RU2310426C1 - Device for curing functional vision dysfunctions - Google Patents

Abstract

FIELD: medical equipment; ophthalmology.

SUBSTANCE: device can be used for treating vision dysfunctions caused by problems with accommodation and amblyopia. Device has elongated case having opening at open end and blackened internal surface; substrate; blackened screen with slot disposed onto substrate, which slot is turned to edge opening; monochromatic light source and pulse power unit. Device also has a number of substrates, each provided with blackened screens with slots, and monochromatic light source. Substrates are mounted in series one after other along and in perpendicular to longitudinal axis of case at distance of L_n=L₁x(L_N/L₁)^{( n-1)(N-1)} from edge opening, where L_n is distance from edge opening to n-th substrate (mm); L₁ is distance form edge opening to first substrate (mm); n is order number of substrate at side of edge opening, n=1,...N; N is number of substrates (pieces). Any subsequent slot is turned about its axis in relation to previous one for angle of α=180°/(N-1), where α is angle of slope of slot (degrees). Slot is disposed at height of h_n=l₁/2x (L_N/L₁)^(n-1)(N-1)xsin[(n-1)α} in relation to top end of previous substrate, where h_n is height of rise of n-th substrate relatively top edge of previous (n-1)-th substrate (mm); l1 is length of first slot. Any monochromatic light source allows training accommodation of eye followed by subsequent treatment of amblyopia.

EFFECT: improved efficiency of treatment of myopia.

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Description

The invention relates to medical equipment, namely to ophthalmology, and is intended for the treatment of functional visual disorders associated with impaired accommodation and amblyopia.

A device for training accommodation is known, comprising a screen equipped with a carriage with a pusher and a cartridge with interchangeable test objects, a guide with support and a fixed screen with a hole located coaxially with the test object. If necessary, an interchangeable lens is installed in the opening of the screen (RF Patent No. 2131210, class A61B 3/00. Publ. 10.06.99. Bull. No. 16).

A device for training accommodation is also known, comprising a guide and a screen with a test object. The screen is equipped with a cartridge for installing the test object and a carriage with a pusher made in one piece with the screen, and the guide is equipped with a support for contact with the patient's face (RF Patent No. 2038035, class А61В 3/09. Publish. 06/27/95. Bull. No. 18).

It should be noted that a violation of accommodation is often accompanied by another functional disorder - amblyopia. The above analogues do not allow the treatment of amblyopia and, therefore, reduce the effectiveness of treatment. In this case, the accompanying pathology (amblyopia) may be more pronounced in the patient than the main one (accommodation spasm). In addition, the mechanical movement of the stimulus does not allow varying the speed of its movement depending on the degree of remoteness, which reduces the effectiveness of treatment. It is important to observe the proportionality of the speed of movement depending on the distance of the stimulus to the eye, since the speed of movement determines the speed of tension and relaxation of accommodation.

A device is known for treating amblyopia, comprising a housing with electrical circuit elements and controls, a rack-mounted unit with a reversible electric motor, and a lighting-optical channel, including an eyepiece, illuminator, and light filters located between them. The device is equipped with a rotatable holder installed between the illuminator and the eyepiece with a film of reflective material fixed to it with a layer of point-blind objects, which are microscopic glass balls (RF Patent No. 2027420, class A61F 9/00. Publ. 27.01.95. Bull. No. 3).

There is also known a device for the treatment of amblyopia (amblyotrener) A.M. Vodovozova containing a rotating screen with black stripes on a white background. In this case, the black stripes consist of individual fragments, which are made in the form of figures or drawings (RF Patent No. 2043095, class A61A 9/00. Publish. 09/10/95. Bull. No. 25).

A disease such as amblyopia is also often accompanied by a violation of accommodation, the treatment of which is not provided by these devices. In addition, the presence of “blinding” objects and fragments of bands does not allow sequential effects on rods and cones of various types of retina. The chaotic stimulation, which does not have the character of clear lines, does not allow to form the maximum response of certain retinal cells (Hubel D. Brain, eye, eyesight. - M .: Mir. Publishing House, 1990, 239 p.), And therefore does not provide sufficient treatment effect.

Closest to the proposed invention in terms of essential features is a device for the treatment of functional visual disorders, namely a device for the treatment of amblyopia, comprising an extended case with an opening at the front end and a blackened inner surface, a substrate on which there is a blackened screen with a slot and a source of monochromatic light facing the end hole, pulse distributor and switching power supply (RF Patent No. 2044528, CL A61A 9/00, A61B 3/08, A61N2 / 02. Publish. 09/27/95. Bull No. 27).

