US20130102921A1 - Method and device for monitoring biomechanical properties of the eye - Google Patents

Method and device for monitoring biomechanical properties of the eye Download PDF

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Publication number
US20130102921A1
US20130102921A1 US13/277,379 US201113277379A US2013102921A1 US 20130102921 A1 US20130102921 A1 US 20130102921A1 US 201113277379 A US201113277379 A US 201113277379A US 2013102921 A1 US2013102921 A1 US 2013102921A1
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Prior art keywords
cornea
eye
protrusion
lid
force
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Abandoned
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US13/277,379
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English (en)
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Alain Saurer
Jean-Noel Fehr
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TISSOT MEDICAL RESEARCH SA
TISSOT MEDICAL RES SA
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TISSOT MEDICAL RESEARCH SA
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Priority to US13/277,379 priority Critical patent/US20130102921A1/en
Assigned to TISSOT MEDICAL RESEARCH SA reassignment TISSOT MEDICAL RESEARCH SA ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: FEHR, JEAN-NOEL, SAURER, ALAIN
Priority to PCT/CH2012/000240 priority patent/WO2013056384A2/en
Priority to JP2014536084A priority patent/JP2014531960A/ja
Priority to US14/352,170 priority patent/US9723984B2/en
Priority to EP12780637.0A priority patent/EP2768381B1/en
Publication of US20130102921A1 publication Critical patent/US20130102921A1/en
Priority to JP2018185868A priority patent/JP2019030686A/ja
Priority to JP2020027607A priority patent/JP2020099711A/ja
Priority to JP2021115344A priority patent/JP2021166796A/ja
Abandoned legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B3/00—Apparatus for testing the eyes; Instruments for examining the eyes
    • A61B3/10—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions
    • A61B3/16—Objective types, i.e. instruments for examining the eyes independent of the patients' perceptions or reactions for measuring intraocular pressure, e.g. tonometers

