LIFE 3.0

Tegmark 3.0

In his new book LIFE 3.0, MIT physics professor Max Tegmark poses an interesting question, the answer to which is embedded in a series of nesting questions :  “So what career advice should we give our kids?  I’m encouraging mine to go into professions that machines are currently bad at, and therefore seem unlikely to get automated in the near future.  Recent forecasts for when various jobs will get taken over by machines identify several useful questions to ask about a career before decided to educate oneself for it.  For example:

  • Does it require interacting with people and using social intelligence?
  • Does it involve creativity and coming up with clever solutions?
  • Does it require working in an unpredictable environment?”

To what extent might what we do in vision therapy be taken over, at least in part by automation?  On that note, I was intrigued by a presentation at the 39th European Conference on Visual Perception (ECVP) 2016 in Barcelona, published in a supplement to the journal Perception.  If you have the patience, scroll to page 363 and you’ll find information about a new 3d virtual reality system to assess visual function and perform visual therapy.  It’s short enough that I’ll save you the trouble, and reproduce in its entirety here:

“Assessment of visual function in a clinical optometric examination is carried out through a battery of subjective tests. A complete examination is time-consuming leading to patient fatigue and the results can be influenciated (sic) by the optometrist. Vision therapy procedures take even longer sessions and are also dependent on subjective patient responses. A new 3D virtual reality system with matching accommodation and convergence planes has been developed (Eye and Vision Analyzer, EVA, DAVALOR, Spain). While the patient plays a short videogame (<5min), objective and fast measurements of most optometric parameters are obtained. The system generates 3D images on two displays. Vergence is induced through image disparity and accommodation is stimulated using a varifocal optical system. EVA also incorporates a Hartmann-Shack autorefractometer and an eye-tracker. Measurements are repeated until obtaining a high confidence level and patient collaboration is also measured. A clinical validation of the system was performed in a group of 250 patients. Optometric parameters related with refraction (objective and subjective), accommodation (amplitude, accommodative facility) and vergence (cover test, near point of convergence, fusional vergence and vergence facility) were obtained with EVA and compared to conventional clinical procedures. Results showed good correlation and differences obtained were always within clinical tolerance.

Takes alot of computing power to take a Hartmann-Shack autorefractometer and combine it with a vergence analyzer together with an eye tracker.  Davalor’s EVA has done this in an attractive high tech way, making it look like a designer version of a visual system imaging station for accommodation, vergence, and ocular motility.



Take a look at Davalor’s business model briefing and note the following:

“Davalor focuses on functional health, being its first interest the visual function. Optometry is the pertinent branch of science (related to how eyes form image on the retina and how the brain: 1) processes image information – interpreting and understanding, 2) makes decisions – voluntary and parasympathetic, and 3) formulates and executes oculo-motor orders – on pupil, crystalline and eye globes). Services for visual function healthcare include sight exam, vision exploration, diagnosis and behavioural training and therapy. The majority of learning at any age (both by means of reading, as well as through emulation) depends on the visual function. 50% of the population suffers from some type of visual impairment which hinders personal and professional development in 10% of the population. Today, less than 2% of population get visual function healthcare. Davalor aims reaching most of population with exploration and diagnosis services, and for those in need, with visual training and therapy services.”


“EVA is a completely autonomous and automatic system which acts as a remote terminal of Davalor IT system. EVA placed at an Optical retailer allows selling services of exploration and diagnosis based on objective measuring (including all 75 parameters of the visual function described by classic Optometry, performing it in only 5 minutes whilst the user interacts with a true 3D videogame), as well as selling services of behavioural training and therapies (typical case is 20 sessions of 10 minutes each performed through 3D videogames). In addition, in its initial set-up, EVA replaces manual equipment of optical stores (and does it in a completely autonomous and automatic manner): phoropter, autorefractor, aberrometer (low orders), 3D visagraph and campimeter (+/- 30o), apart from measuring all the optometric parameters and allowing therapies to be carried out.”


Sound like science fiction?  Not really.  It will be a fundamental component of Optometric Life 3.0 …

10 thoughts on “LIFE 3.0

  1. MONSTROUS machine, but hopefully a shift in the right direction: Paying attention to visual function is a fundamental need, and social good. Still, one can only shiver at the notion of a virtual environment being the test bed for vision in reality.

  2. So disturbing. I have never had an autorefractor for one simple reason: you cannot run it 3x in a row on a patient and get the same results all three times. So what is it really measuring, and what does that have to do with being able to move and interact successfully in a real world environment? And what about the patients who cannot interact with a video game? Or patients with midline shift, poor posture, orthopedic issues, or just plain poor attention? Will it also prescribe them 2-3 diopters of cyl like the auto refractors do? I must admit that I like the statistics about vision. I don’t think our jobs are threatened.

    • Hi Marsha, do you feel you ever get the same ret reading on multiple attempts, or blood pressure, or blood glucose? none of these can ever be ‘correct’ or static, they are simply probes. I love my autorefractor, but never take its reading as anything but clues. Btw, variabilty in A/R readings is in itself informative.

      • Good comments. I have also found that all instruments are variable and inconsistent. Nothing beats working with the patient and observing them. I agree about refraction too. Since most of my patients don’t have any immediate need for 20/20 it is a non-issue. (They just want to know where their hands and feet are and how to move them.)

  3. As a therapist, part of my job in therapy is to stimulate the patient to “take charge” of their visual performance (to the extent that is possible with whatever refractive status they may have), comfort, and to effect change through their own “buy-in”. Somehow, this machine-led idea seems to me to be in direct opposition to the idea that the patient is in charge of what they wish to do/feel/accomplish with their visual system. I have to wonder just how much “thought” will go into the patient’s interaction with this 3D model…..will the patient be led to understand what/how their differing interactions change their visual system?

  4. Thank you all for commenting. As you can see, reaction to this new device will be somewhere in between Luddite-like feelings and an exuberant embrace of new technology. As long as there are humans, observation will continue to be as important as any other tool. Perhaps that’s where the current shift resides: it used to be that each new device was used as a potential tool in ones toolkit, competing with observation. Now observation is looked upon as another tool in the toolkit. How supreme it will remain will likely be a function of the population that one deals with. A book that I’m reading has much to say about AI machines/devices (like EVA above), with a telling title: “The Digital Mind – How Science in Redifining Humanity”. This is a stimulating area and one that is admittedly fraught with controversy. Thank you all again for taking the time to read and to comment.

  5. The instrument appears to provide an automatic/stimulus/response therapy of accommodation and convergence. If we think that vision is an active process, something we do rather than something that happens to us, and that conscious awareness of central-peripheral interactions and voluntary control of the system are useful, then the instrument could still be useful, but hardly capable of handling a large part of a therapy program. Since the visual system is much more complex than the clinician, the proof the the pudding will remain in the eating: how does the therapy change performance.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s