Wearable Virtual White Cane Network for navigating people with visual impairment

Digital health and wearable devices for retinal disease monitoring

Digital health is wielding a growing influence across all areas of healthcare, encompassing various facets such as telemedicine, artificial intelligence (AI), and electronic healthcare records. In Ophthalmology, digital health innovations can be broadly divided into four categories: (i) self-monitoring home devices and apps, (ii) virtual and augmented reality visual aids, (iii) AI software, and (iv) wearables. Wearable devices can work in the background, collecting large amounts of objective data while we do our day-to-day activities, which may be ecologically more valid and meaningful to patients than that acquired in traditional hospital settings. They can be a watch, wristband, piece of clothing, glasses, cane, smartphone in our pocket, earphones, or any other device with a sensor that we carry with us. Focusing on retinal diseases, a key challenge in developing novel therapeutics has been to prove a meaningful benefit in patients' lives and the creation of objective patient-centred endpoints in clinical trials. In this review, we will discuss wearable devices collecting different aspects of visual behaviour, visual field, central vision, and functional vision, as well as their potential implementation as outcome measures in research/clinical trial settings. The healthcare landscape is facing a paradigm shift. Clinicians have a key role of collaborating with the development and fine-tuning of digital health innovations, as well as identifying opportunities where they can be leveraged to enhance our understanding of retinal diseases and improve patient outcomes.

Dynamic stability evaluation of trunk accelerations during walking in blind and sighted individuals

BACKGROUND

Dynamic stability is a fundamental goal in standing activities. In this regard, monitoring, analysis, and interventions made to improve stability is a research topic investigated in the biomechanics of human movements. Vision has a major role to play in controlling human movement. Nonetheless, little is known about the effects of visual deprivation, especially from birth on dynamic gait stability.

METHODS

The current study was conducted on 20 congenital blind and 10 sighted people (15-38 years). To evaluate the dynamic stability, descriptive data, harmonic ratio (HR), improved harmonic ratio (iHR), and root mean square (RMS), based on trunk acceleration data were measured in three axes: anteroposterior (AP), vertical (V), and mediolateral (ML) while participants walked an eight-meter straight path.

RESULTS

In the comparison of blind and sighted people (eyes open), standard deviation, HR, iHR, and RMS indices were found to be significantly different in both AP and V directions. All the mentioned parameters were significantly lower in blind than in sighted participants. In the comparison of blind people and sighted ones with closed eyes, changes were observed in the maximum, range, standard deviation, and RMS only in the AP axis. In the comparison between eyes open and closed in sighted people, a significant difference was found only in the harmonic ratio of the vertical axis.

CONCLUSION

Visual deprivation led to a decrease in dynamic stability parameters in the AP and V axes. Even the movement of sighted people in unchallenged conditions is dependent on visual information.

Intelligent Head-Mounted Obstacle Avoidance Wearable for the Blind and Visually Impaired

Individuals who are Blind and Visually Impaired (BVI) take significant risks and dangers on obstacles, particularly when they are unaccompanied. We propose an intelligent head-mount device to assist BVI people with this challenge. The objective of this study is to develop a computationally efficient mechanism that can effectively detect obstacles in real time and provide warnings. The learned model aims to be both reliable and compact so that it can be integrated into a wearable device with a small size. Additionally, it should be capable of handling natural head turns, which can generally impact the accuracy of readings from the device's sensors. Over thirty models with different hyper-parameters were explored and their key metrics were compared to identify the most suitable model that strikes a balance between accuracy and real-time performance. Our study demonstrates the feasibility of a highly efficient wearable device that can assist BVI individuals in avoiding obstacles with a high level of accuracy.

Wearable Travel Aids for Blind and Partially Sighted People: A Review with a Focus on Design Issues

The ability to travel (independently) is very important for participation in education, work, leisure activities, and all other aspects of modern life. Blind and partially sighted people experience a number of barriers to travel, including inaccessible information and environments, and consequently require support from technology or other people to overcome them. Despite the potential of advanced technologies and the development of electronic travel aids, the long cane and guide dog remains the most commonly used solutions. Wearable technologies are becoming increasingly popular. They have the particular advantage of keeping the hands free, thereby facilitating the use of a long cane, guide dog or another device at the same time. They also have the potential to change the ways in which users interact with the environment. The main contributions of this paper are surveying the current state-of-the-art of travel aids from a design perspective and investigating the following issues: (1) The important design issues in wearable travel aids and the extent to which they are taken into account in different devices; (2) The relationship, if any, between where and how travel aids are worn and their design, features and functions; (3) Limitations of existing devices, gaps in provision and future research directions, particularly with regard to meeting potential users' needs.

