Usability of prostaglandin monotherapy eye droppers

AIM: To determine the force needed to extract a drop from a range of current prostaglandin monotherapy eye droppers and how this related to the comfortable and maximum pressure subjects could exert. METHODS: The comfortable and maximum pressure subjects could apply to an eye dropper constructed around a set of cantilevered pressure sensors and mounted above their eye was assessed in 102 subjects (mean 51.2±18.7 years), repeated three times. A load cell amplifier, mounted on a stepper motor controlled linear slide, was constructed and calibrated to test the force required to extract the first three drops from 13 multidose or unidose latanoprost medication eye droppers. RESULTS: The pressure that could be exerted on a dropper comfortably (25.9±17.7 Newtons, range 1.2-87.4) could be exceeded with effort (to 64.8±27.1 Newtons, range 19.9-157.8; F=19.045, p<0.001), and did not differ between repeats (F=0.609, p=0.545). Comfortable and maximum pressures exerted were correlated (r=0.618, p<0.001), neither were influenced strongly by age (r=0.138, p=0.168; r=-0.118, p=0237, respectively), but were lower in women than in men (F=12.757, p=0.001). The force required to expel a drop differed between dropper designs (F=22.528, p<0.001), ranging from 6.4 Newtons to 23.4 Newtons. The force needed to exert successive drops increased (F=36.373, p<0.001) and storing droppers in the fridge further increased the force required (F=7.987, p=0.009). CONCLUSIONS: Prostaglandin monotherapy droppers for glaucoma treatment vary in their resistance to extract a drop and with some a drop could not be comfortably achieved by half the population, which may affect compliance and efficacy.

Anterior eye health recording

Aims: To survey eye care practitioners from around the world regarding their current practice for anterior eye health recording to inform guidelines on best practice. Methods: The on-line survey examined the reported use of: word descriptions, sketching, grading scales or photographs; paper or computerised record cards and whether these were guided by proforma headings; grading scale choice, signs graded, level of precision, regional grading; and how much time eye care practitioners spent on average on anterior eye health recording. Results: Eight hundred and nine eye care practitioners from across the world completed the survey. Word description (p <. 0.001), sketches (p = 0.002) and grading scales (p <. 0.001) were used more for recording the anterior eye health of contact lens patients than other patients, but photography was used similarly (p = 0.132). Of the respondents, 84.5% used a grading scale, 13.5% using two, with the original Efron (51.6%) and CCLRU/Brien-Holden-Vision-Institute (48.5%) being the most popular. The median features graded was 11 (range 1-23), frequency from 91.6% (bulbar hyperaemia) to 19.6% (endothelial blebs), with most practitioners grading to the nearest unit (47.4%) and just 14.7% to one decimal place. The average time taken to report anterior eye health was reported to be 6.8. ±. 5.7. min, with the maximum time available 14.0. ±. 11. min. Conclusions: Developed practice and research evidence allows best practice guidelines for anterior eye health recording to be recommended. It is recommended to: record which grading scale is used; always grade to one decimal place, record what you see live rather than based on how you intend to manage a condition; grade bulbar and limbal hyperaemia, limbal neovascularisation, conjunctival papillary redness and roughness (in white light to assess colouration with fluorescein instilled to aid visualisation of papillae/follicles), blepharitis, meibomian gland dysfunction and sketch staining (both corneal and conjunctival) at every visit. Record other anterior eye features only if they are remarkable, but indicate that the key tissue which have been examined.

What is the optimum artificial treament for dry eye?

