Remote method of conducting the procedure of restoring fusion stability in patients with amblyopia

Abstract

A remote method of performing the procedure of restoring fusion stability in patients with amblyopia, wherein a healthcare worker enters patient data obtained as a result of a preliminary examination and monitors performance of the procedure by the patient; based on the entered patient data, test objects are generated in a user interface on a patient's computer work station that are divided into parts, where some of the parts are red and some are green; while performing the procedure, the patient uses optical equipment consisting of red and blue photofilters; the patient, looking at a test object through the optical equipment, assembles the test object parts into a single image by means of an input device, where the test objects' contrast is reduced during performance of the procedure so that the better-seeing eye sees like the amblyopic eye.

Description

[0001] REMOTE METHOD OF CONDUCTING THE PROCEDURE OF

[0002] RESTORING FUSION STABILITY IN PATIENTS WITH AMBLYOPIA

[0003] RELATED APPLICATION

[0004] This international patent application claims priority to Eurasian Application No. 2024000066 (RU) filed on March 28, 2024 (published as Eurasian Publication No. 202490706A1 ), the contents of which are incorporated here by reference.

[0005] FIELD OF TECHNOLOGY

[0006] The present technical solution belongs to the field of medicine, specifically to ophthalmology, and can be used to restore fusion stability in patients with amblyopia.

[0007] LEVEL OF TECHNOLOGY

[0008] The state of the art knows information source RU 2 718 269 C1 , published 4 / 1 / 2020, which discloses a method of restoring and developing stereo vision. According to that information source, a stereo image is displayed on a monitor screen alternately for the right and left eyes with variation in complexity level due to variation in disparity level. The stereo image consists of a lilac-colored ring on a black background, within which are two identically shaped and sized partially overlapping red and blue butterfly shapes. The image is displayed through eyeglasses with red and blue photofilters for 20 tasks. Then the disparity level is varied randomly both downward and upward from an average level corresponding to 34.25 arc minutes. First, an alternating regime is used including monocular phases for the right and left eyes and an interval with only a black background between monocular phases with sequential reduction in the duration of monocular phases and an interval from 50 to 20 ms. Then a nonalternating regime is used in the form of continuous presentation of stimuli for the right and left eyes, where a varying stereo image is presented in each task by varying the distance on the screen between the centers of the partially overlapping red and blue butterfly shapes relative to the ring plane until the patient merges the perceived butterfly shape in depth with the ring plane. If ametropia and a squint angle are present, the stereo test is presented with optimal optical correction of the ametropia and full prismatic compensation for the squint angle. The color stimuli have characteristics R 255, G 0, B 0 for the red parts, R 0, G 0, B 255 for the blue ones, and R 215, G 102, B 162 for the lilac ones.

[0009] The claimed solution differs from the prior art in that in the claimed solution, the test objects’ contrast is reduced for the better-seeing eye so that the better-seeing eye sees like the amblyopic eye.

[0010] The state of the art knows a procedure for performing telemedicine consultations (Rossi yskaya oftalmologiya online [“Russian Ophthalmology Online”] no. 23, Research Papers. Khodzhayev N. S. “Basics of Construction of Telemedicine in Ophthalmology https: / / eyepress.ru / article.aspx722675). Pursuant to the prior-art procedure, the attending physician for the patient’s contact location arranges an examination in the scope available for the given healthcare facility (HCF). The attending physician identifies indications for referring the patient to a medical commission in the form of a telemedicine (TM) consultation with the Facility’s specialist(s). After which the attending physician issues an order for TM consultation on the approved form and signs the patient’s informed consent to TM consultation. To these documents, he / she attaches medical documentation in the form of electronic files; the request for telemedicine consultation is sent by electronic mail. The Facility’s medical recorder (parent entity or branch) records the incoming request in a log, transmits the patient information to the head of the TM consultation department, and according to the electronic queue and work schedule of the Facility’s TM office, sets the date and time of the consultation (the consultation is provided within one or two business days) and notifies the attending physician of the parameters for authorized connection to the TM consultation (name and password). The TM consultation is conducted at the scheduled time in a specially equipped office. Patient information is reported by the attending physician, and the Facility’s consulting ophthalmologist either creates an electronic outpatient chart for a new patient or enters information into the patient’s electronic outpatient chart per protocol. The result of the TM consultation is documented by the consulting physician as “Telemedicine Consultation Findings,” which specifies the diagnosis and recommendations for managing the patient. The Findings are electronically mailed to the attending physician and entered into the electronic outpatient chart.