Definitions

  • the present invention relates to a method for monitoring biomechanical properties of the eye, more particularly intraocular pressure or characteristics of the cornea, and a device for measuring eye properties of that kind.
  • IOP cf. Glossary
  • IOP is measured by applanation of the cornea, e.g. by the Goldman applanometer.
  • Devices of this type exert about centrally pressure on the cornea up to a predefined applanation and measure the force required.
  • due to the central impact on the cornea a significant dependence on the curvature of the cornea and its stiffness exists.
  • pressure sensors have been developed measuring the pressure or force exerted in a peripheral region of the cornea.
  • One such sensor is described in British patent application 1017637.8 in the name of the University of Dundee et al. which is not yet published.
  • the pressure sensor is a contact lens with a circumferentially embedded pressure sensor.
  • the pressure sensor bears toward the cornea an elevation. If the lid closes over the contact lens, it is flattened and the elevations are pressed on the cornea.
  • the IOP can be monitored over extended periods, e.g. 24 hours.
  • the front side of the sensor portion i.e. opposite the cornea, may be constituted by a material significantly stiffer than the cornea so that the pressure of the lid is transmitted to the sensor without significant deterioration.
  • the senor is of the type of a variable capacitor coupled to an inductance to constitute a resonance circuit.
  • the inductance serves as the antenna so that the resonance frequency can be wirelessly determined.
  • the frame of glass may be provided with a suitable antenna and the emitter electronics may be implemented in the frame.
  • the emitter electronics may be implemented in the frame.
  • Another object is to provide method and device allowing the monitoring of other properties of the eye than the IOP.
  • Such a method is a method for monitoring biomechanical properties of the eye, using a measuring arrangement which comprises a measuring device designed to be born in the manner of a contact lens, the measuring device comprising a force detector in operative engagement with a protrusion directed towards the cornea of an eye once the measuring device is applied to the eye, the measuring device being flexible in order to be pressed against the cornea by a lid of the eye moving over the measuring device, wherein the method comprises the following steps:
  • the shape of the protrusion is provided with at least one discontinuity so that at least one significant step in the force values is observed, with the step being attributable to an indentation depth predefined by the discontinuity
  • the object is attained by a device for measuring properties of the eye substantially shaped as a contact lens, wherein the device comprises a sensor of annular shape and peripherally arranged and having at least one protrusion directed towards the eye when applied to an eye, the device having such an overall flexibility the a lid closing over the device can deform it sufficiently to indent the cornea by the protrusion, wherein the protrusion has at least two portions of different height.
  • An alternate device is a device for measuring properties of the eye substantially shaped as a contact lens, wherein the device comprises a sensor of annular shape and peripherally arranged and having a protrusion directed towards an eye when applied to the eye, the device having such an overall flexibility the a lid closing over the device can deform it sufficiently to indent the cornea by the protrusion, wherein the protrusion has flanks which comprises at least one step creating a transition zone from a larger protrusion to a smaller protrusion.
  • a further alternate device is a device for measuring properties of the eye substantially shaped as a contact lens, wherein the device comprises a sensor of annular shape and peripherally arranged and having a protrusion directed towards an eye when applied to the eye, the device having such an overall flexibility the a lid closing over the device can deform it sufficiently to indent the cornea by the protrusion, wherein the sensor is subdivided in at least to subsensors, the subsensor having protrusions of different size, so that the subsensors timely shifted touch the cornea when a lid closes over the device.
  • FIG. 1 Top view on a monitoring lens
  • FIG. 2 Enlarged cross-section through a sensor, with indented situation indicated by broken lines;
  • FIG. 3 Cross-section through an eye with monitoring lens
  • FIG. 4 Mechanical model
  • FIG. 5 Hysteresis-diagram for uniform knob
  • FIG. 6 Flow diagram: Indentation depth interpolation according to constant acceleration model for the eye lid
  • FIG. 7 Flow diagram: Computation of hysteresis, interpolation only
  • FIG. 8 Top view on lens with two sensors
  • FIG. 9 Partial cross-section of the sensor of FIG. 8 ; enlarged;
  • FIG. 10 Force-time diagram of the lens of FIG. 8 ;
  • FIG. 11 Extrapolation diagram
  • FIG. 12 Cross-section of knob with transition
  • FIG. 13 Force-time diagram of knob of FIG. 12 ;
  • FIG. 14 Cross-section through monitoring lens with sensor having varying knob shape
  • FIG. 15 p-H-diagram of sensors with transition.
  • FIG. 1 shows a “monitoring lens” 1 , i.e. a contact lens with a sensor 3 .
  • the sensor 3 is an annular arrangement of a pressure sensing device. Preferably, it is a capacitive sensor.
  • a coil 4 is arranged as an annular winding on the outside. Sensor 3 and coil 4 build a resonance circuit with a resonance frequency dependent on the force exerted on the sensor.
  • FIG. 2 A schematic cross-section through sensor 3 is shown in FIG. 2 .
  • An essentially U-shaped rigid frame 5 is closed by a membrane 7 . On the bottom of the frame 5 (upper side in FIG. 2 ), one electrode 9 is provided.
  • the other electrode 10 is attached to the interior face of membrane 7 .
  • the second electrode 11 is fixed (glued, soldered or the like) to the center of membrane 7 so that its flexibility is less reduced. If the electrode 10 is attached to the membrane by its entire surface, the membrane-electrode stack has a significantly increased stiffness. Furthermore, by the only quite small attachment zone 8 , it is avoided that the second electrode 11 is bent in the indented state.
  • knob 14 On the exterior face of membrane 7 , a so-called knob 14 is provided. As it is to be pressed on the cornea 16 , it is of a soft, resilient and biocompatible material like silicone or a hydrogel.
  • indented cornea 16 of an eye Further indicated by dash-dotted lines is the indented cornea 16 of an eye.
  • the indentation occurs under the influence of the lid when closed, either by blinking or during sleep.
  • the knob is to create indentation of the cornea in the magnitude of micrometers, hence its shape may have a generally flatter aspect, cf. GB 1017637.8.
  • the only minimal indentation of the cornea still constitutes an important advantage of the monitoring lens over the prior art applanometers. Due to the only minimal impact on the eye considered in its entirety, it is reasonable to assume that the true IOP is not influenced by the measurement, i.e. is considered as constant with regard to the time needed for a spontaneous blink, i.e. the time scale of the dynamic measurement where during a blink of the lid, a measurement cycle is performed.
