Apparatuses and methods for the treatment of glaucoma are provided. The instrument uses either cauterization, a laser to ablate, sonic or ultrasonic energy to emulsify, or mechanical cutting of a portion of the trabecular meshwork. The instrument may also be provided with irrigation, aspiration, and a footplate. The footplate is used to enter Schlemm's canal, serves as a guide, and also protects Schlemm's canal.

This disclosure features chemical entities (e.g., a compound or a pharmaceutically acceptable salt and/or hydrate and/or prodrug of the compound) that that generates cross-linking in the cornea in response to exposure to an electromagnetic irradiation. This disclosure also features compositions containing the same as well as other methods of using and making the same. The chemical entities are useful, e.g., for treating a subject (e.g., a human) having a disease, disorder, or condition in which in which abnormal shaping of the cornea (e.g., thinning of the cornea, e.g., bilateral thinning of the cornea, e.g., bilateral thinning of the central, paracentral, or peripheral cornea; or steepening (e.g., bulging) of the cornea) contributes to the pathology and/or symptoms and/or progression of the disease, disorder, or condition. Non-limiting examples of such diseases, disorders, or conditions include: (i) corneal ectatic disorders; (ii) vision conditions; and (iii) diseases, disorders, or conditions that are sequela or comorbid with any of the foregoing or any disclosed herein. More particular non-limiting examples of such diseases, disorders, or conditions include keratoconus, keratoglobus, pellucid marginal degeneration, corneal ectasia (e.g., post-operative ectasia, e.g., post-LASIK ectasia), Terrien's marginal degeneration, myopia, hyperopia, astigmatism, irregular astigmatism, and presbyopia.

Technologies are generally described for normalized standard deviation transition based dosimetry monitoring for laser treatment. In some examples, a response signal may be generated based on a physical response to a laser pulse detected through acoustic or optical means. Each response signal may be a time series of data with a number of points. Standard deviation may be determined for each response signal and normalized using a mean or comparable normalization factor. Thus, a robust distribution may be computed from the response to each laser pulse. A change in the normalized standard deviation from each single pulse's time domain response data may be used to determine how many laser pulses remain before completion of the treatment (similar to event onset response). Thus, laser treatment may be continued based on an estimation of remaining pulses for completion or ceased if completion is reached.

A formulation for an eye treatment includes a photosensitizer and a permeability enhancing composition. The permeability enhancing composition includes one or more permeability enhancers. The permeability enhancing composition has a hydrophilic and lipophilic balance increases a permeability of an area of the eye for the photosensitizer. The hydrophilic and lipophilic balance can be characterized by a Hydrophile-Lipophile Balance (HLB) number. For example, the area of the eye may include a corneal epithelium, the photosensitizer may include riboflavin, and the permeability enhancing composition may have a corresponding HLB number between approximately 12.6 and approximately 14.6.

A system (1) for treating and monitoring the condition of an eye (6) includes a light source, preferably a non-lasing LED (2), for irradiating the eye at a wavelength sufficient to reverse eye damage. The system also includes an excitation light source, preferably a non-lasing LED (4), for exciting fluorescence in the eye and a detector (22) for detecting fluorescence stimulated by the excitation LED (4). The system may also include a second non-lasing light source, preferably a non-lasing LED, for irradiating the eye; and a detector for detecting scatter of light from the eye. Methods for monitoring, diagnosis and treatment of eye conditions such as cataracts are also provided.

A UV-mask for treating keratoconus. The UV-mask could be made by having an image representing a surface of the patient's cornea with a topography map indicating an area of abnormal corneal thickness. The image is printed onto a sheet. The sheet is cut on or around the area of abnormal corneal thickness to create a transparent window in the sheet. The sheet is further cut on or around the corneal surface to result in a UV-mask. Also disclosed is a UV-mask for use in UV-irradiation treatment of keratoconus. Also disclosed are methods of treating keratoconus in an eye of a patient using a UV-mask.

An apparatus to treat refractive error of the eye comprises one or more optics configured to project stimuli comprising out of focus images onto the peripheral retina outside the macula. While the stimuli can be configured in many ways, in some embodiments the stimuli are arranged to decrease interference with central vison such as macular vision. The stimuli can be out of focus images may comprise an amount of defocus within a range from about 3 Diopters (“D”) to about 6 D. In some embodiments, the brightness of the stimuli is greater than a brightness of background illumination by an appropriate amount such as at least 3 times the background brightness. In some embodiments, each of a plurality of stimuli comprises a spatial frequency distribution with an amplitude profile having spatial frequencies within a range from about range of 1×10.sup.−1 to 2.5×10.sup.1 cycles per degree.

A removable tip for a light energy handpiece comprises a hollow conduit configured to surround a light guide in the handpiece; a support extension having a length longer than a length of the hollow conduit; and a shielding extension coupled to the support extension at an angle less than 180 degrees and located in front of the hollow conduit. The shielding extension is configured to be inserted behind an eyelid and extend to the fornix, the shielding extension comprised of a thermally insulative material.

An example system for tracking motion of an eye during an eye treatment includes an image capture device configured to capture a plurality of images of an eye. The system includes controller(s) including processor(s) that receive the plurality of images from the image capture device. The processor(s) implement a plurality of trackers. Each tracker is configured to detect a respective feature in the plurality of images and provide, based on the respective feature, a respective set of data relating to motion of the eye. The respective features detected by the plurality of trackers are orthogonal relative to each other and the respective sets of data provided by the plurality of trackers are independent of each other. The processor(s) coalesce the sets of data from the plurality of trackers and determine an indicator of the motion of the eye based on the coalesced sets of data.

A stimulus is configured to treat astigmatism with changes in retinal thickness, independently of, or in combination with, treatment for myopia. In some embodiments, a stimulus pattern is arranged with respect to an astigmatic axis of the eye to decrease ocular growth in relation to the astigmatic axis. In some embodiments, the apparatus is configured to direct light to regions of retina outside the macula in relation to the astigmatic axis of the eye. In some embodiments, the intensity is modulated to provide the effect. A lens, such as a contact lens or spectacle lens may be configured with a plurality of light sources, such as projection units having a light source and focusing optics that work together to project anteriorly or posteriorly defocused images onto the retina at locations eccentric to the fovea.