Eyelid Movements Research Articles

An Efficient Approach for Detecting Driver Drowsiness Based on Deep Learning

Drowsy driving is one of the common causes of road accidents resulting in injuries, even death, and significant economic losses to drivers, road users, families, and society. There have been many studies carried out in an attempt to detect drowsiness for alert systems. However, a majority of the studies focused on determining eyelid and mouth movements, which have revealed many limitations for drowsiness detection. Besides, physiological measures-based studies may not be feasible in practice because the measuring devices are often not available on vehicles and often uncomfortable for drivers. In this research, we therefore propose two efficient methods with three scenarios for doze alert systems. The former applies facial landmarks to detect blinks and yawns based on appropriate thresholds for each driver. The latter uses deep learning techniques with two adaptive deep neural networks based on MobileNet-V2 and ResNet-50V2. The second method analyzes the videos and detects driver’s activities in every frame to learn all features automatically. We leverage the advantage of the transfer learning technique to train the proposed networks on our training dataset. This solves the problem of limited training datasets, provides fast training time, and keeps the advantage of the deep neural networks. Experiments were conducted to test the effectiveness of our methods compared with other methods. Empirical results demonstrate that the proposed method using deep learning techniques can achieve a high accuracy of 97%. This study provides meaningful solutions in practice to prevent unfortunate automobile accidents caused by drowsiness.

Allogeneic Cultivated Limbal Epithelial Sheet Transplantation in Reconstruction of Conjunctival Sac After Chemical and Thermal Burns.

The study aims to evaluate the effect of allogeneic cultivated limbal epithelial cell sheet transplantation (CLET) in reconstructing conjunctival sac for severe symblepharon after chemical and thermal burns. A retrospective, non-comparative case series. Thirty-six eyes (36 patients) underwent CLET for severe symblepharon and conjunctival sac stenosis or atresia. Symblepharon was separated, and pseudopterygium was preserved to replace the palpebral conjunctiva. Allogeneic cultivated limbal epithelial cell sheet using human amniotic membrane as a carrier was transplanted into the recipient's eye to reconstruct the conjunctival sac. The effect of conjunctival sac reconstruction, eye and eyelid movement, ocular surface restitution, and symblepharon recurrence were analyzed after surgery. Symblepharon was completely relieved in 30 of the 36 eyes (83.3%) by a single surgical procedure, with fornix reconstruction, as well as free movement of eye globe and eyelids. Strip-like symblepharon remained in 6 eyes (16.7%) and was completely relieved after the second CLET. Twenty patients without visual function received prostheses 3 months after surgery and the other sixteen patients underwent different corneal transplantation for visual acuity improvement. During the follow-up period, no one had symblepharon recurrence. The transplantation of cultivated allogeneic limbal epithelial sheets offers an effective and safe alternative in the treatment of symblepharon and reconstruction of conjunctival sac in eyes with severe ocular burns, which lays the foundation for subsequent treatments.

Role of the motor cortex in the generation of classically conditioned eyelid and vibrissae responses

The eyelid motor system has been used for years as an experimental model for studying the neuronal mechanisms underlying motor and cognitive learning, mainly with classical conditioning procedures. Nonetheless, it is not known yet which brain structures, or neuronal mechanisms, are responsible for the acquisition, storage, and expression of these motor responses. Here, we studied the temporal correlation between unitary activities of identified eyelid and vibrissae motor cortex neurons and the electromyographic activity of the orbicularis oculi and vibrissae muscles and magnetically recorded eyelid positions during classical conditioning of eyelid and vibrissae responses, using both delay and trace conditioning paradigms in behaving mice. We also studied the involvement of motor cortex neurons in reflexively evoked eyelid responses and the kinematics and oscillatory properties of eyelid movements evoked by motor cortex microstimulation. Results show the involvement of the motor cortex in the performance of conditioned responses elicited during the classical conditioning task. However, a timing correlation analysis showed that both electromyographic activities preceded the firing of motor cortex neurons, which must therefore be related more with the reinforcement and/or proper performance of the conditioned responses than with their acquisition and storage.

