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

青光眼是一种与年龄有关的疾病，是世界上第二大致盲原因。当眼内压（IOP）升高时，发生青光眼的风险增加。眼压的测量是青光眼诊断/治疗的基础，因为升高的眼压是唯一可以通过侵入性手术改变的危险因素。然而，眼压测试现在需要由专业护理人员进行，并且已知由于自然昼夜节律和眼压的零星波动而错过了压力的变化。其结果是，传统的IOP测量方法在就诊期间错过了日常变化和峰值的重要信息，并且无法证明药物的效果或患者对给定治疗的依从性。在这个项目中，我们建议开发一种非处方家用眼压计，使用工程原理，即在眼科中从未探索过的孤立波传播，来进行眼压的自我测量。这种新型眼压计可以通过智能手机和一个基于网络的应用程序，将青光眼患者与他们的眼科保健提供者远程连接起来，并与患者的电子健康记录相连接。所提出的青光眼评估眼压计是基于高度非线性孤立波（hnsw）之间的动态相互作用，这些孤立波在嵌入仪器的几毫米颗粒链中传播，被评估的眼睛与仪器尖端（链的一端）点接触。该仪器将包含：(1)触发波的触发器；(2)带有内部传感器的短链，用于测量波浪；(3)可编程硬件，将波的特征与IOP连接起来；(4)蓝牙技术，与智能手机通信；(5)一款App，在智能手机上绘制IOP数据，并与患者的电子病历接口，供眼科护理专业人员直接访问。该团队还致力于通过外展活动、志愿服务或在国际比赛中担任评委来教育最年轻的孩子。最后，项目结果将在国际会议上提出，并通过同行审查的出版物传播。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

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.