Quick and dirty survey

**wpt** · 02-08-2006, 11:29 AM

Hi all,

I just joined Optiboard on the advice of a friend...great site. I would like your opinion on a new device I have formed a company around. This is medical device that non-invasively measures eye movements. It looks like horn rimmed glasses, is very lightweight with no cords attached. It was originally going to measure sedation in recovery room patients since saccadic eye movements correlate with sedation level. However, during our development we found that it also can detect occular misalignment in a matter of a few seconds. So we think that our first application will be screening of kids for strabismus. It is so lightweight and unobtrusive, you can place it on a 1-4 year old and get measurements in a few seconds. We would be looking at putting this in the hands of pediatricians, optometrists and opticians...eventually looking at a home use version for parents. What do you all think?

**SpecialT** · 02-08-2006, 11:55 AM

It sounds a little like the visagraph. Here is a quick link so you can get an idea what I am talking about. http://www.vftn.org/projects/justiss...relim_rpt.html

Is it any different than this? If so, how does it differ?

**wpt** · 02-08-2006, 12:05 PM

Originally Posted by SpecialT

It sounds a little like the visagraph. Here is a quick link so you can get an idea what I am talking about. http://www.vftn.org/projects/justiss...relim_rpt.html

Is it any different than this? If so, how does it differ?

Yes, both devices are based upon limbus tracking technology...the difference is that our device is not cumbersome at all (as opposed to goggles), very fast and accurate and very inexpensive. No restriction is put on the type of eye movement either...as opposed to reading goggles.

**SpecialT** · 02-08-2006, 01:56 PM

Depending on how inexpensive you are talking, I would think that any Vision Therapy specialist and many pediatric practices would be interested. I just have no idea how many pediatric and VT specialists there are. Otherwise, I wouldn't think that most primary eye care docs would make the purchase. I find that one of the major drawbacks to instruments like this is the software. I encourage you to focus extra effort on the ease of use and professional appearance of your software.

Who knows, this thinking may be way off but at least I am giving you some feedback.

**fjpod** · 02-08-2006, 05:00 PM

Will it detect constant misalignment or only a variable turn? How long does the subject have to wear it? 1 to 4 year olds aren't going to wear anything...for very long.

**harry a saake** · 02-08-2006, 08:45 PM

wpt , if you want we have a section on this board for all new optical gear of any type, send one in to one of our resident experts and they will evaluate it for you free of charge and then post it on the optiboard

**eyegirl** · 02-09-2006, 10:20 PM

Although this does sound quite interesting. I'm wondering two things.

1. Would kids really WEAR the glasses? Typically, children aren't very cooperative with wearing glasses, unless they see some visual benefit.

2. Parents currently can moniter for misalignment with a $4 penlight, by watching for unequal corneal reflexes.
Have you thought about these issues? If you have, what plans do you have to overcome them?

**Johns** · 02-09-2006, 10:31 PM

WPT,

I think some of the folks here are confused. Or maybe I am. The use you are suggesting for these is purely for screening, correct ? It sounds like it would just be a real quick, on/off screen.

It sounds great. Is it already pattented ?

**eyegirl** · 02-09-2006, 10:33 PM

Johns,
I think you're right. I believe I misread the OP.
I think this would be a great screening tool for schools!

**fjpod** · 02-10-2006, 07:17 AM

Originally Posted by eyegirl

Johns,
I think you're right. I believe I misread the OP.
I think this would be a great screening tool for schools!

Not trying to be a naysayer, but if the instrument can only "screen" eye movements, and we're not even sure yet if it detect constant vs intermittant tropias, I think it would be a while before it would be a useful tool in schools.
Besides, it doesn't screen for myopia, hyperopia, astigmatism, anisometropia (which is a leading cause of amblyopia), pathology,etc. By the time you "screen" for all these other things, half the schoolday is gone. The kid might as well go for an eye exam.

IMHO

I know people will say that I'm just trying to drum up business...

**wpt** · 02-10-2006, 08:01 AM

Good points all. The Bruckner test with the pen light is not very sensitive.. 65% when done by someone who knows what they are doing. Our test is close to 100%. Any phoria and strabismus will be detected with our system. It actually measures position and speed of each eye at the same time and compares the two. It is meant as a very quick screen for any alignment problems. Moreover, it will have LCD lenses that can be blackened in milliseconds to replicate patching...not allowing fusion of the eyes and forcing the strabismic eye to deviate....so a precise extropic measurement may be taken. But with a non-cooperative kid, a quick measurement is sufficient to pick up non phoria misalignment. Let me look over some of the other replies to make sure that I have addressed everything. Thanks all for your input!!

**wpt** · 02-10-2006, 08:03 AM

Good points all. The Bruckner test with the pen light is not very sensitive.. 65% when done by someone who knows what they are doing. Our test is close to 100%. Any phoria and strabismus will be detected with our system. It actually measures position and speed of each eye at the same time and compares the two. It is meant as a very quick screen for any alignment problems. Moreover, it will have LCD lenses that can be blackened in milliseconds to replicate patching...not allowing fusion of the eyes and forcing the strabismic eye to deviate....so a precise extropic measurement may be taken. But with a non-cooperative kid, a quick measurement is sufficient to pick up non phoria misalignment. Let me look over some of the other replies to make sure that I have addressed everything. Thanks all for your input!!

**eyegirl** · 02-10-2006, 08:15 AM

The bruckner test is different. What I was referring to was Hirshberg.

In response to school screenings and just having them get an eye exam.

In a perfect world where parents were informed I'm sure that would be ideal.

A lot of parents rely on school screenings or pediatric well child visit screenings, to detect problems.

**wpt** · 02-10-2006, 08:31 AM

My mistake I guess...but based on our surveys, the pediatricians do not do even these tests at well kid visits. Besides, they aren't that good. The randot e test will pick up strabismus usually, but requires a kid cooperating (age 4 and above).
Parents may rely on pediatricians for this, but the pediatricians state that they rely on the parents to pick up any gross misalignment...which is ok if it is truly bad >6 degrees. But mild misalignment is not picked up till late in the game and it gets progressively more difficult to fix as the kid ages. Best time to fix it is before all the patterning is done in the visual cortex (ages 1-6).

**eyegirl** · 02-10-2006, 06:26 PM

Originally Posted by wpt

My mistake I guess...but based on our surveys, the pediatricians do not do even these tests at well kid visits. Besides, they aren't that good. The randot e test will pick up strabismus usually, but requires a kid cooperating (age 4 and above).

Parents may rely on pediatricians for this, but the pediatricians state that they rely on the parents to pick up any gross misalignment...which is ok if it is truly bad >6 degrees. But mild misalignment is not picked up till late in the game and it gets progressively more difficult to fix as the kid ages. Best time to fix it is before all the patterning is done in the visual cortex (ages 1-6).

The Bruckner test shows that the brain is using both eyes together. It is done using a direct ophthalmoscope, not a penlight.

I mentioned it to one of the doctors today and it peaked his curiousity as well. He too was concerned of the cooperation of the child, as well as the cost/benefit factor.

I work in ped's ophthalmology. Do you have a prototype available?

**wpt** · 02-10-2006, 08:32 PM

The prototype for use in the clinic is a couple of month away. We are having it tested at MEEI in Boston. It will be quite inexpensive and very easy to use. It should not take more than 5-10 seconds to get an accurate reading.