Smart soft contact lenses for continuous 24-hour monitoring of intraocular pressure in glaucoma care

Closed-eye intraocular pressure and eye movement monitoring via a stretchable bimodal contact lens

Chronic ophthalmic diseases are multivariate, time-varying, and degenerative. Smart contact lenses have emerged as a scalable platform for noninvasive ocular signal detection and disease diagnosis. However, real-time monitoring and decoupling of multiple ocular parameters, particularly when the eyes are closed, remain challenging in clinical medicine. In this work, we propose a stretchable bimodal contact lens (BCL) amalgamating self-decoupled electromagnetic capacitive intraocular pressure (CIOP) and magnetic eye movement (MEM) monitoring components. The sandwich-integrated BCL can be intimately attached to the eyeball, enabling closed-eye, wireless, and precise signal acquisition without interference. During the eye open and closed, the serpentine-geometry CIOP unit was validated on a rabbit model, achieving supered resolution (1 mmHg) and sensitivity (≥0.22 MHz mmHg-1) for reversible hypo- to hyper-IOP fluctuations. Ex vivo and in vivo MEM monitoring, based on composition-optimized magnetic interlayer film, demonstrated exceptional accuracy (≥97.25%) with eyes open and closed, surpassing existing methods. The collected CIOP and MEM data could be wirelessly aggregated and transmitted to portable devices via integrated acquisition modules within frame glasses for real-time eye healthcare. Emerging noninvasive and bimodal modalities reconcile the trade-off between minimal discomfort, eye status, and reliable measurement, spurring the widespread adoption of the integrated monitoring system for continuous ocular health monitoring.

Unperceivable Designs of Wearable Electronics

Wearable smart electronics are taking an increasing part of the consumer electronics market, with applications in advanced healthcare systems, entertainment, and Internet of Things. The advanced development of flexible, stretchable, and breathable electronic materials has paved the way to comfortable and long-term wearables. However, these devices can affect the wearer's appearance and draw attention during use, which may impact the wearer's confidence and social interactions, making them difficult to wear on a daily basis. Apart from comfort, one key condition for user acceptance is that these new technologies seamlessly integrate into our daily lives, remaining unperceivable to others. In this review, strategies to minimize the visual impact of wearable devices and make them more suitable for daily use are discussed. These new devices focus on being unperceivable when worn and comfortable enough that users almost forget their presence, reducing psychological discomfort while maintaining accuracy in signal collection. Materials selection is crucial for developing long-term and unperceivable wearable devices. Recent developments in these unperceivable electronic devices are also covered, including sensors, transistors, and displays, and mechanisms to achieve unperceivability are discussed. Finally, the potential applications are summarized and the remaining challenges and prospects are discussed.

Enhancing glaucoma care with smart contact lenses: An overview of recent developments

Glaucoma is a leading cause of irreversible blindness worldwide, affecting millions of individuals due to its progressive damage to the optic nerve, often caused by elevated intraocular pressure (IOP). Conventional methods of IOP monitoring, such as tonometry, provide sporadic and often inaccurate readings due to fluctuations throughout the day, leaving significant gaps in diagnosis and treatment. This review explores the transformative potential of smart contact lenses equipped with continuous IOP monitoring and therapeutic capabilities. These lenses integrate advanced materials such as graphene, nanogels, and magnetic oxide nanosheets alongside sophisticated biosensing and wireless communication systems. By offering continuous, real-time data, these lenses can detect subtle IOP fluctuations and provide immediate feedback to patients and clinicians. Moreover, drug-eluting capabilities embedded in these lenses present a groundbreaking approach to glaucoma therapy by improving medication adherence and providing controlled drug release directly to the eye. Beyond IOP management, these innovations also pave the way for monitoring biochemical markers and other ocular diseases. Challenges such as biocompatibility, long-term wearability, and affordability remain, but the integration of cutting-edge technologies in smart contact lenses signifies a paradigm shift in glaucoma care. These developments hold immense promise for advancing personalized medicine, improving patient outcomes, and mitigating the global burden of blindness.

Biomaterials in Relative Devices for Traumatic Cataract: Recent Advances and Future Perspectives

Ocular trauma deprives one of the vision for high-quality life. Management of a traumatic cataract requires extensive surgical experience with a range of biomaterials and biomedical devices including intraocular lenses (IOLs), capsular tension rings (CTRs), prosthetic iris (PSI) implants, bandage contact lenses (BCLs), artificial corneas (ACs), and surgical sutures. Numerous demands, involving biocompatibility, cell toxicity, processability, mechanical strength, toughness/flexibility, transparency/opacity, hydrophilicity/hydrophobicity, and stability/biodegradability, are widely considered for fabricating these biomaterials and devices. Furthermore, a multifunction including drug-release and photothermal therapy is also endearing to those biomaterials in IOLs, CTRs, BCLs, and surgical sutures for anti-inflammational and antibacterial characteristics during traumatic cataract treatments. More recently, 3D printing has been demonstrated to effectively fabricate PSI and ACs with complex shapes to meet the personal requirements of patients. We summarize the main principles and the recent achievements of these advances. We also suggest the potential directions for their future development and discuss the remaining challenges.