This device has the same drawback as the above counterparts, namely, limited opportunities in terms of accommodation spasm, which often accompanies amblyopia and prevents its effective treatment.

The task to which the invention is directed is to expand the functionality of the device, namely, to obtain the possibility of training accommodation of the eye with the simultaneous treatment of amblyopia, which increases the effectiveness of the treatment of amblyopia.

The solution to this problem is achieved by the fact that in a device for the treatment of functional visual disorders, namely, a device for the treatment of amblyopia, containing an extended case with a hole at the front end and a blackened inner surface, a substrate on which there is a blackened screen with a slot facing the end hole , and a monochromatic light source, a pulse distributor and a switching power supply, a number of substrates are additionally introduced with a blackened screen with a slot placed on each of them and a source of monochromatic light, while the substrates are installed sequentially one after another along and perpendicular to the longitudinal axis of the housing at a distance

from the end hole

where: L _n is the distance from the end hole to the nth substrate (mm);

L ₁ is the distance from the end hole to the first substrate (mm);

L _N is the distance from the end hole to the last substrate (mm);

n is the serial number of the substrate from the side of the end hole, n = 1 ... N;

N is the number of substrates (pcs.),

and each subsequent slot is rotated around its axis relative to the previous one by an angle

where: α is the angle of inclination of the slot (deg.);

N is the number of substrates (pcs.)

and is located at a height

relative to the top edge of the previous substrate,

where: h _n is the elevation of the slot of the n-th substrate relative to the upper edge of the previous (n-1) th substrate (mm);

l ₁ - the length of the first slot (mm);

L _N is the distance from the end hole to the last substrate (mm);

L ₁ is the distance from the end hole to the first substrate (mm);

n is the serial number of the substrate from the side of the end hole, n = 1 ... N;

N is the number of substrates (pcs.);

α is the angle of inclination of the slot (deg.),

and each monochromatic light source is electrically connected through a pulse distributor to the corresponding output of the switching power supply.

The number of substrates N is selected in the range of 4≤N≤8,

where: N is the number of substrates (pcs.),

the length of each slot is equal

where: l _n is the length of the nth slot (mm);

l ₁ - the length of the first slot (mm);

L _N is the distance from the end hole to the last substrate (mm);

L ₁ is the distance from the end hole to the first substrate (mm);

n is the serial number of the substrate from the side of the end hole, n = 1 ... N;

N is the number of substrates (pcs.),

and the width of each slot is equal

where: d _n is the width of the n-th slot (mm);

d ₁ - the width of the first slot (mm);

L _N is the distance from the end hole to the last substrate (mm);

L ₁ is the distance from the end hole to the first substrate (mm);

n is the serial number of the substrate from the side of the end hole, n = 1 ... N;

N is the number of substrates (pcs.).

The introduction of an additional row of substrates into the device with a blackened screen with a slit placed on each of them and a source of monochromatic light, the wavelength of which varies, allows creating conditions for accommodation training due to the different distances of light stimuli.

The installation of substrates sequentially one after another and perpendicular to the longitudinal axis of the body at a distance from the end hole, determined by formula 1, makes it possible to minimize the viewing angle of all light stimuli and, as a result, minimize the load on the oculomotor apparatus during angular movements of the eyeball.

The rotation of each subsequent slot around its axis relative to the previous slot by the angle given by formula 2 creates the appearance of rotation of light stimuli, which makes it possible to treat amblyopia by presenting to the amblyopic eye the most complete set of stimuli in the form of slots that differ in orientation around the optical axis of the eye.

According to D. Hubel (Brain, Eye, Vision - M .: Mir. Publishing House, 1990, 239 pp.), Various cells are located in the retina of the eye that respond differently to the gap stimulus depending on its orientation. Changing the angular orientation simultaneously with the removal or approximation of the light stimulus allows you to train not only the accommodation apparatus, but also to stimulate the maximum number of retinal cells in the treatment of amblyopia.

The location of each slot of the n-th substrate at a height determined by formula 3 relative to the upper edge of the previous (n-1) -th substrate allows us to avoid overlapping substrates with each other and to see (observe) light stimuli on all substrates in the treatment of amblyopia and accommodation training .

