Ocular torsion quantification with video images

The effect of uncorrected ametropia on ocular torsion induced by changes in fixation

Background and Objective

Ocular torsion, the eye movements to rotating around the line of sight, has not been well investigated regarding the influence of refractive errors. The purpose of this study was to investigate the effect of uncorrected ametropia on ocular torsion induced by fixation distances.

Methods

Seventy-two subjects were classified according to the type of their refractive error, and ocular torsion of the uncorrected eye was compared based on changes induced by different fixation distances. Ocular torsion was measured using a slit-lamp biomicroscope equipped with an ophthalmic camera and a half-silvered mirror.

Results

In all groups, excyclotorsion values increased as the fixation distance decreased, but the myopia and astigmatism groups had larger amounts of ocular torsion than the emmetropia group. In addition, as the amount of uncorrected myopia and astigmatism increased, the amount of ocular torsion increased.

Conclusion

Since the amount of ocular torsion caused by a change to a shorter fixation distance was larger when the refractive error was uncorrected, we suggest that ametropia should be fully corrected in patients frequently exposed to ocular torsion due to changes in fixation distance.

Measurement of ocular counter-roll using iris images during binocular fixation and head tilt

Objective

To compare the ocular counter-roll (OCR) measured using iris images during binocular fixation and head tilt with OCR measured via fundus photography.

Methods

Fifty-three healthy college students participated in this study. The mean OCR was measured by collection of iris images and fundus images under seven head tilt conditions (0 degrees; 10, 20, and 30 degrees right; and 10, 20, and 30 degrees left). Three iris images (crossed pupil center, pupil center, and pupil periphery) were taken using a slit-lamp biomicroscope with an ophthalmic camera and a half-silvered mirror; fundus images were collected via fundus photography. The mean OCR values were compared between images taken with each method.

Results

No iris images or head tilt conditions revealed any significant differences in mean OCR comparison with fundus images. The mean difference in OCR was smallest, and the correlation was greatest, between the crossed pupil center and fundus images.

Conclusion

A half-silvered mirror and iris images can replace fundus photography for the measurement of OCR.

Differences in eye movement range based on age and gaze direction

PURPOSE

To determine the range of eye movement in normal human subjects and to investigate the effect of age and gaze direction on eye movement.

PATIENTS AND METHODS

A prospective observational study. We enrolled 261 healthy subjects, 5-91 years of age. Photographs were obtained in the cardinal gaze positions and processed using Photoshop. The processed images were analyzed using the Image J program to measure the angle of eye movement. The angle of eye movement was quantified using a modified limbus test. We measured the angle of eye movement in adduction, abduction, elevation, and depression.

RESULTS

The ranges of eye movement were 44.9 ± 7.2° in adduction, 44.2 ± 6.8° in adduction, 27.9 ± 7.6° in elevation, and 47.1 ± 8.0° in depression. The ranges of eye movement in the younger group were higher than that in the older group in adduction, abduction, and elevation (P < 0.001, P = 0.013, and P < 0.001, respectively), except in depression (P = 0.790). There were significant negative correlations between the angles of horizontal and upward gazes and age (R = -0.294 in adduction, R = -0.355 in abduction, and R = -0.506 in elevation, all P < 0.001). However, the angle of downward gaze was not significantly correlated with age (R = 0.017, P = 0.722).

CONCLUSIONS

The angle of upward gaze most rapidly decreased with age than the angle of other gaze. Unlike the age-related decline of range in horizontal and upward gazes, only downward gaze was not impaired by increasing age. Differences in eye movement range based on gaze direction and their associated aging mechanisms should be considered when assessing eye movements.

Use of iris pattern recognition to evaluate ocular torsional changes associated with head tilt

Purpose

To describe the use of enhanced iris images and a computer software program to quantify ocular torsional changes associated with head tilt.

Methods

Pixel coordinates of the pupil and different iris landmarks were obtained manually using paint program from digital images of the right and left iris of 3 subjects with normal extraocular motility. Photographs of the right eye and of the left eye were taken in the straight-ahead position and at various degrees of right and left head tilt. A computer software program converted the x- and y-pixel coordinates into angles of rotation after averaging multiple points and determining the degree and the direction of torsion for each eye. The degree of head tilt was mathematically calculated from the digital images. The degree and the direction of ocular torsion were correlated with the degree and the direction of head tilt.

Results

The average degree of head tilt was 27.5 degrees (from 8 to 43 degrees). The average intorsion of the lower eye per degree of head tilt was 0.61 degrees (from 0.54 to 0.65 degrees). The average extorsion of the higher eye per degree of head tilt was 0.56 degrees (from 0.43 to 0.60 degrees). The average ocular torsional changes strongly correlated with the degree of head tilt (correlation coefficient = 0.92).