Tear film dynamics with blinking and contact lens motion

We develop a lubrication theory-based mathematical model that describes the dynamics of a tear film during blinking and contact lens (CL) wear. The model extends previous work on pre-corneal tear film dynamics during blinking by coupling the partial differential equation for tear film thickness to a dynamic model for CL motion. We explore different models for eyelid motion and also account for possible voluntary and involuntary globe (eyeball) rotation that may accompany blinking. Boundary conditions for mass flux at the eyelids are also adapted to account for the presence and motion of the CL. Our predictions for CL motion compare reasonably with existing data. Away from the eyelids the pre-lens tear film (PrLTF) is shifted, relative to its pre-corneal counterpart, in the direction of CL motion. Near the eyelids, the inflow/outflow of fluid under the eyelids also influences the PrLTF profile. We also compare our PrLTF dynamics to existing in vivo tear film thickness measurements.

K. M. Tanashev. Paradoxical movements of the upper eyelid with paralysis of the oculomotor nerve (PseudoGraefe symptom).Proceedings and duct. Imp. Kavk. total April-October 1910.

The symptom of Graefe is that the eyelid drops unsatisfactorily when the gaze is lowered, sometimes even a convulsive, continuing moment is observed, an upward movement, when raising the gaze, it rises with exaggerated vigor.

Mechanobiology of conjunctival epithelial cells exposed to wall shear stresses.

The human conjunctival epithelial cells (HCEC) line the inner sides of the eyelids and the anterior part of the sclera. They include goblet cells that secret mucus into the tear film that protects the ocular surface. The conjunctival epithelium is subjected to mechano-physical stimuli due to eyelid movement during blinking, during wiping and rubbing the eyes, and when exposed to wind and air currents. We cultured primary HCEC under air-liquid interface (ALI) conditions in custom-designed wells that can be disassembled for installation of the in vitro model in a flow chamber. We exposed the HCEC after ALI culture of 8-10days to steady and oscillatory airflows. The in vitro model of HCEC was exposed to steady wall shear stresses (sWSS) of 0.5 and 1.0 dyne/cm2 for lengths of 30 and 60min and to oscillatory wall shear stresses (oWSS) of 0.5 and 0.77 dyne/cm2 amplitudes for a length of 10min. Cytoskeletal alterations and MUC5AC mucin secretion in response to WSS were investigated using immunohistochemically fluorescent staining and enzyme-linked lectin assay (ELLA), respectively. The results revealed that both exposure times and sWSS values increased the polymerization of F-actin filaments while mucin secretion decreased. However, after a recovery of 24h in the incubator we observed a decrease of F-actin fibers and mucin secretion only for exposure of 30min. The length of exposure was more influential on cytoskeletal alterations than the level of sWSS. The very small effect of sWSS on mucin secretion is most likely related to the much smaller amount of goblet cell than in other mucus-secreting tissue. The results for both oWSS amplitudes revealed similar trends regarding F-actin and mucin secretion. Immediately post-exposure we observed an increase in polymerization of F-actin filaments while mucin secretion decreased. However, after 24-h recovery we observed that both F-actin and mucin secretion returned to the same values as for unexposed cultures. The results of this study suggest that WSS should be considered while exploring the physiological characteristics of HCEC.

Lamotrigine induced Blepharospasm in a bipolar depression type-ii: A case report

The association of extrapyramidal side effects (EPS) with the use of conventional antipsychotics is well established, however, EPS can occur during treatment with anticonvulsant medications as well. There are several case reports of the development of involuntary movement disorders including chorea and tic disorder after lamotrigine (LTG) treatment. However, LTG-induced involuntary eyelid movement disorder is extremely rare. Most of this side effect was reported in patients with partial and generalized seizures, and only very few cases were in nonepileptic patients. In contrast, we present the case of 42 years old bipolar patient who developed blepharospasm during LTG therapy and again during re-challenge with the same agent. The focus of discussion will be on common side effects of this medication and previous reports of lamotrigine associated blepharospasm. We will also discuss a possible underlying mechanism.

