RU2090164C1 - Apparatus and method for correcting primary disorders in binocular vision - Google Patents

Abstract

FIELD: ophthalmology. SUBSTANCE: method resides in limiting field of patient's vision on side of temples with help of contact lenses having opaque temporal halves. EFFECT: simple method and apparatus permitting early detection and adjustment of emerging disorders. 2 cl, 4 dwg

Description

 The invention relates to medicine and can be used in ophthalmology and neurology.

 Known devices and methods for the study and treatment of patients with impaired binocular vision, based on the principle of separation of the field of view.

 The XC-1 cheiroscope device is intended for training exercises of binocular vision restoration. With one eye, the patient sees the image of the picture in the mirror, and under the control of the other, reproduces the contours of the observed image on a sheet of paper with a pencil / 1 /.

 The synoptophore device is intended for the diagnosis and treatment of strabismus, the restoration of binocular vision.

 However, these devices are complex, relatively expensive devices that are used only in medical institutions.

These methods of correction of primary binocular visual impairment using the above devices have the following disadvantages:
based on the principle of separation of the field of view, therefore, training exercises on the device do not correspond to real conditions
are deprived of the possibility of constant exposure to the visual analyzer, training exercises are short-lived, as a result, the achieved effect is unstable.

 Contact lenses are known. They are used to correct refractive errors: high degree myopia, anisometropia, aphakia, especially monocular, keratoconus, irregular astigmatism and high degree astigmatism / 2 /. But existing contact lenses are not used to restore binocular vision in primary binocular vision disorders in the form of friendly strabismus or diplopia, triplopia in the absence of strabismus and gross aniseikonia.

 It is also known that space is perceived by the visual analyzer at certain levels, not only in two, but also in four visual images, which normally ultimately merge into one. The temporal halves of the retina produce reproductive visual images displaced in space, and the nasal halves of perceptual visual images not displaced in space / 3 /.

 The closest technical solution to the claimed device is a device for acting on primary binocular vision impairment containing optical elements in the form of glasses with opaque parts / French patent N 2489136 C. A 61 B 3/08, 03/05/82. Opaque parts are located on the nasal sides. The distance between the outer edges of the opaque parts is 32-35 mm. The device is designed to detect strabismus and amblyopia in children.

However, the known device has the following disadvantages:
1. Used to detect strabismus and amblyopia, and not for correction;
2. Used to affect primary binocular vision impairment in patients only of childhood, and not of all ages;
3. The opacity of part of the optical element in the form of glasses is not similar to deprivation; the corresponding part / or half / field of view and the contralateral part / or half / retina due to constant macro- and micro-eye movements.

 The closest technical solution to the claimed method is a method of sectoral or partial occlusion / 4 /.

However, the known method has the following disadvantages:
1. With partial, as with full, occlusion, a deterioration in function / visual acuity / corresponding eye occurs. With sectoral occlusion, which is used, as a rule, after complete occlusion, function / visual acuity / of the corresponding eye also worsens, since exposure to one eye creates unequal conditions for both eyes, which leads to the preference of one of them;
2. The method of using occluders / segmentally opaque / does not actually turn off or leave the free half of the central and peripheral field of view / or the opposite half of the retina / due to constant macro- and micro-movements of the eyes, but consists only in changing the field of view of the occluder itself.

3. The method of occlusion during the use of occluders is based on the principle of stimulation of monocular vision with the exception of the possibility of binocular vision;
The task was set to restore binocular vision with primary violations in the form of friendly strabismus and diplopia in the absence of strabismus and gross aniseukonia, reducing treatment time.

 The task in the proposed device is achieved by contact lenses with opaque temporal halves.

 In the proposed method, binocular vision is achieved by partial visual deprivation with the shutdown of two of the four physiological visual images. The temporal halves of the visual fields / perceptual images of the nasal halves of the retina are switched off, and the nasal halves of the visual fields / reproductive images of the temporal halves of the retina are preserved. The reproductive image of one eye, merging with primary binocular vision impairments only with the perceptive image of the same eye, in the conditions of deprivation of this perceptual image merges with the reproductive image of the other eye, which is in similar conditions.

 The novelty of the proposed device is the implementation of optical elements in the form of contact lenses, the location of the opaque parts on the contact lenses from the temporal sides, the entire half / functionally significant / contact lenses are opaque, the necessary change in the field of view does not depend on the position, movement of the eyeballs.

 The novelty of the proposed method lies in a certain type of visual deprivation, namely in turning off the temporal halves of the visual fields.

