Orthotic rehabilitation apparatus for treating binocular diplopia

Abstract

The invention relates to an orthoptic rehabilitation device for the treatment of binocular diplopia comprising a longitudinal element (12, 13) having a first face (1a) and a second face (1b) and a median axis (X) delimiting, on each of the faces, two symmetrical parts on which are arranged, respectively, a series of fixed visual targets and moving visual targets and a stereogram (11), characterized in that the series of visual targets comprises light-emitting diodes (LEDs 2) arranged on the median axis which are powered by a battery (3) and whose activation is programmable by means of a microprocessor (4).

Description

TECHNICAL FIELD OF THE INVENTION

[0001] The invention relates, in general, to the field of optics and is more particularly concerned with an apparatus intended for orthoptic rehabilitation. STATE OF THE PRIOR ART

[0002] Some people suffer from binocular diplopia, which is when they see two images of the same object. This double vision can affect one eye, in which case it is called monocular diplopia, or both eyes, in which case it is called binocular diplopia.

[0003] The causes of this visual impairment are multiple and can be found in an infection or an eye trauma, or be a consequence of rheumatological or cerebral problems, the presence of diabetes or even high blood pressure... This physiological impairment can be treated through surgery or by means of various orthoptic rehabilitation procedures aimed at restoring visual convergence.

[0004] There are different types of rehabilitation devices allowing, in particular, the practice of visual correction exercises using stereograms formed of two identical figures juxtaposed symmetrically with respect to an axis.

[0005] Patent FR2488131B1 describes a device of this type for the rehabilitation of binocular vision comprising a plate supporting moving targets and fixed targets associated with printed stereograms.

[0006] Another device called "Unicorn glasses" allows, thanks to a removable central rod associated with interchangeable lenses and prisms, to train convergence and maintain it while wearing a frame at home.

[0007] Document US2011 / 184498A1 describes an example of an additional device for learning binocularity and depth.

[0008] These known devices are, however, intended to be used with the assistance of specialized personnel (ophthalmologist, orthoptist, or optician) who manages rehabilitation exercise programs depending on the nature and extent of the ocular deficiency. STATEMENT OF THE INVENTION

[0009] In this context, the invention sought a technical solution which, in its most general aspect, makes it possible to automatically implement several orthoptic rehabilitation exercise programs for the treatment of binocular diplopia. These programs are adapted to the patient's deficiency, who can practice his visual exercises independently and remotely by means of an oculomotor device and without the need to call upon a specialized establishment or medical personnel.

[0010] This object is achieved, according to the invention, by means of an orthoptic rehabilitation apparatus for the treatment of diplopia according to claim 1. The apparatus comprising a longitudinal element provided with a first face and a second face and a median axis delimiting, on each of the faces, two symmetrical parts on which are arranged, respectively, a series of fixed visual targets and moving visual targets and a stereogram, characterized in that the series of visual targets comprises light-emitting diodes (LEDs) arranged on the median axis which are powered by a battery and whose activation is programmable by means of a microprocessor.

[0011] The stereogram includes a graduated ruler placed on either side of the median axis.

[0012] The diode series includes diodes capable of emitting light of variable color by being controlled by the microprocessor according to the programming.

[0013] According to yet another characteristic of the apparatus of the invention, the diodes are capable of being activated successively and in an order governed by the microprocessor according to the programming so as to simulate a virtual movement along the longitudinal element.

[0014] According to one embodiment of the apparatus of the invention, the series of diodes is housed in a slot extending along the median axis such that the emitted light is visible on both faces of the longitudinal element.

[0015] According to an alternative embodiment, the microprocessor is connected to a wireless network.

[0016] According to another embodiment of the invention, the device comprises push buttons mounted on the longitudinal element and intended, respectively, for activating, deactivating and pausing the device and for adjusting the intensity of the light emitted by the diodes and their activation frequency.

[0017] According to yet another embodiment, the device comprises a program display member.

[0018] According to a first embodiment of the invention, the longitudinal element of the rehabilitation device consists of a plate carrying the battery and the programmable microprocessor.

