A contact lens sensor equipped with the right technology could potentially serve to prevent and treat many ophthalmic diseases. Early detection and treatment of ophthalmic disease often results in better visual outcomes. Our contact lens solution, Smart Lens, focuses on glaucoma. This is a chronic disease that affects more than 3 million Americans, and close monitoring of intraocular pressure (IOP) and optic nerve cup to disc (C/D) ratio would likely be of great benefit for the patient and clinician. IOP is known exhibit a diurnal variation of up to 6 mmHg throughout the day. For patients with borderline or manifest ocular hypertension, this can be problematic as clinicians must determine the risk of glaucomatous damage from just one IOP measurement in the office. Furthermore, early detection of changes in C/D ratio would serve to alert the ophthalmologist that more intensive management is required before additional loss of vision.
Glaucoma causes damage to the optic nerve through incompletely understood mechanisms. However, we know that it is a slowly progressive disease, and it affects the peripheral vision first. Therefore, patients are often asymptomatic even into the later stages of the disease. Because of this, patients are often monitored closely with three main tests: IOP measurement, C/D ratio of the optic nerve head, and visual field testing. With current technology, the patient must return to clinic often for repeat testing in order to prevent glaucomatous nerve damage resulting in visual field loss. Smart Lens will fulfill two of these tests. IOP can be measured by sensors attached to the inside of the contact lens. A longitudinal plot of the IOP throughout the day can then be generated. Doctors will use this data to determine if the patient is adequately treated, or if there is risk of optic nerve damage from transient but significant pressure elevations that may not be captured in the clinic. Further, machine-learning algorithms will be used to intelligently assign risk scores to pressure readings, and send alerts to the ophthalmologist. Eventually, this system will also be able to recommend treatment modifications and management goals. Additionally, an inward facing camera inside Smart Lens will take photos of the inside of the eye through the pupil. The camera will be placed in the physiological blindspot and not interfere with vision. Periodic photos will be taken and sent to the ophthalmologist, who will use it to determine whether the patient needs to be seen for further evaluation. This will reduce the number of visits for patients, reduce costs for the healthcare system, and allow for better outcomes through prevention of vision loss.
In addition to preventative care, Smart Lens will be used by ophthalmologists to treat glaucoma in the future as well. Antihypertensive medication will be integrated into the back of the contact lens and treat the eye through a slow-release mechanism. This has many benefits for the patients and the clinician. It will relieve the patient of the burden of self-dosing eye drops throughout the day. It will also provide better adherence to the treatment regimen desired by the ophthalmologist. This may result in additional prevention of visual loss through better, more consistent treatment.
Smart Lens represents the future of glaucoma management. Patients and clinicians have been burdened by the inadequacy of frequent office visits, poor estimation of risk of glaucomatous damage, and poor adherence to treatment regimens with few technological improvements to care. Smart Lens is a wearable device designed to simplify and enhance the prevention and treatment of glaucoma through the use of modern technology. It will reduce improve the quality of patient care, reduce healthcare costs, and improve the patient experience.
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