Ex vivo porcine model for eye, eyelid, and orbit movement analysis of 4-mm ferromagnetic foreign bodies in MRI.

Ferromagnetic foreign bodies (FFB) present during magnetic resonance imaging (MRI) explorations can lead to tissue injury due to movement, especially in and around the eyes. Ferromagnetic foreign bodies located in the intraocular area, eyelids, and orbit are thus prohibited from undergoing MRI. The aim of the study was to analyze movement of 4-mm ferromagnetic foreign bodies in MRI in the eye, eyelid, and orbit using computed tomography (CT) scan. We developed a porcine model using 12 quarters of fresh porcine heads. Each porcine head included one whole orbit with the ocular globe, orbital fat, muscles, and eyelids. Four-millimeter FFB were implanted in the eye within 2 days post-slaughter, and images were acquired within 5 days post-slaughter. Four-millimeter FFB movement was analyzed after 1.5-Tesla (T) MRI. Four locations were tested: intravitreous, suprachoroidal, intraorbital fat, and intrapalpebral. Movement analysis was assessed using computed tomography (CT) scan. The intravitreous ferromagnetic ball moved 14.0 ± 8.8 mm (p < 0.01), the suprachoroidal ball moved 16.8 ± 5.4 mm (p < 0.01), the intraorbital fat ball moved 5.8 ± 0.9 mm (p > 0.05), and the intrapalpebral ball moved 2.0 ± 0.4 mm (p > 0.05). The ex vivo porcine model was able to study FFB movement. The 4-mm ferromagnetic balls moved in intravitreous and in suprachoroidal locations after MRI.

A ROLE OF AYURVEDIC MANAEGEMENT IN BLEPHAROSPASM w.s.r. NIMESHA - A CASE STUDY

Ayurveda can provide effective and harmless relief for certain diseases which sometimes can’t be cured with modern medicine. Nimesha is a condition, pertaining to Shalakya Tantra in which eye lids starts blinking involun- tary due to influence of Vata Dosha. In this condition patients can’t be able to focus things properly and having lots of discomfort. It can be correlated to blepharospasm i.e., an abnormal contraction of eye lid muscles, which is also refers to benign essential blepharospasm. It is thought to be rare, affecting about 16–133 cases per million. There is no cure for blepharospasm in modern practice. Generally, doctors inject botox injection into eyelid mus- cles which need to get injected in every 4-6 month, rather than permanent benefits it has lots of side effects like diplopia ectropion etc. Ayurveda can be useful in the treatment of blepharospasm and its complication that it is a Vataj Vyadhi all Vatashamak therapies could be effective for its treatment. A 61 years old male patient known case of bilateral blepharospasm was visited in OPD of Government Autonomous Dhanwantari Ayurveda Hospi- tal, Ujjain. He had complained of excessive blinking with tired eye muscles, heaviness around eyes, headache, anxiety and irritation etc. for 3 years. He was on regular allopathic medicine along with botox injection around each eye which is repeated in every 6 months, but after few shots of treatment pt. didn’t receive any benefits.Therefore, he came to us and after Ayurvedic treatment patient showed marked improvement in symptomatology, with limited abnormal eye lid movement and with negligible side effects. Here was 70% relief after Ayurvedic treatment. Keyword: Ayurveda, Nimesha, Blepharospasm, Botox

A Wearable Brain-Computer Interface Instrument with Aug- Mented Reality-Based Interface for General Applications

In the project we are demonstrating the combined usage Augmented Reality(AR) and brain faced com- puter interface(BI) which can be used to control the robotic acurator by. This method is more simple and more user friendly. Here brainwave senor will work in its normal setting detecting alpha, beta, and gam- ma signals. These signals are decoded to detect eye movements. These are very limited on its own since the number of combinations possible to make higher and more complex task possible. Asa solution to this AR is integrated with the BCI application to make control interface more user friendly. This application can be used in many cases including many robotic and device controlling cases. Here we use BCI-AR to detect eye paralysis that can be archive by detecting eye lid movement of person by wearing head bend.