  • FIG. 3 shows a partial section through an eye 18 (lens 19 ; iris 20 ; cornea 22 ) bearing a monitoring lens 1 with sensor 3 . Noteworthy in the passive state, the knob 14 does not touch the cornea.
  • a basic finding in the context of the present invention consists in that during closing, the lid is first accelerated by a constant value, then slowed down by substantially the same value.
  • a viscoelastic model 23 ( FIG. 4 ) (D. H. Glass, C. J. Roberts, A. S. Litsky, P. A. Weber, A Viscoelastic Biomechanical Model of the Cornea Describing the Effect of Viscosity and Elasticity on Hysteresis, IOVS 49 (2008) 3919-3926.).
  • the model 23 allows to calculate the contribution p cornea to the uncompensated pressure IOP raw .
  • the model 23 is characterized by the following equations (cf. FIG. 4 ):
  • the contribution Pcornea during the period t IOP0 to t IOP1 i.e. on the measured pressure during the quasi-steady state while the lid is closed, can be determined and in consequence the true or compensated IOP be obtained.
  • a non-linear fit algorithm may be used to resolve the equations of the model.
  • a further property of the monitoring lens 1 is that its flattening is quantitatively correlated with the movement of the lid.
  • the position s lid of the lid in the direction of the opening/closing movement is a measure for the distance between cornea 16 , 22 and frame 5 and therefore also a measure for the indentation H of the cornea 16 by the knob 14 once the knob 14 touches it.
  • the finding is used that the acceleration values during opening (a open ) and closing (a close ) of the lid can be derived from the delay between occurrence of maximal force, corresponding to the closed lid, and the time when the force is zero again, i.e. the lid is opened to a degree that the knob 14 does no more exert a sensible force on the cornea.
  • the indentation depth H is then accessible by interpolating the position of the lid using the general equation
  • the measured time interval covers only the phases when the lid is decelerating during the closing movement and accelerating during the opening movement.
  • s lid is determined by calibration of the lens 1 and stored.
  • s lid may also correspond to the angle of the lid.
  • the force F(t) sensed by the knob 14 when indenting the cornea is generally unambiguously related to the pressure p although the contact surface varies with the indentation depth H.
  • the relationship between F(t) and p(t) for a given knob shape can be empirically determined and used as a lookup table or a numerically determined function, e.g. a polynomial, or a set of functions, e.g. a (cubic) spline.
  • rounded shapes of the knob have been found suited, i.e. knobs with rounded apex (obviously also avoiding irritations of the cornea).
  • the pressure may additionally be dependent on the interpolated indentation depth, e.g.
  • the shape is, with sufficient precision, independent of an individual eye.
  • the exact shape can be found e.g. by numeric methods on the basis of mechanical properties of the cornea, e.g. by Finite Element Analysis FEA.
  • the evaluation of the sensor signal is shown by flow diagrams in FIGS. 6 and 7 .
  • the sensor furnishes its values with a sufficient high rate to an evaluation device, e.g. constituted by an embedded controller, possibly integrated in glasses, or a separate station to which data received by the monitoring circuitry in the glasses are continuously (wireless) or periodically transferred. Hence, the data may be locally stored and transferred later on to a evaluation station, or immediately evaluated.
  • an evaluation device e.g. constituted by an embedded controller, possibly integrated in glasses, or a separate station to which data received by the monitoring circuitry in the glasses are continuously (wireless) or periodically transferred.
  • the data may be locally stored and transferred later on to a evaluation station, or immediately evaluated.
  • Eyelid closing occurs within typically 75 ms, with the period used for the measurement (t start to t IOP0 ) in the range of 1 to 3 ms, and lid opening within about 3 times those periods (i.e. totally about 225 ms, t IOP1 to t end about 3 to 9 ms), while the lid remains typically closed during a spontaneous blink for about 16 ms.
  • the force data have to be sampled sufficiently fast, at least 5 values are required per branch 30 , 31 of the hysteresis curve.
  • transfer rates from the sensor to the emitter/receiver is limited, it is preferred to base the interpolation for determining the acceleration values from the opening phase which occurs over a significantly longer period. Empirically and from theoretical considerations, a data acquisition rate of about 5 kHz is sufficient. Higher rates tend to improve the performance.
  • the time t max when the lid is closed is determined as the point in time where the force signal is at its maximum F max . Practically, as the period the lid is closed is taken as the interval from t IOP0 to t IOP1 where the force F(t) remains above a predetermined threshold. As such, it is taken e.g. a percentage of the maximum signal. The percentage is at most 10%, preferably at most 5%, and most preferably at most 2%, i.e. the threshold F th is defined to be at least 0.9 F max , or 0.95 F max or 0.98 F max .
  • the time period t End ⁇ t IOP1 (t End : point in time where the sensor signal gets 0 again, i.e. the knob does no more exert a measurable force of the cornea) is used 32 as an index in a generic lookup table 33 ( FIG. 6 ).
  • the table 33 furnishes the values of a open and a close for the acceleration during opening of the lid and the deceleration during closing of the lid.
  • the knobs are designed such that they measurably contact the cornea only in the periods where the lid is slowing down in lid closing and accelerating in lid opening.
  • the lid velocity v close0 at t start is determined 34 :
  • the pressure p(t) is determined on the basis of the sensor signal, i.e. the force exerted on the knob by the eye.
  • the hysteresis curve p(H(t)) can be constructed and the true IOP can determined by compensating the influence of the cornea on the measured uncompensated IOP raw which is the pressure measured as an average in the quasi-steady state period from t IOP0 to t IOP1 . This separation is done by considering the IOP as a constant on the measurement time scale, i.e. for the duration of a blink as set forth above.
  • A) and C) are characterized by that the sensor frame 5 is not yet or no more in touch with the eye 18 , although the cornea is indented. During these phases, the viscoelastic model 23 is applied.
  • phase B however, the frame 5 touches the cornea 22 . Therefore, independently of the position of the lid (which is now closed), indentation depth is assumed to be constant because the sensor is steady with respect to the eye, and the viscous component has a sufficiently short relaxation, that its contribution can be neglected.
  • the pressure component of the cornea is determined by the elastic elements E 1 and E 2 only.
  • the non-linear fit can be determined on the basis of the [H(t), p(t)] value pairs yielding the parameters E 1 , E 2 , and ⁇ of the model.
  • the equations given above can be used in a numerical equation solver or they can be combined to a reduced set of equations, down to only one equation, and then subjected to a usual non-linear fitting algorithm.
