SCH: INT: Managing Glaucoma in the Digital Age: A New Tonometer to Connect Patients to their Caregivers

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Glaucoma is an age-related disease and the second cause of blindness in the world. The risk of developing glaucoma surges when the intraocular pressure (IOP) increases. The measurement of IOP is the cornerstone of the diagnosis/management of glaucoma because elevated pressure is the only risk factor that can be modified through invasive surgery. However tests for IOP now need to be administered by professional caregivers, and is known to miss changes in pressure due to the natural circadian rhythm and the sporadic surges of IOP. The consequence is that the traditional ways IOP is measured during an office visit miss vital information about daily changes and spikes, and are unable to demonstrate the effect of medication or patients’ compliance to a given therapy. In this project, we propose to develop an off-the-counter home tonometer to perform self-measurements of the intraocular pressure using an engineering principle, the propagation of solitary waves, never explored in ophthalmology. This new tonometer would connect remotely glaucoma patients to their eye-care providers via smartphone and a Web-based App, interfaced with the patients’ electronic health record. The proposed glaucoma assessment tonometer is based on the dynamical interaction between the highly nonlinear solitary waves (HNSWs) propagating within a chain of a few mm particles, embedded in the instrument, and the eye to be evaluated and in point-contact with the tip of the instrument (one end of the chain). The instrument will contain: (1) a trigger to induce the waves; (2) a short chain with an internal sensor to measure the waves; (3) a programmable hardware to link the waves’ features to the IOP; (4) Bluetooth technology to communicate with smartphones; (5) an App to chart the IOP data on the smartphone and to interface with the patient’s EHR for direct access by the eye-care professionals. The team is also committed to educating the youngest through outreach activities, volunteering, or judging at international competitions. Finally, the project results will be presented at international conferences and disseminated through peer-reviewed publications.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.