[0011] However, the prior-art method is limited to patient consultation and formulation of recommendations for treatment or prescription of treatment, but the actual treatment and prophylaxis of vision in said method cannot be performed.

[0012] SUMMARY OF THE INVENTION

[0013] The technical problem at whose solution the claimed technical solution is aimed is the creation of a remote, individually customizable, monitorable and accessible method of treating and preventing oculomotor and refractory pathology in patients with amblyopia by the performance of remote treatment, remote observation of the procedure by medical staff, and monitoring of the treatment process by the same.

[0014] The technical result achievable by solving the aforementioned technical problem is an improvement in visual acuity and restoration of binocular vision.

[0015] The claimed technical result is achieved by realizing the remote method of performing the procedure of restoring fusion stability in patients with amblyopia, containing phases in which:

[0016] • the patient undergoes preliminary examination;

[0017] • online communication is established between the healthcare worker’s computer work station and the patient’s computer work station, where each computer work station has a user interface;

[0018] • a healthcare worker, by means of the user interface on his / her computer work station, enters patient data obtained as a result of the preliminary examination and monitors performance of the procedure by the patient;

[0019] • based on the entered patient data, test objects are generated in the user interface on the patient’s computer work station that are divided into parts, where some of the parts are red and some are green;

[0020] • while performing the procedure, the patient uses optical equipment consisting of red and blue photofilters;

[0021] • the patient, looking at a test object through the optical equipment, assembles the test object parts into a single image by means of an input device, where the test objects’ contrast is reduced during performance of the procedure so that the better-seeing eye becomes less dominant than the amblyopic eye.

[0022] In a specific variant embodiment of the claimed method, the patient data include at least: patient visual parameters, the presence of eyeglass or contact lens correction, and the presence or absence of room darkening.

[0023] In a specific variant embodiment of the claimed method, the patient’s distance from the computer work station must be 50 cm.

[0024] In a specific variant embodiment of the claimed method, the healthcare worker monitors the patient’s performance of the procedure verbally and visually.

[0025] In a specific variant embodiment of the claimed method, [upon] completion of a ten-day course of treatment, the patient undergoes remote diagnosis with measurement of visual acuity.

[0026] DETAILED DESCRIPTION OF THE INVENTION

[0027] The detailed description of the invention’s embodiment presented below presents numerous details of the embodiment intended to ensure a clear understanding of the present invention. However, it will be obvious to a specialist qualified in the subject field how to use the present invention both with and without these details of the embodiment. In other cases, well-known methods, procedures, and components have not been described in detail in order not to hinder understanding of the features of the present invention.

[0028] In addition, it will be clear from this explanation that the invention is not limited to the embodiment presented. Numerous possible modifications, alterations, variations, and changes that preserve the essence and form of the present invention will be obvious to specialists qualified in the subject field.

[0029] The claimed method of remotely performing the procedure of restoring fusion stability in patients with amblyopia1is realized by means of a system consisting of a patient’s computer work station and a healthcare worker’s computer work station. Each computer work station contains a software user interface, a video camera, a microphone, and speakers.

[0030] Before the remote method of consultation is performed, the patient undergoes preliminary examination in an ophthalmologist’s office to determine his / her visual functions.

[0031] To begin realizing the method, communication is established via a wireless link between the healthcare worker’s computer work station and the patient’s computer work station.

