The cornea is the outermost lens of the eye. Along with the crystalline lens, it projects images of the outside world onto the retina. An adequate corneal shape, that is essential for the process of focusing light rays onto the retina, is dependent on the cornea’s biomechanics, which vary from one person to another.
There are eye conditions in which the cornea is surgically altered, either by laser carving or by corneal implants or incisions. This is the case in treatments against myopia, which affects 30% of the population in western countries and 90% in some Asian populations; presbyopia, which is the loss of dynamic focus ability that affects 100% of people over 45 years of age, and cataract, which causes loss of transparency and affects 50% of the population over 65 years of age.
In various pathologies, such as keratoconus, which affects more than 2% of the population, the cornea weakens locally, resulting in bulging and distortion of vision. Keratoconus treatment requires implanting a support structure inside the cornea (segments of an intracorneal ring) or stiffening the cornea by UV light in a technique called cross-linking.
Customising eye treatments for individual patients
The IMCUSTOMEYE project, funded by the European Commission's Horizon 2020 programme, aims to implement non-invasive techniques for patients with corneal disease and glaucoma.
“Despite the fact that these treatments, and the conditions they help with, interact or interfere mechanically with the cornea, there is currently no method to accurately measure corneal biomechanical properties in vivo. Such a method would be essential for customising these treatments for individual patients’ needs and ultimately improving their clinical outcomes. The IMCUSTOMEYE project is intended to address this need,” explains lead of the Liverpool group, Professor Ahmed Elsheikh.
The group is currently developing two devices as part of the IMCUSTOMEYE project.
“The first device is an air puff based instrument that closely monitors the cornea’s deformation under an external air pressure and uses advanced mathematical and statistical techniques to determine the cornea’s biomechanical properties and estimate the eye’s internal pressure – needed for glaucoma management,” say Ashkan Eliasy and Bernardo Lopes, post-doctoral researchers on the project.
“The second device is intended as a screening device for keratoconus. The device monitors cornea’s response to a sound excitation and uses asymmetry in amplitudes of corneal vibration as a possible sign of the local weakness associated with the disease in its preclinical stages,” explains Dr Ahmed Abass, Lecturer in Biomedical Engineering.
Three patent applications have been filed so far with contributions from Liverpool for different aspects of the technology, and efforts to commercialise the devices to companies within the project consortium and outside are ongoing.
International collaboration
IMCUSTOMEYE is coordinated by VioBio Lab, Institute of Optics CSIC, a world pioneer in optical instrumentation development for ocular diagnosis, and includes international leaders in biomedical optics from the Polish Academy of Sciences and the National University of Ireland.
The project also includes international companies, selected for their unique technical expertise in the ophthalmic industry and their strategic position in the field (the Spanish company 2EyesVision, the German OCULUS and the Swiss Optimeyes and IROC Science) and ophthalmology clinics (Moorfields Eye Hospital in London and the Fernández Vega Ophthalmological Institute in Oviedo), in which clinical studies will be carried out to test these technologies.
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