE: To show that the limited quality of surfaces produced by one model of excimer laser systems can degrade visual performance with a polymethylmethacrylate (PMMA) model. METHODS: A range of lenses of different powers was ablated in PMMA sheets using five DOS-based Nidek EC-5000 laser systems (Nidek Technologies, Gamagori, Japan) from different clinics. Surface quality was objectively assessed using profilometry. Contrast sensitivity and visual acuity were measured through the lenses when their powers were neutralized with suitable spectacle trial lenses. RESULTS: Average surface roughness was found to increase with lens power, roughness values being higher for negative lenses than for positive lenses. Losses in visual contrast sensitivity and acuity measured in two subjects were found to follow a similar pattern. Findings are similar to those previously published with other excimer laser systems. CONCLUSIONS: Levels of surface roughness produced by some laser systems may be sufficient to degrade visual performance under some circumstances.

Architecting self-aware software systems

Contemporary software systems are becoming increasingly large, heterogeneous, and decentralised. They operate in dynamic environments and their architectures exhibit complex trade-offs across dimensions of goals, time, and interaction, which emerges internally from the systems and externally from their environment. This gives rise to the vision of self-aware architecture, where design decisions and execution strategies for these concerns are dynamically analysed and seamlessly managed at run-time. Drawing on the concept of self-awareness from psychology, this paper extends the foundation of software architecture styles for self-adaptive systems to arrive at a new principled approach for architecting self-aware systems. We demonstrate the added value and applicability of the approach in the context of service provisioning to cloud-reliant service-based applications.

Comparative performance between two photogrammetric systems and a reference laser tracker network for large-volume industrial measurement

This paper determines the capability of two photogrammetric systems in terms of their measurement uncertainty in an industrial context. The first system – V-STARS inca3 from Geodetic Systems Inc. – is a commercially available measurement solution. The second system comprises an off-the-shelf Nikon D700 digital camera fitted with a 28 mm Nikkor lens and the research-based Vision Measurement Software (VMS). The uncertainty estimate of these two systems is determined with reference to a calibrated constellation of points determined by a Leica AT401 laser tracker. The calibrated points have an average associated standard uncertainty of 12·4 μm, spanning a maximum distance of approximately 14·5 m. Subsequently, the two systems’ uncertainty was determined. V-STARS inca3 had an estimated standard uncertainty of 43·1 μm, thus outperforming its manufacturer's specification; the D700/VMS combination achieved a standard uncertainty of 187 μm.