The choice of the number of substrates N within 4≤N≤8 is due to considerations of a compromise between the real efficiency of the device and the complexity of its technical implementation. As a result of clinical testing, it was found that with the number of substrates N <4, the number of presented stimuli for the treatment of amblyopia and the number of stages of accommodation training are too small to obtain a sufficiently noticeable treatment effect. At N> 8, the device is unnecessarily complicated without a significant increase in the effectiveness of treatment. This fact is experimentally substantiated in the clinic of eye diseases of the Saratov State Medical University.

The length and width of each slot, determined respectively by formulas 4 and 5, are established from the conditions of perception of the light stimulus in the same angular size. This creates the appearance of a constancy of the length and width of the light stimulus, regardless of the distance of the substrates from the end hole (the law of perspective).

Figure 1 shows a device for the treatment of functional visual disorders, General view.

Figure 2 schematically shows the arrangement of the substrates.

Figure 3 schematically shows the position of the slots on the substrates.

A device for the treatment of functional visual disorders contains (Fig. 1) an extended case 1 with an opening 2 at the front end 3 and a blackened inner surface, mounted sequentially one after the other along and perpendicular to the longitudinal axis of the substrate body 1 (n ₁ ... N) 4, on which there is a blackened screen 5 with a slot 6 facing the end hole 2, and a source of monochromatic light 7; a pulse distributor 8 and a switching power supply 9. The device is mounted on a rack 10.

In the device developed by the applicant (figure 2), the first (n = 1) substrate 4 is located from the end hole 2 at a distance of L ₁ = 95 mm, and the last (N = 8) substrate 4 is located at a distance of L ₈ = 600 mm

The choice of these values of L ₁ and L ₈ is due to well-known data (Somov E.E. Introduction to clinical ophthalmology. - St. Petersburg, 1993, 199 pp.) On the minimum and maximum distance of observation of an object in patients with various refraction pathologies under conditions of clear visibility.

So with hyperopia, the closest clear zone L ₁ is 95-100 mm, while with myopia and emetropia these values are in the range of 80-85 mm. To increase the efficiency of the device in the treatment of accommodation, it is desirable to change the value of L ₁ in the range from 80 mm to 100 mm, taking into account the specific pathology. The change in the distance L ₁ can be achieved by, for example, manufacturing the housing 1 of the device telescopic, i.e. in the form of sliding sections. The choice of L ₈ = 600 mm is due to the distance from the eye to the object accepted in ophthalmology, perceived as infinitely distant. In this case, the accommodating muscle of the average patient is almost relaxed.

All substrates 4 are installed at distances from the end hole 2, defined by formula 1, in geometric progression. In this case, with L ₈ = 600 mm, L ₁ = 95 mm and N = 8 the value is (L _N / L ₁ ) ^{1 / (N-1)} , and L _n = 1,3 ^(n-1) . Such a condition for arranging the substrates 4 from the end opening 2 gives a tangible perception of a uniform change in the distance from the substrate to the eye when the light stimulus is removed or approaches (the light stimulus is the exposure of the source of monochromatic light 7 through slot 6), which makes the accommodation apparatus react with the same effort.

Monochromatic light sources 7 act on the patient’s eye through slots 6 (FIG. 3), the length I _n and the width d _{n of} which are determined by formulas 4 and 5, respectively. In the applicant’s device, for example, l ₁ = 2 mm, ad ₁ - 0, 3 mm, which in this device is determined by considerations of proportionality and comfort of perception for the eye.

Т.е. если угол поворота первой прорези 6 принимается равным нулю, то угол поворота второй прорези 6 относительно первой будет равен 25,7°, угол поворота третьей прорези 6 относительно второй также будет равен 25,7° (а относительно первой прорези 6 равен 51,4°) и т.д. Угол наклона последней, восьмой, прорези 6 относительно седьмой тоже будет равен 25,7° (а относительно первой прорези 6 равен 180°). Последняя прорезь 6 будет находиться в том же, исходном, положении, что и первая. Цикл замкнулся.In addition, each subsequent slot 6 is rotated around its axis relative to the previous one by an angle established by formula 2 (in this case, when N = 8, by an angle

Those. if the rotation angle of the first slot 6 is taken to be zero, then the rotation angle of the second slot 6 relative to the first will be 25.7 °, the angle of rotation of the third slot 6 relative to the second will also be 25.7 ° (and relative to the first slot 6 is 51.4 ° ) etc. The angle of inclination of the last, eighth, slot 6 relative to the seventh will also be 25.7 ° (and relative to the first slot 6 is 180 °). The last slot 6 will be in the same initial position as the first. The cycle is closed.