Ictal Lid Movements: Blinks and Lid Saccades

ABSTRACT Two types of lid movements, blinks and lid saccades, have discrete kinematic properties and physiology. These differences are reflected in distinct phenomenology of disorders affecting their neural substrate. Proof of this principle was seen in two patients, one with parietal lobe epilepsy and the other with temporal lobe epilepsy. The lid movements in the patient with parietal lobe epilepsy were rhythmic, yoked, and had a rapid upward component that instantaneously followed a slow downward drift. These cyclic movements strikingly resembled nystagmus, but unlike typical eye nystagmus, the rapid upward component was pathological and seemed to involve a saccadic mechanism. We suggest the terms “ictal lid saccades” or “ictal lid nystagmus” to describe such a phenomenon. In contrast, the patient with temporal lobe epilepsy had ipsilateral lid movements with rapid downward trajectories resembling reflex or spontaneous blinks. The term “ictal blink” is appropriate for this phenomenon.

Effects of uniform or non-uniform heating at bottom wall on MHD mixed convection in a porous cavity saturated by nanofluid

Abstract A numerical investigation on the effects of uniform and non-uniform heating of bottom wall on mixed convective heat transfer in a square porous chamber filled with nanofluid in the appearance of magnetic field is carried out. Uniform or sinusoidal heat source is fixed at the bottom wall. The top wall moves in either positive or negative direction with a constant cold temperature. The vertical sidewalls are thermally insulated. The finite volume approach based on SIMPLE algorithm is followed for solving the governing equations. The different parameters connected with this study are Richardson number (0.01 ≤ Ri ≤ 100), Darcy number (10−4 ≤ Da ≤ 10−1), Hartmann number (0 ≤ Ha ≤ 70), and the solid volume fraction (0.00 ≤ χ ≤ 0.06). The results are presented graphically in the form of isotherms, streamlines, mid-plane velocities, and Nusselt numbers for the various combinations of the considered parameters. It is observed that the overall heat transfer rate is low at Ri = 100 in the positive direction of lid movement, whereas it is low at Ri = 1 in the negative direction. The average Nusselt number is lowered on growing Hartmann number for all considered moving directions of top wall with non-uniform heating. The low permeability, Da = 10−4 keeps the flow pattern same dominating the magnetic field, whereas magnetic field strongly affects the flow pattern dominating the high Darcy number Da = 10−1. The heat transfer rate increases on enhancing the solid volume fraction regardless of the magnetic field.

Teaching Video NeuroImage: Reflex Facilitation in Lambert-Eaton Myasthenic Syndrome.

A 41-year-old woman presented with progressive fluctuating lower limb weakness, urinary incontinence, and dry eyes and mouth. Physical examination revealed proximal flaccid tetraparesis (Medical Research Council 4). The patellar reflex was absent, but with postexercise facilitation (video 1). Eyelid and eye movements were normal. Electroneuromyography revealed a presynaptic neuromuscular junction disorder (figure). Antibodies to anti-voltage-gated calcium channels were positive. Periodic cancer screening, including whole-body FDG-PET, was negative during 2 years of follow-up. These findings were consistent with nonparaneoplastic Lambert-Eaton myasthenic syndrome.1 The patient had a good response to IV immunoglobulin. The presence of ascending muscle weakness, autonomic dysfunction, and postexercise facilitation of reflexes should raise suspicion for the diagnosis.

Eye-blink artifact removal from single channel EEG with k-means and SSA

In recent years, the usage of portable electroencephalogram (EEG) devices are becoming popular for both clinical and non-clinical applications. In order to provide more comfort to the subject and measure the EEG signals for several hours, these devices usually consists of fewer EEG channels or even with a single EEG channel. However, electrooculogram (EOG) signal, also known as eye-blink artifact, produced by involuntary movement of eyelids, always contaminate the EEG signals. Very few techniques are available to remove these artifacts from single channel EEG and most of these techniques modify the uncontaminated regions of the EEG signal. In this paper, we developed a new framework that combines unsupervised machine learning algorithm (k-means) and singular spectrum analysis (SSA) technique to remove eye blink artifact without modifying actual EEG signal. The novelty of the work lies in the extraction of the eye-blink artifact based on the time-domain features of the EEG signal and the unsupervised machine learning algorithm. The extracted eye-blink artifact is further processed by the SSA method and finally subtracted from the contaminated single channel EEG signal to obtain the corrected EEG signal. Results with synthetic and real EEG signals demonstrate the superiority of the proposed method over the existing methods. Moreover, the frequency based measures [the power spectrum ratio (Gamma ) and the mean absolute error (MAE)] also show that the proposed method does not modify the uncontaminated regions of the EEG signal while removing the eye-blink artifact.