Dry eye disease is a common clinical condition whose aetiology and management challenges clinicians and researchers alike. Practitioners have a number of dry eye tests available to clinically assess dry eye disease, in order to treat their patients effectively and successfully. This thesis set out to determine the most relevant and successful key tests for dry eye disease diagnosis/ management. There has been very little research on determining the most effective treatment options for these patients; therefore a randomised controlled study was conducted in order to see how different artificial treatments perform compared to each other, whether the preferred treatment could have been predicted from their ocular clinical assessment, and if the preferred treatment subjectively related to the greatest improvement in ocular physiology and tear film stability. This research has found: 1. From the plethora of ocular the tear tests available to utilise in clinical practice, the tear stability tests as measured by the non-invasive tear break (NITBUT) up time and invasive tear break up time (NaFL TBUT) are strongly correlated. The tear volume tests are also related as measured by the phenol red thread (PRT) and tear meniscus height (TMH). Lid Parallel Conjunctival Folds (LIPCOF) and conjunctival staining are significantly correlated to one another. Symptomology and osmolarity were also found to be important tests in order to assess for dry eye. 2. Artificial tear supplements do work for ocular comfort, as well as the ocular surface as observed by conjunctival staining and the reduction LIPCOF. There is no strong evidence of one type of artificial tear supplement being more effective than others, and the data suggest that these improvements are more due to the time than the specific drops. 3. When trying to predict patient preference for artificial tears from baseline measurements, the individual category of artificial tear supplements appeared to have an improvement in at least 1 tear metric. Undoubtedly, from the study the patients preferred artificial tear supplements’ were rated much higher than the other three drops used in the study and their subjective responses were statistically significant than the signs. 4. Patients are also willing to pay for a community dry eye service in their area of £17. In conclusion, the dry eye tests conducted in the study correlate with one another and with the symptoms reported by the patient. Artificial tears do make a difference objectively as well as subjectively. There is no optimum artificial treatment for dry eye, however regular consistent use of artificial eye drops will improve the ocular surface.

Sucrose cryo-protection facilitates imaging of whole eye sections by MALDI mass spectrometry

Sucrose is used as a cryo-preservation agent on large mammalian eyes post formalin fixation and is shown to reduce freezing artefacts allowing the collection of 12-μm thick sections from these large aqueous samples. The suitability of this technique for use in MALDI imaging experiments is demonstrated by the acquisition of the first images of lipid distributions within whole sagittal porcine eye sections. © 2012 John Wiley & Sons, Ltd.

Simple eye-closure penalty estimate for amplitude noise-degraded signals

We present a simplified model for a simple estimation of the eye-closure penalty for amplitude noise-degraded signals. Using a typical 40-Gbit/s return-to-zero amplitude-shift-keying transmission, we demonstrate agreement between the model predictions and the results obtained from the conventional numerical estimation method over several thousand kilometers.

Transversal and longitudinal images from the retina of the living eye using low coherence interferometry

An optical coherence tomography (OCT) system to produce both longitudinal and transversal images of the in vivo human eye is presented. For the first time, OCT transversal images collected from the living eye at 50-µm depth steps show details unobtainable with the state-of-the-art scanning laser ophthalmoscope. Images of up to 3×3?mm are produced from the retina in less than a second. For images larger than 1.6×1.6?mm, a path modulation is introduced by the galvanometric scanning mirror and is used as an effective phase modulation method.

One's own country and familiar places in the mind's eye:different topological representations for navigational and non-navigational contents

Visual mental imagery is a process that draws on different cognitive abilities and is affected by the contents of mental images. Several studies have demonstrated that different brain areas subtend the mental imagery of navigational and non-navigational contents. Here, we set out to determine whether there are distinct representations for navigational and geographical images. Specifically, we used a Spatial Compatibility Task (SCT) to assess the mental representation of a familiar navigational space (the campus), a familiar geographical space (the map of Italy) and familiar objects (the clock). Twenty-one participants judged whether the vertical or the horizontal arrangement of items was correct. We found that distinct representational strategies were preferred to solve different categories on the SCT, namely, the horizontal perspective for the campus and the vertical perspective for the clock and the map of Italy. Furthermore, we found significant effects due to individual differences in the vividness of mental images and in preferences for verbal versus visual strategies, which selectively affect the contents of mental images. Our results suggest that imagining a familiar navigational space is somewhat different from imagining a familiar geographical space. © 2014 Elsevier Ireland Ltd.

