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Spectacles device gives hope to eye disorder patients

09/11/2016

A simple spring loaded device that is attached to spectacles is giving Oxford NHS researchers hope in the treatment of people with a debilitating condition which forces their eyes to close uncontrollably. 

Staff at the John Radcliffe Hospital have trialled a device that clips to the arms of the spectacles to exert gentle pressure to the temple.

The outcome of the trial suggests this is an effective way to support people with blepharospasm, an eyelid disorder characterised by excessive blinking and involuntary closure of the eyes. 

This device replicates 'sensory tricks', such as touching the temples, which individuals develop to relieve their symptoms.

The condition is treated with small injections of botulinum toxin to relax the muscles controlling the eyelids, usually every two to three months.

However the symptoms of blepharospasm can persist for up to two weeks while the toxin takes effect and can reappear as it wears off in the two weeks prior to the patient’s next injection.

Researchers in the Eye Research Group at the Oxford Eye Hospital at the John Radcliffe Hospital have designed the device to alleviate the symptoms during these periods.

In people with blepharospasm the motor cortex, the part of the brain which controls voluntary muscle activity such as the closing of the eyes, becomes over excited. The device works by calming the nerve pathway circuits that connect the eyes to the motor cortex, thereby reducing symptoms.

Among those who have used the device is Oxford’s Anne Watson, 68, an Emeritus Professor of Mathematics Education at the University of Oxford.

She said: "When I was working with students one-to-one my eyes would close, they thought I was falling asleep or angry with them.

"My face wouldn’t respond so it was uncomfortable having those face-to-face conversations. I thought I would have to adjust my working life, or even stop work, so I could live with what I had ended up with.

2If I close my eyes in a seminar you look like you have nodded off. It takes up a lot of mental energy to keep your eyes open. This also made driving difficult."

She said of the Pressop device: "It is amazing. It is like it reminds the nervous system to behave itself."

Retired catering director John Whybrew, 69, whose feedback to the research team helped to improve the device, developed symptoms 15 years ago. The Newbury resident said: "I found that when I was driving I automatically held one eye lid up to prevent it from closing. I also found that I was walking into people in the street as my eyes involuntarily closed. 

"The device applies a light pressure to the side of the temple that results in the lids opening. I find that when I attach the device to my glasses my eyes immediately open and I get relief from the spasms for about 30 minutes. I continue to use the device whilst sitting watching television."

His condition is also supported by lundie loops, nylons wires inside the lens of his spectacles that keep the eyelids in place.

He said: "The device together with the injections and the lundie loops enable me to continue to lead an active normal life."

Eye Research Group Clinical Research Nurse Manager Alexina Fantato said: "It has long been recognised and documented that patients suffering with movement disorders like  Blepharospasm experience relief with  a physical gesture like touching the temples, which can serve to temporarily interrupt the spasms. 

"At the Oxford Eye Hospital we had an idea which could replicate this phenomenon and to complement the standard Botulinum Toxin treatment. A device, which, when attached to the spectacles, would allow individuals to keep their eyes open when the spasms are particularly severe, enabling them to carry out their activities of daily living, for example reading a book, writing or using the computer, shopping or preparing a meal. 

"This device has supported those Blepharospam sufferers in employment and those fearing loss of independence. 

"Participants wearing the device in our trial have reported feeling safer, and having a new lease of life with more confidence, especially when attending social events or going to work. 

"Patients who have tried the device have reported feeling safer and more confident. We are now seeking financial support to enable us to take this device to manufacture. 

"We hope that this will enable patients to reduce their Botulinum Toxin injections, to continue in their employment, and to enjoy all of their usual social activities."