  • the principle of least squares error is suitable.
  • E 1 E 2 (D. H. Glass, Characterization of the Biomechanical Properties of the in vivo Human Cornea (Thesis), Ohio State University, 2008, cf. p. 59).
  • the hysteresis constant ⁇ can be determined by determining the pressure at equal indentations H trigger during opening and closing the eye. For determining the values for these indentations, interpolation techniques known per se may be used.
  • the hysteresis ⁇ is supposed to furnish information of the healthy state of the cornea and the eye and is used in the non-linear fit.
  • FIG. 7 shows the flow diagram of calculating ⁇ . The initial steps are identical with the determination of IOP explained above, although not shown in FIG. 6 :
  • the force signal of the sensor is read 39 until it significantly deviates 40 from zero. This point in time is defined 41 as t start . Force signals F sensor are recorded and stored 42 at 5 kHz until it is determined 43 that it no more deviates significantly from zero. This point in time is stored 44 as t end .
  • the maximum F sensor,max value is searched 45 , and the corresponding time t max is recorded.
  • the data are postprocessed for determining properties of the eye or values indicative of its health state, in particular the IOP as set forth above.
  • Next step is again determining 32 the parameters of the movement of the lid using the look-up table 34 and therefrom 36 the indentation depths H 1 for the F 1 values.
  • time t trigger0 is determined in a predefined position between t start and t max (or as an alternative t IOP0 ) and, and the corresponding point in time t trigger1 for the lid opening phase between t max (alternative: t IOP1 ) and t end as the point in time where the same indentation as at t trigger0 , occurs, wherein intermediate values are interpolated.
  • the force values F trigger0 and F trigger1 during closing resp. opening the eye are calculated 46 using interpolation as required.
  • the difference F trigger0 ⁇ F trigger1 yields 47 a measure of ⁇ .
  • the threshold force value F th is determined in an autocalibration cycle.
  • the device determines whether the eye is closed longer than a predefined time t th .
  • the start and stop criterion is whether the force is greater than zero resp. zero again.
  • the initial and final values representing closing and opening the eye are discarded.
  • the resulting period is significantly longer than the usual time for these movements, e.g. at least 1 ⁇ 2 s or at least 1 s.
  • the force values of this period of closed eye are postprocessed.
  • an averaging is included.
  • F th is then set to be a small percentage lower than the obtained steady state force value, cf. above.
  • the patient may be asked to close the eyes for a few seconds, or periods of extended lid closure may be used and automatically detected, e.g. sleep. Manual triggering and controlling is possible as well, where even discarding of initial and final values may be avoided.
  • t th may be a few seconds, e.g. at least 2 s, preferably at least 5 s or even at least 10 s.
  • the senor can be modified the way that at least two segments of distinctly different height H knob (i), i ⁇ 2, are present,
  • the segmentation is at least mirror-symmetrical in view of the about mirror-symmetrical movement of the lids.
  • FIG. 8 shows an arrangement with two large segments S 0 51 which constitutes the first sensor. Between them two smaller segments S 1 53 are provided, constituting sensor 2 . They are characterized by a knob significantly lower than the knob of S 0 .
  • two antennas 55 , 56 are provided for sensor 51 resp. 53 , each extending over the whole periphery.
  • the antenna/sensor capacitor arrangements are responsive to different frequencies so that the sensors are capable to furnish data independently and without additional measures for avoiding conflicts.
  • FIG. 9 also shows the differing heights H knob,s0 58 and H knob,s1 59 .
  • FIG. 10 The effect of the different knob elevations is depicted in FIG. 10 .
  • the points in time when sensor S 1 53 , too, gets in contact with the cornea or looses contact immediately defines the times t trigger10 61 and t trigger11 corresponding to a well-defined indentation H S0 by the sensor S 0 51 .
  • sensor S 1 53 furnishes by itself a maximum quasi steady state force value 63 in addition to the maximum steady state value 62 of sensor s 0 51 .
  • the force values F max,S0 62 and F trigger,S0 64 of sensor S 0 at t max (eyelid closed, maximum force signal) resp. at t trigger10 which is now a well-defined indentation depth by S 0 are used.
  • the maximum force signal of the second sensor can be used.
  • Another usable value is the force F trigger1,S0 at t trigger11 , which is, however, more difficult to determine due to its more complicate history, yet because of the slower lid movement, the time resolution is better.
  • the force or pressure values at t trigger10 and t trigger11 may be used to calculate the hysteresis parameter ⁇ , too.
  • the concept is not limited to two sensors. Further sensors each of different knob may be provided, and the sizes of the sensors are not restricted to S 1 being significantly smaller than S 0 .
  • the knob is provided with a transition 70 .
  • the transition is a transition to a broader knob shape.
  • the shape of the knob corresponds to a small knob
  • the shape of the basis 71 corresponds to a bigger knob.
  • the signals obtained are those as if the knob has the shape of the small knob (portion 73 in FIG. 13 ). If the indentation increases, the cornea gets in touch with the transition 70 at time t trigger0 74 . As the contact zone is stepwise increased, also the force signal of the sensor shows a step increase 74 . Afterwards, the signal 75 merely corresponds to that of a virtual bigger knob.
  • the force signal shows a sharp decay 77 when the cornea no more touches the broader basis 71 .
  • the same effect may be obtained by a small knob shape 79 over one part of the sensor extension, and the remainder 80 being shaped as a significantly bigger knob.
  • the transition zone is preferably wave-shaped so that a smooth transition occurs to avoid an irritation of the eye.
  • the resulting p/H diagram is shown in FIG. 15 .
  • the part 81 toward the closed eye is shifted to higher pressure values.
  • the shift zone defines a predetermined point in time, and the pressures p trigger0 83 and p trigger1 85 allow to determine the hysteresis ⁇ .
  • the transition depth H trigger 87 once again defines a point in time where the indentation depth either corresponds to the apex 72 or the difference between greater knob height and smaller knob height in the variant of FIG. 14 .
  • the pressure p trigger0 83 defines a pressure at indentation H trigger 87 .
  • the upwards shifted part 81 of the hysteresis curve is normalized or corrected by using the effective contact surface (the continuous line indicate a calculation assuming a uniform shape) yielding the curve 88 (dashed line).
  • the thereby obtained vertex point 90 is p max at H knob , i.e. frame 5 in contact with the cornea 22 .
  • the two points obtained (p trigger0 83 , p max 90 ) allow a linear extrapolation as explained above for FIG. 11 yielding the true IOP 63 .

