Development of a Smart Assistance System for Patients With Blepharoptosis

Ching Feng Lien ,Bor-Shyh Lin,Pei Jung Wu ,Lu Xun Liao ,Li Ren Chang ,Yen‐Chun Lin ,Seng‐Feng Jeng

doi:10.1109/access.2019.2946172

Abstract

Blepharoptosis is defined as an abnormal low-lying upper eyelid margin in primary gaze. Without adequate management, the disease may cause amblyopia, strabismus, and astigmatism in children as well as constriction of the upper visual field, blurred vision, increased tearing, fatigue, and frontal headache in adults. In most cases of blepharoptosis, surgical intervention is the primary treatment. However, the risk of recurrence is high, and some complications may occur after the surgical intervention. Although ptosis crutches and magnetic eyelid devices have been reported to be beneficial for managing the disease, many disadvantages must be overcome. To avoid sequelae from the disease and to mitigate the discomfort and complications, this study proposes a novel assistance system. In this system, a controllable permanent electromagnet and a piece of iron sheet affixed to the paralytic upper eyelid were used for elevating the drooping eyelid according to the degree of the eyelid being opened or closed, as estimated by an optical probe. Finally, the performance of the proposed system in detecting eyelid actions and the effect of eyelid elevation were validated. The experimental results showed that the proposed system could effectively detect eyelid closing events and successfully, symmetrically, and synchronously elevate the drooping upper eyelid with a mean correction of 3.5 ± 0.4 mm (range, 2.7 - 4.0 mm) in 14 patients with unilateral blepharoptosis. The proposed system therefore may be applied to patients with unilateral blepharoptosis in the future.

Highlights

Blepharoptosis is an abnormal low-lying upper eyelid margin in primary gaze and results in narrowing of the palpebral fissure opening [1]
For the 14 patients with unilateral blepharoptosis, the mean gain in interpalpebral fissure length (IPFL) from using the device prototype was 3.5±0.4 mm, which was comparable to the results (1.0−4.0 mm) for patients treated with frontalis suspension and/or levator muscle resection [27]–[30]
The device might be applied to assist in managing patients with ptosis and poor levator and frontalis muscle function, which was a problem that might be caused by traumatic injury or a cerebrovascular accident and was difficult to treat successfully with surgical interventions

Summary

Introduction

Blepharoptosis is an abnormal low-lying upper eyelid margin in primary gaze and results in narrowing of the palpebral fissure opening [1]. The prevalence of blepharoptosis in Korea and the United Kingdom has been reported to be approximately 11% [2], [3]. Unilateral blepharoptosis is defined as either a measured palpebral fissure asymmetry of ≥ 1 mm between the two upper eyelids or a marginal reflex distance of < 2.5 mm [4]. Constriction of the upper visual field, blurred vision, increased tearing, and a sleepy appearance, can occur [5]. For most cases of blepharoptosis, surgical intervention is the primary treatment [5]. There is a high reoperation rate (3%–72%), and complications following the surgical intervention may occur [5]–[7]

Methods

Results

Discussion

Conclusion