Crack-Enhanced MXene-Carbon Nanotube Soft Contact Lens for Body-Induced Intracranial Pressure Application

Continuous monitoring of intracranial pressure (ICP) can guarantee stable vital signs and help avoid the risk of debilitating headaches, transient ocular blindness, and optic atrophy caused by elevated ICP, which are critical for patients or specific groups like astronauts and athletes. However, in situ ICP detection typically relies on neural pixels that require a surgical procedure, such as a craniotomy. Here, we report a continuous and nondestructive ICP detection approach via an in situ intraocular pressure (IOP) monitoring system, which includes a pressure response unit using a microcracked MXene@carboxylated carbon nanotube (C-MWCNT) IOP sensor with Wheatstone bridge architecture, an electrical circuit, and a mobile platform to record and display the IOP value. Inspired by the ″lotus root″, the microcracked MXene@C-MWCNT IOP sensor capabilities include both high sensitivity of 33.21 mV/mmHg and a wide monitoring range of 60 mmHg, ensuring real-time IOP monitoring and early warning of elevated IOP or ICP levels. The real-time IOP and ICP data recorded by live rabbits wearing our devices or embedding a commercial implant probe show superior consistency across different body positions, demonstrating the feasibility of ICP monitoring using the eye-wearable IOP sensor system and its potential applications in cerebrovascular/ophthalmic diagnosis and treatment, as well as astronaut training.

Microfluidic contact lens: fabrication approaches and applications

Microfluidic contact lenses integrate microscale features that can efficiently and precisely manipulate, interact, and analyze the small volumes of tears available in the limited accessible space for the lens in the eye. The microfluidic network on contact lenses allows the miniaturization of biochemical operations on the wealth of physiological information available in the eye. Sensors integrated into channels enable real-time monitoring of ocular parameters, including glucose, pH, electrolytes, or other biomarkers. Additionally, microchannel-integrated contact lenses have demonstrated potential as power-free, continuous intraocular pressure monitoring platforms for the effective management of glaucoma. Furthermore, the controlled release of medications directly onto the eye from microfluidic contact lenses enhances therapeutic efficacy by increasing bioavailability. Despite current challenges such as scalable fabrication techniques, microfluidic contact lenses hold immense promise for ocular health, bridging the gap between diagnostics and treatment. This review summarizes the progress made in the design and fabrication of microfluidic contact lenses, with a special emphasis on the methods adopted to fabricate microfluidic contact lenses. Furthermore, the various applications of microfluidic contact lenses, ocular disease diagnosis, and drug delivery in particular are discussed in detail. Aside from outlining the state-of-the-art research activities in this area, challenges and future directions are discussed here.

Responsive Microneedles for Diagnostic and Therapeutic Applications of Ocular Diseases

Traditional ophthalmic formulations are characterized by low bioavailability, short intraocular retention time, strong irritation, and failure to achieve the expected therapeutic effect due to the special physiological structure of the eye and the existence of many barriers. Microneedle drug delivery is a novel transdermal drug delivery modality. Responsive microneedles are defined as controllably releasing the drug payloads in response to physiological stimuli, including pH levels, temperature, enzymes, and reactive oxygen species (ROS), as well as external stimuli such as magnetic fields and light. In addition to inheriting the advantages of traditional microneedles, which include enhanced targeting and permeability, non-invasiveness, and painless application, the integration with stimulus-responsive materials enables responsive microneedles to achieve a personalized precision drug delivery process, which further increases the accuracy and efficiency of ocular treatments, making on-demand drug delivery possible. This article systematically reviews the classification, mechanisms, and characteristics of responsive microneedles and provides a detailed introduction to their diagnostic and therapeutic applications as well as real-time monitoring potential in ocular diseases, aiming to offer insights for the precision treatment of ocular diseases in the future.

Smart theranostic contact lenses

Although smart contact lenses have demonstrated great potential in theranostics, there remain critical challenges and opportunities in their commercial development. In this Perspective, the current status and capability of smart theranostic contact lenses are highlighted, focusing on their application as sensing systems for detecting biomarkers such as glucose, intraocular pressure (IOP), and inflammatory cytokines, and as drug delivery systems (DDS) for precise and controlled therapy. Additionally, key challenges associated with clinical development and commercialization of smart theranostic contact lenses are discussed, to optimize diagnostic and therapeutic interventions. Considering the rapid evolution of the field, we finally also discuss the need for systematic studies on safety, efficacy, and mass-production, and we spark new ideas for advancing smart theranostic contact lenses into versatile platforms for personalized medicine.

Biomaterials for reliable wearable health monitoring: Applications in skin and eye integration

Recent advancements in biomaterials have significantly impacted wearable health monitoring, creating opportunities for personalized and non-invasive health assessments. These developments address the growing demand for customized healthcare solutions. Durability is a critical factor for biomaterials in wearable applications, as they must withstand diverse wearing conditions effectively. Therefore, there is a heightened focus on developing biomaterials that maintain robust and stable functionalities, essential for advancing wearable sensing technologies. This review examines the biomaterials used in wearable sensors, specifically those interfaced with human skin and eyes, highlighting essential strategies for achieving long-lasting and stable performance. We specifically discuss three main categories of biomaterials-hydrogels, fibers, and hybrid materials-each offering distinct properties ideal for use in durable wearable health monitoring systems. Moreover, we delve into the latest advancements in biomaterial-based sensors, which hold the potential to facilitate early disease detection, preventative interventions, and tailored healthcare approaches. We also address ongoing challenges and suggest future directions for research on material-based wearable sensors to encourage continuous innovation in this dynamic field.