Conclusions

Computer-assisted iris pattern recognition and analysis of the ocular torsional changes associated with head tilt may provide a useful and objective means of assessing ocular torsion.

Knowing what the brain is seeing in three dimensions: A novel, noninvasive, sensitive, accurate, and low-noise technique for measuring ocular torsion

Torsional eye movements are rotations of the eye around the line of sight. Measuring torsion is essential to understanding how the brain controls eye position and how it creates a veridical perception of object orientation in three dimensions. Torsion is also important for diagnosis of many vestibular, neurological, and ophthalmological disorders. Currently, there are multiple devices and methods that produce reliable measurements of horizontal and vertical eye movements. Measuring torsion, however, noninvasively and reliably has been a longstanding challenge, with previous methods lacking real-time capabilities or suffering from intrusive artifacts. We propose a novel method for measuring eye movements in three dimensions using modern computer vision software (OpenCV) and concepts of iris recognition. To measure torsion, we use template matching of the entire iris and automatically account for occlusion of the iris and pupil by the eyelids. The current setup operates binocularly at 100 Hz with noise <0.1° and is accurate within 20° of gaze to the left, to the right, and up and 10° of gaze down. This new method can be widely applicable and fill a gap in many scientific and clinical disciplines.

Measuring torsional eye movements by tracking stable iris features

We propose a new method to measure torsional eye movements from videos taken of the eye. In this method, we track iris features that have been identified as Maximally Stable Volumes. These features, which are stable over time, are dark regions with bright borders that are steep in intensity. The advantage of Maximally Stable Volumes is that they are robust to nonuniform illumination and to large changes in eye and camera position. The method performs well even when the iris is partially occluded by reflections or eyelids, and is faster than cross-correlation. In addition, it is possible to use the method on videos of macaque eyes taken in the infrared, where the iris appears almost featureless.

A novel haploscopic viewing apparatus with a three-axis eye tracker

PURPOSE

To validate the accuracy and precision of a novel haploscope for use in investigating the mechanisms underlying normal eye control as well as the mechanisms of cyclovertical strabismus in pediatric and adult subjects. The accuracy and precision represent the device's ability to reproducibly measure true eye positions.

METHODS

A novel haploscope was developed that allows the measurement of eye positions and movements under specified conditions of vergence, head tilting, and cover testing. Equipped with video oculography, the haploscope can aid in the objective assessment of binocular and adaptive mechanisms that maintain oculomotor alignment. The device's accuracy and precision were assessed using a model eye with 3 axes of rotation. The device was then used to measure ocular torsion during the well-documented phenomenon of ocular counter-roll with head tilt. The eye movements of 6 normal subjects were measured as each subject fixated binocularly on the center of radially symmetric targets during head tilting.

RESULTS

The device yielded Pearson correlations with the model eye of R = 1.0, with residual error (re), a measure of accuracy, about all 3 ocular axes peaking at re = 19 +/- 5 arcmin. For human subjects, average positional error was re = 21 +/- 9 arcmin. Ocular counter-roll averaged 5.7 +/- 0.9 degrees for left and right eyes.

CONCLUSIONS

These results validate the accuracy and precision of this novel haploscope. They support its use in future investigations of the mechanisms of oculomotor control and alignment.

Robust high-speed binocular 3D eye movement tracking system using a two-radii eye model

Existing video-based eye movement tracking systems measure three-dimensional eye orientations by assuming the eye is a sphere that rotates around its center at a fixed radius. We found this model inaccurate. We have developed a system that uses a two-radii eye model, which assumes that the eye rotates around two different centers with different radii horizontally and vertically. We found this two-radii model more accurate in estimating the three-dimensional eye positions than the traditional one-radius eye model.

Measurement of ocular torsion using digital fundus image

Computer-based objective measurement of the ocular cyclotorsion using digital fundus photograph was developed. Color digital fundus photographs acquired with the field angle of 60 degrees , 1520 x 1080 in resolution were analyzed. Optic disc and macula were segmented by the program developed on MATLAB, which executed the serial analysis of the Otsu threshold, labeling, Canny edge. The angle between the horizontal line that bisects the optic disc and the line connecting the center of optic disc and macula was measured and compared with the torsion determined by the specialist. Optic disc and macula were segmented and the mean of the calculated angle was 3.02+/-1.24 degrees . The mean of the torsion determined by the specialist was 3.13+/-1.98 degrees and there was no difference between the two. The measurement of the cyclotorsion using computer program showed good coincidence with that of the specialist and it can be a good candidate as a tool helping precise diagnosis and the objective evaluation of the disease for the physicians.

