EP4316449A1 - Orthotic rehabilitation apparatus for treating binocular diplopia - Google Patents

Abstract

The invention relates to an orthoptic rehabilitation apparatus for the treatment of binocular diplopia comprising a longitudinal element (12, 13) provided with a first face (1a) and a second face (1b) and a central axis ( X) delimiting, on each of the faces, two symmetrical parts on which are arranged, respectively, a series of fixed fixed targets and mobile visual targets and a stereogram (11), characterized in that the series of visual targets includes electroluminescent diodes (Leds 2) arranged on the central axis which are powered by a battery (3) and whose activation is programmable by means of a microprocessor (4).

Description

TECHNICAL FIELD OF THE INVENTION

The invention relates, generally, to the field of optics and is concerned, more particularly, with an apparatus intended for orthoptic rehabilitation.

STATE OF PRIOR ART

Some people suffer from binocular diplopia which results in the perception of two images of the same object. This double vision can affect one eye, and we then speak of monocular diplopia, or both, and in this case it is binocular diplopia.

The causes of this visual deficiency are multiple and can be found in an infection or ocular trauma, or be a consequence of rheumatological or cerebral problems, the presence of diabetes or even high blood pressure... This physiological deficiency can be treated via surgery or through various orthoptic rehabilitation procedures aimed at restoring visual convergence.

There are different types of rehabilitation devices allowing, in particular, the practice of visual correction exercises by means of stereograms formed of two identical figures juxtaposed symmetrically with respect to an axis.

The patent FR2488131B1 describes a device of this type for the rehabilitation of binocular vision comprising a plate supporting moving targets and fixed targets associated with printed stereograms.

Another device called “Unicorn glasses” allows, thanks to a removable middle rod associated with interchangeable lenses and prisms, to train convergence and maintain it by wearing a frame at home.

These known devices are however intended to be used with the assistance of specialized personnel (ophthalmologist, orthoptist, or optician) who manages the rehabilitation exercise programs depending on the nature and extent of the eye deficiency.

STATEMENT OF THE INVENTION

In this context, the invention sought a technical solution which, in its most general aspect, makes it possible to implement, automatically, several orthoptic rehabilitation exercise programs for the treatment of binocular diplopia. These programs are adapted to the patient's deficiency, who can practice visual exercises independently and remotely using an oculomotor device and without the need to call on a specialized establishment or medical personnel.

This goal is achieved, according to the invention, by means of an orthoptic rehabilitation device for the treatment of binocular diplopia comprising a longitudinal element provided with a first face and a second face and a median axis delimiting, on each of the faces, two symmetrical parts on which are arranged, respectively, a series of fixed visual targets and moving visual targets and a stereogram, characterized in that the series of visual targets comprises light-emitting diodes (Leds) arranged on the central axis which are powered by a battery and whose activation is programmable by means of a microprocessor.

According to an advantageous characteristic of the apparatus of the invention, the stereogram comprises a graduated ruler placed on either side of the central axis.

According to another characteristic of the invention, the series of diodes comprises diodes capable of emitting light of variable color by being controlled by the microprocessor depending on the programming.

According to yet another characteristic of the device of the invention, the diodes are capable of being activated successively and in an order governed by the microprocessor according to the programming so as to simulate a virtual movement along the longitudinal element .

According to one embodiment of the device of the invention, the series of diodes is housed in a slot extending along the central axis such that the emitted light is visible on both faces of the longitudinal element.

According to a variant embodiment, the microprocessor is connected to a wireless network.

According to another alternative embodiment of the invention, the device comprises push buttons mounted on the longitudinal element and intended, respectively, for activating, deactivating and pausing the device and for adjusting the intensity of the light emitted by the diodes and their activation frequency.

According to yet another alternative embodiment, the device comprises a program display member.

According to a first embodiment of the invention, the longitudinal element of the rehabilitation device consists of a plate carrying the battery and the programmable microprocessor.