Kirigami Design Smart Contact Lens for Highly Sensitive Eyelid Pressure Measurement

Eyelid pressure is a crucial biomechanical parameter for ocular health and refractive status, yet measuring it poses challenges related to flexibility, sensitivity, and regional specificity. This study introduces a novel smart contact lens that incorporates kirigami designs and an iontronic capacitive sensing array to enhance flexibility and conformability. The unique structural composition of this device allows for precise and simultaneous monitoring of eyelid pressure in multiple regions with a high sensitivity and seamlessly fit across corneal curvatures. The efficacy of the sensor has been thoroughly confirmed through comprehensive evaluations in rabbits and porcine eyes, demonstrating improved conformity and sensitivity compared to conventional single-point sensors. Assessments have been conducted in various conditions, including under anesthesia and in awake states, as well as the deliberate alteration of intraocular pressure fluctuations, all affirming the exceptional accuracy in detecting eyelid pressure. We envision that the smart contact lens has the potential to revolutionize diagnosis and management of eyelid-related ocular diseases.

Photonic Nanomaterials for Wearable Health Solutions

This review underscores the transformative potential of photonic nanomaterials in wearable health technologies, driven by increasing demands for personalized health monitoring. Their unique optical and physical properties enable rapid, precise, and sensitive real-time monitoring, outperforming conventional electrical-based sensors. Integrated into ultra-thin, flexible, and stretchable formats, these materials enhance compatibility with the human body, enabling prolonged wear, improved efficiency, and reduced power consumption. A comprehensive exploration is provided of the integration of photonic nanomaterials into wearable devices, addressing material selection, light-matter interaction principles, and device assembly strategies. The review highlights critical elements such as device form factors, sensing modalities, and power and data communication, with representative examples in skin patches and contact lenses. These devices enable precise monitoring and management of biomarkers of diseases or biological responses. Furthermore, advancements in materials and integration approaches have paved the way for continuum of care systems combining multifunctional sensors with therapeutic drug delivery mechanisms. To overcome existing barriers, this review outlines strategies of material design, device engineering, system integration, and machine learning to inspire innovation and accelerate the adoption of photonic nanomaterials for next-generation of wearable health, showcasing their versatility and transformative potential for digital health applications.

Revolutionizing human healthcare with wearable sensors for monitoring human strain

With the rapid advancements in wearable sensor technology, healthcare is witnessing a transformative shift towards personalized and continuous monitoring. Wearable sensors designed for tracking human strain offer promising applications in rehabilitation, athletic performance, occupational health, and early disease detection. Recent advancements in the field have centered on the design optimization and miniaturization of wearable biosensors. Wireless communication technologies have facilitated the simultaneous, non-invasive detection of multiple analytes with high sensitivity and selectivity through wearable biosensors, significantly enhancing diagnostic accuracy. This review meticulously chronicles noteworthy advancements in wearable sensors tailored for healthcare and biomedical applications, spanning the current market landscape, challenges faced, and prospective trends, including multifunctional smart wearable sensors and integrated decision-support systems. The domain of flexible electronics has witnessed substantial progress over the past decade, particularly in flexible strain sensors, which are crucial for contemporary wearable and implantable devices. These innovations have broadened the scope of applications in human health monitoring and diagnostics. Continuous advancements in novel materials and device architectural methodologies aim to expand the utility of these sensors while meeting the increasingly stringent demands for enhanced sensing performance. This review explores the diverse array of wearable sensors-from piezoelectric, piezoresistive, and capacitive sensors to advanced optical and bioimpedance sensors-each distinguished by unique material properties and functionalities. We analyzed these technologies' sensitivity, accuracy, and response time, which were crucial for reliably capturing strain metrics in dynamic, real-world conditions. Quantitative performance comparisons across various sensor types highlighted their relative effectiveness, strengths, and limitations regarding detection precision, durability, and user comfort. Additionally, we discussed the current challenges in wearable sensor design, including energy efficiency, data transmission, and integration with machine learning models for enhanced data interpretation. Ultimately, this review emphasized the revolutionary potential of wearable strain sensors in advancing preventative healthcare and enabling proactive health management, ushering in an era where real-time health insights could lead to more timely interventions and improved health outcomes.

Advancements in Passive Wireless Sensing Systems in Monitoring Harsh Environment and Healthcare Applications

Recent advancements in passive wireless sensor technology have significantly extended the application scope of sensing, particularly in challenging environments for monitoring industry and healthcare applications. These systems are equipped with battery-free operation, wireless connectivity, and are designed to be both miniaturized and lightweight. Such features enable the safe, real-time monitoring of industrial environments and support high-precision physiological measurements in confined internal body spaces and on wearable epidermal devices. Despite the exploration into diverse application environments, the development of a systematic and comprehensive research framework for system architecture remains elusive, which hampers further optimization of these systems. This review, therefore, begins with an examination of application scenarios, progresses to evaluate current system architectures, and discusses the function of each component-specifically, the passive sensor module, the wireless communication model, and the readout module-within the context of key implementations in target sensing systems. Furthermore, we present case studies that demonstrate the feasibility of proposed classified components for sensing scenarios, derived from this systematic approach. By outlining a research trajectory for the application of passive wireless systems in sensing technologies, this paper aims to establish a foundation for more advanced, user-friendly applications.

Beyond Flexible: Unveiling the Next Era of Flexible Electronic Systems

Flexible electronics are integral in numerous domains such as wearables, healthcare, physiological monitoring, human-machine interface, and environmental sensing, owing to their inherent flexibility, stretchability, lightweight construction, and low profile. These systems seamlessly conform to curvilinear surfaces, including skin, organs, plants, robots, and marine species, facilitating optimal contact. This capability enables flexible electronic systems to enhance or even supplant the utilization of cumbersome instrumentation across a broad range of monitoring and actuation tasks. Consequently, significant progress has been realized in the development of flexible electronic systems. This study begins by examining the key components of standalone flexible electronic systems-sensors, front-end circuitry, data management, power management and actuators. The next section explores different integration strategies for flexible electronic systems as well as their recent advancements. Flexible hybrid electronics, which is currently the most widely used strategy, is first reviewed to assess their characteristics and applications. Subsequently, transformational electronics, which achieves compact and high-density system integration by leveraging heterogeneous integration of bare-die components, is highlighted as the next era of flexible electronic systems. Finally, the study concludes by suggesting future research directions and outlining critical considerations and challenges for developing and miniaturizing fully integrated standalone flexible electronic systems.

