Vision Expo West

Vision Expo West

Issue: November 2016
September 27, 2016
4 min read

ODs to play important role in wearables

Issue: November 2016
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LAS VEGAS – Wearable technology will make its way into the optometric practice in the near future, Jerome Legerton, OD, MS, MBA, FAAO, reported here at Vision Expo West.

Optometrists will need to “manage psychophysiologic optics considerations and adaptation issues related to a new set of near eye display-related problems,” he said.

They will also be prescribing and fitting smart contact lenses and display eye wear, along with implementing the technology for low vision, vision therapy and sports performance enhancement, he said.

“Most of the proponents of wearable technology believe that it will replace your cell phone, and what you’ll have is your virtual or augmented reality dashboard within your eye wear,” Legerton said.

Some say Google Glass was a “failed experiment,” he said, but they learned a lot. “Don’t put a 13-degree display off to the side of one eye.”

Low vision applications

Low vision and vision therapy will be the first two applications of wearables in optometry, he said.

“Innovega just received a National Eye Institute grant for a low vision study that will include a clinical study conducted at the Ohio State University,” he said. “We will be using the systems for driving, reading and pumping cell phone content for low vision patients.

“Wearing wearables is vision therapy,” he continued. “Everyone that wears them will have to adapt to some degree in their binocular and psychophysiological optics.”

Many opportunities exist in the field of low vision. Most of the magnification aids currently used result in a smaller field, Legerton said.

“If there’s a camera in the eye wear and patients can hold reading materials at a normal distance and can increase the resolution,” he said, “now you have something that can facilitate independent living and make it enjoyable.”

Legerton also sees uses with electronic medical records for practitioners and staff.

“Now you can face the patient and see them and talk to them while you’re typing,” he said.

More products

The VisionFit by Sonomed Escalon is a wearable adaptive optics refractor, Legerton said, that can measure for higher-order aberrations.

“It’s like an aberrometer, except it’s subjective, with the ability to refine vision correction with adaptive optics,” he said.

The Zeiss VR One, a virtual reality headset, works by altering the content on a cell phone, sending one image to the left eye and one image to the right eye, producing 3-D.


The PlayStation VR, Sony’s virtual reality headset for use with the PS4, will launch by Christmas, Legerton said. And Oculus Rift and the HTC Vive, two other virtual reality headsets, are available now.

“Most displays are only about 30% to 40% efficient,” he said. “Sixty percent of the power is converted to heat. These systems are physically hot to wear. There has to be a means of cooling or venting.  An eye wear form factor will reduce this problem.”

At Innovega Inc., co-founder Legerton and colleagues have designed tip-down display eye wear.

“Tip-down technologies allow you to keep your line of sight where you need to,” he said. “You tip the eye wear down and get everything that’s on the display and raise your head and never move your line of sight”

With the Innovega iOptik Transparent, your display content appears directly in front of you, on top of what your real world vision, Legerton explained.

Contact lenses

Wearable technology extends to contact lenses as well.

The FDA approved Sensimed AG’s Triggerfish, a silicone contact lens that monitors IOP, in the spring. Google has a number of patents and a partnership with Alcon for measuring blood sugar with a contact lens, Legerton said.

“And Google also has a published camera contact lens patent,” he said.

Sony has a patent pending for an image capture and storage system.

“Johnson & Johnson has more than 50 patents pending for smart contact lens technology,” Legerton said.

They include the placement of a light source in a contact lens to combat seasonal affective disorder as well as electronic accommodating contact lenses.

Myolite Inc., a company that Legerton founded, has two patents for a spectacle lens and contact lens to produce the outdoor light needed to prevent myopia.

“It could be combined with a corneal reshaping lens where the lens is emitting the right dose of light at night,” he said.

Legerton explained that Innovega is working on technology where an outer contact lens provides normal vision for the real world and the center streams high-definition and 3-D digital media from the eye wear.

“Eye-borne optics facilitate the field of view with style and comfort and multiple eye wear configurations,” Legerton said. “The communication is in the temples of the eye wear.”

He referred to the eye wear as “contact lens-enabled immersive virtual reality eye wear. Outside the display you still have your world lock and can be mobile.”


Optometrist’s role

Optometrists will have a role in this industry, Legerton said, with a need for measurements and fitting.  Display eye wear can be optimized with split PDs and vertical adjustments of displays.

“The first response as an industry, however, could be to criticize wearables: they’re horrible and bad for children,” he said. “The right approach is to create a response where our services are valuable.”

Controversies such as invasion of privacy, as with the Google Glass camera, and distraction while driving exist.

“And yet we’re looking down at a GPS and information on our dashboard,” Legerton said.

Other controversies involve cyber sickness, potential blue light hazard and accommodative convergence conflict.

“The positive impact of wearables is the evolution of visual experience,” he said. “While the demands on the visual system are evolving, our functionality is improving. Our visual perception is enhanced. We are developing a much faster reaction time. We’re improving cognitive processing and recall – multi-tasking and perceptual processing.”

Legerton cautioned practitioners about losing this segment “like we lost sunglasses and contact lens care product sales.”

Optometrists can be health care professionals and electronic device providers under one roof, he said.

The contact lens industry in the U.S. is about $3 billion; the wearables industry including augmented reality/virtual reality segment is forecast to be $150 billion by 2020, he said. – by Nancy Hemphill, ELS, FAAO


Legerton J. Wearables: Where it’s at, where it’s going and impact on vision. Presented at: Vision Expo West; Las Vegas; Sept. 14-17.

Disclosure: Legerton is founder of Myolite and co-founder of Innovega.