1. SECOND -STAGE OF PATENT PROJECT TITLE: TREATMENT /REDUCTION OF FUNCTIONAL MYOPIA PROBLEM BACKGROUND,PATENT SEARCH AND DESCRIPTION OF THE STATE OF ART IN TREATMENT. BY SACHIN JAMBAWALIKAR

2. THE PROBLEM :MYOPIA MYOPIA: The ray of light from a distant object is focussed in front of the retina rather than on the retina. TYPES: Functional: It is an inability to see at the distance due to the weakening of the ciliary muscles that regulate the medium of accommodation (crystalline lens). Structural :Here the eye ball gets elongated and as a result the rays from distant object don’t focus on the retina. NORMAL MYOPIC

3. PRESENT APPROACH TOWARDS TREATMENT : OPTICAL CORRECTION MEDICAL (PHARMACEUTICAL) VISION THERAPY ORTHOKERATOLOGY SURGERY FOOD AND NUTRITION

4. OPTICAL CORRECTION INVOLVES THE USE OF SPECTACLES AND CONTACT LENSES. SPECTACLES ARE ECONOMICAL WHILE THE CONTACT LENSES PROVIDE BETTER COSMESIS. OPTICAL CORRECTION :

5. CYCLOPLEGIC AGENTS ARE USED TO REDUCE ACCOMODATIVE RESPONSE AS PART OF TREATMENT OF PSEUDOMYOPIA. THE CYCLOPLEGIC AGENTS USED ARE ATROPINE AND CYCLOPENTOLATE. MEDICAL (PHARMACUETICAL):

6. UNAIDED VISUAL ACUITY CAN BE IMPROVED USING VISION THERAPY. VISION THERAPY TO REDUCE ACCOMODATIVE RESPONSE IS OFTEN PROVIDED FOR PSEUDOMYOPIA. VISION THERAPY :

7. Orthokeratology is the programmed fitting of a series of contact lenses,over a period of weeks or months, to flatten the cornea and reduce myopia. Corneas with greater peripheral flattening are thought more likely to have successful central flattening thus leading to reduced myopia via orthokeratology. Studies suggest that the refractive error shifts towards the original base line in patients who stop wearing contact lenses. ORTHOKERATOLOGY:

8. Several refractory surgery methods are in use One procedure is radial keratotomy(RK) here spoke like micro incisions are made in a radial pattern in the paracentral cornea. This weakened part steepens while the central cornea flattens. The amount of resultant refractive change depends on the size of the optical zone and the number of incisions. REFRACTIVE SURGERY:

9. Another important surgical method is PRK (Photo Refractive Keratectomy. Here corneal power is decreased by laser ablation of the central cornea.

10. Additional refractive surgery include: cryolathe keratomileusis,automated lamellar keratomileusis (ALK) and Laser insitu keratomileusis(LASIK). In cryolathe keratomileusis a section of corneal stroma is removed, frozen and shaped on a lathe to minus power. In ALK a layer of corneal epithelium is removed with a microkeratome except for a small section providing attachment to the cornea.The microkeratome is then used to remove a specific amount of corneal strom to flatten it, after which the flap is replaced. The LASIK is similar to ALK except that the corneal stroma is removed by the laser rather than microkeratome.The lasik procedure is gaining popularity among the surgeons.

11. Some current patents for devices and methods in the treatment of Myopia : Accomodating intraocular lens implant: There are three patents related to this. Here artificial lens is fitted and it is linked to the ciliary muscles or the zonules which helps in controling the curvature of the lens (US PAT :6013101,6096078,5843188). Placement of second artificial lens in the eye, to correct for the defects of the first: Here the second artificial lens is placed between the first(in the lens capsule) and the iris (US PAT :5769890). Optical refraction correction method :This relates to photo refractive surgery.Something similar to LASIK (US PAT:5603709). Corneal heat and stretch method and apparatus:This is a method and apparatus to non -invasively alter the shape of cornea.Here the cornea is selectively heated and suction pressure is applied, thereby causing a permanent deformation of collagen fibers and hence a refractive change in the cornea (US PAT :6024095).

12. CONCLUSION: My patent project will be on the treatment or reduction of functional myopia by controlling the accommodation of the lens. My approach will be based on the relaxation of the ciliary muscles for the flattening of the lens.The ciliary muscles are innervated by the third cranial nerve.When innervated the ciliary muscles overcome the inherent choroidal tension so that the choroid is moved forward and the zonules relax,thereby causing the lens to bulge.My concern will be to cause the ciliary muscles to relax and hence reduce the refractive power of the lens.