In this case, one of the longitudinal end edges of the plate is provided with a cutout for positioning a patient's nose.

According to a second embodiment of the invention, the longitudinal element of the rehabilitation device consists of a bar.

Another object of the invention is a use of the orthoptic rehabilitation device, characterized in that the activation of the series of diodes is programmed according to the visual exercises intended for the treatment of binocular diplopia.

Thus, in principle, the invention proposes an orthoptic rehabilitation device capable and intended to facilitate the resumption of visual convergence through the practice of programmable exercises.

The oculomotor device of the invention is light, portable and easy to use and allows a patient to practice visual exercises independently and ergonomically. These exercises are directly programmable from the device and unfold automatically while remaining adjustable at any time by the patient.

BRIEF DESCRIPTION OF THE FIGURES

• [Fig. 1] est une vue de dessus d'un premier mode de réalisation de l'appareil de rééducation selon l'invention.
• [Fig. 2] est une vue de dessous de l'appareil de rééducation de la figure 1.
• [Fig. 3] est une vue de côté de l'appareil de rééducation de la figure 1.
• [Fig. 4] est une vue de face d'un second mode de réalisation de l'appareil de rééducation selon l'invention.
• [Fig. 5] est une vue de profil de l'appareil de rééducation de la figure 4.

Other characteristics and advantages of the invention will emerge on reading the description which follows, with reference to the appended figures, for which:

• [ Fig. 1 ] is a top view of a first embodiment of the rehabilitation device according to the invention.
• [ Fig. 2 ] is a bottom view of the rehabilitation device of the figure 1 .
• [ Fig. 3 ] is a side view of the rehabilitation device of the figure 1 .
• [ Fig. 4 ] is a front view of a second embodiment of the rehabilitation device according to the invention.
• [ Fig. 5 ] is a profile view of the rehabilitation device of the figure 4 .

For greater clarity, identical or similar elements are identified by identical reference signs throughout the figures.

Naturally, the embodiments of the rehabilitation device according to the invention illustrated schematically by the figures presented above and described below, are given only by way of non-limiting examples. It is explicitly provided in the context of the invention that it is possible to propose and combine different modes to propose others.

DETAILED DESCRIPTION OF AN EMBODIMENT

The invention relates to the general field of orthoptic rehabilitation in the treatment of binocular diplopia.

More specifically, the invention sought to develop a portable, easy-to-use and autonomous eye-tracking device that can be used for orthoptic rehabilitation on the go and without the assistance of specialized personnel.

This device includes, in the traditional manner and as illustrated by the figures 1 to 5 representing two distinct embodiments, a longitudinal element 1 provided with a first face 1a, a second face 1b and a median axis X.

The axis figure 1 ).

According to the invention, the series of visual targets comprises light-emitting diodes or “Leds” 2 arranged on the central axis X which are powered by a battery 3 and whose activation is programmable by means of a microprocessor 4 (as illustrated over there figure 1 ). This control microprocessor 4 is preferably an ESP32 with low power consumption and having the possibility of Bluetooth and/or Wifi communication.

Battery 3 is preferably of the LiPO type. This battery 3 can be recharged either wirelessly by induction (QI charging standard), or with a conventional USB charger by plugging it into the port provided for this purpose. When the device is turned off, Battery 3 can be charged, either wirelessly or in wired mode with a USB charger.

The stereogram 11 here comprises a graduated ruler arranged on either side of the central axis chosen programming.

More precisely, the diodes 2 are capable of being activated successively or simultaneously and in an order governed by the microprocessor 4 depending on the programming, as described below, so as to simulate a movement of the targets along the axis X. Preferably, the microprocessor 4 is connected to a wireless network, wifi or Bluetooth (registered trademark).