Eye movement analysis in congenital nystagmus:concise parameters estimation

Along with other diseases that can affect binocular vision, reducing the visual quality of a subject, Congenital Nystagmus (CN) is of peculiar interest. CN is an ocular-motor disorder characterized by involuntary, conjugated ocular oscillations and, while identified more than forty years ago, its pathogenesis is still under investigation. This kind of nystagmus is termed congenital (or infantile) since it could be present at birth or it can arise in the first months of life. The majority of CN patients show a considerable decrease of their visual acuity: image fixation on the retina is disturbed by nystagmus continuous oscillations, mainly horizontal. However, the image of a given target can still be stable during short periods in which eye velocity slows down while the target image is placed onto the fovea (called foveation intervals). To quantify the extent of nystagmus, eye movement recordings are routinely employed, allowing physicians to extract and analyze nystagmus main features such as waveform shape, amplitude and frequency. Use of eye movement recording, opportunely processed, allows computing "estimated visual acuity" predictors, which are analytical functions that estimate expected visual acuity using signal features such as foveation time and foveation position variability. Hence, it is fundamental to develop robust and accurate methods to measure both those parameters in order to obtain reliable values from the predictors. In this chapter the current methods to record eye movements in subjects with congenital nystagmus will be discussed and the present techniques to accurately compute foveation time and eye position will be presented. This study aims to disclose new methodologies in congenital nystagmus eye movements analysis, in order to identify nystagmus cycles and to evaluate foveation time, reducing the influence of repositioning saccades and data noise on the critical parameters of the estimation functions. Use of those functions extends the information acquired with typical visual acuity measurement (e.g., Landolt C test) and could be a support for treatment planning or therapy monitoring. © 2010 by Nova Science Publishers, Inc. All rights reserved.

Characterisation of baseline oscillation in congenital nystagmus eye movement recordings

Congenital nystagmus is an ocular-motor disorder that develops in the first few months of life; its pathogenesis is still unknown. Patients affected by congenital nystagmus show continuous, involuntary, rhythmical oscillations of the eyes. Monitoring eye movements, nystagmus main features such as shape, amplitude and frequency, can be extracted and analysed. Previous studies highlighted, in some cases, a much slower and smaller oscillation, which appears added up to the ordinary nystagmus waveform. This sort of baseline oscillation, or slow nystagmus, hinder precise cycle-to-cycle image placement onto the fovea. Such variability of the position may reduce patient visual acuity. This study aims to analyse more extensively eye movements recording including the baseline oscillation and investigate possible relationships between these slow oscillations and nystagmus. Almost 100 eye movement recordings (either infrared-oculographic or electrooculographic), relative to different gaze positions, belonging to 32 congenital nystagmus patients were analysed. The baseline oscillation was assumed sinusoidal; its amplitude and frequency were computed and compared with those of the nystagmus by means of a linear regression analysis. The results showed that baseline oscillations were characterised by an average frequency of 0.36 Hz (SD 0.11 Hz) and an average amplitude of 2.1° (SD 1.6°). It also resulted in a considerable correlation (R2 scored 0.78) between nystagmus amplitude and baseline oscillation amplitude; the latter, on average, resulted to be about one-half of the correspondent nystagmus amplitude. © 2009 Elsevier Ltd. All rights reserved.

Laser tracker position optimization

This article presents a laser tracker position optimization code based on the tracker uncertainty model developed by the National Physical Laboratory (NPL). The code is able to find the optimal tracker positions for generic measurements involving one or a network of many trackers, and an arbitrary set of targets. The optimization is performed using pattern search or optionally, genetic algorithm (GA) or particle swarm optimization (PSO). Different objective function weightings for the uncertainties of individual points, distance uncertainties between point pairs, and the angular uncertainties between three points can be defined. Constraints for tracker position limits and minimum measurement distances have also been implemented. Furthermore, position optimization taking into account of lines-of-sight (LOS) within complex CAD geometry have also been demonstrated. The code is simple to use and can be a valuable measurement planning tool.

Laser tracker position optimization

This article presents a laser tracker position optimization code based on the tracker uncertainty model developed by the National Physical Laboratory (NPL). The code is able to find the optimal tracker positions for generic measurements involving one or a network of many trackers, and an arbitrary set of targets. The optimization is performed using pattern search or optionally, genetic algorithm (GA) or particle swarm optimization (PSO). Different objective function weightings for the uncertainties of individual points, distance uncertainties between point pairs, and the angular uncertainties between three points can be defined. Constraints for tracker position limits and minimum measurement distances have also been implemented. Furthermore, position optimization taking into account of lines-of-sight (LOS) within complex CAD geometry have also been demonstrated. The code is simple to use and can be a valuable measurement planning tool.