Moreover, each slot 6 of the n-th substrate 4 is located relative to the upper edge of the previous (n-1) -th substrate 4 at a height determined by the formula 3. Thus, in the above example, the second slot 6 is raised relative to the upper edge of the first substrate 4 by h ₂ = 2 · 1.3 · sin25.7 ° = 1.2 mm. The third slot 6 is raised relative to the upper edge of the second substrate 4 by h ₃ = 2 · 1.3 ² · sin 51.4 ° = 2.6 mm, etc.

Those. all slots 6 (8 pcs.) are in the line of sight through the end hole 2.

The device operates as follows.

When the power supply unit 9 is turned on, it generates pulses that are transmitted through the pulse distributor 8 to monochromatic light sources 7, which are light sources of 3 colors: red, green and blue, combined in one housing (for example, a full-color LED LM1-TPP1-01 ) In addition to the primary colors (red, green and blue), the device allows receiving additional (yellow, magenta and cyan) and white colors depending on the number of pulses arriving at the light sources (LEDs). Monochromatic light sources 7 can be received from the pulse distributor 8 simultaneously from one to three pulses, depending on the desired color of the glow.

When a single pulse is applied, one of the primary colors (either red, or green, or blue) is displayed.

When two pulses are applied, one of the complementary colors is highlighted (either yellow, or magenta, or cyan).

When applying three pulses, sources of monochromatic color 7 emit white.

At each moment, the pulse (s) is supplied (s) to only one source of monochromatic light 7. Then, the next (s) pulse (s) is supplied (s) to the source of monochromatic light 7 located on an adjacent (subsequent or previous) substrate 4. Thus In this way, alternating illumination of monochromatic light sources 7 is carried out, and the illumination movement can be different: both in the forward direction - from the first n = 1 of the substrate 4 to the last N = 8, and in the opposite direction - from the last N = 8 of the substrate 4 to the first n = one.

The process of treating amblyopia and training accommodation using the proposed device is as follows.

The doctor sets the device body 1 fixed on the stand 10 in a position convenient for the patient. The patient looks into the hole 2, made on the front end 3 of the housing 1, with that eye, which requires treatment and training. In this case, the other eye is closed.

Turn on the pulse power supply 9 and apply alternately pulses through the pulse distributor 8 to the sources of monochromatic light 7. Alternately illuminate the sources of monochromatic light 7, which, changing color (a) and creating the effect of rotation, affect the eye through the slots 6 on the blackened screen 5 , the angle of which varies from one substrate 4 to another. At predetermined intervals of time in the device, the color of the glow of the light stimuli changes. For example, the treatment procedure begins with red, then the color changes to yellow, then to green, etc., and the procedure ends, for example, in blue.

A device for the treatment of functional visual disorders was developed by TRIMA LLC and successfully passed clinical trials.

Example 1. Patient C. Age 12 years. Spasm of accommodation. Visual acuity was: OD = 0.4 s - 1.0 D = 1.0 and OS = 0.6 s - 1.0 D = 1.0; positive portion of relative accommodation 2.0 diopters.

The course of treatment is 10 sessions of 15 minutes.

The number of substrates in the device is 4.

After the course of treatment, visual acuity was OD = 0.7 s - 0.5 D = 1.0 and OS = 0.8 s - 0.5 D = 1.0; positive portion of relative accommodation 4.0 diopters.

Example 2. Patient N. Age 10 years. Spasm of accommodation. Visual acuity was: OD = 0.2 s - 2.5 D = 1.0 and OS = 0.2 s - 0.5 D = 1.0; the positive part of the relative accommodation of 1.0 diopter.

The course of treatment is 10 sessions of 15 minutes.

The number of substrates in the device is 6.

After the course of treatment, visual acuity was OD = 0.6 s - 1.0 D = 1.0 and OS = 0.7 s - 1.25 D = 1.0; the positive part of the relative accommodation of 3.5 diopters.

Example 3. Patient T. Age 19 years. Spasm of accommodation. Visual acuity was: OD = 0.8 s - 1.0 D = 1.0 and OS = 0.7 s - 0.75 D = 1.0; the positive part of the relative accommodation of 2.5 diopters.

