Illuminated contact lens and system for improved eye diagnosis, disease management and surgery
11768316 · 2023-09-26
Assignee
Inventors
Cpc classification
G16H80/00
PHYSICS
G02C7/049
PHYSICS
G16H50/20
PHYSICS
A61B3/14
HUMAN NECESSITIES
C08L33/12
CHEMISTRY; METALLURGY
C08L33/12
CHEMISTRY; METALLURGY
G16H15/00
PHYSICS
International classification
A61B3/06
HUMAN NECESSITIES
A61B5/00
HUMAN NECESSITIES
Abstract
A new ocular contact lens has been designed to increase the amount of light reaching the retina. The contact lens edge is chamfered to redirect and increase the light reaching the retina. A light source encircles and contacts the straight or curved chamfered edge. Additionally, a reflective cylinder and its top wall encircle the lens to block any loss of light. This distal edge of the contact lens may be rounded to increase the angle of retina visible. A new ocular imaging camera has a low-light camera subassembly with server, a photosensor next to low-light camera, a short cylindrical housing, a space between the camera subassembly and the housing, an internal program in server to detect good or poor image quality and an alarm for poor image quality, wherein an operator recaptures the image. A system has a highly efficient method to screen and diagnose a large number of patients using the new ocular contact lens and ocular imaging camera. The system receives and processes the photographs. The photographs are transmitted to eye care specialists' smart phone, tablet or virtual reality device for evaluation. As specified, the eye care specialist separates normal from abnormal, diagnoses the abnormality, and may even provide detailed information, such as the grade of the abnormality. The server receives this information and automatically generates the suitable report for the healthcare professional. The server also processes payment to the eye care specialist.
Claims
1. An ocular contact lens comprising: a curved surface on a first side; a flat surface on a second side opposing the first side; one or more chamfered edges between the first side and the second side wherein the one or more chamfered edges has a wider circumference closer to the curved surface and a narrower circumference near the flat surface; and a straight edge between the curved surface and the one or more chamfered edges oriented perpendicular with the flat surface, wherein, during use, the ocular contact lens is not fixedly coupled with an ocular imaging camera.
2. The ocular contact lens of claim 1, wherein the ocular contact lens comprises at least one of glass, polymers, poly(methyl) methacrylate, a coating, silicone, or plastics.
3. The ocular contact lens of claim 1, wherein an angle relative to the flat surface of the one or more chamfered edges is 0° to 90°.
4. The ocular contact lens of claim 1, wherein an angle relative to the flat surface of the one or more chamfered edges is 45°.
5. The ocular contact lens of claim 1, wherein the distal flat surface is slightly rounded to widen the view through the lens and allow for capture of a wider angle of the retina.
6. The ocular contact lens of claim 1, wherein a maximum feasible angle Θ relative to the flat surface for the one or more chamfered edges made of a contact lens material is determined by Θ<180-2*arcsin(1/n), wherein n is the refractive index of the contact lens material.
7. The ocular contact lens of claim 1, wherein a thickness between the curved surface and the flat surface is 0.25 mm to 2.75 mm.
8. The ocular contact lens of claim 1, wherein the one or more chamfered edges are one of straight or curved.
9. The ocular contact lens of claim 1, wherein a thickness between the curved surface the flat surface is 2.75 mm to 10 mm.
10. An ocular contact lens consisting essentially of: a curved surface on a first side; a flat surface on a second side opposing the first side; one or more chamfered edges between the first side and the second side wherein the one or more chamfered edges has a wider circumference closer to the curved surface and a narrower circumference near the flat surface; and a straight edge between the curved surface and the one or more chamfered edges of the ocular contact lens oriented perpendicular with the flat surface.
11. The ocular contact lens of claim 10, wherein the ocular contact lens comprises at least one of glass, polymers, poly(methyl) methacrylate, a coating, silicone, or plastics.
12. The ocular contact lens of claim 10, wherein an angle relative to the flat surface of the one or more chamfered edges is 0° to 90°.