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US13/277,379 2011-10-20 2011-10-20 Method and device for monitoring biomechanical properties of the eye Abandoned US20130102921A1 (en)

Priority Applications (8)

Application Number Priority Date Filing Date Title
US13/277,379 US20130102921A1 (en) 2011-10-20 2011-10-20 Method and device for monitoring biomechanical properties of the eye
PCT/CH2012/000240 WO2013056384A2 (en) 2011-10-20 2012-10-19 Method and device for monitoring biomechanical properties of the eye
JP2014536084A JP2014531960A (ja) 2011-10-20 2012-10-19 眼球の生体力学特性を監視するための方法および装置
US14/352,170 US9723984B2 (en) 2011-10-20 2012-10-19 Method and device for monitoring biomechanical properties of the eye
EP12780637.0A EP2768381B1 (en) 2011-10-20 2012-10-19 Method and device for monitoring biomechanical properties of the eye
JP2018185868A JP2019030686A (ja) 2011-10-20 2018-09-28 眼球の生体力学特性を監視するための方法および装置
JP2020027607A JP2020099711A (ja) 2011-10-20 2020-02-20 眼球の生体力学特性を監視するための方法および装置
JP2021115344A JP2021166796A (ja) 2011-10-20 2021-07-12 眼球の生体力学特性を監視するための方法および装置

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EP2768381B1 (en) 2019-05-22
US20140257074A1 (en) 2014-09-11
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JP2014531960A (ja) 2014-12-04
US9723984B2 (en) 2017-08-08
EP2768381A2 (en) 2014-08-27

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