The course of treatment is 10 sessions of 15 minutes.

The number of substrates in the device is 8.

After the course of treatment, visual acuity was OD = 1.0 and OS = 0.9; the positive part of the relative accommodation of 6.5 diopters.

Example 4. Patient K. Age 5 years. Amblyopia of the left eye. The visual acuity of the left eye was 0.5 s + 2.5 D = 0.7.

The course of treatment is 15 sessions of 15 minutes.

The number of substrates in the device is 8.

After 2 courses of treatment with an interval of one month, the visual acuity of the left eye was 0.8 s + 2.5 D = 1.0.

Example 5. Patient R. Age 25 years. Hypermetropia of an average degree of both eyes. Amblyopia of the left eye. Work involves using a computer for 6-9 hours a day. In the last 6 months, he noted discomfort, fatigue during visual work, heaviness in the eyeballs, periodically blurred vision, i.e. phenomena of accommodative asthenopia. Visual acuity was: OD = 0.6 s + 3.0 D = 1.0 and OS = 0.3 s = 3.75 D = 0.7.

The course of treatment is 15 sessions of 15 minutes.

The number of substrates in the device is 8.

After 2 courses of treatment with an interval of one month, visual acuity OD = 1.0 and OS = 0.7 s + 2.5 D = 1.0.

The proposed device for the treatment of functional visual disturbances can improve vision and prevent its impairment in people with daily increased visual load (drivers of vehicles, computer operators, air traffic controllers, etc.). Universality, low cost and relative simplicity make this device very useful for a wide range of both specialists and those suffering from visual disorders.

Claims (4)

1. A device for the treatment of functional visual disorders, comprising an extended case with a hole at the front end and a blackened inner surface, a substrate on which there is a blackened screen with a slot facing the end hole, and a monochromatic light source, a pulse distributor and a switching power supply, characterized by the fact that a number of substrates are additionally introduced into it with a blackened screen with a slit and a source of monochromatic light placed on each of them; Lena sequentially one after another along and perpendicular to the longitudinal axis of the body at a distance L _n = L ₁ × (L _N / L ₁ ) ^{(n-1) (N-1)} from the end hole where L _n is the distance from the end hole to the n-th substrate (mm); L ₁ is the distance from the end hole to the first substrate (mm); L _N is the distance from the end hole to the last substrate (mm); n is the serial number of the substrate from the side of the end hole, n = 1 ... N; N is the number of substrates (pcs.), and each subsequent slot is rotated around its axis relative to the previous one by an angle α = 180 ° / (N-1), where α is the angle of inclination of the slot (deg.); N is the number of substrates (pcs.), and is located at a height h _n = l _1/2 × (L _N / L ₁ ) ^{(n-1) (N-1)} × sin [(n-1) α] relative to the top edge of the previous substrate, where h _n is the elevation of the slot of the nth substrate relative to the upper edge of the previous (n-1) th substrate (mm); l ₁ - the length of the first slot (mm); L _N is the distance from the end hole to the last substrate (mm); L ₁ is the distance from the end hole to the first substrate (mm); n is the serial number of the substrate from the side of the end hole, n = 1 ... N; N is the number of substrates (pcs.); α is the angle of inclination of the slot (deg.), and each monochromatic light source is electrically connected through a pulse distributor to the corresponding output of the switching power supply. 2. The device according to claim 1, characterized in that the number of substrates N is selected within 4≤N≤8. 3. The device according to claim 1, characterized in that the length of each slot is equal to l _n = l ₁ × (L _N / L ₁ ) ^{(n-1) (N-1)} , where l _n is the length of the n-th slot (mm); l ₁ - the length of the first slot (mm); L _N is the distance from the end hole to the last substrate (mm); L ₁ is the distance from the end hole to the first substrate (mm); n is the serial number of the substrate from the side of the end hole, n = 1 ... N; N is the number of substrates (pcs.). 4. The device according to claim 1, characterized in that the width of each slot is equal d _n = d ₁ × (L _N / L ₁ ) ^{(n-1) (N-1)} , where d _n is the width of the n-th slot (mm); d ₁ - the width of the first slot (mm); L _N is the distance from the end hole to the last substrate (mm); L ₁ is the distance from the end hole to the first substrate (mm); n is the serial number of the substrate from the side of the end hole, n = 1 ... N; N is the number of substrates (pcs.).

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