Context-sensitive smart glasses monitoring wear position and activity for therapy compliance-A proof of concept

Treatment compliance in amblyopia: A mini-review and description of a novel online platform for compliance tracking

Patient compliance with amblyopia therapies, including eye patching and atropine drops, is crucial for optimal visual acuity outcomes. Studies utilizing objective measures of compliance measurement have consistently shown that a majority of patients receive significantly less treatment than prescribed. We review the subjective and objective compliance rates reported in the literature, assess possible explanations for poor compliance and describe studies of interventions to improve compliance. Additionally, we report our experience implementing Inside Out Care, a novel online platform designed to improve monitoring of amblyopia patient compliance, in our clinics. We have found that this platform, which is accessible via both computer and smartphone, has improved monitoring of amblyopia patient patching compliance, as well as allowed for enhanced doctor-patient communication.

Monitoring of wearing and occlusion times with smart shutter glasses—A proof of concept

Purpose

To develop and evaluate an electronic glasses frame for smart liquid crystal shutter glasses that monitors wearing and occlusion times to potentially improve therapy adherence in amblyopia therapy of children.

Methods

The first generation of an electronic glasses frame for adults was further developed, miniaturized and functionally tested in a proof of concept study on a small group of healthy children. Seven healthy children (4 females, 3 males, 2–9 years) were enrolled in the study. The subjects were instructed to wear the smart shutter glasses and to record their activities in daily life. Averaged and individual results were calculated for the precision of wearing position detection and activity recognition. Also, the proper execution of the configured occlusion pattern was observed.

Results

The first generation of an electronic glasses frame for smart liquid crystal shutter glasses in a miniaturized form factor for children. A key element is the implementation of the adaptive shutter operation and of smart algorithms for real-time therapy monitoring. In the proof of concept study, these algorithms monitored the state of wearing position, the wearer’s activity and the configured occlusion pattern. The average agreement of the detected states of wearing position was 72.6%. The average activity recognition match was 77.3%. The removal of the glasses was 100% correctly detected and the occlusion was 100% halted when active motion was recognized.

Conclusion

The assembled smart shutter glasses for children are suitable for demonstrating the feasibility of continuous therapy monitoring by calculating wearing and occlusion times due to smart algorithms for wearing position detection, activity recognition, and occlusion monitoring. However, further research and studies are necessary to optimize the individual fit and performance of this wearable therapeutic device.

Development of a Spectacle Wear Monitor System: SpecsOn Monitor

Purpose

This study aimed to custom design, build, and test a removable device that accurately and objectively monitors adherence to spectacle wear in preschool children participating in clinical trials. This work will provide researchers with the tools to investigate the effect of adherence to optical treatment in conditions relating to refractive error, such as anisometropia, amblyopia, myopia, and accommodative esotropia, where spectacle wearing behaviors are of interest.

Methods

Several sensors were considered in the design of the SpecsOn monitor. The final version included two temperature sensors, one that measures skin temperature through an infrared sensor directed at the wearer's temple on the spectacle arm and the other measuring device temperature. The difference between the two temperature readings is used to determine if the spectacles were worn. The SpecsOn monitor was tested in two phases in adult participants (laboratory n = 10 and real world n = 5).

Results

Results from both phases showed good agreement between the objective measurement of wear based on skin and device temperature differences and participants’ manually logged wear times. The custom built SpecsOn monitor was 99% successful in accurately detecting spectacle wear in our adult cohort.

Conclusions

The SpecsOn monitor offers a convenient, accurate, and reliable system to monitor spectacle adherence. The devices were comfortable, secure, and unobtrusive to wear, and fitted easily to a variety of frame styles.

Translational Relevance

Easy access to spectacle compliance information from the SpecsOn monitor during the optical treatment phase will optimize visual outcomes and provide detailed clinical data to support decision making on the need and timing of additional therapies, improving treatment efficiency.