As illustrated by the figure 1 , this rehabilitation device further comprises a series of push buttons 5 mounted on the longitudinal element 1 and some of which are placed on the side of the housing containing the microprocessor 4. These buttons are intended, respectively, for the activation, deactivation and pausing of the device, for program changes and for adjusting the intensity of the light emitted by the diodes 2, their activation frequency and of their direction of movement. More precisely, one of these buttons makes it possible to invert the virtual movement of the LEDs which in fact corresponds to successive and rapid phases of lighting one LED and extinguishing the immediately adjacent LED. As illustrated by the Figure 3 , a 5a side button allows updating the “firmware” and a 5b USB port provides connection for battery charging.

A display unit 6 for the programs completes the equipment of the device. This display member or display includes a seven-segment LED presenting the program selected by the patient among the twenty programs available

Loading and updating of programs in the computer system embedded in the device and controlled by the microprocessor 4 are carried out by connection to an external server, for example, via a USB cable or via a wireless connection of the wifi type.

The invention also provides, according to a variant embodiment, the possibility of controlling the device remotely through an application on a smartphone or tablet (under Android or IOS). If necessary, an independent and remote operator can change the program and vary the speed of virtual movement of the light targets and their intensity, thus letting the user of the plate concentrate on their exercise.

According to a first embodiment of the invention represented on the figures 1 , 2 And 3 , the longitudinal element 1 of the rehabilitation device is produced here in the form of a plate 12 carrying the battery 3 and the programmable microprocessor 4.

According to a variant of the specific invention of this first embodiment, it is possible to provide that the plate 12 of the rehabilitation device integrates all the on-board electronics, by arranging it in a sandwich between the two faces 1a, 1b while not exceeding a total thickness of a few millimeters.

In this embodiment, a series of diodes 2 is placed on each face. A variant could provide for the series of diodes to be housed in a slot extending along the central axis X such that the emitted light is visible on the two faces 1a, 1b of the plate 1.

The diodes could be controlled independently or simultaneously if necessary. By default, it is expected that the diodes located on both sides of the device are systematically and permanently lit and synchronized in the same way. Indeed, it turns out that the patient, during his exercise, does not actively use both sides, the professional operator who assists him obtains visual feedback of what the patient sees.

An update allows, at the request of the operator, to turn off one of the two sides. To do this, he will perform a long press on the program change button. Indeed, although it is practical for the operator to have visual feedback, it turns out that the operator ends up suffering eye fatigue after his successive interventions with numerous patients.

The LEDs are integrated into the plate 12 and, where applicable, they are flush with the plate. The plate is made, for example, of matte acrylic and is therefore slightly flexible while still being durable. The plate has a semi-transparent screen 12a ( figure 1 ) glued and serving, at the same time, as a reflector to improve the visibility of lit LEDs and as a filter.

One of the longitudinal end edges of the plate 1 is provided with a cutout 10 for positioning a patient's nose. The plate 12 can be used in the vertical direction or in the horizontal direction depending on the rehabilitation exercises performed, as described below.

For programs using only the upper face of the plate 12, the user holds the plate 12 by hand while maintaining it in a horizontal plane and positions it in contact with his nose in the location formed by the cutout 10 intended for this purpose. For programs using both sides 1a, 1b, the user holds the plate 12 by hand on the edge and positions it in contact with its nose, the X axis being oriented horizontally.

It is however possible, without departing from the scope of the invention, to provide other modes of use of the device of the invention such as, for example, by asking the patient to hold the plate at arm's length, or in a vertical position or in a horizontal position. In this case, using the plate essentially amounts to practicing the same exercises as with the bar but at half distance. Therefore, a professional with both embodiments of the device can practice any form of rehabilitation.

Rehabilitation exercises are performed as described below. Generally speaking, the objective of the exercises is to lead the user to follow with their eyes the virtual movement of the moving light target formed by a lit LED.

Depending on the program used, he can also wear stereoscopic glasses with red and green filters (not shown). This accessory makes it possible to make an LED invisible for one of the eyes, for example, a glasses with a red filter on the left and a green filter on the right. Thus, the lighting of a red LED will only be visible to the right eye while an LED emitting green light will only be visible to the left eye.

