Angle closure glaucoma accounts for majority of the bilateral blindness in Asian countries such as Singapore, China, and India. Abnormalities in the optic nerve and aqueous outflow system are the most indicative clinical hallmarks for glaucoma of this clinical subtype. Traditional photographic imaging techniques to assess the drainage angle are contact based, and may expose patients to risk of corneal abrasion and infections. In addition, these procedures require the use of viscous ophthalmic gels as coupling medium to overcome the phenomenon of total internal reflection at the tear-air interface. In this paper, we propose an integrated flexible handheld probe consisting of a micro color CCD video camera and white light LEDs. The handheld probe is able to capture images of the fundus and opposite iridocorneal angle when placed at the central cornea or limbus respectively. Here, we propose the use of hydrogel contact lens as an index matching medium and better protective barrier, as an alternative to conventional ophthalmic gels. The proposed imaging system and methodology has been successfully tested on porcine eye samples, <i>ex vivo</i>. With its high repeatability, reproducibility, and a good safety profile, it is believed that the proposed imaging system and methodology will complement existing imaging modalities in the diagnosis and management of glaucoma.
Photographic imaging methods allow the tracking of anatomical changes in the iridocorneal angle structures and the monitoring of treatment responses overtime. In this work, we aim to design an imaging probe to evaluate the iridocorneal angle structures using geometrical optics. We first perform an analytical analysis on light propagation from the anterior chamber of the eye to the exterior medium using Snell’s law. This is followed by adopting a strategy to achieve uniform near field irradiance, by simplifying the complex non-rotational symmetric irradiance distribution of LEDs tilted at an angle. The optimization is based on the geometric design considerations of an angled circular ring array of 4 LEDs (or a 2 × 2 square LED array). The design equation give insights on variable parameters such as the illumination angle of the LEDs, ring array radius, viewing angle of the LEDs, and the working distance. A micro color CCD video camera that has sufficient resolution to resolve the iridocorneal angle structures at the required working distance is then chosen. The proposed design aspects fulfil the safety requirements recommended by the International Commission on Non-ionizing Radiation Protection.
A simple and low cost optical probe system for the high resolution imaging of the cornea is proposed, based on a Gaussian beam epi-illumination configuration. Corneal topography is obtained by moving the scanning spot across the eye in a raster fashion whereas pachymetry data is achieved by reconstructing the images obtained at different depths. The proposed prototype has been successfully tested on porcine eye samples <i>ex vivo</i> and subsequently on laboratory animals, such as the New Zealand White Rabbit,<i> in vivo</i>. This proposed system and methodology pave the way for realizing a simple and inexpensive optical configuration for pachymetry and keratometry readings, with achievable resolution up to the cellular level. This novel and non-contact high resolution imaging modality demonstrates high intraobserver reproducibility and repeatability. Together with its sophisticated data analysis strategies and safety profile, it is believed to complement existing imaging modalities in the assessment and evaluation of corneal diseases, which enable a decrease in morbidity and improvement in the effectiveness of subsequent treatment.
Noninvasive medical imaging techniques have generated great interest and high potential in the research and development of ocular imaging and follow up procedures. It is well known that angle closure glaucoma is one of the major ocular diseases/ conditions that causes blindness. The identification and treatment of this disease are related primarily to angle assessment techniques. In this paper, we illustrate a probe-based imaging approach to obtain the images of the angle region in eye. The proposed probe consists of a micro CCD camera and LED/NIR laser light sources and they are configured at the distal end to enable imaging of iridocorneal region inside eye. With this proposed dualmodal probe, imaging is performed in light (white visible LED ON) and dark (NIR laser light source alone) conditions and the angle region is noticeable in both cases. The imaging using NIR sources have major significance in anterior chamber imaging since it evades pupil constriction due to the bright light and thereby the artificial altering of anterior chamber angle. The proposed methodology and developed scheme are expected to find potential application in glaucoma disease detection and diagnosis.
Primary angle closure glaucoma is a major form of disease that causes blindness in Asia and worldwide. In glaucoma, irregularities in the ocular aqueous outflow system cause an elevation in intraocular pressure (IOP) with subsequent death of retinal ganglion cells, resulting in loss of vision. High resolution visualization of the iridocorneal angle region has great diagnostic value in understanding the disease condition which enables monitoring of surgical interventions that decrease IOP. None of the current diagnostic techniques such as goniophotography, ultrasound biomicroscopy (UBM), anterior segment optical coherence tomography (AS-OCT) and RetCam<sup>™</sup> can image with molecular specificity and required spatial resolution that can delineate the trabecular meshwork structures. This paper in this context proposes new concepts and methodology using Bessel beams based illumination and imaging for such diagnostic ocular imaging applications. The salient features using Bessel beams instead of the conventional Gaussian beam, and the optimization challenges in configuring the probe system will be illustrated with porcine eye samples.
A biocompatible fiber-optic pH sensor based on a unique double-pass Mach–Zehnder interferometer is proposed. pH responsive poly(2-hydroxyethyl methacrylate-co-2-(dimethylamino)ethyl methacrylate) hydrogel coating on the fiber swells/deswells in response to local pH, leading to refractive index changes that manifest as shifting of interference dips in the optical spectrum. The pH sensor is tested in spiked phosphate buffer saline and demonstrates high sensitivity of 1.71 nm/pH, pH 0.004 limit of detection with good responsiveness, repeatability, and stability. The proposed sensor has been successfully applied in monitoring the media pH in cell culture experiments to investigate the relationship between pH and cancer cell growth.