13. The ocular contact lens of claim 10, wherein an angle relative to the flat surface of the one or more chamfered edges is 45°.
14. The ocular contact lens of claim 10, wherein the flat surface is slightly rounded to widen the view through the lens and allow for capture of a wider angle of the retina.
15. The ocular contact lens of claim 10, wherein a maximum feasible angle relative to the flat surface for the one or more chamfered edges made of a contact lens material is determined by Θ<180-2*arcsin(1/n), wherein n is the refractive index of the contact lens material.
16. The ocular contact lens of claim 10, wherein a thickness between the curved surface and the flat surface is 0.25 mm to 2.75 mm.
17. The ocular contact lens of claim 10, wherein the one or more chamfered edges are one of straight or curved.
18. The ocular contact lens of claim 10, wherein a thickness between the curved surface the flat surface is 2.75 mm to 10 mm.
19. An ocular contact lens consisting of: a curved surface on a first side; a flat surface on a second side opposing the first side; one or more chamfered edges across a thickness of a material of the ocular contact lens between the first side and the second side wherein the one or more chamfered edges comprise an angle Θ relative to the flat surface; and a straight edge between the curved surface and the one or more chamfered edges lens oriented perpendicular with the flat surface.
20. The ocular contact lens of claim 19, wherein a maximum feasible angle Θ relative to the flat surface for the one or more chamfered edges made of a contact lens material is determined by Θ<180-2*arcsin(1/n), wherein n is the refractive index of the contact lens material.
Description
BRIEF DESCRIPTION OF THE FIGURES
(1) Implementations will hereinafter be described in conjunction with the appended drawings, where like designations denote like elements, and:
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
(10)
(11)
(12)
(13)
(14)
(15)
(16)
(17)
DETAILED DESCRIPTION
(18) After much thought and experimentation, we invented a method to create a much more efficient way for connecting the primary practitioner and the eye care specialist for earlier eye diagnosis. This method enables a retina specialist, ophthalmologist, optometrist, etc. (eye care specialist) to diagnose and triage hundreds of patients per hour.
(19) First, we have invented a special illuminated contact lens that is designed to make the front-line healthcare professional's lens placement and photography simpler and more effective. We also describe an improved ocular imaging camera, also designed for ease of use by healthcare professionals. We further link obtaining the photo with a system (described below) with certified eye care specialists. Although the three parts are synchronized to produce a new paradigm in healthcare, each of the parts can be used with other medical devices or systems, which they can be expected to improve the patient results. The three parts are described below.
(20) New Contact Lens with Integral Light Source
(21) Adequate illumination is a vital part of ophthalmology and presents a challenge, because various parts of the eye, including the pigmented epithelium layer or inner surface of a mammalian eye, have very low reflectivity. Any stray light reflected from the interface between air and the most distal phase of vitreous humor can significantly distort the view of the intraocular space. These illumination challenges affect both ocular imaging and intraocular surgeries. For example, in intraocular surgeries one or more intraocular illumination probes are inserted into the sclera, the protective outer layer of the eye, to deliver light directly to the retina to increase visibility within the eye. These light probes are expensive and require an invasive entry into the eye.
(22) In retinal imaging, a specialized low power microscope with an attached camera is designed to photograph the interior surface of the eye (i.e. the fundus), including the retina, retinal vasculature, optic disc, and macula. Current techniques for retinal imaging include using anti-reflection (AR) coating on the glass of the lens used in the camera. Even with the anti-reflection coating, reflection from the cornea still presents a challenge in clearly viewing the inner portions of the eye. Many fundus camera designs separate the illumination light path and the imaging path spatially. This design results in a smaller clear aperture for imaging, which limits the image quality.