According to a second embodiment of the invention represented by the figures 4 And 5 , the longitudinal element 1 of the rehabilitation device consists of a bar 13.

Bar 13 can be available in several different sizes, for example, with a length of 1.5m and 1m with a length of 1.5m and has up to 50 red/green/blue LEDs spaced approximately 1.25cm apart. It is intended that the device in the form of a bar 13 be autonomous or connected by a cable and a connector (for example, of the 3.5mm jack type) to a control box. This control box is powered by a separate 5V power supply.

Around ten exercise programs are available with this bar. Changing the program is done using a simple push button.

The bar 13 can be positioned either horizontally or vertically. It can be attached to a photographer's tripod or hung on the wall or even placed on a table.

An element 13a ( figure 4 And 5 ) allowing the bar 13 to be fixed to a photographer-type tripod is mounted in the center of the bar. This element 13a has a thread on each side. Indeed, depending on the tripod and the exercise performed, it is sometimes necessary to attach yourself to the other side to be able to correctly orient the bar facing the patient (horizontal, vertical/oblique/facing the LEDs upwards, etc.) . Incidentally, an element 13b located at the end of the bar 13 ( figure 5 ) allows you to plug the box onto the bar.

Depending on the program used, the user can also wear stereoscopic glasses with red and green filters. This accessory makes it possible to make an LED invisible on one eye, for example, a glasses with a red filter on the left and a glasses with a green filter on the right. In this case, a red LED will only be visible to the right eye while a green LED will only be visible to the left eye.

As with plate 12, updating the “firmware” of bar 13 can be carried out by means of a USB cable connection, thus making it possible to modify or add new programs.

The control box (or microcontroller) is an “Arduino” or an “ESP32” which can be self-powered and designed to support OTA (wifi) updates. This box is autonomous or controlled remotely via an application loaded on a smartphone or tablet (Android or IOS) via Bluetooth or wifi. The box is attached in a possibly removable manner to the bar 13. A small battery can also be integrated into the bar. Alternatively, the box could be removably attached to the bar while remaining connected by a cable to improve the compactness of the device and allow the operator to position themselves wherever they wish to control the exercises.

The spacing of the LEDs can also change from 3.5cm spacing to a smaller spacing so as to increase the number of light targets on the bar and therefore make the successive lighting of the LEDs more fluid.

The lighting of the LEDs and therefore their virtual movement speed as well as their light intensity is adjustable, by the operator, by means of potentiometers provided for this purpose.

The modes of implementation of the rehabilitation method using the apparatus of the invention are described in detail below, first with the apparatus in the form of a plate 12 then with the apparatus in the form of a bar 13.

For each program, the intensity of the light of the LEDs and their virtual movement speed are adjustable directly and autonomously by the user or by an independent operator.

Program 1.1 with the device in the form of plate 12.

The plate is held flat, horizontally and placed in contact with the user's nose. A first red LED lights up on face 1a above in a position away from the user, indicating the starting point of the program. The LED changes from red to white and moves closer to the user. Arriving closest to the user, it lights up red, indicating the end position to the user. The LED lights up white again, starts moving away and so on.

Program 1.2.

The first LED and the last LED light up red, indicating to the patient where the exercise begins and stops. The red LED then stays on for 1/4 second longer before starting to move. The blue LED only goes back and forth (or back if the user changes the direction). For example, arriving at the point closest to the user, we start again from the point farthest from the user.

The user, using the button provided for this purpose, can interrupt the movement at any time (by exerting a long manual press) and/or reverse it (with a short press).

Program 1.3 with the device in the form of plate 12.

The plate 12 is held flat, horizontally and placed in contact with the user's nose.

A steady blue LED lights up at the end of plate 12. A red LED lights up closest to the user and then moves away from the user. Arriving at the opposite end of plate12, the virtual movement of the LED is reversed and so on.