 Figure 1, 2, 3 presents contact lenses, where "a" is a transparent part, "in" an opaque part. The proposed contact lenses can be opaque in the temporal part throughout the thickness (Fig. 1/), or only in the outer surface of the entire temporal half (Fig. 2/), or only in the suprapupillary part of the temporal half (Fig. 3/). The contact lens may be made of an opaque material with a hole in the nasal half of the nasal half / FIG.

 The method is carried out by the proposed device as follows. The patient is put on the cornea of both eyes with contact lenses with the opaque side to the temples. Lenses are worn for two to four weeks.

The proposed device is characterized in that:
1) optical elements are made in the form of contact lenses;
2) the opaque parts of the optical elements are located on the temporal sides;
3) the opaque part is half / functionally significant / contact lenses;
4) the restoration of binocular vision can occur from the moment of putting on contact lenses.

The proposed method is characterized in that:
1) a simultaneous effect on both eyes;
2) deprivation of the temporal half of the field of view of both eyes is carried out;
3) stimulation of binocular vision occurs during the application of the proposed device;
4) deprivation of the nasal halves of the retina does not depend on macro- and micro-movement of the eyes.

The usefulness and effectiveness of the proposed device and method:
1) wearing contact lenses allows you to fix in the memory of nerve structures a new type of perception of visual information and displace monocular or alternating vision;
2) allows to cure in a short time the primary disturbances of binocular vision in the form of friendly strabismus and diplopia without strabismus and gross aniseikonia;
3) is simple and cheap;
4) the possibility of prolonged use.

Example 1. Patient Soloviev Roma, 15 years old. The diagnosis established at the Moscow Research Institute of Eye Diseases. Helmholtz: squint constant friendly non-accommodating divergent. Amblyopia is dysbinocular with off-center fixation. The angle of squint 15 ^o , visual acuity of the right eye of 0.01, the sharpness of the left eye of 1.0. When the temporal half-fields of vision of the right and left eyes were turned off using contact lenses with opaque temporal halves, the squint was replaced by orthophoria. When removing contact lenses after half an hour, strabismus resumed.

 Example 2. Patient Kravtsova S. D. 27 years. Diagnosis: posthypoxic encephalopathy. Primary (cortical) disturbances of binocular vision in the form of binocular and monocular (right and left) diplopia. Cortical hearing impairment. Bilateral pyramidal syndrome. When the temporal half-fields of vision were turned off using contact lenses with opaque temporal halves, diplopia regressed.

 Example 3. Rzhevskaya T.F. 21 years old. Diagnosis: primary binocular vision impairment in the form of binocular diplopia and right-sided monocular diplopia. Amblyopia of the right eye. When the temporal half-field of the right eye is turned off using a contact lens with an opaque half, there is no diplopia; when the temporal half-field of the right eye and both half-fields of the left eye are turned off, there is no diplopia. When the nasal half-field of the right eye is turned off (for this, the contact lens, without removing, is turned so that the opaque half is on the nasal half of the eye), diplopia persists.

 Example 4. Patient Majorova T.G. 49 years old. Diagnosis: diverging friendly squint, right-sided, pronounced degree. When the temporal field of the right eye was turned off using a contact lens with an opaque temporal half, the degree of strabismus decreased. When both temporal halves of the field of view were turned off with the help of two contact lenses with opaque temporal half-fields, almost complete regression of friendly strabismus occurred, relief of diplopia when looking to the left, and subjective improvement in visual perception. Removing contact lenses after a few minutes led to the resumption of friendly strabismus.

Information sources:
1. Urmacher P.S. Handbook of ophthalmic optics and devices. M. 1971.

 2. Avetisov E.S. Rosenblum Yu.Z. Optical vision correction. M. 1981.

 3. Suvorova VV Matova M.A. Turovskaya Z.G. Reproductive images of binocular vision in atypical interhemispheric relationships / in stutters /. Psychology issues. 1984, no. one.

 4. Ocular Motility and Strabismus in System of Ophthalmology ed. by St. Duke Elder, vol. vi. London 1973. p. 224, 43i.

Claims (2)

 1. A device for correcting primary binocular vision impairment, containing optical elements with opaque parts, characterized in that the optical elements are made in the form of contact lenses, and the opaque parts are located on the contact lenses from the temporal sides.  2. A method for correcting primary binocular vision impairment by limiting the field of view from the temporal side, characterized in that contact lenses with opaque temporal parts are established.

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