(23) Referring to
(24) Referring to
(25) Without being tied to any one theory, various implementations of flat lens assemblies as described herein may work based on total internal reflection (TIR). TIR is the phenomenon that involves the reflection of all the incident light off the boundary of a surface. TIR only takes place when two conditions are met: the light is in the denser medium and approaching the less dense medium and the angle of incidence is greater than the so-called critical angle. Total internal reflection only occurs with large angles of incidence. For example, large angles of incidence may be any angle greater than 48o when light is reflected between air and water. For other media or materials the angle may be determined using the formula Θ=arcsin(n2/n1), where n1 is the refractive index of the more dense medium and n2 is the refractive index or the less dense medium.
(26) Implementations of contact lens assemblies as described herein are designed to improve retinal imaging and intraocular surgeries through optimized delivery of light to the retina in a non-invasive and non-traumatic way. In various implementations of contact lens assemblies, there are no components in front of the lens and proximal to the eye. This may increase the field of view of the lens up to the limitation of the pupil and may avoid geometrically interfering with other devices. Lastly, various implementations of contact lens assemblies eliminate most stray light since little light escapes from the distal surface of the flat lens before being reflected back to the retina. We have designed the contact lens to transmit more light ways and reduce light scatter.
(27) Referring to
(28) Referring to
(29) Referring to
(30) Referring to
(31) Referring to
(32) Referring to
(33) Referring to
(34) Although the precursor of the inventive contact lens has been described as a “flat” lens, it may be beneficial to provide a slight curve on the distal surface of our contact lens. Such a curve enables a wider view of the eye's internal space.
(35) The components used for illuminated contact lens assembly may be made of conventional materials used to make goods similar to these in the art, such as, by non-limiting example, glass, polymers, poly(methyl methacrylate), silicone, plastics, fiber optics, reflective materials, and LEDs. Those of ordinary skill in the art will readily be able to select appropriate materials and manufacture these products from the disclosures provided herein.
(36) Ocular Imaging Camera
(37) We have invented a new ocular imaging camera that is more suitable for front-line healthcare professionals to use and to share data with eye care specialists.
(38) Currently preferred is a short cylindrical housing, mimicking a short pen for easy storage. Preferably there is a photosensor and lens in the low-lens camera subassembly end and a spacer between the housing and camera subassembly. Preferably the ocular imaging camera records multiple photos and even video that may provide more insight into the patient's current retinal status as well as the status of other ocular structures imaged with our camera.
(39) Increasingly sensitive and smaller cameras are available, and our inventive ocular imaging camera will take advantage of those improvements. Moreover, these cameras are increasingly effective in low-light situations and will produce better ocular photos than previously available. These factors combine to produce better quality images, whether the patient provides an unsteady gaze or is very young.
(40) The ocular imaging camera is digital for ease of transfer of images to computer for 1) enlarging, 2) professional analysis, 3) adding to patient files for comparison, etc. The ocular imaging camera has a server optionally programmed to detect whether a captured image has achieved the necessary quality standard for an eye care specialist and/or diagnostic algorithm to diagnose diabetic retinopathy and other retinal disorders. The algorithm is designed to run quickly and efficiently either in the camera or in the cloud so that health care providers are warned by light or sound within minutes (preferably seconds) in the event of poor image quality and need for images recapture. Preferably the images are recaptured within the same doctor visit and that only high-quality images undergo analysis. Real time feedback on captured images will increase the value to and confidence of health care professionals.
(41) The digital ocular imaging camera is preferably WIFI competent to minimize weight. The inventive ocular imaging camera preferably has a battery for convenient use without cords getting in the way.
(42) The inventive ocular imaging camera preferably has a housing that can sustain impact from accidental dropping in various clinic and emergency settings and from uncooperative patients. The more compact the ocular imaging camera is, the more convenient it is for use by health care professionals and paraprofessionals; this increases availability in a wider variety of settings from clinics to disaster zones.
(43) The portable ocular imaging camera optionally offers good lighting for detailed views of the retina. Currently this is best provided with light-emitting diode (LED) lights that have the advantage of brightness with lower heat generation. The LED lights can be configured in a variety of ways, including but not limited to a) one or more pinpoint lights, b) a line of LED lights and/or c) a ring of LED lights within the lens portion of our design.
