RU2391895C1 - Device for measuring lagophthalmos and palpebral fissure size - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: device represents metal handle with straight or curved rod and metal replaceable measuring heads of rectangular form 1-10×1-10 mm in size with 3×2×2 mm lug and hole in it for fixation onto rod tightly.

EFFECT: application of claimed device will allow to obtain more accurate measuring parametres along the entire length of palpebral tissue.

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Description

The present invention relates to medicine, namely to ophthalmology, and is intended to measure the magnitude of lagophthalmos and palpebral fissure.

Lagophthalmus is characterized by incomplete closure of the palpebral fissure, exposure of the eyeball, and constant dryness of the corneal and conjunctival epithelium. The lack of adequate protection for the eyeball, xerosis of the cornea and conjunctiva, a violation of the blinking reflex often lead to the occurrence of keratitis and in severe cases its ulceration.

As analogues, we consider the Messpatel measuring spatula according to the catalog of Hans Geuder No. G-32225, which is a curved scale on the handle, and the Zirkel compass No. G-19130, No. G-19135, which has a handle with a curved measuring scale at the end, according to the catalog of the company Hans Geuder (Germany, 1997, p. 217, p. 219). The analogues mentioned above have disadvantages in the measurement. So, the measuring spatula due to the curved scale can distort the data of the lagophthalmus value estimation, in addition, it cannot be located perpendicular to the edges of the eyelids. The measuring compass gives more accurate data, but has sharp ends, which pose a risk of corneal damage, perforation of the eyeball, in addition, its measuring scale is far from the measurement area, which complicates photographic recording.

The closest analogue of the proposed device is the measuring ophthalmological line "Masstab" 15 cm No. G-18650 (1997), which is a straight plate with a scale. This analogue has a number of disadvantages: firstly, due to the location at some distance from the eyeball, eyelids and eyelashes, as well as because of its orientation in the frontal plane, it is not always possible to accurately measure the width of the palpebral fissure when looking up and down , which does not allow to correctly assess the degree of lagophthalmus, and therefore the correct tactics of surgical treatment. In addition, an accurate assessment of the magnitude of lagophthalmus is difficult due to the remoteness of the scale from the eyes of the researcher, as a result of which the error of the method increases.

The objective of the invention is to improve the measuring tool for measuring lagophthalmos and palpebral fissure.

The technical result of the invention is to obtain more accurate measurement parameters throughout the palpebral fissure, which allows to clarify the clinical diagnosis, develop adequate treatment tactics and carry out dynamic monitoring based on objective data.

The technical result is achieved through the use of replaceable nozzles of rectangular shape with dimensions of 1-10 mm × 1-10 mm with a tide size of 3 × 2 × 2 mm and a hole in it for fastening on the forearm of the preload.

The nozzle is marked with a number corresponding to the size of the measuring part, on which a scale can be applied for convenience. It is possible to fix the device to the slit lamp. Product material: stainless steel, titanium.

This device allows you to evaluate the value of the measured parameter from the measuring part of the device outside the eye of the subject after fixing this value on the eye. With different directions of gaze, it is the selection of the nozzle that allows you to most accurately assess the magnitude of lagophthalmos. The use of various nozzles significantly improves the quality of measurement due to the convenience of using the tool, its safety, as well as the ease of photo documentation of the result. The invention allows to more accurately assess the magnitude of lagophthalmus without touching the edges of the eyelids and eyelashes when examining a patient behind a slit lamp, as well as lying down during surgery (including at different stages of the operation). The use of the device allows a much more accurate assessment of the magnitude of lagophthalmus, including for different directions of the gaze, in different parts of the palpebral fissure, and also simultaneously carry out photo documentation.

The device is shown in figures 1, 2 and 3, where in figure 1: 1 - a cylindrical grip with a ribbed surface, which contributes to the convenience of gripping the device; 2 - forend with a different degree of bending, which provides a more accurate measurement of the parameter in different parts of the palpebral fissure and at different positions of the patient. Figure 2 shows a replaceable nozzle of a rectangular shape, where: 3 - measuring part of the nozzle, 4 - tide, 5 - hole for mounting on the forearm.