Real-time error compensation of a three-axis machine tool using a laser tracker

The concept of measurement-enabled production is based on integrating metrology systems into production processes and generated significant interest in industry, due to its potential to increase process capability and accuracy, which in turn reduces production times and eliminates defective parts. One of the most promising methods of integrating metrology into production is the usage of external metrology systems to compensate machine tool errors in real time. The development and experimental performance evaluation of a low-cost, prototype three-axis machine tool that is laser tracker assisted are described in this paper. Real-time corrections of the machine tool's absolute volumetric error have been achieved. As a result, significant increases in static repeatability and accuracy have been demonstrated, allowing the low-cost three-axis machine tool to reliably reach static positioning accuracies below 35 μm throughout its working volume without any prior calibration or error mapping. This is a significant technical development that demonstrated the feasibility of the proposed methods and can have wide-scale industrial applications by enabling low-cost and structural integrity machine tools that could be deployed flexibly as end-effectors of robotic automation, to achieve positional accuracies that were the preserve of large, high-precision machine tools.

Experimental comparison of dynamic tracking performance of iGPS and laser tracker

External metrology systems are increasingly being integrated with traditional industrial articulated robots, especially in the aerospace industries, to improve their absolute accuracy for precision operations such as drilling, machining and jigless assembly. While currently most of the metrology assisted robotics control systems are limited in their position update rate, such that the robot has to be stopped in order to receive a metrology coordinate update, some recent efforts are addressed toward controlling robots using real-time metrology data. The indoor GPS is one of the metrology systems that may be used to provide real-time 6DOF data to a robot controller. Even if there is a noteworthy literature dealing with the evaluation of iGPS performance, there is, however, a lack of literature on how well the iGPS performs under dynamic conditions. This paper presents an experimental evaluation of the dynamic measurement performance of the iGPS, tracking the trajectories of an industrial robot. The same experiment is also repeated using a laser tracker. Besides the experiment results presented, this paper also proposes a novel method for dynamic repeatability comparisons of tracking instruments. © 2011 Springer-Verlag London Limited.

Congenital prosopagnosia in a child:neuropsychological assessment, eye movement recordings and training

Here we report the assessment and treatment of a 6-year-old boy (L.G.) who was referred to us for congenital prosopagnosia (CP). We investigated his performance using a test battery and eye movement recordings pre- and post-training. L.G. showed deficits in recognising relatives and learning new faces, and misrecognition of unfamiliar people. Eye movement recordings showed that L.G. focused on the lower part of stimuli in naming tasks based on familiar or unfamiliar incomplete or complete faces. The training focused on improving his ability to explore internal features of faces, to discriminate specific facial features of familiar and unfamiliar faces, and to provide his family with strategies to use in the future. At the end of the training programme L.G. no longer failed to recognise close and distant relatives and classmates and did not falsely recognise unknown people.

Medical management of diabetic retinopathy:fenofibrate and ACCORD eye studies

The approach of all ophthalmologists, diabetologists and general practitioners seeing patients with diabetic retinopathy should be that good control of blood glucose, blood pressure and plasma lipids are all essential components of modern medical management. The more recent data on the use of fenofibrate in the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) and The Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye studies is reviewed. In FIELD, fenofibrate (200 mg/day) reduced the requirements for laser therapy and prevented disease progression in patients with pre-existing diabetic retinopathy. In ACCORD Eye, fenofibrate (160 mg daily) with simvastatin resulted in a 40% reduction in the odds of retinopathy progressing over 4 years, compared with simvastatin alone. This occurred with an increase in HDL-cholesterol and a decrease in the serum triglyceride level in the fenofibrate group, as compared with the placebo group, and was independent of glycaemic control. We believe fenofibrate is effective in preventing progression of established diabetic retinopathy in type 2 diabetes and should be considered for patients with pre-proliferative diabetic retinopathy and/or diabetic maculopathy, particularly in those with macular oedema requiring laser. © 2011 Macmillan Publishers Limited All rights reserved.