Paper integrated microfluidic contact lens for colorimetric glucose detection

Contact lenses offer a simple, cost-effective, and non-invasive method for in situ real-time analysis of various biomarkers. Electro-chemical sensors are integrated into contact lenses for analysis of various biomarkers. However, they suffer from rigid electronic components and connections, leading to eye irritation and biomarker concentration deviation. Here, a flexible and microfluidic integrated paper-based contact lens for colorimetric analysis of glucose was implemented. Facilitating a three-dimensional (3D) printer for lens fabrication eliminates cumbersome cleanroom processes and provides a simple, batch compatible process. Due to the capillary force of the filter paper, the sample was routed to detection chambers inside microchannels, and it allowed further colorimetric detection. The paper-embedded microfluidic contact lens successfully detects glucose down to 2 mM within ∼10 s. The small dimension of the microfluidic system enables detection of glucose levels as low as 5 μl. The results show the potential of the presented approach to analyze glucose concentration in a rapid manner. It is demonstrated that the fabricated contact lens can successfully detect glucose levels of diabetic patients.

Power Scavenging Microsystem for Smart Contact Lenses

On-the-eye microsystems such as smart contacts for vision correction, health monitoring, drug delivery, and displaying information represent a new emerging class of low-profile (≤ 1 mm) wireless microsystems that conform to the curvature of the eyeball surface. The implementation of suitable low-profile power sources for eye-based microsystems on curved substrates is a major technical challenge addressed in this paper. The fabrication and characterization of a hybrid energy generation unit composed of a flexible silicon solar cell and eye-blinking activated Mg-O2 metal-air harvester capable of sustainably supplying electrical power to smart ocular devices are reported. The encapsulated photovoltaic device provides a DC output with a power density of 42.4 µW cm-2 and 2.5 mW cm-2 under indoor and outdoor lighting conditions, respectively. The eye-blinking activated Mg-air harvester delivers pulsed power output with a maximum power density of 1.3 mW cm-2. A power management circuit with an integrated 11 mF supercapacitor is used to convert the harvesters' pulsed voltages to DC, boost up the voltages, and continuously deliver ≈150 µW at a stable 3.3 V DC output. Uniquely, in contrast to wireless power transfer, the power pack continuously generates electric power and does not require any type of external accessories for operation.

Wearable smart contact lenses: A critical comparison of three physiological signals outputs for health monitoring

Smart contact lenses (SCLs) have been considered as novel wearable devices for out-of-hospital and self-monitoring applications. They are capable of non-invasively and continuously monitoring physiological signals in the eyes, including vital biophysical (e.g., intraocular of pressure, temperature, and electrophysiological signal) and biochemical signals (e.g., pH, glucose, protein, nitrite, lactic acid, and ions). Recent progress mainly focuses on the rational design of wearable SCLs for physiological signal monitoring, while also facilitating the treatment of various ocular diseases. It covers contact lens materials, fabrication technologies, and integration methods. We also highlight and discuss a critical comparison of SCLs with electrical, microfluidic, and optical signal outputs in health monitoring. Their advantages and disadvantages could help researchers to make decisions when developing SCLs with desired properties for physiological signal monitoring. These unique capabilities make SCLs promising diagnostic and therapeutic tools. Despite the extensive research in SCLs, new technologies are still in their early stages of development and there are a few challenges to be addressed before these SCLs technologies can be successfully commercialized particularly in the form of rigorous clinical trials.

Approaches of wearable and implantable biosensor towards of developing in precision medicine

In the relentless pursuit of precision medicine, the intersection of cutting-edge technology and healthcare has given rise to a transformative era. At the forefront of this revolution stands the burgeoning field of wearable and implantable biosensors, promising a paradigm shift in how we monitor, analyze, and tailor medical interventions. As these miniature marvels seamlessly integrate with the human body, they weave a tapestry of real-time health data, offering unprecedented insights into individual physiological landscapes. This log embarks on a journey into the realm of wearable and implantable biosensors, where the convergence of biology and technology heralds a new dawn in personalized healthcare. Here, we explore the intricate web of innovations, challenges, and the immense potential these bioelectronics sentinels hold in sculpting the future of precision medicine.

Neuroprosthetic contact lens enabled sensorimotor system for point-of-care monitoring and feedback of intraocular pressure

The wearable contact lens that continuously monitors intraocular pressure (IOP) facilitates prompt and early-state medical treatments of oculopathies such as glaucoma, postoperative myopia, etc. However, either taking drugs for pre-treatment or delaying the treatment process in the absence of a neural feedback component cannot realize accurate diagnosis or effective treatment. Herein, a neuroprosthetic contact lens enabled sensorimotor system is reported, which consists of a smart contact lens with Ti3C2Tx Wheatstone bridge structured IOP strain sensor, a Ti3C2Tx temperature sensor and an IOP point-of-care monitoring/display system. The point-of-care IOP monitoring and warning can be realized due to the high sensitivity of 12.52 mV mmHg-1 of the neuroprosthetic contact lens. In vivo experiments on rabbit eyes demonstrate the excellent wearability and biocompatibility of the neuroprosthetic contact lens. Further experiments on a living rate in vitro successfully mimic the biological sensorimotor loop. The leg twitching (larger or smaller angles) of the living rat was demonstrated under the command of motor cortex controlled by somatosensory cortex when the IOP is away from the normal range (higher or lower).

