Eye of the STORM
An experimental medical device under development by a Stanford ophthalmologist has earned a top recognition from his oculoplastics peers and offers new hope to suffering patients.
The “STORM” device (Soft Tissue of the Orbit Range of Motion) received this year’s Quickert Award for most outstanding new member research thesis at the American Society of Ophthalmic Plastic & Reconstructive Surgery (ASOPRS) research meeting.
STORM is the brainchild of Ben Erickson, MD, MHS, clinical assistant professor of ophthalmology at Stanford. The device targets sufferers of pain, double vision, and other deficits arising from scarring or traumatic injury or malformation of the eye muscles, nerves, and associated soft tissue of the eye socket.
The bone and delicate soft tissues of the eye socket govern vital vision ingredients, including proper eye alignment and motion. Deficits in this area can greatly impact the day-to-day lives of sufferers, from the inability to read or do computer work essential to school and career, to the inability to safely drive a car or carry on other daily life activities.
The causes of eye socket maladies may include traumatic injury to the socket, ocular cancer, disorders such as thyroid eye disease, congenital issues causing mis-aligned eyes in children and adults, and more. Oculoplastic surgeons treat these eye socket problems with a broad array of tools, including cutting-edge antibody infusions, rehab therapy, and microsurgery.
Bone tissue shows well on x-rays and other medical imaging, so doctors treating eye socket injuries have precision tools to repair bone related defects and injuries. If an implant is needed, the doctor can view an exact 3D scan of the problem area, 3D-print a custom replacement part, and use image-guided navigation tools to ensure exact placement.
In contrast, soft tissue functional capacity is not well measured with current medical imaging technologies. Here, doctors must instead make pre- and intra-operative decisions by feel.
With the patient sedated, the doctor gently manipulates the eyeball, probing for tension or restrictions in the range of motion, to estimate injury or disease effects in the surrounding soft tissues.
This expert intuition is well supported at experienced tertiary care settings like Stanford but is often limited in practice settings where surgeons may not treat high volumes of patients with such problems, leading to referrals and additional corrective surgeries with more patient suffering.
As a clinician-scientist and a serial innovator recognizing this unmet need, Erickson set out to develop a new tool to bring precision measurements to soft tissues, as precise and beneficial as the tools used in repairing bone.
“I noticed we have a burgeoning number of therapeutic options available, but outcomes often fall short of desired treatment goals,” says Erickson. “I realized we have a lack of precision tools to quantitatively characterize eye socket deficits and guide interventions.”
Erickson considered how a person putting in their contact lens uses their index fingertip as a delicate force-tester, momentarily, in docking the lens onto the eye.
What if the lens were to linger a bit, touching the eye and fingertip, to gently test the range-of-motion of the eye? A device like this could gather data to act as a precision roadmap to guide the doctor in characterizing the surrounding soft tissue.
The result is Erickson’s STORM, a non-invasive device which uses a contact lens with micro suction to briefly adhere and measure the eye, through a range of motions. STORM is packed with tiny piezoelectric motors to gently move the eye, up-down, in-out, in all three axes, gathering granular 3D force-sensing data at each point.
Now in the prototype stage, STORM is non-invasive, requires no forceps, and aims to have the patient awaken with zero pain or after-effects. STORM represents a leapfrog advance over current diagnosis by “feel” alone, pinpointing exactly where a muscle may be binding or tissue may be impinging on a nerve.
The device distinguishes between a muscle-movement issue, gauged by restriction in the eye’s normal range of motion “excursion”, versus a muscle-tone issue gauged by the degree of push-back against the force applied.
Too much resistance or restricted eye movement may reveal a muscle impinged or a pinched nerve, traced to its exact root origin, with STORM indicating a specific microsurgery to release the precise pinch point where the tissue is bound while also minimizing damage to the surrounding healthy tissues.
On the other hand, too much “give” may reveal a lack of muscle tone or musculature imbalance, also traced to its exact point of origin, STORM indicating a specific eye therapy to restore muscle tone and balance to correct vision.
The device’s readout highlights the exact yellow caution or red flag points identified by its precision sensors. Ongoing STORM scans can also trace the progression of recovery after an injury. Erickson anticipates STORM will also speed-up the development and testing of new medical products including new prosthetic eye muscle implants.
He also anticipates the STORM devices to be internet-connected, to gain the additional pattern-recognition and predictive powers of artificial intelligence. The accumulated data from thousands of STORM scans will continually improve STORM’s diagnostic abilities, to support doctors and benefit patients worldwide.
Erickson additionally looks to STORM serving as a great equalizer, transforming patient care in under-resourced areas of the globe.
“My hope is that STORM also levels the playing field, empowering those who serve the medically underserved with the tools they need to achieve clinical and surgical outcomes equal to the best-resourced providers.”