[0019] In this case, one of the longitudinal end edges of the plate is provided with a cutout for positioning a patient's nose.

[0020] According to a second embodiment of the invention, the longitudinal element of the rehabilitation device consists of a bar.

[0021] Another object of the invention is a use of the orthoptic rehabilitation device, characterized in that the activation of the series of diodes is programmed according to the visual exercises intended for the treatment of binocular diplopia.

[0022] Thus, in principle, the invention proposes an orthoptic rehabilitation device suitable and intended to facilitate the resumption of visual convergence through the practice of programmable exercises.

[0023] The ocular motor training device of the invention is lightweight, portable and easy to use and allows a patient to practice visual exercises independently and ergonomically. These exercises are directly programmable from the device and take place automatically while remaining adjustable at any time by the patient. BRIEF DESCRIPTION OF THE FIGURES

[0024] Other characteristics and advantages of the invention will emerge from reading the description which follows, with reference to the appended figures, for which: [ Fig. 1 ] is a top view of a first embodiment of the rehabilitation apparatus according to the invention. [ Fig. 2 ] is a bottom view of the rehabilitation device of the figure 1 . [ Fig. 3 ] is a side view of the rehabilitation device of the figure 1 . [ Fig. 4 ] is a front view of a second embodiment of the rehabilitation apparatus according to the invention. [ Fig. 5 ] is a side view of the rehabilitation device of the figure 4 .

[0025] For clarity, identical or similar elements are identified by identical reference signs throughout the figures.

[0026] Naturally, the embodiments of the rehabilitation apparatus according to the invention illustrated schematically by the figures presented above and described below are given only as non-limiting examples. It is explicitly provided within the scope of the invention that different modes can be proposed and combined together to propose others. DETAILED DESCRIPTION OF AN EMBODIMENT

[0027] The invention relates to the general field of orthoptic rehabilitation in the context of the treatment of binocular diplopia.

[0028] More specifically, the invention sought to develop a portable, easy-to-use and autonomous oculomotor device that could be used for orthoptic rehabilitation on the go and without the assistance of specialized personnel.

[0029] This device includes, in the traditional manner and as illustrated by the figures 1 to 5representing two distinct embodiments, a longitudinal element 1 provided with a first face 1a, a second face 1b and a median axis X.

[0030] The X axis delimits, on each of the faces 1a, 1b, two symmetrical parts on which are arranged, respectively, a series of visual targets, some of which are fixed and others mobile, and a stereogram 11 ( figure 1 ).

[0031] According to the invention, the series of visual targets comprises light-emitting diodes or “LEDs” 2 arranged on the median axis X which are powered by a battery 3 and whose activation is programmable by means of a microprocessor 4 (as illustrated by the figure 1 ). This control microprocessor 4 is preferably an ESP32 with low power consumption and having the possibility of Bluetooth and / or Wifi communication.

[0032] Battery 3 is preferably of the LiPO type. This battery 3 can be recharged either wirelessly by induction (QI charging standard) or with a conventional USB charger by plugging it into the port provided for this purpose. When the device is switched off, battery 3 can be charged either wirelessly or in wired mode with a USB charger.

[0033] The stereogram 11 here comprises a graduated ruler arranged on either side of the median axis X. The series of diodes 2 comprises diodes capable of emitting lights of variable colors by being controlled by the microprocessor 4 according to the chosen programming.

[0034] More precisely, the diodes 2 are capable of being activated successively or simultaneously and in an order governed by the microprocessor 4 according to the programming, as described below, so as to simulate a movement of the targets along the X axis. Preferably, the microprocessor 4 is connected to a wireless network, wifi or Bluetooth (registered trademark).

[0035] As illustrated by the figure 1, this rehabilitation device further comprises a series of push buttons 5 mounted on the longitudinal element 1 and some of which are placed on the side of the housing containing the microprocessor 4. These buttons are intended, respectively, for activating, deactivating and pausing the device, for changing programs and for adjusting the intensity of the light emitted by the diodes 2, their activation frequency and their direction of movement. More precisely, one of these buttons makes it possible to reverse the virtual movement of the LEDs which in fact corresponds to successive and rapid phases of lighting up one LED and extinguishing the immediately adjacent LED. As illustrated by the figure 3 , a side button 5a allows the firmware update and a USB port 5b provides the connection for charging the battery.