Wireless Technologies in Flexible and Wearable Sensing: From Materials Design, System Integration to Applications

Wireless and wearable sensors attract considerable interest in personalized healthcare by providing a unique approach for remote, noncontact, and continuous monitoring of various health-related signals without interference with daily life. Recent advances in wireless technologies and wearable sensors have promoted practical applications due to their significantly improved characteristics, such as reduction in size and thickness, enhancement in flexibility and stretchability, and improved conformability to the human body. Currently, most researches focus on active materials and structural designs for wearable sensors, with just a few exceptions reflecting on the technologies for wireless data transmission. This review provides a comprehensive overview of the state-of-the-art wireless technologies and related studies on empowering wearable sensors. The emerging functional nanomaterials utilized for designing unique wireless modules are highlighted, which include metals, carbons, and MXenes. Additionally, the review outlines the system-level integration of wireless modules with flexible sensors, spanning from novel design strategies for enhanced conformability to efficient transmitting data wirelessly. Furthermore, the review introduces representative applications for remote and noninvasive monitoring of physiological signals through on-skin and implantable wireless flexible sensing systems. Finally, the challenges, perspectives, and unprecedented opportunities for wireless and wearable sensors are discussed.

3D Printable Active Hydrogels with Supramolecular Additive-Driven Adaptiveness

Smart hydrogels are a promising candidate for the development of next-generation soft materials due to their stimuli-responsiveness, deformability, and biocompatibility. However, it remains challenging to enable hydrogels to actively adapt to various environmental conditions like living organisms. In this work, supramolecular additives are introduced to the hydrogel matrix to confer environmental adaptiveness. Specifically, their microstructures, swelling behaviors, mechanical properties, and transparency can adapt to external environmental conditions. Moreover, the presence of hydrogen bonding provides the hydrogel with applicable rheological properties for 3D extrusion printing, thus allowing for the facile preparation of thickness-dependent camouflage and multistimuli responsive complex. The environmentally adaptive hydrogel developed in this study offers new approaches for manipulating supramolecular interactions and broadens the capability of smart hydrogels in information security and multifunctional integrated actuation.

Smart Contact Lenses in Ophthalmology: Innovations, Applications, and Future Prospects

Smart contact lenses represent a breakthrough in the intersection of medical science and innovative technology, offering transformative potential in ophthalmology. This review article delves into the technological underpinnings of smart contact lenses, emphasizing the current landscape and advancements in biosensors, power supply, biomaterials, and the transmission of ocular information. This review further applies new innovations to their emerging role in the diagnosis, monitoring, and management of various ocular conditions. Moreover, we explore the impact of technical innovations on the application of smart contact lenses in monitoring glaucoma, managing postoperative care, and dry eye syndrome, further elucidating the non-invasive nature of these devices in continuous ocular health monitoring. The therapeutic potential of smart contact lenses such as treatment through targeted drug delivery and the monitoring of inflammatory biomarkers is also highlighted. Despite promising advancements, the implementation of smart contact lenses faces technical, regulatory, and patient compliance challenges. This review synthesizes the recent advances to provide an outlook on the state of smart contact lens technology. Furthermore, we discuss future directions, focusing on potential technological enhancements and new applications within ophthalmology.

An Ultrasensitive Ti3C2Tx MXene-based Soft Contact Lens for Continuous and Nondestructive Intraocular Pressure Monitoring

Wearable soft contact lens sensors for continuous and nondestructive intraocular pressure (IOP) monitoring are highly desired as glaucoma and postoperative myopia patients grow, especially as the eyestrain crowd increases. Herein, a smart closed-loop system is presented that combines a Ti3C2Tx MXene-based soft contact lens (MX-CLS) sensor, wireless data transmission units, display, and warning components to realize continuous and nondestructive IOP monitoring/real-time display. The fabricated MX-CLS device exhibits an extremely high sensitivity of 7.483 mV mmHg-1, good linearity on silicone eyeballs, excellent stability under long-term pressure-release measurement, sufficient transparency with 67.8% transmittance under visible illumination, and superior biocompatibility with no discomfort when putting the MX-CLS sensor onto the Rabbit eyes. After integrating with the wireless module, users can realize real-time monitoring and warning of IOP via smartphones, the demonstrated MX-CLS device together with the IOP monitoring/display system opens up promising platforms for Ti3C2Tx materials as the base for multifunctional contact lens-based sensors and continuous and nondestructive IOP measurement system.

An adaptive drug-releasing contact lens for personalized treatment of ocular infections and injuries

This research introduces an innovative solution to address the challenges of bacterial keratitis and alkali burns. Current treatments for bacterial keratitis and alkali burns rely on the frequent use of antibiotics and anti-inflammatory eye drops. However, these approaches suffer from poor bioavailability and fluctuating concentrations, leading to limited efficacy and potential drug resistance. Our approach presents an adaptive drug-releasing contact lens responsive to reactive oxygen species (ROS) at ocular inflammation sites, synchronously releasing Levofloxacin and Diclofenac. During storage, minimal drug release occurred, but over 7 days of wear, the lens maintained a continuous, customizable drug release rate based on disease severity. This contact lens had strong antibacterial activity and biofilm prevention, effectively treating bacterial keratitis. When combined with autologous serum, this hydrophilic, flexible lens aids corneal epithelial regeneration, reducing irritation and promoting healing. In summary, this ROS-responsive drug-releasing contact lens combines antibacterial and anti-inflammatory effects, offering a promising solution for bacterial keratitis and alkali burns.

