By Whitney Heins
It has been said, “The eyes are the window to the soul.” But Ying-Ling Chen believes the eyes are also the window to the brain—and peering into them could provide some very important insights about a child’s health.
Chen, a research assistant professor in physics at the UT Space Institute (UTSI), says abnormalities in eye functions could signal serious and potentially fatal diseases, neurological, psychological, and behavioral disorders, and learning disabilities.
For instance, a child who has a slow-tracking eye movement, abnormal pupil response, and uncharacteristic saccades (small, rapid eye movements) could be autistic. Examining eyes, particularly at a young age, can reveal clues about underlying conditions before they become grave problems.
This is why Chen, along with Lei Shi, post-doctoral research associate in the Center for Laser Applications, and Jim Lewis, professor emeritus in physics, have invented a device that makes children’s eye exams inexpensive, comprehensive, simple to administer, and fun.
Called the Dynamic Ocular Evaluation System (DOES), the test involves the child watching a short, 3-D cartoon through a special pair of goggles.
“What we are looking at is not only the vision, but also the ocular response to visual and audio stimuli,” says Chen. “We have two eyes that send information to the brain. Then the brain processes and integrates the information and sends decisions back to the eyes that instruct them how to move. That response of the eyes tells us how well the brain is functioning.”
The examination begins with a three-second comprehensive test that screens for binocular refractive risks, high-order aberration, scattering, ocular alignment, and significant neural problems. The subsequent dynamic test searches for less significant signs of abnormal ocular alignment, neural responses, amblyopia, and, hopefully in the near future, mental statuses that include dyslexia, attention deficit hyperactivity disorder, post-traumatic stress disorder, and autism.
“The eyes will be stimulated and controlled at different angles and illuminated at different levels so that the pupils, convergence, and accommodations will respond accordingly,” says Chen. “And DOES will measure at the proper time without the child knowing.”
Infrared light is used to analyze the binocular condition, but the children will not see it. “While they watch the cartoon, an invisible light is checking on their eyes all the time, including how their eyes move, how their pupils respond, and how their lenses accommodate,” Chen says.
The images and results are digitally recorded and can be easily entered into electronic health records or electronically transmitted to specialists for referral if necessary.
Chen believes DOES eye exams at the appropriate age could lead to an early diagnosis of many different ailments. For example, lazy eye and crossed eyes—which impact up to 5 percent of the US population—could be treated more effectively if detected early.
Unfortunately, statistics show that up to 80 percent of American children never receive an eye exam or any vision screening before kindergarten. According to Chen, children usually do not visit eye doctors unless their eyes hurt. They don’t know if their vision is impaired because they don’t know what they should be seeing. This means troubles with sight and brain function could go undetected—potentially causing irreversible damages.
The problem is compounded by the fact that current pediatric eye exams are not fun for either party involved. They usually entail a lengthy process of eye charts, bright lights, and eye drops for the child. Neither eye dilation nor verbal response is required by the DOES system, making it easy for kids to cooperate. They simply sit and watch a cartoon.
Another benefit of the DOES exam is that it can help prevent irreversible blindness by catching a variety of symptoms early, unlike current methods that typically only test for one or two conditions. “We also will be able to detect potentially fatal retinoblastoma earlier, as well as diagnose learning disabilities, which is crucial to helping children develop self-esteem,” says Chen.
Since 85 percent of a child’s learning is related to vision, detecting learning disabilities early will allow parents and teachers to modify how those children learn and communicate, ultimately helping them succeed in school.
Chen recently completed the first round of DOES clinical tests. Fifty patients were examined at the Walmart in Tullahoma, Tennessee, over a three-week period. She compared the results of the device to the results of doctor’s tests.
The initial study showed that DOES was child-friendly and very easy to perform. The pupil response to stimuli and eye movement tracking were measured with both high sensitivity and precision.
However, improvements and testing are ongoing. For instance, the intended ocular relaxations will need improved 3-D cartoon scenery. The current design includes many 3-D images, and Chen is working to find an artist to create the animation with the right stimulus, such as a doctor teddy bear.
Chen plans to collaborate with Vanderbilt University’s Kennedy Center for Research on Education and Human Development and hopes to take her invention to market. She has received funds from the UT Research Foundation for commercialization and has been issued two patents, with two others pending.
“My vision is for children to come into a pediatrician’s waiting room and instead of waiting, they can watch a cartoon and within a few minutes have their eyes examined,” she said.
Once the system is perfected and implemented globally, there’s no telling how many more children will be afforded the opportunity to grow up as healthy adults. Looking into the eyes of a child will never be the same.