The device is used as follows: when examining the patient for a slit lamp, with the forehead and chin fixed, the patient closes his eyes. On the forearm put on the nozzle size, visually corresponding to the value of the measured parameter. The measuring device is brought to the eye at a distance of 2 mm (between the ciliary edges of the upper and lower eyelids). If the nozzle size and the measured parameter do not match, the nozzle is changed to a larger or smaller one until a match is reached in the part of the palpebral focal region of interest. Thus, a reliable value of lagophthalmus or palpebral fissure is established. In the supine position, measurements are taken in the same way.

Example: patient A., born in 1947, was admitted with complaints of a “skewed” face, periodically occurring pain in the left half of the face, parotid region, constant lacrimation. Discomfort and irritation of the left eye worsened over the past 4 months. From the anamnesis it is known that after a viral infection transferred at 3 years of age, she developed neuritis of the facial nerve on the left. At 10, 20 and 25 years, relapses of neuritis were noted. From the age of 25, the closing of the eye has been broken, in the last 4 months there has been severe hyperemia of the eyeball, severe pain has appeared.

Visual acuity at admission - OD 0.2 from the spheres. -2.5, cyl. -1.5, axis 30 ° = 0.9-1.0; OS 0.3 from the spheres. + 2.0 = 1.0. IOP OD = OS = 19 mm Hg

On examination: OD - PFv - 8 mm, PFh - 23 mm, MRD1 - 4 mm, MRD2 - 4 mm, upper eyelid tour - 10 mm, lower eyelid tour - 2 mm, lower eyelid return time - 2 sec, EOM - 14 mm (base 86 mm), tension -> 60. The conjunctiva is calm. The cornea is transparent, the epithelium is dull, overlay on the endothelium, cornea guttata.

OS: PFv - 10 mm, PFh - 27 mm, MRD1 - 2 mm, MRD2 - 5 mm, excursion of the upper eyelid - 7 mm, return time of the lower eyelid - 2 mm, lagophthalmus in the sitting and lying position, Bell + symptom. The conjunctiva is annoyed. The corneal epithelium is dull, overlapping on the endothelium, cornea guttata.

Clinical diagnosis: OS - paralytic lagophthalmos, OU - epithelial-endothelial dystrophy of the cornea, initial complicated cataract, destruction of the vitreous body.

The lagophthalmus value was measured by the measuring device proposed in the invention by selecting the replaceable nozzle corresponding to the lagophthalmos value, the measurement was carried out in the medial part of the palpebral fissure, where the lagophthalmos had the largest value. First, a 2 mm nozzle was put on the forearm, the device was brought to the eye between the ciliary edges of the upper and lower eyelids. This size was smaller than the measured parameter, so the selection was continued using larger nozzles. In the sitting position, the nozzle was 5 mm in size, and in the lying position the nozzle 3 mm most closely corresponded to the size of lagophthalmos, therefore, lagophthalmus in the first case was 5 mm, in the second case - 3 mm. Ease of use was noted and accuracy in measuring lagophthalmos was achieved. The data obtained made it possible to recommend comprehensive surgical treatment to the patient: suture fixation of the inner part of the tarsal plate and resection of the tendon of the superior tarsal muscle.

Thus, the proposed device made it possible to accurately measure the magnitude of lagophthalmus in the medial part of the palpebral fissure, which made it possible to clarify the clinical diagnosis, develop an adequate treatment tactic and perform dynamic monitoring based on objective data.

Claims (1)

A device for measuring the magnitude of lagophthalmus and palpebral fissure, which is a metal handle with a straight or curved forearm and metal interchangeable measuring tips of rectangular shape with dimensions of 1-10 × 1-10 mm with a tide size of 3 × 2 × 2 mm and a hole in it for mounting on swivel forearm.

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