Temperature Self-Compensating Intelligent Wireless Measuring Contact Lens for Quantitative Intraocular Pressure Monitoring

Flexible bioelectronic devices that can perform real-time and accurate intraocular pressure (IOP) monitoring in both clinical and home settings hold significant implications for the diagnosis and treatment of glaucoma, yet they face challenges due to the open physiological environment of the ocular. Herein, we develop an intelligent wireless measuring contact lens (WMCL) incorporating a dual inductor-capacitor-resistor (LCR) resonant system to achieve temperature self-compensation for quantitative IOP monitoring in different application environments. The WMCL utilizes a compact circuitry design, which enables the integration of low-frequency and high-frequency resonators within a single layer of a sensing circuit without causing visual impairment. Mechanically guided microscale 3D encapsulation strategy combined with flexible circuit printing techniques achieves the surface-adaptive fabrication of the WMCL. The specific design of frequency separation imparts distinct temperature response characteristics to the dual resonators, and the linear combination of the dual resonators can eliminate the impact of temperature variations on measurement accuracy. The WMCL demonstrates outstanding sensitivity and linearity in monitoring the IOP of porcine eyes in vitro while maintaining satisfactory measurement accuracy even with internal temperature variations exceeding 10 °C. Overcoming the impact of temperature variations on IOP monitoring from the system level, the WMCL showcases immense potential as the next generation of all-weather IOP monitoring devices.

Frequency-encoded eye tracking smart contact lens for human-machine interaction

Eye tracking techniques enable high-efficient, natural, and effortless human-machine interaction by detecting users' eye movements and decoding their attention and intentions. Here, a miniature, imperceptible, and biocompatible smart contact lens is proposed for in situ eye tracking and wireless eye-machine interaction. Employing the frequency encoding strategy, the chip-free and battery-free lens successes in detecting eye movement and closure. Using a time-sequential eye tracking algorithm, the lens has a great angular accuracy of <0.5°, which is even less than the vision range of central fovea. Multiple eye-machine interaction applications, such as eye-drawing, Gluttonous Snake game, web interaction, pan-tilt-zoom camera control, and robot vehicle control, are demonstrated on the eye movement model and in vivo rabbit. Furthermore, comprehensive biocompatibility tests are implemented, demonstrating low cytotoxicity and low eye irritation. Thus, the contact lens is expected to enrich approaches of eye tracking techniques and promote the development of human-machine interaction technology.

Smart Contact Lenses for Healthcare Monitoring and Therapy

The eye contains a wealth of physiological information and offers a suitable environment for noninvasive monitoring of diseases via smart contact lens sensors. Although extensive research efforts recently have been undertaken to develop smart contact lens sensors, they are still in an early stage of being utilized as an intelligent wearable sensing platform for monitoring various biophysical/chemical conditions. In this review, we provide a general introduction to smart contact lenses that have been developed for disease monitoring and therapy. First, different disease biomarkers available from the ocular environment are summarized, including both physical and chemical biomarkers, followed by the commonly used materials, manufacturing processes, and characteristics of contact lenses. Smart contact lenses for eye-drug delivery with advancing technologies to achieve more efficient treatments are then introduced as well as the latest developments for disease diagnosis. Finally, sensor communication technologies and smart contact lenses for antimicrobial and other emerging bioapplications are also discussed as well as the challenges and prospects of the future development of smart contact lenses.

Towards Precision Ophthalmology: The Role of 3D Printing and Bioprinting in Oculoplastic Surgery, Retinal, Corneal, and Glaucoma Treatment

In the forefront of ophthalmic innovation, biomimetic 3D printing and bioprinting technologies are redefining patient-specific therapeutic strategies. This critical review systematically evaluates their application spectrum, spanning oculoplastic reconstruction, retinal tissue engineering, corneal transplantation, and targeted glaucoma treatments. It highlights the intricacies of these technologies, including the fundamental principles, advanced materials, and bioinks that facilitate the replication of ocular tissue architecture. The synthesis of primary studies from 2014 to 2023 provides a rigorous analysis of their evolution and current clinical implications. This review is unique in its holistic approach, juxtaposing the scientific underpinnings with clinical realities, thereby delineating the advantages over conventional modalities, and identifying translational barriers. It elucidates persistent knowledge deficits and outlines future research directions. It ultimately accentuates the imperative for multidisciplinary collaboration to enhance the clinical integration of these biotechnologies, culminating in a paradigm shift towards individualized ophthalmic care.

Characterization of intraocular pressure variability in conscious rats

Elevation of mean intraocular pressure (IOP) has long been recognized as a leading risk factor for glaucoma. Less is known about the possible contribution of moment-to-moment variations in IOP to disease development and progression due to limitations of tonometry, the prevailing method of IOP measurement. Tonometry provides good estimates of mean IOP but not IOP variance. The aim of this study was to quantitatively characterize IOP variability via round-the-clock IOP telemetry in conscious unrestrained rats. The anterior chamber of one eye was implanted with a microcannula connected to a wireless backpack telemetry system, and IOP data were collected every 4 s for one week. The cannula was then repositioned under the conjunctiva, and control data were collected for an additional week. IOP statistics were computed in 30-min intervals over a 24-h period and averaged across days. All animals exhibited a diurnal variation in mean IOP, while deviations about the mean were independent of time of day. Correlation analysis of the deviations revealed transient and sustained components, which were respectively extracted from IOP records using an event detection algorithm. The amplitude and interval distributions of transient and sustained events were characterized, and their energy content was estimated based on outflow tissue resistance of rat eyes. Transient IOP events occurred ∼231 times per day and were typically ≤5 mmHg in amplitude and 2-8 min in duration, while sustained IOP events occurred ∼16 times per day and were typically ≤5 mmHg in amplitude and 20-60 min in duration. Both persisted but were greatly reduced in control recordings, implying minor contamination of IOP data by motion-induced telemetry noise. Sustained events were also often synchronous across implanted animals, indicating that they were driven by autonomic startle and stress responses or other physiological processes activated by sensory signals in the animal housing environment. Not surprisingly, the total daily fluidic energy applied to resistive outflow pathways was determined primarily by basal IOP level. Nevertheless, transient and sustained fluctuations collectively contributed 6% and diurnal fluctuations contributed 9% to daily IOP energy. It is therefore important to consider the cumulative impact of biomechanical stress that IOP fluctuations apply over time to ocular tissues.