[0036] A program display unit 6 completes the equipment of the device. This display unit or display includes a seven-segment LED showing the program selected by the patient from among the twenty available programs.

[0037] The loading and updating of programs in the computer system embedded in the device and controlled by the microprocessor 4 are carried out by connection to an external server, for example, via a USB cable or via a wireless connection of the wifi type.

[0038] The invention also provides, according to an alternative embodiment, the possibility of controlling the device remotely via an application on a smartphone or tablet (under Android or IOS). If necessary, an independent and remote operator will be able to change the program and vary the speed of virtual movement of the light targets and their intensity, thus allowing the user of the plate to concentrate on his exercise.

[0039] According to a first embodiment of the invention shown in the figures 1 , 2 And 3 , the longitudinal element 1 of the rehabilitation device is produced here in the form of a plate 12 carrying the battery 3 and the programmable microprocessor 4.

[0040] According to a variant of the invention specific to this first embodiment, it is possible to provide that the plate 12 of the rehabilitation device integrates all the on-board electronics, by arranging it in a sandwich between the two faces 1a, 1b while not exceeding a total thickness of a few millimeters.

[0041] In this embodiment, a series of diodes 2 is placed on each face. A variant could provide that the series of diodes is housed in a slot extending along the median axis X so that the emitted light is visible on the two faces 1a, 1b of the plate 1.

[0042] The LEDs could be controlled independently or simultaneously if necessary. By default, the LEDs on both sides of the device are planned to be systematically and permanently lit and synchronized in the same way. In fact, it happens that the patient, during his exercise, does not actively use both sides, the professional operator who assists him obtains visual feedback of what the patient sees.

[0043] An update allows, at the operator's request, to turn off one of the two sides. To do this, the operator will perform a long press on the program change button. Indeed, although it is convenient for the operator to have visual feedback, it turns out that the operator ends up suffering from eye fatigue after successive interventions with numerous patients.

[0044] The LEDs are integrated into the plate 12 and, where appropriate, they are flush with the plate. The plate is made, for example, of matte acrylic and is therefore slightly flexible while being resistant. The plate has a semi-transparent screen 12a ( figure 1 ) glued and serving both as a reflector to improve the visibility of lit LEDs and as a filter.

[0045] One of the longitudinal end edges of the plate 1 is provided with a cutout 10 for positioning a patient's nose. The plate 12 can be used in the vertical or horizontal direction depending on the rehabilitation exercises performed, as described below.

[0046] For programs using only the upper face 1a of the plate 12, the user holds the plate 12 by hand, keeping it in a horizontal plane, and positions it in contact with his nose in the location formed by the cutout 10 provided for this purpose. For programs using both faces 1a, 1b, the user holds the plate 12 by hand on the edge and positions it in contact with his nose, the X axis being oriented horizontally.

[0047] It is however possible, without departing from the scope of the invention, to provide other modes of use of the apparatus of the invention, such as, for example, by asking the patient to hold the plate at arm's length, either in a vertical position or in a horizontal position. In this case, the use of the plate is essentially the same as performing the same exercises as with the bar but at half distance. Consequently, a professional possessing both embodiments of the apparatus can perform any form of rehabilitation.

[0048] The rehabilitation exercises are carried out as described below. In general, the aim of the exercises is to get the user to follow with their eyes the virtual movement of the moving light target formed by a lit LED.

[0049] Depending on the program used, he can also wear stereoscopic glasses with red and green filters (not shown). This accessory makes it possible to make an LED invisible to one of the eyes, for example, glasses with a red filter on the left and a green filter on the right. Thus, the lighting of a red LED will only be visible to the right eye while an LED emitting a green light will only be visible to the left eye.