A wireless measurement system for three-dimensional ocular movement using the magnetic contact lens sensing technique

A new and innovative method to measure the eye movement in a wireless manner was proposed. We verified the feasibility of our idea by fabrication and performance test of a prototype system. The prototype system consisted of a contact lens with a ring-shaped thin magnet, and eyeglasses frame-shaped PCB with analog/digital signal processing circuitry as well as four magnetoresistive sensors. This new method based on the magnetic contact lens sensing technique (MCLST) is expected to overcome all the disadvantages of the existing techniques.

Iris-Based Cyclotorsional Image Alignment Method for Wavefront Registration

In refractive surgery, especially wavefront-guided refractive surgery, correct registration of the treatment to the cornea is of paramount importance. The specificity of the custom ablation formula requires that the ablation be applied to the cornea only when it has been precisely aligned with the mapped area. If, however, the eye has rotated between measurement and ablation, and this cyclotorsion is not compensated for, the rotational misalignment could impair the effectiveness of the refractive surgery. To achieve precise registration, a noninvasive method for torsional rotational alignment of the captured wavefront image to the patient's eyes at surgery has been developed. This method applies a common coordinate system to the wavefront and the eye. Video cameras on the laser and wavefront devices precisely establish the spatial relationship between the optics of the eye and the natural features of the iris, enabling the surgeon to identify and compensate for cyclotorsional eye motion, whatever its cause.

Functional Assessment of Head???Eye Coordination During Vehicle Operation

PURPOSE

Visual impairment, resulting from ocular abnormalities or brain lesions, can significantly affect driving performance. The impact of vestibulopathy on head-eye coordination is also a concern in vehicle operation safety, yet to date there has been little functional research in this area. An understanding of decrements in driving ability resulting from visual and vestibular pathology, plus the differences in visual strategies used by novice and experienced drivers, would benefit from an objective analysis of head-eye coordination during vehicle operation.

METHODS

We have developed a laptop-based system for measuring eye, head, and vehicle movement in real time. Digital video cameras mounted on lightweight swimming goggles are used to provide images of the eye and scene, allowing assessment of gaze. In addition, the use of inertial measurement units to simultaneously transduce head and vehicle movement allows us to evaluate the vestibular contribution to stable vision.

RESULTS

Data was obtained from a flight simulator and while driving a car. During banking turns in the flight simulator, there was a sustained roll tilt of the head and eyes toward the scene-derived visual vertical with a combined gain of approximately 25%. One of the most complex visual tasks when driving was exiting a multistory car park, which involved the scanning of hundreds of parked vehicles with an average fixation time of approximately 100 ms. The vertical vestibulo-ocular reflex was also found to make a significant contribution to the maintenance of dynamic visual acuity even while driving on paved surfaces.

CONCLUSION

These results demonstrate the viability of functional assessment of head-eye coordination during vehicle operation, and potential applications of this technology to driver assessment are discussed. Analysis of both active and reflex contributions to gaze may provide a clearer understanding of the impact of visual and vestibular impairment on driving ability.

Alignment in Customized Laser in situ Keratomileusis

PURPOSE

To identify fundamentals of beam alignment in customized laser in situ keratomileusis (LASIK) with a special focus on the Nidek NAVEX system.

METHODS

Analysis of Nidek specifications and recommendations for beam alignment with regard to a critical case example are presented. The potential impact of misalignment (tilt and defocus) is calculated. Cyclotorsional error evaluation in a normal LASIK population was performed by video image comparison. Potential problems of infrared-based eyetracking systems are discussed.

RESULTS

The laser beam should be aligned with reference to the line of sight (LOS) when customized segmental laser ablation is applied. Only in cases with significant offset between the LOS and the visual axis it is recommended not to use segmental ablation and to manually align the beam toward the visual axis. Eye drift (tilt) as well as defocus should be avoided since undercorrection and irregular astigmatism can result. Almost 30% of eyes in a normal LASIK population showed a torsional error of 5 degrees to 10 degrees (9% more than 10 degrees) on video-based image comparison. Eye-trackers not only are defined by take-up speed and latency, but also by their sensibility (picking the real center of the pupil) and robustness (keeping it tracked during surgery). Errors due to parallax and reflex effects can systematically influence the performance of an eyetracker.