(44) The LED lights are designed with enough power and aimed to provide adequate lighting of the retina, particularly the macula that only has a diameter of about 5.5 mm.
(45) The System
(46) As mentioned above, there will be tens of millions more AMD patients in the upcoming years—far more than current and future numbers of eye care providers available to adequately diagnose and sift through with traditional eye exams. After much thought, we invented a method to create a much more efficient way to connect the primary practitioner and the eye care specialist for earlier diagnosis. This method enables a retina specialist, ophthalmologist, optometrist (“eye care specialist”) to diagnose hundreds of patients per hour.
(47) The illuminated contact lens is placed on the patient's eyes, each one receiving a retinal photograph. Optionally the exterior of the eye and anterior segment are also photographed. Exterior photos will help explain quality limitations due to eyelid abnormalities or anterior segment opacities. The photographs and attendant patient information are transmitted to a central server and then fed to mobile devices of selected retina analysts, including but not limited to retina specialists, ophthalmologists, optometrists, etc. (eye care specialists). Programming appropriately identifies and arrays the photos.
(48) Eye care specialists are selected by their ability to differentiate normal from abnormal retina. The eye care specialist signs into the system. The mobile application (app) opens and automatically loads retinal images for rapid diagnosis (
(49) When the specialist observes eyes requiring follow-up, a swipe gesture forwards this decision to the server that in turn sends a letter to the patient and/or referring physician recommending follow-up.
(50) In one embodiment, at the bottom of each image are three choices: 1) a side-sweep mark to expedite reporting the diagnosis of no pathology and follow up, 2) an information image and 3) a locking mechanism to permit viewing more data. The lock retains the present image and enables the specialist to magnify the image (zoom by pinching fingers on the screen or other convenient method). Enlarging specific areas enables an improved view of pathology. The image can also be swept directionally to pan over more of the surface of the retina, enabling the specialist to access all magnified areas of the photo in order to analyze the overall health of the eye and to locate problems in all imaged areas of the eye. Alternately the eye care specialist can expend the image with a double swipe or click or two fingers dragging parts of the image apart.
(51)
(52)
(53) In another embodiment, retinal images for both left and right eyes for the same patient are displayed together on one screen.
(54) The system automatically generates a report and forwards the report to the designated patient(s), primary care providers and/or other designated parties to inform them of the diagnosis. The system has a high level of security and complies with laws governing patient privacy.
(55) Three service tiers are contemplated for the system, although fewer or more are possible. Specific activities can be assigned to different tiers.
(56) Tier One is the screening level where the photos are reported as grossly normal or abnormal. This is a simple and efficient triage method that saves a physician office exam. Tier One is also amenable to a health optimization protocol, as it provides monitoring eye health well before the individual notices loss of vision. Abnormal blood vessels may be one such sign of developing hypertensive or diabetic retinopathy.
(57) Tier Two provides the information of Tier One and more information, such as the diagnosis of the pathology.
(58) Tier Three provides the information of Tier Two and more information, such as degrees of pathology and other specialist annotation and insights. This level may include degree of damage detected. For diabetic retinopathy, the specialist assigns a description of mild, moderate, and severe non-proliferative, as well as proliferative retinopathy; for hypertensive retinopathy, a standardized rating is assigned.
(59) Tier Three also lends itself to monitoring of the progress of eye pathology. Preferably previous photos are compared with current photos, for example, by overlaying the previous and current images.
(60) Tier Three activities also can be used for tracking the progression of other chronic diseases (i.e., diabetes and hypertension) because the blood vessels can be examined only in the retina.
(61) While the server generates the report, the server pays specialists by any electronic banking app, and the next set of retinal images loads.