Advances and Challenges in Wearable Glaucoma Diagnostics and Therapeutics

Glaucoma is a leading cause of irreversible blindness, and early detection and treatment are crucial for preventing vision loss. This review aims to provide an overview of current diagnostic and treatment standards, recent medical and technological advances, and current challenges and future outlook for wearable glaucoma diagnostics and therapeutics. Conventional diagnostic techniques, including the rebound tonometer and Goldmann Applanation Tonometer, provide reliable intraocular pressure (IOP) measurement data at single-interval visits. The Sensimed Triggerfish and other emerging contact lenses provide continuous IOP tracking, which can improve diagnostic IOP monitoring for glaucoma. Conventional therapeutic techniques include eye drops and laser therapies, while emerging drug-eluting contact lenses can solve patient noncompliance with eye medications. Theranostic platforms combine diagnostic and therapeutic capabilities into a single device. Advantages of these platforms include real-time monitoring and personalized medication dosing. While there are many challenges to the development of wearable glaucoma diagnostics and therapeutics, wearable technologies hold great potential for enhancing glaucoma management by providing continuous monitoring, improving medication adherence, and reducing the disease burden on patients and healthcare systems. Further research and development of these technologies will be essential to optimizing patient outcomes.

Advancing Glaucoma Care: Integrating Artificial Intelligence in Diagnosis, Management, and Progression Detection

Glaucoma, the leading cause of irreversible blindness worldwide, comprises a group of progressive optic neuropathies requiring early detection and lifelong treatment to preserve vision. Artificial intelligence (AI) technologies are now demonstrating transformative potential across the spectrum of clinical glaucoma care. This review summarizes current capabilities, future outlooks, and practical translation considerations. For enhanced screening, algorithms analyzing retinal photographs and machine learning models synthesizing risk factors can identify high-risk patients needing diagnostic workup and close follow-up. To augment definitive diagnosis, deep learning techniques detect characteristic glaucomatous patterns by interpreting results from optical coherence tomography, visual field testing, fundus photography, and other ocular imaging. AI-powered platforms also enable continuous monitoring, with algorithms that analyze longitudinal data alerting physicians about rapid disease progression. By integrating predictive analytics with patient-specific parameters, AI can also guide precision medicine for individualized glaucoma treatment selections. Advances in robotic surgery and computer-based guidance demonstrate AI's potential to improve surgical outcomes and surgical training. Beyond the clinic, AI chatbots and reminder systems could provide patient education and counseling to promote medication adherence. However, thoughtful approaches to clinical integration, usability, diversity, and ethical implications remain critical to successfully implementing these emerging technologies. This review highlights AI's vast capabilities to transform glaucoma care while summarizing key achievements, future prospects, and practical considerations to progress from bench to bedside.

Bioinspired nanoplatforms for human-machine interfaces: Recent progress in materials and device applications

The panoramic characteristics of human-machine interfaces (HMIs) have prompted the needs to update the biotechnology community with the recent trends, developments, and future research direction toward next-generation bioelectronics. Bioinspired materials are promising for integrating various bioelectronic devices to realize HMIs. With the advancement of scientific biotechnology, state-of-the-art bioelectronic applications have been extensively investigated to improve the quality of life by developing and integrating bioinspired nanoplatforms in HMIs. This review highlights recent trends and developments in the field of biotechnology based on bioinspired nanoplatforms by demonstrating recently explored materials and cutting-edge device applications. Section 1 introduces the recent trends and developments of bioinspired nanomaterials for HMIs. Section 2 reviews various flexible, wearable, biocompatible, and biodegradable nanoplatforms for bioinspired applications. Section 3 furnishes recently explored substrates as carriers for advanced nanomaterials in developing HMIs. Section 4 addresses recently invented biomimetic neuroelectronic, nanointerfaces, biointerfaces, and nano/microfluidic wearable bioelectronic devices for various HMI applications, such as healthcare, biopotential monitoring, and body fluid monitoring. Section 5 outlines designing and engineering of bioinspired sensors for HMIs. Finally, the challenges and opportunities for next-generation bioinspired nanoplatforms in extending the potential on HMIs are discussed for a near-future scenario. We believe this review can stimulate the integration of bioinspired nanoplatforms into the HMIs in addition to wearable electronic skin and health-monitoring devices while addressing prevailing and future healthcare and material-related problems in biotechnologies.

Smart Contact Lenses-A Step towards Non-Invasive Continuous Eye Health Monitoring

According to the age-old adage, while eyes are often considered the gateway to the soul, they might also provide insights into a more pragmatic aspect of our health: blood sugar levels. This potential breakthrough could be realized through the development of smart contact lenses (SCLs). Although contact lenses were first developed for eyesight correction, new uses have recently become available. In the near future, it might be possible to monitor a variety of ocular and systemic disorders using contact lens sensors. Within the realm of glaucoma, SCLs present a novel prospect, offering a potentially superior avenue compared to traditional management techniques. These lenses introduce the possibility of non-invasive and continuous monitoring of intraocular pressure (IOP) while also enabling the personalized administration of medication as and when needed. This convergence holds great promise for advancing glaucoma care. In this review, recent developments in SCLs, including their potential applications, such as IOP and glucose monitoring, are briefly discussed.

Smart Contact Lenses as Wearable Ophthalmic Devices for Disease Monitoring and Health Management

The eye contains a complex network of physiological information and biomarkers for monitoring disease and managing health, and ocular devices can be used to effectively perform point-of-care diagnosis and disease management. This comprehensive review describes the target biomarkers and various diseases, including ophthalmic diseases, metabolic diseases, and neurological diseases, based on the physiological and anatomical background of the eye. This review also includes the recent technologies utilized in eye-wearable medical devices and the latest trends in wearable ophthalmic devices, specifically smart contact lenses for the purpose of disease management. After introducing other ocular devices such as the retinal prosthesis, we further discuss the current challenges and potential possibilities of smart contact lenses.

Mechanically-Guided 3D Assembly for Architected Flexible Electronics

Architected flexible electronic devices with rationally designed 3D geometries have found essential applications in biology, medicine, therapeutics, sensing/imaging, energy, robotics, and daily healthcare. Mechanically-guided 3D assembly methods, exploiting mechanics principles of materials and structures to transform planar electronic devices fabricated using mature semiconductor techniques into 3D architected ones, are promising routes to such architected flexible electronic devices. Here, we comprehensively review mechanically-guided 3D assembly methods for architected flexible electronics. Mainstream methods of mechanically-guided 3D assembly are classified and discussed on the basis of their fundamental deformation modes (i.e., rolling, folding, curving, and buckling). Diverse 3D interconnects and device forms are then summarized, which correspond to the two key components of an architected flexible electronic device. Afterward, structure-induced functionalities are highlighted to provide guidelines for function-driven structural designs of flexible electronics, followed by a collective summary of their resulting applications. Finally, conclusions and outlooks are given, covering routes to achieve extreme deformations and dimensions, inverse design methods, and encapsulation strategies of architected 3D flexible electronics, as well as perspectives on future applications.

Wearable sensors for telehealth based on emerging materials and nanoarchitectonics

Wearable sensors have made significant progress in sensing physiological and biochemical markers for telehealth. By monitoring vital signs like body temperature, arterial oxygen saturation, and breath rate, wearable sensors provide enormous potential for the early detection of diseases. In recent years, significant advancements have been achieved in the development of wearable sensors based on two-dimensional (2D) materials with flexibility, excellent mechanical stability, high sensitivity, and accuracy introducing a new approach to remote and real-time health monitoring. In this review, we outline 2D materials-based wearable sensors and biosensors for a remote health monitoring system. The review focused on five types of wearable sensors, which were classified according to their sensing mechanism, such as pressure, strain, electrochemical, optoelectronic, and temperature sensors. 2D material capabilities and their impact on the performance and operation of the wearable sensor are outlined. The fundamental sensing principles and mechanism of wearable sensors, as well as their applications are explored. This review concludes by discussing the remaining obstacles and future opportunities for this emerging telehealth field. We hope that this report will be useful to individuals who want to design new wearable sensors based on 2D materials and it will generate new ideas.

Contact Lens Sensor with Anti-jamming Capability and High Sensitivity for Intraocular Pressure Monitoring

Contact lens sensors provide a noninvasive approach for intraocular pressure (IOP) monitoring in patients with glaucoma. Accurate measurement of this imperceptible pressure variation requires highly sensitive sensors in the absence of simultaneously amplifying IOP signal and blinking-induced noise. However, current noise-reduction methods rely on external filter circuits, which thicken contact lenses and reduce signal quality. Here, we introduce a contact lens strain sensor with an anti-jamming ability by utilizing a self-lubricating layer to reduce the coefficient of friction (COF) to remove the interference from the tangential force. The sensor achieves exceptionally high sensitivity due to the strain concentration layout and the confined occurrence of sympatric microcracks. The animal tests prove our lens can accurately detect IOP safely and reliably.

Smart Contact Lenses Keep an Eye on Health

Contact lenses are ideal conduits for continuous health monitoring. They have a long safety record, and they sit on the eye, where they have access to a range of biological signals. Making the transition from vision correction to biological monitoring, however, requires advances in technological development so the lenses not only detect and report signals accurately, but retain the high level of comfort that users have come to expect.

Recent Progress in Long-Term Sleep Monitoring Technology

Sleep is an essential physiological activity, accounting for about one-third of our lives, which significantly impacts our memory, mood, health, and children's growth. Especially after the COVID-19 epidemic, sleep health issues have attracted more attention. In recent years, with the development of wearable electronic devices, there have been more and more studies, products, or solutions related to sleep monitoring. Many mature technologies, such as polysomnography, have been applied to clinical practice. However, it is urgent to develop wearable or non-contacting electronic devices suitable for household continuous sleep monitoring. This paper first introduces the basic knowledge of sleep and the significance of sleep monitoring. Then, according to the types of physiological signals monitored, this paper describes the research progress of bioelectrical signals, biomechanical signals, and biochemical signals used for sleep monitoring. However, it is not ideal to monitor the sleep quality for the whole night based on only one signal. Therefore, this paper reviews the research on multi-signal monitoring and introduces systematic sleep monitoring schemes. Finally, a conclusion and discussion of sleep monitoring are presented to propose potential future directions and prospects for sleep monitoring.