A CASE STUDY ON AYURVEDIC MANAGEMENT OF VATAHATA VARTMA (PTOSIS)

Vatahata Vartma is a condition of Vartma where in the Vartma-Shuklagata Sandhi is afflicted by vitiated Vata leading to Vimukta Sandhi (functional deterioration of the Shuklavartmagata Sandhi which facilitates the movement of eyelids), Nischeshta (no or reduced eyelids activity), Nimilayati (unable to close the eyelids). The signs and symptoms of Vatahata Vartma can be corelated to Ptosis in modern medical science. Ptosis is a medical condition in which there will be drooping or falling of upper eyelid. The condition worsens when there is exhaustion of the extra ocular muscles. This condition can be either uni-ocular or binocular. If the condition is left untreated, it can lead to complications. Surgical intervention is the only line of treatment mentioned for ptosis in contemporary science. Ayurveda has mentioned different treatment modalities for similar conditions. This paper highlights a case study of Vatahata Vartma (ptosis) managed with Ayurvedic line of treatment with Mukhabhyanga, Sweda, Nasya, Akshipindi and Akshi Tarpana. Keywords: Vatahata Vartma, Ptosis, Nasya, Akshitarpana, Akshipindi

Efficacy of intra‐arterial thrombolytic therapy for vision loss resulting from hyaluronic acid filler embolization

BackgroundThe incidence of hyaluronic acid (HA) embolism has increased markedly in recent years. HA embolism can lead to serious complications such as blindness, eye and eyelid movement disorders, skin necrosis, and cerebral embolism. However, there is a lack of robust clinical evidence regarding the benefits of treatment of HA embolism with intra‐arterial thrombolytic therapy (IATT).MethodsIn the present study, we enrolled 45 patients with decreased visual acuity, including 40 patients with symptoms of vision loss and eight patients with symptoms of intracranial embolism. The patients underwent emergency IATT via hyaluronidase and papaverine injections, followed by conventional sequential therapy.ResultsIn the 45 patients with symptoms of vision loss, 16 (36%) exhibited improvements in final visual acuity, even when the clinical application of the thrombolytic treatments was performed beyond the recommended window for optimal treatment. The facial skin necrosis of all patients was restored to near normal appearance. Notably, for eight patients with suspected symptoms of intracranial infarction we performed cerebral angiography and IATT, and in two patients obtained partial recanalization of the obstruction, the symptoms of heavy headache and binocular distension pain were improved in one patient with intracranial embolism after IATT treatment.ConclusionOur results indicate that IATT is feasible for patients with vision loss induced by HA embolism. IATT combined with conventional sequential therapy was beneficial in the recovery from other serious HA embolism complications. Nevertheless, the underlying pathophysiological mechanism needs to be clarified in future animal experiments.

Intelligent Analysis for Drowsiness Alert using Conventional Neural Networks

When a job is assigned to drivers who travel through the roads and highways riding a CAB or NATIONAL PERMIT TRUCKS face the risk of tiredness especially during night travels and early morning. This project is to develop a driver drowsiness detection system by using Deep learning. It is known that a driver is under drowsiness influences by looking at the eyes for a moment of duration. Based on the previous research, there is none added tome counter that may exclude driver drowsiness from other activities of eyelid movement. The result can be accurate because histogram analysis analyzed the whole image upto a certain duration giving alarm with battery connection to be disabled for mentioned span of time. Therefore, he can start the vehicle only when the driver completes his rest time.

Apraxia of Lid Opening in Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease-Frequency, Risk Factors and Response to Treatment.

