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相关的疾病，是世界上第二大致盲原因。当眼内压（IOP）增加时，发生青光眼的风险激增。眼压测量是青光眼诊断/治疗的基石，因为眼压升高是唯一可以通过侵入性手术改变的风险因素。然而，IOP的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IOP的零星波动而错过压力变化。其结果是，在诊室就诊期间测量IOP的传统方法错过了关于每日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，我们建议开发一个非处方的家庭眼压计，使用工程原理，孤立波的传播，从未在眼科探索进行自我测量的眼内压。这种新的眼压计将通过智能手机和基于网络的应用程序远程连接青光眼患者和他们的眼科护理提供者，并与患者的电子健康记录相连。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，在几毫米的颗粒链内传播，嵌入在仪器中，眼睛被评估，并与仪器的尖端（链的一端）点接触。该文书将包括：（1）触发器，用于诱发波;（2）具有内部传感器的短链，用于测量波;（3）可编程硬件，用于将波的特征链接到IOP;（4）蓝牙技术，用于与智能手机通信;（5）应用程序，用于在智能手机上绘制IOP数据，并与患者的EHR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，志愿服务或国际比赛的评判来教育最年轻的孩子。最后，项目成果将在国际会议上展示，并通过同行评审的出版物传播。该奖项反映了NSF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.