[0050] According to a second embodiment of the invention represented by the figures 4 And 5 , the longitudinal element 1 of the rehabilitation device consists of a bar 13.

[0051] The 13 bar can be made in several different sizes, for example, with a length of 1.5m and 1m a length of 1.5m and has up to 50 red / green / blue LEDs spaced approximately 1.25cm apart. The device in the form of the 13 bar is intended to be autonomous or connected by a cable and a connector (for example, a 3.5mm jack type) to a control box. This control box is powered by a separate 5V power supply.

[0052] This bar offers around ten exercise programs. Changing programs is done with a simple push button.

[0053] The 13 bar can be positioned either horizontally or vertically. It can be attached to a photographer's tripod, hung on a wall, or placed on a table.

[0054] An element 13a ( figure 4 And 5) for attaching the bar 13 to a photographer-type tripod is mounted in the center of the bar. This element 13a has a thread on each side. Indeed, depending on the tripod and the exercise being performed, it is sometimes necessary to attach the bar on the other side to be able to correctly orient the bar facing the patient (horizontal, vertical / oblique / facing the LEDs upwards, etc.). Incidentally, an element 13b located at the end of the bar 13 ( Figure 5 ) allows the box to be plugged onto the bar.

[0055] Depending on the program used, the user can also wear stereoscopic glasses with a red and green filter. This accessory makes it possible to make an LED invisible on one eye, for example, a red filter glasses on the left and a green filter glasses on the right. In this case, a red LED will only be visible to the right eye while a green LED will only be visible to the left eye.

[0056] As with plate 12, the firmware of bar 13 can be updated using a USB cable connection, thus making it possible to modify or add new programs.

[0057] The control box (or microcontroller) is an "Arduino" or an "ESP32" that can be self-powered and designed to support OTA (wifi) updates. This box is autonomous or controlled remotely via an application loaded on a smartphone or tablet (Android or IOS) via Bluetooth or wifi. The box is possibly removably attached to the bar 13. A small battery can also be integrated into the bar. Alternatively, the box could be removably attached to the bar while remaining connected by a cable to improve the compactness of the device and allow the operator to position himself wherever he wants to control the exercises.

[0058] The spacing of the LEDs can also change, going from 3.5cm spacing to a smaller spacing in order to increase the number of light targets on the bar and therefore make the successive lighting of the LEDs more fluid.

[0059] The lighting of the LEDs and therefore their virtual movement speed as well as their light intensity can be adjusted by the operator using potentiometers provided for this purpose.

[0060] The methods of implementing the rehabilitation method using the apparatus of the invention are described in detail below, first with the apparatus in the form of a plate 12 then with the apparatus in the form of a bar 13.

[0061] For each program, the intensity of the LED light and their virtual movement speed are adjustable directly and independently by the user or by an independent operator.

[0062] Program 1.1 with the device in the form of plate 12.

[0063] The plate is held flat, horizontally and placed in contact with the user's nose. A first red LED lights up on the top face 1a in a position far from the user, indicating the starting point of the program. The LED changes from red to white and moves closer to the user. When it gets closest to the user, it lights up red, indicating the end position to the user. The LED lights up white again, moves away again, and so on. Program 1.2.

[0064] The first and last LEDs light up red, indicating to the patient where the exercise begins and ends. The red LED then remains lit for a quarter of a second longer before starting to move. The blue LED only moves forward (or backward if the user changes direction). For example, when you reach the point closest to the user, you start again from the point furthest from the user.

[0065] The user, using the button provided for this purpose, can at any time interrupt the movement (by exerting a long manual pressure) and / or reverse it (with a short pressure).

[0066] Program 1.3 with the device in the form of plate 12.

[0067] The plate 12 is held flat, horizontally and placed in contact with the user's nose.

[0068] A fixed blue LED lights up at the end of plate 12. A red LED lights up closest to the user and then moves away from the user. When it reaches the opposite end of plate 12, the virtual movement of the LED is reversed and so on. Program 1.4

[0069] The plate 12 is held flat, horizontally and placed in contact with the user's nose. A fixed blue LED is lit in the middle of the plate. A red LED moves from the end of the plate (position furthest from the user) and approaches the midpoint without going beyond it. Arriving at the middle of the plate, the movement is reversed and the LED moves away again.

