PowerPoint Presentation

Eye .. Window to Health

Bulky, expensive , trained professionalsHere is a cataract exam with a slit lamp .. A device that hasnt really changed for decades2

3Slit Lamp ExamRetinal Scan

And here getting a retinal scan .. But checkout the user interface .. It is a quarter million dollar device but the nurse has to shove my head into the eyepiece3

Phoropter

And here to get eyeglasses, I am lost in a phoropter.

This diagnostics while a fine solution in developed countries is not going to scale in developing countries lack of diagnostics .. Millions worldwide are suffering from conditions that have proven treatments

Reading charts appear to be an easy solution, this method has too many problems. Sharpness of legible text is very subjective. The brightness of the chart has to be very carefully chosen otherwise the pupil size will change, increasing depth of field, and allowing user to recognize even lower rows.

The trial lenses + the lens frame the doctor will use also cost over $150

% Reading chart tests involve using a frame or a phoropter. The doctor will swing a sequence of lenses in front of your eye and ask for which lens allows you to see the lower rows on the reading chart.

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Vitor Pamplona, Ankit Mohan, Manuel Oliveira, Ramesh Raskar SIGGRAPH 2010

eyeNETRA - Refraction and CataractRx

ImagineWe call our tool NETRA: a one dollar clip on eye piece that goes on top a cellphone

near eye tool for refractive assessmentsuch as nearsightedness/far/astigmatism

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Diabetic Retinopathy

Diabetes is the leading cause of irreversible blindness in the working population, and a diagnosis, and consequent early treatment can prevent this outcome.6

eyeMITRA.com

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many systemic diseases of different etiologies are manifested in the retina, sometimes earlier than in the rest of the body8

Lawson, Roesch, Canham, Ben-Ezra, Raskar 2013

Credits: Wired UK

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Often in medicine, new knowledge is generated when methods of acquiring new information is created. So, from this information, it creates a new understanding and new perspectives for diagnosis and treatment.11

Eye .. Window to CURRENT Health

DiabetesSyphilisGraves diseaseSjogrenMarfans SyndromeSickle Cell Disease

Toxoplasmosis

CoagulationDisorder

Tuberculosis

Systemic Conditions Lagging Indicators

Many systemic diseases manifest themselves in the eye, and indeed ophthalmologist already search for indicators of such disease in the routine eye exams. Additionally, ocular manifestations require frequent monitoring, determining the follow up (the precise time intervals is critical).-----------------------------------------Just as FYI: Yellow blurry spots: Toxoplasmosis (parasitic- protozoan)White yellow deposits indicate Diabetes, Hypertension

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Monitor

First Indicator

Hypertension

Red SpotsBlurred VesselsColor Changes

Harrisons Principles of Internal Medicine, 2011, Longo D, Fauci A, Kasper DIllustrated Manual of Ophthalmology, MEEI, 2009, Friedman NJ, Kaiser PK, Pineda R

Hypertension affects all blood vessels of the body and is initially asymptomatic, and can bring disastrous consequences later, like heart attack and stroke. An ophthalmological examination, even in early stage disease, detects vascular changes due to the disease.

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AIDS, CMV

Blurry vessels

Cheese and KetchupRetinographyHarrisons Principles of Internal Medicine, 2011, Longo D, Fauci A, Kasper DIllustrated Manual of Ophthalmology, MEEI, 2009, Friedman NJ, Kaiser PK, Pineda R

For example, Many patients have a diagnosis of AIDS during an eye examination, although signs in the eye are not the first symptoms to arise.

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Red SpotsThinner ScleraChoroid visible (black)

Other Symptoms:Joint PainNodules in Finger Jointsearlylate

Slit Lamp

Rheumatoid Arthritis Harrisons Principles of Internal Medicine, 2011, Longo D, Fauci A, Kasper DIllustrated Manual of Ophthalmology, MEEI, 2009, Friedman NJ, Kaiser PK, Pineda R

The rheumatoid arthritis may have ocular symptoms that help in the diagnosis and monitoring of disease activity (autoimmune response can be controlled by medication) .

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White Ring around Cornea

Hyper- Cholesterolemia

Harrisons Principles of Internal Medicine, 2011, Longo D, Fauci A, Kasper DIllustrated Manual of Ophthalmology, MEEI, 2009, Friedman NJ, Kaiser PK, Pineda R

The increased cholesterol is related to various cardiovascular diseases. This increase can be seen in the cornea and the eyelid.19

Tumor, Metastasis

Blurry Edges of Optic disc

Accumulation of FluidHarrisons Principles of Internal Medicine, 2011, Longo D, Fauci A, Kasper DIllustrated Manual of Ophthalmology, MEEI, 2009, Friedman NJ, Kaiser PK, Pineda R

Conditions which cause increased intracranial pressure can lead to the onset of papilledema (swelling of the disc), such as brain tumors.Some intracranial tumors can cause asymptomatic increased intracranial pressure, papilledema is usually observed.Metastasis usually occurs in the choroid, which is the most vascularized layer of the eye. The most common places that send tumors to the eye are lung and breast.

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Wilsons (Metabolism)

Kayser-Fleischer Copper Ring

Harrisons Principles of Internal Medicine, 2011, Longo D, Fauci A, Kasper DIllustrated Manual of Ophthalmology, MEEI, 2009, Friedman NJ, Kaiser PK, Pineda R

Wilson's disease can cause many systemic symptoms. The finding of Kayser-Fleischer ring in the ophthalmologic examination can help with the diagnosis. HOUSE YOUTUBE VIDEOCLIP

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Access

MonitorFirst Indicator

Monitor

First IndicatorPredictor

eyeMITRA.com

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Width Branching Flow speed

VascularStrokeHeart AttackMcGeechan K et al., 2009, Ann Intern Med, Meta- Analysis: Retinal Vessel Caliber and Risk for Coronary Heart DiseaseMcGeechan K et al., 2009, Am J Epidemiol, Prediction of incident stroke events based on retinal vessel caliber

Heart attack and stroke are the leading causes of death in developed countries today. Microvascular changes are related to early alterations of these diseases. Studies involving the microcirculation could demonstrate this relationship more strongly in the future.------------FYI. Also Red spots (due to vein blockage) and Pale retina (due to artery block associated with Carotid artery disease risk for stroke

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Direct Access: Vessels, Nerve FL

Body changes slowly

Co-located vascular + neurological

Involuntary, fine detail

Eye .. a Predictor?

Parkinsons Disease

Alzheimers Disease

Nerve Fiber Layer

NeurologicalBerisha F. et al., 2007, IOVS, Retinal Abnormalities in early Alzheimers DiseaseGarcia-Martin E. et al., 2012, Ophthalmology, Ability and reproducibility of OCT to detect RNFL atrophy in Parkinsons disease

The eye manifestations of parkinsons and alzheimers are not yet well studied. If you have some more info and data then we could understand how these disease work in the eye, considering the optic nerve presents a direct link to the brain/CNS.

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Pupil opening Eyelid Strabismus

e.g. Myasthenia Gravis

NeuromuscularVaphiades MS et al., 2012, Curr Opin Ophthalmol, Ocular myasthenia gravis

Pupil opening and eyelid movement could indicate neuromuscular problems in early stage. Eye muscle can be the first muscles in your body affected by disease because of their frequent use (blinking).

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InfectionsSclera

Collagen Disorders

The main component of the sclera is collagen, and this can be changed in collagen disorders.

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hurricane

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eyeMITRA.com

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