Test Your Patient

healthcare, medicine and vision concept - male ophthalmologist with eye chart

Patients with advanced AMD would need the assistance of a family member or another care-taker in order to complete the two self-tests below:

The tests consist of two stages (one involves answering some yes/no questions and the other is a minor visual test). Only if you pass stage one successfully you can proceed to stage two. The questions in the first stage require some knowledge of the current visual condition.

Once you click “Submit” the system will reply if the patient may be eligible for treatment or not and it will save the patient’s data on our server and provide a username and a password that would allow the patient, his family or professionals to see the records that were filled for further evaluation. If the patient is not found eligible for treatment, she would not benefit from OriLens implantation.

For further guidelines regarding the self-testing, please see the video below.

Stage 1:

Please read carefully the yes/no questions below and answer them to the best of your knowledge. Once you complete answering the questionnaire, click “Submit” below.

Please note: upon submitting, any “wrong” answers that cause a patient not be eligible for treatment will show in red. Examine any “wrong” answers and see if they could be reconsidered and changed after a second thought. You may re-think your answers and correct them after the initial attempt and then click “submit” again.

Please click “yes” or “no” and then submit.  

Yes No
1.   Do you suffer from macular degeneration in both eyes?
2.   Are you at least 60 years old?
3.   Are you aware of any sensitivity to any medications that may be involved in such surgery?
4.   Are you interested and willing to undergo an eye surgery in order to achieve some visual improvement?
5.   Is your visual acuity in at least one eye between 20/80 and 20/800 (equivalent to 6/24 to 6/120)?
6.   Are you under immunosuppressive treatment or do you use systemic steroid or anticoagulants?
7.   Do you suffer from any other eye diseases (other than AMD) and did you go through anyprevious eye Surgery (other than      cataract  surgery)?
8.   Does your fellow eye suffer from any ocular disease that may affect the peripheral visual field?
9.   Do you suffer from severe communication impairment or a severe neurological disorder,which could prevent orInterfere  with the  eyesurgery?
10.   Do you feel that you have the mental ability to undergo the testing required for the surgery and are you likely to complete the  entire course of follow-up, usually 1 day, 1 week, 4 weeks, 13 weeks, 26 weeks and 52 weeks after surgery?
11.   Do you agree to sign a written informed consent for performing the surgery on your eye?
12.   Are you currently involved, or in last 30 days, have been involved in any clinical trial of an investigational drug or device?




Stage 2:  

In stage 2 the patient uses a chart that can help to demonstrate some of the possible outcomes of OriLens implantation.

The test below should be performed indoor with regular room light condition (the room should not be darkened). The test will be performed when the patient is at a distances of 30 cm, 1 meter and 2 meters from the screen. If you use glasses, you should wear them during the test.

Please take a look at the chart below. You will need to adjust the size of the chart, so that the letter H (on the top left side of the screen) would be roughly 6 cm high for testing you distance vision (1 meter and above). For near vision testing (less than 1 meter) you will need the same letter H to be 1.2 cm high.

You can adjust the size of the chart using the ↑↓ buttons on the right side of the chart. You can also adjust the image contrast from high to low by choosing from the menu on the right side of the chart. Testing should be performed for both high contrast and low contrast charts.

For purposes of filling the data below correctly, line 1 is the largest line that starts with the letter H, line 2 is the second largest line that starts with the letter N, line 3 starts with C and so forth.


Begin with a distance of 1 meter from the screen.

Cover your left eye completely (while the right eye is being tested). Read the smallest letters that you can detect on the chart (consider only lines that can be read completely – the entire 5 letters).

Count the number of lines on the chart that you can read. For example: if you can read the letters CZSHN, record in the table below the number 3 for 1 meter with your right eye, as this is the third line on the chart and you were tested for one meter with your right eye. Then, cover your right eye and read the smallest letters and fill in the results for the left eye.

Now you can find out what will be the best possible result that you may reach following OriLens implantation.

The best possible result would be 3 lines smaller than the result that you reached in the initial self-testing. For example, if you could read line 4, which is ONVSR, then the best result that you may be able to achieve after implantation is line 7, which shows the letters DVOHC on the chart in front of you.

Another way to demonstrate what could be achieved is to look at a line that is 3 lines higher than what you read and note that the line that you could read (line 4 on that example ) will be seen by your eye in the size of line 1 (which is 3 lines bigger).

You should perform the same test from a distance of two meters, only if you could detect all of the letters in the chart for a distance of one meter.  If you could not read the entire chart from one meter, you do not to test yourself from two meters. Simply ignore the two meter test.

Please note that there is no guarantee that you will reach an improvement of 3 lines. There are several factors, such as your eye condition, the progression of the disease and the surgical procedure that may affect the benefit that you may achieve from the implantation.

Also, it is important to note that the actual image would be seen in lower contrast after implantation, which means the luminosity will be somehow darker.

In order to simulate the lower contrast that you will see with the implant, please click on the “low contrast” button near the chart and you will be able to see the same chart and compare the normal contrast and the low contrast that you will experience after surgery.

Then, record the smallest line that you can read in low contrast from one meter, and, if applicable, from two meters.

Now that you have completed testing your eye for distance vision, let’s test you for near vision (reading).

Use your reading glasses for this test (if you do not have one that you use a +3.00 sph normal reading glasses).

Adjust the chart for near vision (as explained above). The test should be performed at a distance of 30 cm from the screen.

Follow the same instructions as for distance vision: cover one eye, test for the smallest line that you can see completely, and look for three lines below for a simulation on what can be achieved for near. You can also simulate the new contrast if you click on the “low contrast button”.

The results that you have recorded in the table below may serve you when you visit your ophthalmologist for consultation.

Smallest line detected from 1 m,regular contrast:
Smallest line detected from 2 m,regular contrast:
Smallest line detected from 40 cm,regular contrast:


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