[0070] Each press of the push button shifts and repositions the blue LED (fixed) by a certain distance so that it is increasingly closer to the user. At the same time, the virtual displacement amplitude of the blue LED changes according to three distinct amplitudes, respectively, from the middle to the closest to the user. Program 1.5

[0071] At the start of the program, three fixed LEDs light up. A blue LED in the center of the plate, a red LED at one end away from the user and a green LED at the other end.

[0072] Pressing the push button starts the movement. The blue LED remains fixed while the red and green LEDs move simultaneously towards the blue LED. When they reach the central point, they cross. When the red and green LEDs reach the end of the plate, the movement reverses.

[0073] At any time, the user can interrupt the movement or reverse it by pressing the push button. This program allows working with stereoscopic glasses Program 1.6

[0074] This program is similar in its mode of operation to program 1. A green LED and a red LED are alternately lit and move. The choice of color allows you to work with stereoscopic glasses with red and green filters. Program 1.7

[0075] The plate 12 is still held on its edge, its longitudinal axis X being oriented in a horizontal direction, and placed in contact with the user's nose. Each eye views a different face of the plate 12.

[0076] The LEDs are lit in sync between the two sides 1a and 1b. One LED per side is lit and in the same position.

[0077] Initially, a blue LED at the end of the plate furthest from the user moves closer in virtual jumps of approximately 3 cm.

[0078] This program corresponds to a default movement of the order of one second and, at the slowest, 3 seconds between each movement and at the fastest 0.5 seconds. The default program 1.1 starts with a change every 150ms, but these changes can take place in a range between 5ms and 600ms. Program 1.8

[0079] The plate 12 is this time held on its edge, its longitudinal axis X being oriented in a horizontal direction, and placed in contact with the user's nose. Thus, each eye views a different face of the plate 12.

[0080] The LEDs are lit up synchronously between the two sides 1a and 1b. One LED per side is lit in the center. The color alternates between red and green with each virtual movement.

[0081] The movement is from the center to the ends. The green LED moves closer to the user. The red LED moves away. There is only one colored LED lit at a time. Either the red or the green. When you reach the end of the plate, the movement is reversed.

[0082] The user, using the push button provided for this purpose, can at any time interrupt the virtual movement (by exerting a long pressure) and / or reverse it (with a short pressure) to indicate to the operator the precise position in which he observes the LEDs in duplicate. The choice of color allows working with stereoscopic glasses with red and green filters. Program 1.9

[0083] The plate 12 is still held on its edge, its longitudinal axis X being oriented in a horizontal direction, and placed in contact with the user's nose. Each eye views a different face of the plate 12.

[0084] The LEDs are lit in sync between the two sides 1a and 1b. One LED per side is lit and in the same position.

[0085] Alternately a red then green LED lights up at a random position.

[0086] This program, by default, is a slow program. The user must have time to find and see the LED lit on the plate

[0087] The choice of color allows working with stereoscopic glasses with red and green filters.

[0088] The various rehabilitation exercise programs using the apparatus of the invention in the form of a bar 13 will now be described in detail. In each of these programs, the light intensity and the virtual movement speed of the LEDs are always adjustable by an operator or the user himself.

[0089] Fixed program 2.0 with the embodiment of the device in the form of bar 13.

[0090] To the left of bar 13 is a fixed green LED, in the middle a fixed blue LED and to the right a fixed red LED. Program 2.1: Visual pursuit with amplitude change.

[0091] Initially, a blue LED lights up in the center of the bar 13. It moves from left to right over an amplitude of approximately 20 cm, making back and forth movements. After a phase of five back and forth movements, the amplitude increases by 20 cm until it reaches an amplitude corresponding to the total length of the bar. Once the maximum amplitude is reached, the exercise starts again, adopting the smallest amplitude. Program 2.2: Complete visual pursuit.