Living Without a Diagnosis: A Patient's Perspective on Diabetic Macular Ischemia

Diabetic macular ischemia (DMI) is a common complication of diabetic retinopathy (DR) that can result in progressive and irreversible vision loss. DMI is associated with damage in the vessels that supply blood to the retina and the enlargement of the foveal avascular zone. Currently, there are no approved treatments specifically for DMI. Furthermore, there is limited published information about the prognosis, prevalence or outcomes of DMI, and there is no consensus regarding diagnostic criteria. It is vital to ensure that there is sufficient, accessible and accurate information available to support patients, caregivers and physicians. To lay the foundation for more research into DMI and its impact on patients, we (a patient with DMI and an expert ophthalmologist) have worked together to interweave our personal perspectives and clinical experiences with a review of currently available literature on DMI. The development of a set of confirmed diagnostic criteria for DMI would assist both patients and physicians, allowing patients to access validated information about their condition and supporting the development of clinical trials for treatments of DMI. Training for physicians must continue to emphasise the importance of treating a patient holistically, rather than only treating their symptoms. Most importantly, developing trust and a healthy rapport between a patient and their physician is important in managing health anxiety and ensuring adherence to beneficial treatments or lifestyle adjustments; physicians must cultivate an open and flexible management approach with their patients. Finally, holistic educational programmes for patients, physicians and the general public around DMI and how it can affect daily functioning would facilitate general understanding and disease awareness.

Diabetic macular ischemia (DMI) is a common problem for patients with diabetic retinopathy that can lead to sight loss. There is very little information available about DMI, particularly from a patient’s point of view. To address the lack of information about DMI, we (a person with DMI and her eye doctor) have worked together to examine what it is like to live with DMI. It is important to provide clear and accessible information about diseases to patients and carers. The lack of information about DMI may be upsetting for some people, and should be addressed with more research. Developing of a set of confirmed signs and symptoms for the diagnosis of DMI would allow people to be more confident in the information that they receive about their disease, and support the development of treatments for DMI. The support of others is central to the wellbeing of people with vision loss. Although people with vision loss may also lose independence, care from loved ones can help to improve quality of life. Most importantly, developing trust between a patient and their doctor is central to managing people’s fears about their eyesight, and making sure that they follow helpful advice. Doctors must use an open and flexible approach with their patients, providing information in an honest and understandable way.

Emergence of non-artificial intelligence digital health innovations in ophthalmology: A systematic review

The prominent rise of digital health in ophthalmology is evident in the current age of Industry 4.0. Despite the many facets of digital health, there has been a greater slant in interest and focus on artificial intelligence recently. Other major elements of digital health like wearables could also substantially impact patient-focused outcomes but have been relatively less explored and discussed. In this review, we comprehensively evaluate the use of non-artificial intelligence digital health tools in ophthalmology. 53 papers were included in this systematic review - 25 papers discuss virtual or augmented reality, 14 discuss mobile applications and 14 discuss wearables. Most papers focused on the use of technologies to detect or rehabilitate visual impairment, glaucoma and age-related macular degeneration. Overall, the findings on patient-focused outcomes with the adoption of these technologies are encouraging. Further validation, large-scale studies and earlier consideration of real-world barriers are warranted to enable better real-world implementation.

Communicating through Touch: Macro Fiber Composites for Tactile Stimulation on the Abdomen

Research into sensory substitution systems has expanded, as alternative senses are utilized in real-time to afford object recognition or spatial understanding. Tactile stimulation has long shown promise as a communicatory strategy when applied unobtrusively to the redundant surface areas of the skin. Here, a novel belt, integrating a matrix of macro fiber composites, is purposed to deliver tactile stimuli to the abdomen. The design and development of the belt is presented and a systematic experimental study is conducted to analyze the impact of frequency and duty cycle. The belt is a beta precursor to a soft haptic feedback device that will enable situational awareness and obstacle avoidance through the localization of tactile stimulation relative to a body-centric frame of reference in a local environment.