New-onset apraxia of lid opening (ALO) is reported to occur in Parkinson's disease (PD) patients following Deep Brain Stimulation (DBS). There are only few systematic studies on this uncommon disorder of eyelid movements. We aimed to examine the frequency, temporal evolution, predisposing factors and response to treatment, of new-onset ALO in PD patients who underwent bilateral subthalamic nucleus (STN) DBS. We retrospectively reviewed the data of patients who underwent STN DBS at our centre between 1999 and 2017, with a minimum of 2 years of follow up after surgery. New-onset ALO was seen in 17 (9.1%) of the 187 patients after an average of 16.9 months (Range - 6-36 months). Comparison of the groups with and without ALO revealed that ALO occurred more often in older patients, both at the onset of PD symptoms and at surgery and in those with non-tremor dominant subtypes of PD and freezing of gait at baseline. The extent of levodopa dose reduction after surgery and the pre-operative severity of motor symptoms were not risk factors. Response to adjustments of dopaminergic medications and stimulation parameters was ill-sustained or nil. Botulinum toxin therapy resulted in satisfactory improvement in the majority. New-onset ALO is an uncommon phenomenon that manifests months after STN DBS. Development of ALO is likely to be due to the effects of chronic stimulation of basal ganglia-thalamo-cortical or brain stem circuits controlling lid movements in susceptible patients. Botulinum toxin therapy offers relatively better relief of symptoms than other strategies.

Propeptide in Rhizopus chinensis Lipase: New Insights into Its Mechanism of Activity and Substrate Selectivity by Computational Design.

Most fungal lipases contain a propeptide, which is very important for their function and substrate selectivity. In the present study, Rhizopus chinensis lipase (RCL) was used as a research model to explore the mechanism of the propeptide of the lipase. Conventional molecular dynamics (MD) and metadynamics simulations were used to explore the mechanism by which the propeptide affects the activity of the lipase, which was subsequently verified by mutation experiments. MD simulations indicated that the propeptide had an inhibitory effect on the lid movement of RCL and found a key region (Val5-Thr10) on the propeptide. Subsequently, site-directed mutations were created in this region. The mutations enhanced the lipase catalytic efficiency to 700% and showed the potential for the propeptide to shift the substrate specificity of RCL. The specificity and activity of RCL mutants also had similar trends to wild-type RCL toward triglycerides with varying chain lengths. The mutual corroboration of simulation and site-directed mutagenesis results revealed the vital role of the key propeptide region in the catalytic activity and substrate specificity of the lipase.

An Efficacy and Safety Study of Intra-arterial Recanalization of Occluded Ophthalmic Arteries in Patients with Monocular Blindness Caused by Injection of Hyaluronic Acid in Facial Tissues.

To evaluate the efficacy and safety of recanalizing hyaluronic acid-occluded retinal central artery by intra-arterially infusing hyaluronidase. Between December 2015 and December 2016, 30 patients with monocular blindness due to the injection of hyaluronic acid in facial tissue underwent ophthalmic artery recanalization. The outcome of the intra-arterial treatment was retrospectively reviewed. The fundus was examined 24 hours after the treatment to observe revisualization of the retinal arteries. The success rate of intra-arterial recanalization of the ophthalmic artery, procedure-related complications, visual acuity recovery, eyeball and eyelid movement restoration was followed up for up to 3 months. The success rate of ophthalmic arterial catheterization was 100%. No interventional procedure-related adverse events were found. Twenty-six patients presented ptosis and 23 patients presented ocular motility disorders. The ptosis disappeared and 18 patients had normal eye movement after the intra-arterial therapy. Five of the 30 patients had visual improvement and four patients with complete vision loss gained some light perception. After the intra-arterial thrombolysis, digital subtraction angiographic imaging revealed enlarged and numerous branches of the ophthalmic artery and a clearer ring around the eye. Intra-arterial infusion of hyaluronidase and mechanical recanalization is an effective and safe approach for recovering the visual acuity in the patients with monocular blindness caused by the migration of hyaluronic acid injected in the facial tissues. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .