JP2005509898A - Shielded contact lens with peripheral vision function - Google Patents

Abstract

  A contact lens 50 for rehabilitating or training a target portion of the brain, the contact lens having a shielding region for selectively blinding a portion of the central visual field corresponding to a non-target region of the brain. Thus, visual processing is forced on a specific part of the brain, thereby stimulating the specific part of the brain. The area of the contact lens 50 that covers the pupil 70 portion of the eyeball corresponding to the central visual field of the target area of the brain is substantially transparent. In order to preserve enough visual cues for the patient to maintain balance and stereotaxy, at least part of the contact lens 50 covering the pupil part of the eyeball corresponding to the peripheral vision of the non-target area of the brain is also transparent. is there.

Description

  The present invention relates to brain function training and rehabilitation, and in particular to the use of a shielded contact lens with peripheral vision function to achieve this goal.

  Brain injuries such as cerebrovascular stroke (stroke), non-opening head injury, penetrating head injury, and invasive tumors have a significant impact on an individual's ability to maintain independence in their environment May cause various sensory / perception and other cognitive impairments. When such an injury occurs in the posterior region of the brain, particularly in the parietal and / or occipital lobes, changes in the function of the visual perception system can occur. These sensory / sensory disturbances involve varying degrees of inattention to visual stimuli, from moderate inattention to detail to complete loss of visual information recognition within a given visual field. In some cases, visual field perception is completely lost.

  There are few options for rehabilitation of patients with visual perception deficiencies. Most approaches relate to behavior and / or cognitive training that focuses special attention on the disturbed visual field. The results of this type of rehabilitation are good but limited.

  With recent evidence showing the essential role of attention in almost every other brain function, including motor function in stroke patients suffering from hemiparesis or hemiplegia, methods that can improve attention with respect to brain injury are: It has been suggested to help restore many non-visually related brain functions. Moreover, one study has demonstrated an association between hemispheric attention and visual processing in developmental reading impairment, the most common learning disability-type dysfunction.

  Furthermore, such improvements in brain function can also be effective in visual training in non-medical situations. For example, a baseball batter uses asymmetric visual information when standing on a home base to determine a pitch. By isolating the field of view that catches pitchers and pitches and blocks catchers, referees, and other distracting objects, hitting performance may be significantly improved.

  For the purpose of correcting visual impairment or protecting the eye from damage, contact lenses, eyeglasses, and the like are known in which the lens area is opaque or translucent. In the present specification, a lens whose lens region is opaque or translucent is referred to as a shielding lens.

  Harrell, E.M. H. T. Kramer-Stuffs, and A.M. J. et al. Zolten, “Performance of Subjects with Left Left Visual Next Remove after Removal of the Right Visual Field of Hessual Goggles, 19 It is disclosed that when fully occluded, the function for visual input directed to a neglected field of view is improved. Harrell et al. Disclose complete occlusion of the visual field for one hemisphere of the brain. Harrell et al. Discloses changing the amount of field input by adjusting a Velcro ™ strip attached to protective eyeglasses to shield.

  Harrell et al. Concluded that the approach of using contact lenses in the future is preferred over protective eyeglasses, while it is expensive and perhaps infeasible for rehabilitation and practical application. However, various techniques are known for making contact lenses with opaque or colored areas.

  One problem in using a contact lens with a shielding area is that the contact lens must be positioned on the eyeball without rotating. Various techniques are known for maintaining the position of the contact lens against rotation. For example, such techniques are disclosed in US Pat. Nos. 4,324,461, 5,483,304, 5,502,518, and 5,570,142.

  In US Pat. Nos. 6,062,687 and 5,570,144, Lofgren-Nisser discloses a contact lens having a mass for vertical alignment and a shielding portion, the shielding portion passing through it. Limit.

  The present invention is a shielding contact lens that selectively blocks visual perception input to a specific part of the brain.

  By “blinding” the perceptual block of the brain, it forces the rest of the brain to process all the major visual information. This technique is useful for rehabilitation of visual field defects, brain function training, and other purposes.

  For example, if each left half of a pair of contact lenses is opaque (eg, by splicing the left half of each lens with a black non-transparent contact lens plastic) Forces the left hemisphere of the brain, thereby stimulating that area of the brain. Shielding each right half of a pair of contact lenses with an opaque material will stimulate the opposite hemisphere.

  Target specific areas of the brain by selectively blindfolding over more or less than each half of a pair of contact lenses. For example, a specific 1/4 section of each lens can be transparent, ie the remaining 3/4 section can be opaque. Thus, various combinations of contact lens blocking portions can be used to force visual processing on a particular portion of the brain, thereby stimulating that particular brain portion. Each contact lens is weighted or otherwise configured so that the lens is positioned on the eyeball without rotating.

  Methods to rehabilitate patients with visual deficiencies using shielded contact lenses or to train specific visual processing areas are visual and structured to activate processing in the target portion of the brain. Consists of having the patient perform a non-visual task. A series of graded occluded contact lenses composed of translucent materials of varying degrees of opacity step the patient's visual system into a renewed balance between undamaged and relearned visual processing Can be adapted.

  One difficulty in having a patient perform a task with a part of the field of view blocked, especially in tasks involving patient movement, is that a significant percentage of the sensory input from which the brain obtains stereotactic cues is visual. As such, occlusion of a significant portion of the field of view in one or both hemispheres can leave the patient in the absence of means for localization and balance. Therefore, it is desirable to leave a portion of the field of view unshielded for visual localization cues. However, this acts to undermine the desirability of completely eliminating visual information from non-target areas of the brain. The solution of the present invention is based on the principle that the field of view is not uniform with respect to the amount of visual information received and processed. The field of view inside a relatively narrow cone with a central field of view, ie, an axis that is aligned with the eye gaze line (the “center visual axis”) is much more than the field of view farther from this central line of sight. Process the amount of information. Thus, the latter part of the visual field, the peripheral visual field, does not contribute much to the amount of visual information to the brain. However, the peripheral vision is fully considered to establish equilibrium and stereotactic cues.

  Thus, the present invention takes advantage of these principles to maintain a significant range of visual information received by non-target areas of the brain in a masked state while preserving enough visual cues for localization and balance. Allow non-target areas of the brain to receive information from the peripheral vision. This is done by dividing each contact lens into three parts. That is, the first region is substantially transparent over the pupil portion of the eyeball that guides visual information to the target region of the brain, and the second region is a portion of the pupil portion of the eyeball that guides visual information to the non-target region of the brain. Substantially covering all, and the third region is at least a portion of the peripheral vision corresponding to a non-target region of the brain to leave enough room for visual cues for patient balance and localization Is substantially transparent.

  Accordingly, one object of the present invention is to force visual processing on the target area of the brain to facilitate rehabilitation and training of such target area, while sufficient for the patient to maintain balance and orientation. It is to provide a contact lens product with a shielding area that maintains visual cues by peripheral vision.

  The present invention uses a shielded contact lens product to selectively block visual perception input to specific target portions of the brain. By “blinding” such a perceptual blocked portion of the brain, all processing of the primary visual information is forced on the remaining unblocked portions. This concept of forced processing can be used for rehabilitation of visual field defects, including ipsilateral half-blindness as well as visual half-ignorance and / or half-carelessness. Shielded contact lenses should also be used for rehabilitation of other attention disorders related to brain injury, including spatial attention, motor control, memory impairment, language impairment, and other brain injury problems related to asymmetric brain injury Can do.

  The operation of the present invention can be described with reference to FIG. Visual perception is performed separately by the respective eyeballs 30 and 31 on both hemispheres 10 and 20 of the brain. This allows binocular vision and depth perception. Each eye's lateral field of vision projects visual information to the contralateral field of vision, and each eye's inner field of view intersects and projects visual information to the ipsilateral field of view.

  Intensive retraining of the damaged portion of the brain is accomplished by providing a visual blockage system that effectively removes visual information entering the undamaged hemisphere of the brain.

  Shielding lens 50 is designed to eliminate visual information by “sealing” a portion of each lens using black non-transparent contact lens plastic. In one embodiment, this shielding area is the radial section of the lens. As used herein, the term “radial section” is intended to refer to a section of a lens defined by a line radiating outward from the center of the lens. Each contact lens is securely positioned without rotation on the eyeball so that the shielding area remains oriented in the proper position to occlude a selected field portion of the patient's eyeball. So that it is weighted or configured differently. Means for preventing contact lens rotation are known in the art.

  Intensive retraining or rehabilitation can be described with reference to FIGS. Damage to the optic nerve 32 affects the visual field 37 of the damaged optic nerve schematically shown in FIG. Complete loss of visual field in the left or right eye is not subject to treatment according to the present invention. However, the damage to the optic nerve cross 33 that results in the loss of the lateral field 34 shown in FIG. 3A uses a shielding lens having a shielding radial section 35 that covers the inner field shown in FIG. Can be treated by forcing visual processing.

  Damage to the optic line 38 or to the frontal parietal lobe 39 shown in FIG. 4A results in the loss of the left or right visual field 43 depending on which side of the hemisphere-specific optic line is damaged. The effect on this type of field of view is shown in FIGS. 4A and 5A. Such damage is in accordance with the present invention using a shielding lens 50 having a left or right shielding radial section 51 to force visual processing on the damaged field of view 43 (FIGS. 4B and 5B). Rehabilitation is possible.

  Damage to portions of the posterior parietal lobes 40, 41 can cause loss of the visual radial section 52, which is smaller than the full hemisphere, as shown in FIGS. 6A and 7A. A corresponding shielding contact lens 50 forces visual processing on the damaged field of view 52 to shield the radial section 53 shown in FIGS. 6B and 7B, respectively.

  The damage to the occipital lobe 42 that results in complete loss of the binocular visual field 54 shown in FIG. 8A is not subject to treatment according to the present invention.

  Patient rehabilitation with a shielded contact lens consists of visual and non-visual tasks designed to activate processing in the damaged part of the brain. When visual perceptual stimuli occur clearly, but there is little interference from the uninjured brain due to perceptual blockade, complex perceptual stimuli, hemisphere-specific task processing, and hemisphere-specific motor tasks also stimulate brain damage areas Is involved in the activities.

  As an alternative to the complete opaque radial section 60 of each lens, approximately 90% of the input blocking radial section 61, as schematically shown in FIGS. 9-12 at the gradually decreasing opacity stage. The degree of opacity can be varied from about 10% to the intercept radial section 62. By allowing some of the hemisphere-specific visual information to reach the non-injured visual cortex, it is possible to cause contralateral visual perception, and some perception / cognition in the damaged visual perception area Build the structure. Therefore, the use of a translucent shielding lens increases sensory emphasis on sensory information processing by damaged visual perception organs, and the damaged sensory organs are located in the remaining field of view. It is possible to draw internal feedback from the organ.

  With such a series of graded translucent materials, the occlusion lens can gradually adapt the patient's visual system to the rehabilitated balance between undamaged and relearned visual processing. Some patients require long-term use of these translucent contact lenses, and at all times there is an improvement in attention and safety by blocking a certain level of field of view, while a completely transparent lens Patients can also be seen who can be retrained for section 63.

  As noted above, allowing some of the hemisphere-specific visual information to reach the undamaged visual cortex can provide some desirable perceptual input to non-target areas of the brain. One problem with having the patient perform tasks with a portion of the field of view blocked, especially in tasks involving patient movement, is that a significant percentage of the sensory input from which the brain gets stereotactic cues is visual. As such, occlusion of a significant portion of the field of view in one or both hemispheres can leave the patient in the absence of means for localization and balance. Therefore, it is desirable to leave a portion of the field of view unshielded for visual localization cues. However, this acts to detract from the desirability of completely eliminating visual information from non-target areas of the brain. The solution of the present invention is based on the principle that the field of view is not uniform with respect to the amount of visual information received and processed. The central field of view, i.e., the field of view inside the relatively narrow cone centered around the point at which the eye stares, processes much more information than the field of view farther from the point at which the eye stares. Thus, the latter part of the visual field, the peripheral visual field, does not contribute much to the amount of visual information to the brain. However, the peripheral vision is fully considered to establish equilibrium and stereotactic cues.

  Thus, the present invention takes advantage of these principles to maintain a significant range of visual information received by non-target areas of the brain in a masked state while preserving enough visual cues for localization and balance. Allow non-target areas of the brain to receive information from the peripheral vision.

  This is accomplished by dividing each contact lens 50 into three regions as described below, as shown in FIG. Contact lens 50 is placed on the patient's eye and maintained in a substantially vertical position by various means known in the art. Contact lens 50 is positioned over pupil 70 of the patient's eyeball. A midline 71 through the pupil 70 divides the field of view into a left part and a right part as perceived by both hemispheres of the patient's brain. One hemisphere is targeted for rehabilitation and retraining, while the other hemisphere is not a target, i.e., non-target, as often used herein. In other words, the intent of the present invention is to substantially reduce visual perception input to the non-target hemisphere of the brain and to allow the perceptual input of the brain to be substantially intact. .

  The contact lens 50 includes a substantially transparent first region 72 that covers a portion of the pupil 70 corresponding to the central field of the target hemisphere of the brain, and the second region 73 is in the central field of the non-target hemisphere of the brain. The third region 74 is shielded over a portion of the corresponding pupil 70, and a third region 74 of the pupil 70 corresponding to the peripheral vision of the non-target hemisphere to leave enough room for visual cues for patient balance and localization. It is substantially transparent over at least a portion of the side portion.

  In the preferred embodiment, the second region 73 is substantially vertical and reaches the periphery 77 of the contact lens 50, and is also substantially vertical and reaches the periphery 77 of the contact lens 50. It is defined by the second line 76. Accordingly, this second region 73 includes a substantially vertical shielding strip that extends across the contact lens 50.

  The first line 75 can be located substantially on the midline 71 of the pupil 70 or laterally of the midline 71 toward the target hemisphere's field of view. Since the non-target hemisphere may receive some visual perception input from a field beyond the midline 71, such orientation of the first line 75 may reduce visual perception input to the non-target hemisphere.

  The second line 76 is positioned such that a portion of the side pupil corresponding to the peripheral vision of the non-target hemisphere is not occluded. This allows the non-target hemisphere to receive some visual information. Since visual information is received from the peripheral vision, its perceptual input does not substantially affect the desired effect of forcing the visual processing on the target hemisphere, while the non-target hemisphere is one of sufficient visual information for localization and balance. You can receive the department.

  Attention improves attention with respect to brain damage with recent evidence that he plays an essential role for almost every other brain function, including motor function in stroke patients suffering from hemiparesis or hemiplegia All possible approaches have been suggested to help restore many non-visually related brain functions. Moreover, one study has established a relationship between hemispheric attention and visual processing in developmental reading deficits, the most common inability to learn. Reading and linguistic processing are biased toward the left hemisphere, and spatial, computational, and social / emotional perceptions are biased toward processing the right hemisphere, using shield lenses to effectively block and isolate specific areas of brain function Then, it provides useful information on brain function and is effective for deeper understanding of brain function.

Examples include the following.
Treatment of stroke-related exercise program disorders. Improve attention in relation to brain damage with recent evidence that attention plays an essential role in almost every other brain function, including motor function in stroke patients with hemiparesis or hemiplegia All possible approaches have been suggested to help restore many non-visual related brain functions. Shielding lenses, used as ancillary devices in conjunction with traditional rehabilitation therapy, including physical and vocational therapy, can cause hemispherical paralysis, hemiplegia, and / or incompetence due to hemisphere-specific attention. In addition to the potential to reduce or alleviate contractures associated with use, it has the potential to promote muscle tone and control, balance, and recovery of cooperation.

  Treatment of developmental reading deficits. One study has established a relationship between hemispheric attention and visual processing in developmental reading impairment, the most common inability to learn. Reading and linguistic processing are biased towards the function of the left hemisphere, and visual symbolic decoding in reading can be handled more effectively if the left view is selectively blocked.

  Use as a diagnostic technique in neurological settings. Patients with refractory epilepsy often undergo a special invasive procedure known as the Wada method. In this procedure, sodium amytol is injected into the patient's internal carotid artery and one hemisphere is effectively "sleeped" for a few minutes while the other hemisphere is functionally normal. A series of cognitive tests can then be performed by neurologists and neuropsychologists to assess the functional integrity of the normal hemisphere in an attempt to identify the focus of the seizure disorder. This approach is often unpredictable and the duration of anesthesia is short, limiting the amount of data available for collection. Using a shielding lens, neurologists and neuropsychologists can assess similar separation of hemispheric function without time constraints and without the confusion caused by drug-induced changes in mental state.

  Shielding lenses can be used to diagnose sputum as a useful addition to standard electroencephalogram (EEG) procedures. Such non-invasive neurological diagnostic techniques utilize external electrodes placed around the skull structure to detect and record the electrical activity of the brain, which makes the patient rhythmic Typically, it is necessary to receive flash stimulation by stroboscopic irradiation. By selectively blocking visual input using a shielding lens, the electrical activity of the brain in each hemisphere can be further specified. Another variant of EEG evoked potentials records brain activity in response to specific stimuli, but again uses a shielding lens to block not only the function of the hemisphere exposed to the stimulus, but also between the corpus callosum and perceptually. The brain activity in the hemisphere can also be clarified.

  Use in functional evaluation of cognitive skills. A neuropsychologist can use a shielding lens to perform a functional assessment of hemispheric function by selectively presenting information that matches or interferes with the unobstructed field of view. Such an approach can help clarify the role of each hemisphere in the acquisition and interference of information acquisition.

  Grade improvement training. Shielding lenses can also be useful for visual training in non-medical situations. For example, a baseball batter uses asymmetric visual information when standing on a home base to determine a pitch. By using a shielding lens to seize the pitcher and pitch and isolate the field of view that intercepts the catcher, referee, and other distracting objects, the hit performance can be significantly improved. Golfers can also benefit from the use of shielding lenses to limit the interference from visually distracting that occurs behind the vector line starting from the ball tee. Tennis players can use shielding lenses to help visually follow and concentrate during backhand practice.

  Use as a research tool. In addition to the left hemisphere specialization for reading and language, spatial, computational, and social / emotional perceptions are biased towards processing the right hemisphere. Using a shielding lens to effectively block and isolate specific regions of brain function can provide useful information about brain function and be effective in understanding brain function more deeply.

  Although the invention has been described with reference to a few preferred embodiments and alternative embodiments, these embodiments are merely illustrative and are the full scope of the invention as set forth in the appended claims. Not trying to limit.

FIG. 2 shows a horizontal (along coronal suture) cross section of the human brain through the central visual axis of the eyeball, showing the various parts of the brain involved in visual processing It is a schematic diagram which shows the influence received with respect to the left side and the right side visual field as a result of optic nerve damage. It is a schematic diagram which shows the influence received with respect to the left side and the right side visual field as a result of the optic nerve cross damage. FIG. 3B is a front view of a pair of contact lenses having a shielding area to force visual processing on the damaged area schematically illustrated in FIG. 3A. It is a schematic diagram which shows the influence received with respect to the left side view and the right side visual field as a result of optic line damage. FIG. 3B is a front view of a pair of contact lenses having a shielding area to force visual processing on the damaged area schematically illustrated in FIG. 3A. It is a schematic diagram showing the influence on the left and right visual fields as a result of frontal parietal injury. FIG. 3B is a front view of a pair of contact lenses having a shielding area to force visual processing on the damaged area schematically illustrated in FIG. 3A. FIG. 6 is a schematic diagram showing the effect on the left and right visual fields as a result of partial damage to the posterior parietal lobe. FIG. 3B is a front view of a pair of contact lenses having a shielding area to force visual processing on the damaged area schematically illustrated in FIG. 3A. 6A and 6B are schematic diagrams showing the effect on the left and right visual fields as a result of damage to a portion of the posterior posterior parietal lobe with respect to the damaged site of FIGS. 6A and 6B. FIG. 3B is a front view of a pair of contact lenses having a shielding area to force visual processing on the damaged area schematically illustrated in FIG. 3A. It is a schematic diagram which shows the influence received with respect to the left side and the right side visual field as a result of occipital lobe injury. FIG. 13 is a front view of a pair of contact lenses including shielding regions having varying degrees of opacity ranging from the highest degree of opacity (FIG. 9) to the lowest degree of opacity (FIG. 12). FIG. 13 is a front view of a pair of contact lenses including shielding regions having varying degrees of opacity ranging from the highest degree of opacity (FIG. 9) to the lowest degree of opacity (FIG. 12). FIG. 13 is a front view of a pair of contact lenses including shielding regions having varying degrees of opacity ranging from the highest degree of opacity (FIG. 9) to the lowest degree of opacity (FIG. 12). FIG. 13 is a front view of a pair of contact lenses including shielding regions having varying degrees of opacity ranging from the highest degree of opacity (FIG. 9) to the lowest degree of opacity (FIG. 12). 1 is a front view showing an embodiment of a shielded contact lens according to the present invention, in which a shielded area is a vertical strip that reaches the periphery of the contact lens, and a visual perception input above a part of an eyeball pupil is shown. Although substantially reduced, it does not occlude all of the lateral peripheral vision associated with non-target areas of the brain.

Claims (7)

A contact lens for training and rehabilitating a target hemisphere of a human brain, wherein the contact lens is placed on the human eyeball to receive visual perception input through the pupil of the human eyeball. Substantially reducing and forcing against the non-target hemisphere of the human brain,
A first region of the contact lens made of a substantially transparent material covering a first portion of the pupil so that a substantial range of visual perceptual input can reach the target hemisphere;
A second region of the contact lens made of a substantially opaque material covering the second portion of the pupil, such that visual perceptual input is substantially reduced relative to the non-target hemisphere;
Made of a substantially transparent material that covers at least a portion of the lateral region of the pupil corresponding to the non-target hemisphere, thereby allowing visual perceptual input to the human peripheral vision to maintain localization and balance A third region of the contact lens;
Means for preventing the contact lens from rotating on the human eyeball.   2. The second region is defined by a first line between the first region and the second region, and a second line between the second region and the third region. Contact lens described.   The contact lens according to claim 2, wherein the first line is substantially straight.   The contact lens according to claim 2, wherein the second line is substantially straight.   The contact lens according to claim 3, wherein the first line is substantially vertical when the contact lens is placed on the human eye.   The contact lens according to claim 4, wherein the second line is substantially vertical when the contact lens is placed over the human eye. A contact lens for training and rehabilitating a target hemisphere of a human brain, wherein the contact lens is placed on the human eyeball to receive visual perception input through the pupil of the human eyeball. Substantially reducing relative to the non-target hemisphere of the human brain and substantially forcing against the target hemisphere;
A first region of the contact lens made of a substantially transparent material covering a first portion of the pupil so that a substantial range of visual perceptual input can reach the target hemisphere;
A second region of the contact lens made of a substantially opaque material covering the second portion of the pupil, such that visual perceptual input is substantially reduced relative to the non-target hemisphere;
Made of a substantially transparent material that covers at least a portion of the lateral region of the pupil corresponding to the non-target hemisphere, thereby allowing visual perceptual input to the human peripheral vision to maintain localization and balance A third region of the contact lens;
Means for preventing the contact lens from rotating on the human eyeball;
The second region is defined by a first line between the first region and the second region, and a second line between the second region and the third region;
Each of the first and second lines is substantially straight;
Each of the first and second lines is the contact lens disposed on the eyeball of the human so that the second region is passed through the contact lens and is substantially vertical. Contact lenses, including shielding strips.

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