Smart contact lenses: Is there a role for ocular wearables?

Recently, the FDA approved the Sensimed Triggerfish as a new medical device that can detect eye pressure changes in glaucoma patients. Sensors in the contact lens can detect changes in the curvature of the lens which is an indirect measurement of intraocular pressure (IOP).

In 2014, Google partnered Alcon, the eye division of Novartis, to develop a smart contact lens embedded with tiny electrodes that can measure glucose levels found in a person’s tear film.

As an ophthalmologist, I’m intrigued by the potential these devices have as an adjunctive tool to help manage our patients with chronic diseases.

The potential for better health outcomes

With both glaucoma and diabetes, consistent control of IOP and blood glucose levels, respectively, throughout the day may lead to better health outcomes.

The current standard of care for managing glaucoma is to monitor for optic nerve damage and to control IOP over time. Reducing intraocular pressure can slow progression of glaucoma over time. Patients often come back to the doctor’s office for a pressure check which only provides a single measurement over a period of weeks or months.

Unfortunately, we may miss the ebbs and spikes of IOP measurement which may be more important to know. The ability to continuously measure IOP throughout the day may help the doctor tailor treatment to curb these IOP spikes.

With glucose control, daily measurements can also spike and fall with meals and medications. Patients may do a finger stick, at most a couple times a day, and at worst, never.

These devices will allow for instant and continuous biometric data to be collected via non-invasive means from home. It’s similar to a using a holter monitor to better detect intermittent heart arrhythmias.

Implications for Clinical Research

Furthermore, think of the benefits that continuous biometric data measurement has for clinical research. We would get incredible biometric data to pair with the drug’s pharmacokinetic profile.

What if we are able to test a new blood glucose medication’s effect on glucose levels throughout the day? What if we were able to compare different topical drops for glaucoma? Put one in each eye and do a matched pairs comparison. Connect the app to Apple's ResearchKit and voila... phase 4, post-marketing data!

Will the smart contact lenses pan out?

What will they cost and will insurance cover it? Are they safe? Most ophthalmologists forbid overnight contact lens wear due to the risk of infection. Will patients feel comfortable wearing them and will doctors accept them as part of their management protocol? Their future is unclear.

What is clear is that they certainly are intriguing.

#wearables #ophthalmology #AppleResearchKit #digihealth #mHealth #healthcare #athomemonitoring

Robert Wong, MD
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