[0032] The patient must be at a distance of 50 centimeters from the monitor, and the patient must not have darkening in the room where he / she is located.

[0033] The patient data are at least, but are not limited to:

[0034] • results of preliminary study of the patient at a healthcare facility, such as visual acuity and diagnosis;

[0035] • the need to use visual corrective devices during the procedure (if the patient wears corrective eyeglasses or contact lenses).

[0036] On the patient’s computer work station, based on patient data entered by the healthcare worker, test objects are automatically generated in the user interface by software that are divided into parts, where some of the parts are red and some are green. The test objects consist of, but are not limited to, images of a butterfly, house, fish and pyramid, where the upper right corner of the user interface shows the assembled test object image, and in the center of the user interface, said images are divided into parts that must be assembled into a single image. The parts are divided by color, red and green, where all the red parts are shown on one side relative to the center on the user interface and all the green parts are shown on the other side.

[0037] While performing the procedure, the patient uses optical equipment consisting of red and blue photofilters. If the patient uses corrective eyeglasses, the red and blue photofilters are worn over the patient’s corrective eyeglasses using clips installed on a frame with the photofilters. If the patient uses corrective contact lenses or does not use any visual correction, the red and blue photofilters are placed on eyeglass frames with zero-diopter lenses using clips installed on the frames with photofilters.

[0038] If the patient has amblyopia or strabismus with amblyopia, the image contrast is reduced by 80% so that the nonamblyopic eye sees like the amblyopic eye. This permits it to be made nondominant and the amblyopic eye dominant. That is, the patient with amblyopia or strabismus with amblyopia looking through the photofilters with the “healthy” eye sees the test objects worse due to the contrast reduction; this enables it to be made nondominant and the amblyopic eye dominant. If the patient has strabismus alone, the contrast is not altered.

[0039] The patient, looking at the test object through the optical equipment, assembles the test object parts into a single image by using an input device, for example but not limited to, a mouse, trackball, joystick, etc. The alignment must be within ±10 pixels.

[0040] During treatment, the visual fields of the right and left eyes separate, but during the procedure, the mechanism of bifoveal fusion is engaged to overcome the double image.

[0041] The duration of the entire procedure is six minutes. Successful completion of the procedure requires assembly of at least two images in all that time.

[0042] During treatment, the visual fields of the right and left eyes separate, but during the procedure, the mechanism of bifoveal fusion is engaged to overcome the double image.

[0043] Upon completion of a ten-day course of treatment, the patient undergoes remote diagnosis:

[0044] • with measurement of visual acuity with optimal correction (eyeglasses or contact lenses) if the patient uses it, or without correction in case of amblyopia;

[0045] • with measurement of visual acuity and study of binocular vision at a distance of 33 cm and 1 meter with optimal correction (eyeglasses or contact lenses) if the patient uses it, and without correction2and undergoes final online consultation with an ophthalmologist with further recommendations.

[0046] Clinical Case 1 :

[0047] Patient M, 4 years of age. Diagnosis: OD — severe hypermetropia. OS — mild hypermetropia. Uncorrected visual acuity OD 0.4 OS 1 .0, corrected OD 0.5 OS 1 .0. Autorefractometry at height of cycloplegia OD sph+5.00 cyl+0.25 ax78, OS sph+1 .25 cyl+0.50 ax102. Patient wears corrective lenses to OD sph+3.75 OS planum. After ocular consultation with ophthalmologist, patient was advised to undergo treatment at home under remote observation by healthcare staff. Recommended fusion restoration procedure with amblyopia. The procedure was conducted over 10 days using red-blue filters on clips placed on the patient’s optical corrective lenses. The procedure was conducted for six minutes with 80% blue image contrast reduction. The patient assembled the test objects. After completion of treatment, remote diagnosis of visual acuity was performed: uncorrected OD 0.5 OS 1.0, corrected OD 0.7 OS 1.0.