CONCLUSION

Correct alignment is difficult to achieve but is of fundamental importance in customized LASIK. Strict standardization and further improvement in the alignment strategy is necessary to achieve more consistent results in customized LASIK.

Improving Calibration of 3-D Video Oculography Systems

Eye movement recordings with video-based techniques have become very popular, as long as they are restricted to the horizontal and vertical movements of the eye. Reliable measurement of the torsional component of eye movements, which is especially important in the diagnosis and investigation of pathologies, has remained a coveted goal. One of the main reasons is unresolved technical difficulties in the analysis of video-based images of the eye. Based on simulations, we present solutions to two of the primary problems: a robust and reliable calibration of horizontal and vertical eye movement recordings, and the extraction of suitable iris patterns for the determination of the torsional eye position component.

Qualitative model of otolith-ocular asymmetry in vertical eccentric rotation experiments

Today, investigation of the vestibulo-ocular reactions is a mainstream method of studying the vestibular asymmetry. Analysis of experimental data requires a model of otolith-ocular interaction. The proposed model is based on the literary data concerning measurements of ocular counter-rotation (OCR) and luminous line rotation (LLR) in experiments with eccentric rotation carried out by Wetzig et al. [Acta Astronaut. 21 (1990) 519-525]. The method utilizes a number of simplifications and suppositions, the basic of which is linearity of all stages of transformation of mechanical stimulus with the exception of the proportionality of neural response to acceleration. It was demonstrated that the model qualitatively imitates the behavior of OCR and LLR in response to centrifugal acceleration of utricular otoliths and permits analysis of the role of various parameters of the otolith-ocular interaction. Comparison of modeling and experimental dependences of OCR and LLR on acceleration can help understand otolithic asymmetry.

Using high frame rate CMOS sensors for three-dimensional eye tracking

A novel three-dimensional eye tracker is described and its performance evaluated. In contrast to previous devices based on conventional video standards, the present eye tracker is based on programmable CMOS image sensors, interfaced directly to digital processing circuitry to permit real-time image acquisition and processing. This architecture provides a number of important advantages, including image sampling rates of up to 400/sec measurement, direct pixel addressing for preprocessing and acquisition,and hard-disk storage of relevant image data. The reconfigurable digital processing circuitry also facilitates inline optmization of the front-end, time-critical processes. The primary acquisition algorithm for tracking the pupil and other eye features is designed around the generalized Hough transform. The tracker permits comprehensive measurement of eye movement (three degrees of freedom) and head movement (six degrees of freedom), and thus provides the basis for many types of vestibulo-oculomotor and visual research. The device has been qualified by the German Space Agency (DLR) and NASA for deployment on the International Space Station. It is foreseen that the device will be used together with appropriate stimulus generators as a general purpose facility for visual and vestibular experiments. Initial verification studies with an artificial eye demonstrate a measurement resolution of better than 0.1 degrees in all three components (i.e.,system noise for each of the components measured as 0.006 degrees H, 0.005 degrees V, and 0.016 degrees T. Over a range of +/-20 degrees eye rotation, linearity was found to be <0.5% (H), <0.5% (V), and <2.0% (T). A comparison with the scleral search coil technique yielded near equivalent values for the system noise and the thickness of Listing's plane.

Cyclotorsion: a possible cause of residual astigmatism in refractive surgery

PURPOSE

To determine whether cyclotorsion occurs when a subject changes from binocular to monocular fixation and to assess positionally induced cyclotorsion.

SETTING

Clinics of the Rotterdam Eye Hospital, Rotterdam, The Netherlands.

METHODS

The axis of astigmatism was measured with the Nidek handheld keratometer in 15 normal subjects under monocular and binocular fixation and in seated and supine positions. The limits of agreement for the repeatability of measurements with the Nidek keratometer were used to identify subjects with statistically significant cyclotorsion.

RESULTS

Two subjects (13%) showed statistically significant excyclotorsion when changing from binocular to monocular fixation in a seated position. In a supine position, 3 subjects (20%) showed excyclotorsion when the fixation changed. Body position itself had no influence on ocular torsion.

CONCLUSIONS

Significant cyclotorsion may occur under monocular viewing conditions. If monocular photorefractive keratectomy procedures are based on binocular keratometry readings, an undercorrection of myopic astigmatism may result. Individuals at risk should be identified before refractive keratectomy is performed.

