Test Yourself – are you a candidate?

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” to the yes/no questions 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, s/he would not benefit from OriLens implantation.

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 any previous 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 or  interfere with the  eye surgery?
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 patient should be at a distances of 30 cm, 1 meter and 2 meters from the screen. If the patient uses glasses, s/he should use 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, which are part of the toolbar on the bottom part of the chart. You can also adjust the image contrast from high to low by selecting image 1 (high contrast) or image 2 (lpw contrast) from the same toolbar on the bottom of the chart. Testing should be performed using the high contrast chart only.

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 at a distance of 1 meter from the screen.

Cover the patient’s left eye completely (while the right eye is being tested). Ask the patient to read the smallest letters that s/he 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 the patient can read. For example: if s/he can read the letters CZSHN, record in the table below the number 3 for 1 meter for the right eye, as this is the third line on the chart and the test was performed at a distance of one meter using the right eye. Then, cover the right eye and read the smallest letters using the left eye only and fill in the results for the left eye.

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

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

The patient should perform the same test at a distance of two meters, only if s/he could detect all of the letters in the chart at a distance of one meter.  If the patient could not read the entire chart from one meter, s/he does not need to test from two meters. Simply ignore the two meter test.

Please note that there is no guarantee that the patient would reach an improvement of 3 lines. There are several factors, such as the eye condition, the progression of the disease and the surgical procedure that may affect the benefit that the patient 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 the patient would see with the implant, please click on image 2 in the toolbar under the chart and the patient would be able to see the same chart in low contrast as may be experienced after surgery.

Now that the patient has completed testing his/her eyes for distance vision, let’s test them for near vision (reading).

Use the reading glasses for this test (if the patient does not have reading glasses, use a +3.00 sph normal reading glasses).

Adjust the chart for near vision (as explained above, the first letter H should roughly 1.2 cm high). 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 the patient can see completely, and look for three lines below for a simulation on what could be achieved for near. You can also simulate the low contrast if you move to page 2.

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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