Program 1.4

The plate 12 is held flat, horizontally and placed in contact with the user's nose. A steady blue LED is lit in the middle of the plate. A red LED moves from the end of the plate (position farthest from the user) and approaches the midpoint without going beyond it. Arriving in the middle of the plate, the movement is reversed and the LED moves away again.

Each press of the push button shifts and repositions the blue LED (fixed) by a certain distance so as to be closer and closer to the user. Jointly, the amplitude of virtual movement of the blue LED changes according to three distinct amplitudes, respectively, from the middle to the closest to the user.

Program 1.5

When the program starts, three fixed LEDs light up. A blue LED in the center of the plate, a red LED at one end away from the user and a green LED at the other end.

Pressing the push button starts the movement. The blue LED remains fixed while the red and green LEDs move simultaneously towards the blue LED. Arriving at the central point, they cross paths. When the red and green LEDs reach the end of the plate, the movement is reversed.

At any time, the user can interrupt the movement or reverse it by pressing the push button. This program allows you to work with stereoscopic glasses

Program 1.6

This program is similar in its mode of operation to program 1. We alternately light a green LED and a red LED which move. The choice of color allows you to work with stereoscopic glasses with red and green filters.

Program 1.7

The plate 12 is still held on the edge here, its longitudinal axis X being oriented in a horizontal direction, and placed in contact with the user's nose. Each eye views a different side of plate 12.

The lighting of the LEDs is synchronized between the two faces 1a, 1b. One LED per side is lit and in the same position.

Initially, an LED lit blue at the end of the plate farthest from the user approaches in virtual jumps of approximately 3cm.

This program corresponds to a default movement of around one second and, at the slowest, 3 seconds between each movement and at the fastest 0.5 seconds. The default 1.1 program starts with a change every 150ms, but these changes can take place in a range between 5ms and 600ms.

Program 1.8

The plate 12 is this time held on the edge, its longitudinal axis X being oriented in a horizontal direction, and placed in contact with the user's nose. Thus, each eye visualizes a different side of plate 12.

The lighting of the LEDs is synchronized between the two faces 1a, 1b. One LED per side is lit in the center. The color alternates between red and green with each virtual move.

The movement is from the center to the ends. The green LED moves closer to the user. The red LED goes away. There is only one color LED lit at the same time. Either the red one or the green one. Arriving at the end of the plate the movement is reversed

The user, using the push button provided for this purpose, can at any time interrupt the virtual movement (by exerting a long press) and/or reverse it (with a short press) to indicate to the operator the precise position in which it observes the duplicate LEDs. The choice of color allows you to work with stereoscopic glasses with red and green filters.

Program 1.9

The plate 12 is still held on the edge here, its longitudinal axis X being oriented in a horizontal direction, and placed in contact with the user's nose. Each eye views a different side of plate 12.

The lighting of the LEDs is synchronized between the two faces 1a, 1b. One LED per side is lit and in the same position.

Alternatively a red then green LED lights up at a random position.

This program, by default, is a slow program. The user must have time to find and even see the LED lit on the plate

The choice of color allows you to work with stereoscopic glasses with red and green filters.

The different rehabilitation exercise programs using the device of the invention in the form of a bar 13 will now be described in detail. In each of these programs, the light intensity and the virtual movement speed of the LEDs are always adjustable by an operator or the user himself.

Fixed program 2.0 with the embodiment of the device in the form of a 13 bar.

To the left of bar 13 is a fixed green LED, in the middle a fixed blue LED and to the right a fixed red LED.

Program 2.1: visual pursuit with change of amplitude.

Initially, a blue LED lights up in the center of bar 13. It moves from left to right over a range of approximately 20cm, going back and forth. After a phase of five back and forth movements, the amplitude increases by 20cm until reaching an amplitude corresponding to the total length of the bar. Once the maximum amplitude is reached, the exercise begins again with the smallest amplitude.

Program 2.2: complete visual tracking.

At the start of the program, a blue LED lights up in the middle of the bar then this LED moves from left to right of the bar and vice versa.