(62) The invention has important advantages not only for patients, but also for physicians and healthcare systems. The patient's advantage is that this remote “initial visit” by the eye specialist can be done much earlier in the development of pathology, thereby enabling effective preventative steps, such as lifestyle modifications, earlier retinal intervention, etc. Furthermore, the patient foregoes the inconvenience and cost of an eye specialist visit, transportation there, and lost income. Additionally, patients and doctors can view all history of their retinal images on our secure web portal for education and patient progression monitoring.
(63) Because diagnosis using our system takes up only a fraction of the specialists' time, the cost is accordingly only a fraction of a traditional eye exam. In addition, because the diagnosis can be done via mobile devices, including but not limited to a tablet, a smart phone and a virtual reality device, eye care specialists perform a “screening visit” at their convenience and anywhere. Major savings are brought to the eye care specialist when he is able to perform many more examinations without office and staff overhead cost. The eye care specialist's time and office can then be used for those cases truly requiring a traditional office visit.
(64) The healthcare system benefits in that the “initial visit” is performed quickly and cost-effectively. Traditional office visits with general eye care specialists and retina specialists will become more streamlined and “High yield” as aforementioned.
Example 1
(65) As mentioned above, the eye care specialist remotely using our system can often evaluate a retinal photo and make a gesture swipe or tap diagnosis efficiently, usually in less than ten seconds, particularly for a normal photo. Significantly abnormal photos can also take less than ten seconds, rapidly notated via swipe or tap and then categorized quickly again via swipe or tap. These correspond to Tiers One and Two above. If an eye care specialist can average one (or a right and left pair of) retinal evaluation(s) every ten seconds that translates into 6 patients/pairs of eyes per minute and 360 per hour. Assuming two hours of breaks to rest and six hours of active work time per day and five days a week of evaluations, each eye care specialist could conceivably evaluate 10,800 patients per week, or roughly 540,000 patients per year at a fraction of the cost of a traditional exam. Busy eye care specialists may see 50 patients a day in regular practice at traditional eye examinations in their practice at an annual rate of 12,500 patient visits per year. Many of these traditional visits are also repeat visits, making the efficiency of our proposed system stand out further. If AI were to eliminate the normal eyes from the pool of eyes to be evaluated, the specialist could read mostly pathology and efficiencies would grow even further.
Example 2
(66) Busy eye care specialists will not need to dedicate their entire days to our system. Instead, a few hours a day suffice to make a significant difference—in between patients and during off hours. If each eye care specialist were to analyze retinal photos two hours per day (720) per weekday for 3,600 a week, and three hours on each weekend day (1,080) for 2,160 a weekend, each eye care specialist's evaluations total 288,000 patients per year.
(67) In another embodiment, after the images clear the quality control image inspection (see the ocular imaging camera description) and are uploaded and transmitted, a diagnostic algorithm helps diagnose diabetic and hypertensive retinopathy and annotate the specific retinal features that prompted the diagnosis. Initially, we first use Artificial Intelligence to sort out images of healthy retinas as a pre-processing step before human readers. This is logical, since healthy eyes show less variability in appearance; hence “health” can be more accurately diagnosed by AI. As we build up a database of images, AI will develop to the point of diagnosing all images and rating the degree of diabetic and hypertensive retinopathy. We will compare human evaluations with the AI diagnosis to maintain quality control. Our system is not only an AI product but also includes human verification at all stages of development.
(68) Additional options in the system include returning more detailed data to the data repository and sharing in more detail with the local physician.
(69) The phones, tablets, virtual devices and other computerized devices used for this invention may be conventional models used to operate apps similar to these in the art, such as, by non-limiting example, smart phones, tablets and virtual reality devices. Those of ordinary skill in the art will readily be able to select appropriate materials and manufacture these products from the disclosures provided herein.