[0048] Clinical Case 2:

[0049] Patient M, 4 years of age. Diagnosis: OU — Concomitant horizontal nonaccommo- dative strabismus. Mild hypermetropia. Uncorrected visual acuity OD 1.0 OS 1.0. Autorefractometry at height of cycloplegia OD sph+0.75 cyl+0.25 ax78, OS sph+1 .25 cyl+0.50 ax102. Patient exhibited simultaneous vision at distances of 33 cm and 1 meter. After ocular consultation with ophthalmologist, patient was advised to undergo treatment at home under remote observation by healthcare staff. Recommended fusion restoration procedure with amblyopia. The procedure was conducted over 10 days using red-blue filters on clips placed on the patient’s zero-diopter optical corrective lenses. The procedure was conducted for six minutes. The patient assembled the test objects. After completion of treatment, remote diagnosis of visual acuity was performed: OD 1.0, OS 1.0, binocular vision detected from 33 cm and 1 meter. The computer system supporting data processing necessary for realization of the claimed solution generally comprises components such as the following: one or more processors, at least one memory, data storage unit, input / output interfaces, input device, network adapter. When machine-readable commands contained in the working memory are executed, the device’s processor is configured to perform basic computer operations necessary for the device’s functioning or for the functionality of one or more of its components. The memory is generally in the form of RAM, which is loaded with the necessary software logic to support the required functionality. During realization of the claimed solution, memory is allocated in the volume necessary to realize the claimed solution. The data storage unit may be in the form of HDD, SSD, RAID array, network storage, flash memory, etc. The unit permits long-term storage of various kinds of data. The interfaces consist of standard tools for connection and operation of peripheral and other devices, e.g., USB, RS232, RJ45, COM, HDMI, PS / 2, Lightning, etc. Data input devices used in any embodiment of a system realizing the described method may include a keyboard, joystick, display or sensor display, projector, touchpad, mouse controller, trackball, control pen, speakers, microphone, etc. The network adapter is selected from a device supporting network reception and data transmission, for example an Ethernet card, WLAN / Wi-Fi module, Bluetooth module, BLE module, NFC module, IrDa, RFID module, GSM modem, etc. The devices are used to support organization of data exchange via wired or wireless data link, for example, WAN, PAN, LAN, Intranet, Internet, WLAN, WMAN, or GSM. Device components are connected via a common data transfer bus.

[0050] These application materials have presented the preferable disclosure embodiment of the claimed technical solution, which must not be used as limiting other specific embodiments thereof that do not exceed the boundaries of the requested scope of legal protection and are obvious to specialists in the relevant field of technology.

Claims

Claims1 . A remote method of performing a procedure of restoring fusion stability in patients with amblyopia, the method comprising the steps of:• the patient undergoes preliminary examination;• online communication is established between the healthcare worker’s computer work station and the patient’s computer work station, where each computer work station has a user interface;• a healthcare worker, by means of the user interface on his / her computer work station, enters patient data obtained as a result of the preliminary examination and monitors performance of the procedure by the patient;• based on the entered patient data, test objects are generated in the user interface on the patient’s computer work station that are divided into parts, where some of the parts are red and some are green;• while performing the procedure, the patient uses optical equipment consisting of red and blue photofilters; and• the patient, looking at a test object through the optical equipment, assembles the test object parts into a single image by means of an input device, where the test objects’ contrast is reduced during performance of the procedure so that the better-seeing eye sees like the amblyopic eye.

2. The method of claim 1 , wherein the patient data includes at least: patient visual parameters, the presence of eyeglass or contact lens correction, the presence or absence of room darkening.

3. The method of claim 1 , wherein the patient’s distance from the computer work station is 50 cm.

4. The method of claim 1 , wherein the healthcare worker monitors the patient’s performance of the procedure verbally and visually.

5. The method of claim 1 , wherein upon completion of a ten-day course of treatment, the patient undergoes remote diagnosis with measurement of visual acuity.