Program 2.3: visual pursuit with alternating colors.

Initially, an LED lights up in the center of the bar then this lit LED moves from left to right along the total length of the bar and vice versa. The color changes from green to red alternately with each virtual movement of the LED.

This exercise allows, by using stereoscopic glasses with green and red filters, to visualize, per eye only one LED every other time.

Program 2.4: Sinus.

The user positions himself in the axis of the bar 13, the bar being in front of him.

A blue LED lights up on the left side, closest to the user. It then moves to the right away from the user. Arrival at the end of the bar, it starts again from the left side. But, from the user's point of view, it only seems to go back and forth.

Program 2.5: Reverse sine.

This program is identical to program 4 with the difference that the LED begins its virtual movement on the opposite side of the bar in relation to the user's position. Then, it moves closer to the user and, having reached the start of the bar, it returns to its starting point. But it does not go back and forth. From the user's point of view, it only provides returns.

Program 2.6: alternating flashing.

Three LEDs flash alternately in the following sequence. The LED on the left side of bar 13 lights up red then goes out. The middle LED lights up blue then goes out. The LED on the right side lights up green then goes out, and so on.

Program 2.7: opposite alternate flashing.

Two LEDs light up alternately, left side in green and right side in red.

Program 2.8: random alternate flashing.

Alternate flashing of the LEDs in red and green in random positions on bar 13. This exercise can be done with stereoscopic glasses.

Naturally, the invention is described in the above by way of example. It is understood that those skilled in the art are able to carry out different embodiments of the invention without departing from the scope of the invention.

It is specified that all the characteristics, as they emerge for a person skilled in the art on reading the present description, the figures and the associated claims, even if concretely they have only been described in relation to other specified characteristics, both individually and in any combinations, may be combined with other characteristics or groups of characteristics disclosed herein, provided that this has not been expressly excluded or the technical context makes such combinations impossible or meaningless.

Claims (11)

Orthoptic rehabilitation apparatus for the treatment of binocular diplopia comprising a longitudinal element (12, 13) provided with a first face (1a) and a second face (1b) and a median axis (X) delimiting, on each of the faces, two symmetrical parts on which are arranged, respectively, a series of fixed visual targets and moving visual targets and a stereogram (11), characterized in that the series of visual targets comprises light-emitting diodes (Leds 2) arranged on the central axis which are powered by a battery (3) and whose activation is programmable by means of a microprocessor (4). Apparatus according to claim 1, characterized in that said stereogram (11) comprises a graduated ruler disposed on either side of the central axis. Apparatus according to one of the preceding claims, characterized in that the series of diodes (2) comprises diodes capable of emitting light of variable color by being controlled by the microprocessor (4) depending on the programming. Apparatus according to one of the preceding claims, characterized in that the diodes (2) are capable of being activated successively and in an order governed by the microprocessor depending on the programming so as to simulate a virtual movement along the longitudinal element. Apparatus according to one of the preceding claims, characterized in that the series of diodes (2) is housed in a slot extending along the central axis (X) such that the emitted light is visible on both faces ( 1a, 1b) of the longitudinal element (12). Apparatus according to one of the preceding claims, characterized in that the microprocessor (4) is connected to a wireless network. Apparatus according to one of the preceding claims, characterized in that it comprises push buttons mounted on the longitudinal element (12, 13) and intended, respectively, for activating, deactivating and pausing the apparatus and for adjusting the intensity of the light emitted by the diodes (2) and their activation frequency. Apparatus according to one of the preceding claims, characterized in that it comprises a program display member. Apparatus according to one of the preceding claims, characterized in that said longitudinal element consists of a plate (12) carrying the battery (3) and the programmable microprocessor (4). Apparatus according to the preceding claim, characterized in that one of the longitudinal end edges of the plate (12) is provided with a cutout (10) for positioning a patient's nose. Apparatus according to one of claims 1 to 8, characterized in that said longitudinal element consists of a bar (13).

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