(70) Many other diseases and syndromes affect the retina and can be efficiently evaluated by our devices and method. These include but are not limited to the aforementioned vascular disorders, inflammatory disorders, autoimmune disorders with possible associated eye findings, neoplastic disorders of the eye, glaucoma and other optic nerve anomalies, corneal disorders, disorders of the uvea, disorders of the crystalline lens and associated zonular apparatus, maculopathies, peripheral retinal degenerations, hereditary and congenital conditions with possible associated eye findings, infectious processes with possible associated eye findings, retinopathy of prematurity, neurologic disorders possibly manifesting with ocular findings, retinal tears, retinal detachments, phakomatoses, and other systemic disorders with possible associated eye findings, autoimmune disorders with possible associated eye findings, metabolic disorders with possible associated eye findings, degenerative disorders with possible associated eye findings, environmental or toxic conditions with possible associated eye findings. The implementations listed here, and many others, will become readily apparent from this disclosure. From this, those of ordinary skill in the art will readily understand the versatility with which this disclosure may be applied.
(71) The pet market numbers in the tens of millions in the US alone. Work animals, such as dairy cows, are numerous. Both types of animals need inexpensive care. The disclosed contact lens, ocular imaging camera and system can be readily adapted for the pet and work animal market.
(72) While the invention has been described in conjunction with specific embodiments thereof, it is evident that many alterations, modifications, and variations will be apparent to those skilled in the art in light of the foregoing description. Accordingly, it is intended to embrace all such alterations, modifications, and variations in the appended claims.
(73) The foregoing description is considered as illustrative only of the principles of the invention. Further, since numerous modifications and changes will readily occur to those skilled in the art, it is not desired to limit the invention to the exact creation and process shown and described above. Accordingly, all suitable modifications and equivalents may be resorted to falling within the scope of the invention.
(74) For the purposes of promoting an understanding of the principles of the invention, the above Detailed Description and Examples represent exemplary embodiments, and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is hereby intended. Any alterations and further modifications of the inventive features illustrated herein, and any additional application of the principles of the invention as illustrated herein, which would occur to one skilled in the relevant art and having possession of this disclosure, are to be considered within the scope of the invention.
(75) Reference throughout this specification to an “embodiment,” an “example” or similar language means that a particular feature, structure, characteristic, or combinations thereof described in connection with the embodiment is included in at least one embodiment of the present invention. Thus, appearances of the phrases an “embodiment,” and “example,” and similar language throughout this specification may, but do not necessarily, all refer to the same embodiment, to different embodiments, or to one or more of the figures. Additionally, reference to the words “embodiment,” “example” or the like for two or more features, elements, etc., does not mean that the features are necessarily related, dissimilar, the same, etc.
(76) Each statement of an embodiment or example is to be considered independent of any other statement of an embodiment despite any use of similar or identical language characterizing each embodiment. Therefore, where one embodiment is identified as “another embodiment,” the identified embodiment is independent of any other embodiments characterized by the language “another embodiment.” The features, functions and the like described herein are considered to be able to be combined in whole or in part one with another as the claims and/or art may direct, either directly or indirectly, implicitly or explicitly.
(77) As used herein, “comprising,” “including,” “containing,” “is,” “are,” “characterized by,” and grammatical equivalents thereof are inclusive or open-ended terms that do not exclude additional un-recited elements or method steps. “Comprising” is to be interpreted broadly and including the more restrictive terms “consisting of” and “consisting essentially of.”
(78) Reference throughout this specification to features, advantages, or similar language does not imply that all of features and advantages that may be realized with the present invention should be or are in any single embodiment of the invention. Rather, language referring to the features and advantages is understood to mean that a specific feature, advantage or characteristic described in connection with an embodiment is included in at least one embodiment of the present invention. Thus, discussion of the features and advantages, and similar language, throughout this specification may, but does not necessarily, refer to the same embodiment.
(79) Furthermore, the described features, advantages, and characteristics of the invention may be combined in any suitable manner in one or more embodiments. One skilled in the relevant art will recognize that the invention can be practiced without one or more of the specific features or advantages of a particular embodiment. In other instances, additional features and advantages may be recognized as certain embodiments that may not be present in all embodiments of the invention.