[0092] At the start of the program, a blue LED lights up in the middle of the bar and then this LED moves from left to right of the bar and vice versa. Program 2.3: Visual pursuit with alternating colors.

[0093] Initially, an LED lights up in the center of the bar, then this lit LED moves from left to right along the entire length of the bar and vice versa. The color changes from green to red alternately with each virtual movement of the LED.

[0094] This exercise allows, using stereoscopic glasses with green and red filters, to only visualize one LED every two eyes. Program 2.4: Sine.

[0095] The user positions himself in line with the bar 13, with the bar in front of him.

[0096] A blue LED lights up on the left side, closest to the user. It then moves to the right, moving away from the user. When it reaches the end of the bar, it starts again from the left side. But, from the user's point of view, it only appears to be moving back and forth. Program 2.5: Inverted Sine.

[0097] This program is identical to program 4 except that the LED begins its virtual movement on the opposite side of the bar from the user's position. Then, it moves closer to the user and, upon reaching the beginning of the bar, returns to its starting point. But it does not move back and forth. From the user's point of view, it only returns. Program 2.6: Alternate flashing.

[0098] Three LEDs flash alternately in the following sequence. The LED on the left side of bar 13 lights up red and then goes out. The middle LED lights up blue and then goes out. The LED on the right side lights up green and then goes out, and so on. Program 2.7: Opposite alternating flashing.

[0099] Two LEDs light up alternately, left side in green and right side in red. Program 2.8: Random alternating flashing.

[0100] Alternate flashing of the LEDs in red and green in random positions on bar 13. This exercise can be performed with stereoscopic glasses.

[0101] Naturally, the invention is described in the foregoing by way of example. It is understood that those skilled in the art are able to carry out different variant embodiments of the invention without departing from the scope of the invention.

[0102] It is specified that all the characteristics, as they emerge for a person skilled in the art on reading this description, the figures and the associated claims, even if concretely they have only been described in relation to other determined characteristics, both individually and in any combinations, may be combined with other characteristics or groups of characteristics disclosed here, provided that this has not been expressly excluded or that the technical context makes such combinations impossible or meaningless.

[0103] The invention is defined by the appended claims.

Claims

1. Orthoptic rehabilitation device for the treatment of binocular diplopia comprising a longitudinal element (12, 13) with a first face (1a) and a second face (1b) and a median axis (X) delimiting, on each of the faces, two symmetrical portions on which are arranged, respectively, a series of fixed visual targets and mobile visual targets and a stereogram (11), the series of visual targets comprises light-emitting diodes (LEDs 2) which are arranged on the median axis and are capable of emitting light of variable color, being powered by a battery (3) and controlled by a microprocessor (4) according to programming, characterized in that said stereogram (11) comprises a graduated rule arranged on either side of the median axis (X).

2. Device according to claim 1, characterized in that the diodes (2) are capable of being activated successively or simultaneously and in an order determined by the microprocessor according to the programming so as to simulate a virtual movement along the longitudinal element.

3. Device according to one of the preceding claims, characterized in that the series of diodes (2) is housed in a slot extending along the median axis (X) in such a way that the light emitted is visible on both faces (1a, 1b) of the longitudinal element (12).

4. Device according to one of the preceding claims, characterized in that the microprocessor (4) is connected to a wireless network.

5. Device according to one of the preceding claims, characterized in that it comprises push-buttons which are mounted on the longitudinal element (12, 13) and intended, respectively, for activating, deactivating and pausing the device and for adjusting the intensity of the light emitted by the diodes (2) and the activation frequency thereof.

6. Device according to one of the preceding claims, characterized in that it comprises a program display member.

7. Device according to one of the preceding claims, characterized in that said longitudinal element consists of a plate (12) supporting the battery (3) and the programmable microprocessor (4).

8. Device according to the preceding claim, characterized in that one of the longitudinal end edges of the plate (12) is provided with a cutout (10) for positioning a patient's nose.

9. Device according to one of the preceding claims, characterized in that said longitudinal element consists of a bar (13).

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