This Month in Eye on Vision Video
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Shedding Light on the LuxIQTM System from Jasper Ridge
In continuation of our “Behind the Test” series, this month we look at the revolutionary new exam tool to provide task lighting and filter prescriptions. The LuxIQ from Jasper Ridge is the first of its kind exam tool that can quantify vision performance over a broad range of light levels, color temperatures and filters. Precision Vision sat down with Jasper Ridge’s President Michele Klein to discuss the development of this exciting new tool and how it can enhance your practice and improve the life of your patients.
PV: Michele thanks for joining us on Behind the Test, can you tell us a little bit of background on the development of the LuxIQ™ diagnostic system?
Michele Klein: Patients with vision loss – and their families – may feel sad, even desperate for solutions. Dedicated clinicians regret having to say, “there is nothing more we can do for you”. Now there is one more thing to do—optimize task lighting. The LuxIQ makes it practical to measure and prescribe lighting. That is why we developed the LuxIQ Diagnostic System.
Clinicians prefer an objective method to measure a patient’s needs before prescribing solutions. Before the LuxIQ, there was no standard quantitative, repeatable, practical method to recommend lighting for near-acuity. Now the LuxIQ gives eye care practitioners a science-based method for the office or home.
PV: Michele, why has it traditionally been so hard to measure light that will improve functional vision?
Michele Klein: Traditional methods of swapping bulbs, lamps, and filters, are slow, subjective, and have limited validation in clinical studies. Prescribing with the LuxIQ is fast, calibrated, repeatable, and backed by several independent clinical studies. The LuxIQ allows practitioners to measure and prescribe optimized lighting in less than 5 minutes.
PV: Can you explain how the LuxIQ improves this process of quantifying vision performance through its measurement of ideal task lighting prescriptions?
Michele Klein: Published studies show that many need bright light of 2,000-5,000 lux to maximize acuity. A typical desk lamp provides only 800 lux; an exam room 600 lux. Most people need additional light to work. Now clinicians can give patients a concrete recommendation. The LuxIQ™ makes it practical to vary intensity from 0 to 5000 lux and color temperature from 2,700 to 6,500°K, and use the system to:
• Determine task lighting needs without trial and error
• Prescribe optimum lamps and/or light bulbs
• Educate patients in lighting concepts
• Determine lighting color effects
• Conduct a wide variety of clinical and research studies
• Chart patient lighting changes over time to observe disease progression
PV: an you tell us more about prescribing filters?
Michele Klein: Clinicians may prescribe filters to reduce light or enhance perceived contrast. Like task lighting, filter selection is often based on subjective patient preference rather than a standard, repeatable measurement. Traditionally filter selection was dependent on variable lighting conditions, and required trial and error, sample lenses, and glasses. Now the LuxIQ simulates a broad range of indoor and outdoor filters, and speeds assessment.
PV: Why is it so important to provide task lighting assessments and recommendations for the 60+ and K-12 age groups?
Michele Klein: With lighting exams, student-aged children, especially those with vision disabilities, may be able to better keep up with studies and avoid falling behind early in their education. The LuxIQ helps clinicians and parents best meet a child’s needs.
As we mature, we need more light to see. Most people over 60 need at least 3X more light for near acuity than when they were teenagers. For some, optimized lighting can make the difference between large and regular print books, or being able to read at all. The LuxIQ combined with the LightChooser web app demystifies lamps, light bulbs, and filters, steering patients to exactly the right solution.
PV: It sounds like this tool is a great way for a Clinician to add an important new service to their practice, it that a correct statement?
Michele Klein: Yes. The LuxIQ is a clinic changer. It helps ECPs differentiate their practice, providing a comprehensive solution for each patient’s visual acuity needs. The LuxIQ costs much less than typical exam equipment and pays for itself quickly. A number of clinicians have noticed an increase in their sales of task lighting, prescription filters, and sunglasses since adding the LuxIQ to their exam equipment. We’re particularly excited to see an increasing number of institutions in the US, Canada, and Europe placing volume orders so each vision specialist has their own. The LuxIQ is changing the clinical approach to lighting assessments.
PV: Can the LuxIQ be used in clinical and research studies?
Michele Klein: A number of practitioners have chosen to conduct independent research with the LuxIQ since its introduction over a year ago. It’s quite popular and enables novel research on long-standing “what if” questions. The LuxIQ provides calibrated, repeatable illuminance, with independent control of intensity and color. Clinicians and researchers have been able to document correlations never before seen because of this high degree of control. These studies are listed on the Jasper Ridge Inc. web site at http://jasperridge.net/luxiq/studies-talks/
PV: Why did you choose to partner with Precision Vision to distribute the system?
Michele Klein: Precision Vision Inc. is the world leader in eye charts, a key component of using the LuxIQ. PV has an outstanding reputation for quality, so the LuxIQ, the new gold standard for light assessment, fits right in its product line. PV supports the industry with their participation in professional forums and is our valued partner for serving the general optometry market.
PV: Thank you Michele for all of your time. If someone has more questions regarding the LuxIQ can they contact you?
This month we answer a question from one of our Customers concerning documenting the results of a ETDRS Mixed Contrast Distance Chart
Q: Dear PV, I just purchased your ETDRS cabinet Mixed Contrast Distance Chart for my clinic. However, it did not come with any specific instructions for use. I assume it is to be used with the cabinet illuminated at 2.5 or 4 meters. I did not receive any Low Contrast test recording forms with it, so how should the results be documented?
To answer this question we asked world renown expert on the subject matter: Dr. August Colenbrander to respond.
A: Thank you for your question. The left side of the chart is used like any other high-contrast letter chart. If the chart is used for Low Vision patients, I recommend a 1-meter viewing distance, since 1 meter (measured with a cord) is more accurate than longer distances that are just estimated. If the visual acuity is better the chart can also be used at 2.5 meters. Scales for 1 meter and for 2.5 meter (100 inches) are printed on the left and right margins.
If at 4 meters the patient can read 5 M, the visual acuity is:
Viewing distance (in meters) / Letter size (in M-units) = 4/5 = 20/25
The M-units are listed in the center of the chart.
If the patient reads 1 or 2 lines less on the low-contrast side, this is considered to be within normal limits. Larger differences point to contrast problems. In some AMD patients we have found a difference of 10 lines!
If the HC-LC difference is greater, you will have to explore what the reason is. The HC-LC difference measures the SLOPE of the CS curve. This is different from measuring the PEAK as is done with the Pelli-Robson or Mars cards.
Recording your findings does not require any special form. It is done in the same way as you always record your findings in your record. You can just add (HC) or (LC) after the acuity value.
e.g. 20/25 (HC), 20/32 (LC) represents a normal finding (one line difference).
20/25 (HC), 20/63 (LC) represents an abnormal finding (four lines difference).
The advantage of the Mixed Contrast format is (1) that you do not need to switch charts and (2) that the difference is immediately obvious to the patient and to others. (1) Saves time in not having to switch charts, (2) saves time in explaining the results. We hope that this results in more clinicians paying attention to contrast problems.