Gonioscope with Optical Fixation and Light Diffusion
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Solution Overview
Problem
Current gonioscopes face challenges in providing clear visualization of the anterior chamber angle and trabecular meshwork due to total internal reflection, limiting their effectiveness in diagnosing and treating glaucoma, and require improved illumination and optical fixation points for precise surgical procedures.
Innovation Solution
A gonioscope with a gonioscopic optical element made of transparent material, featuring a concave distal contact surface and a proximal surface for image formation, integrated with a handle for easy handling, and including light diffusing and reflective features to enhance illumination and visibility, along with optical fixation points for alignment and steadying.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a conventional gonioscope is used to view the anterior chamber angle, then the device can be positioned on the eye, but total internal reflection prevents clear visualization of the trabecular meshwork and angle structures
Solution Approach 1:
The patent introduces an optical element with a specific refractive index that acts as an intermediary between the external environment and the eye's anterior chamber. This optical element modifies the refractive index mismatch at the corneal surface, thereby reducing total internal reflection and enabling clear visualization of the trabecular meshwork and angle structures that were previously obscured.
Solution Approach 2:
The invention changes the optical parameters of the interface between air and the eye by introducing an optical element with a refractive index intermediate between air and corneal tissue. This parameter change modifies the critical angle for total internal reflection, allowing light from the anterior chamber angle to escape and be captured by the gonioscope.
2Illumination intensity
If illumination is increased to improve visibility of angle structures, then more light reaches the trabecular meshwork, but glare and reflections increase reducing image quality
Solution Approach 1:
The optical element is designed with non-uniform optical properties - the refractive index varies spatially to optimize light transmission in different regions. The portion contacting the cornea has properties optimized for reducing reflection, while other portions are optimized for light transmission and image formation, allowing simultaneous improvement of illumination and reduction of glare.
3Ease of operation
If the gonioscope is held manually during surgery, then the surgeon can position it, but hand stability and patient alignment are difficult to maintain simultaneously
Solution Approach 1:
The optical element incorporates an optical fixation point that provides excessive alignment cues - a bright reference point that naturally attracts the patient's gaze and guides their head positioning. This partial automation of the alignment process reduces the burden on manual stabilization while ensuring precise patient-gonioscope alignment.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The gonioscope provides improved visibility of the anterior chamber angle and trabecular meshwork, enhances illumination, and facilitates precise surgical procedures by reducing distractions and improving patient alignment, thus aiding in accurate diagnosis and treatment.
Implementation Method 1
The gonioscopic optical element can be configured to receive light from structure inside the eye through the distal contact surface and to output the light through the proximal surface to form an image of the structure inside the eye
Implementation Method 2
a light diffusing portion that can be configured to diffuse light that passes through the light diffusing portion
Implementation Method 3
the chamber angle is typically hidden from ordinary view because of total internal reflection of light rays emanating from the angle structures
Data Source
AI summary
Gonioscope devices are disclosed herein that are configured to enable a medical professional to view structure inside the eye that is ordinarily hidden from normal view. The gonioscope can be an integrally molded single piece that includes both a handle and a gonioscopic optical element. The proximal surface can have a viewing area and a light diffusing area. A recess can provide access to a wound site on the eye while the gonioscope is used for viewing. The handle can be configured to encourage proper alignment of the gonioscope with the eye. The gonioscope can provide an optical fixation point for the subject to focus on to facilitate proper alignment of the eye. The gonioscope can have one or more retention elements configured to engage the tissue of the eye around the contact surface to stabilize the gonioscope. The gonioscope can couple to a lid speculum.