Robust pupil center detection using a curvature algorithm

Determining the pupil center is fundamental for calculating eye orientation in video-based systems. Existing techniques are error prone and not robust because eyelids, eyelashes, corneal reflections or shadows in many instances occlude the pupil. We have developed a new algorithm which utilizes curvature characteristics of the pupil boundary to eliminate these artifacts. Pupil center is computed based solely on points related to the pupil boundary. For each boundary point, a curvature value is computed. Occlusion of the boundary induces characteristic peaks in the curvature function. Curvature values for normal pupil sizes were determined and a threshold was found which together with heuristics discriminated normal from abnormal curvature. Remaining boundary points were fit with an ellipse using a least squares error criterion. The center of the ellipse is an estimate of the pupil center. This technique is robust and accurately estimates pupil center with less than 40% of the pupil boundary points visible.

Image processing for improved eye-tracking accuracy

Video cameras provide a simple, noninvasive method for monitoring a subject's eye movements. An important concept is that of the resolution of the system, which is the smallest eye movement that can be reliably detected. While hardware systems are available that estimate direction of gaze in real-time from a video image of the pupil, such systems must limit image processing to attain real-time performance and are limited to a resolution of about 10 arc minutes. Two ways to improve resolution are discussed. The first is to improve the image processing algorithms that are used to derive an estimate. Off-line analysis of the data can improve resolution by at least one order of magnitude for images of the pupil. A second avenue by which to improve resolution is to increase the optical gain of the imaging setup (i.e., the amount of image motion produced by a given eye rotation). Ophthalmoscopic imaging of retinal blood vessels provides increased optical gain and improved immunity to small head movements but requires a highly sensitive camera. The large number of images involved in a typical experiment imposes great demands on the storage, handling, and processing of data. A major bottleneck had been the real-time digitization and storage of large amounts of video imagery, but recent developments in video compression hardware have made this problem tractable at a reasonable cost. Images of both the retina and the pupil can be analyzed successfully using a basic toolbox of image-processing routines (filtering, correlation, thresholding, etc.), which are, for the most part, well suited to implementation on vectorizing supercomputers.

Determination of ocular torsion by means of automatic pattern recognition

A new, automatic method for determination of human ocular torsion (OT) was developed based on the tracking of iris patterns in digitized video images. Instead of quantifying OT by means of cross-correlation of circular iris samples, a procedure commonly applied, this new method automatically selects and recovers a set of 36 significant patterns in the iris by the technique of template matching as described by In den Haak et al. Each relocated landmark results in a single estimate of the torsion angle. A robust algorithm estimates OT from this total set of individually determined torsion angles, thereby largely correcting for errors which may arise due to misjudgement of the rotation center. The new method reproduced OT in a prepared set of images of an artificial eye with an accuracy of 0.1 degree. In a sample of 256 images of human eyes, a practical reliability of 0.25 degrees was achieved. To illustrate the method's usefulness, an experiment is described in which ocular torsion was measured during two dynamic conditions of whole-body roll, namely during sinusoidally pendular motion about either an earth horizontal or earth vertical axis (that is "with" and "without" otolith stimulation, respectively).

Ocular torsion before and after 1 hour centrifugation

To assess a possible otolith contribution to effects observed following prolonged exposure to hypergravity, we used video oculography to measure ocular torsion during static and dynamic conditions of lateral body tilt (roll) before and after 1 h of centrifugation with a Gx-load of 3 G. Static tilt (from 0 to 57 degrees to either side) showed a 10% decrease in otolith-induced ocular torsion after centrifugation. This implies a reduced gain of the otolith function. The dynamic condition consisted of sinusoidal body roll (frequency 0.25 Hz, amplitude 45 degrees) about an earth horizontal and about an earth vertical axis (respectively, "with" and "without" otolith stimulation). Before centrifugation the gain of the slow component velocity (SCV) was significantly lower "with" otolith stimulation than "without" otolith stimulation. Apparently, the contribution of the otoliths counteracts the ocular torsion response generated by the semicircular canals. Therefore, the observed increase in SCV gain in the condition "with" otolith stimulation after centrifugation, seems in correspondence with the decreased otolith gain in the static condition.

Saccular impact on ocular torsion

When someone is tilted laterally, the shear force on the maculae of the utriculus and the sacculus is described by the sine and the cosine of the angle of tilt, respectively. So both the sacculus and the utriculus are stimulated, but in the literature, ocular torsion is normally attributed to utricular function alone (and, thus, seen as a response to y-axis linear acceleration). However, on the base of a series of experiments on a tilt chair, a linear track, human centrifuges, and during parabolic flights, we conclude that the sacculus contributes to ocular torsion as well (there is a response to z-axis linear acceleration). The data suggest that the ratio of the utricular and saccular impact on ocular torsion is 3:1. The utriculus generates conjugate and the sacculus disjunctive torsional eye movements.