A modular and adjustable ptosis crutch as a non-surgical solution to elevating the upper eyelid of myasthenia gravis patients

Simple item page
dc.contributor.advisorSivarasu, Sudeshen_ZA
dc.contributor.advisorHeckmann, Jeannine Men_ZA
dc.contributor.authorFindlay, Meganen_ZA
dc.date.accessioned2017-06-01T10:12:08Z
dc.date.available2017-06-01T10:12:08Z
dc.date.issued2017en_ZA
dc.description.abstractMyasthenia Gravis (MG) is a treatable autoimmune disorder that affects the neuromuscular junction. MG is characterised by fatigable muscle weakness of voluntary skeletal muscles with the most commonly affected muscles being the eye and facial muscles. Patients of African genetic ancestry, particularly juveniles, are more likely to develop ocular muscle complications of MG compared to their European counterparts. MG ophthalmoplegic complications include persistent difficulty with moving the eyes and blepharoptosis, despite treatment. Blepharoptosis, or ptosis, describes the condition of a lowered upper eyelid(s), beyond its normal anatomic position. Surgical correction of ptosis is often contraindicated in MG patients with severe weakness of the muscles involved in eye closure and in patients with active disease. In these cases, a non-surgical solution to elevating the ptotic eyelid above the visual axis is required. Objective: To design a patient specific, modular and low cost ptosis crutch to elevate the eyelid(s) of myasthenia gravis patients. The ptosis crutch should be low cost, modular and adjustable in nature. Method: 16 MG patients (42 ± 23 years) volunteered to participate in the pre-design phase of the project. Initial eye measurements of each participant were taken using photographic measurement. A bottomup approach was followed for the design of the ptosis crutch. 3D CAD models of the modular ptosis crutch were created in SolidWorks, according to the measured dimensions and the predefined design parameters. The ptosis crutch was prototyped using 3D printing. Eightyseven design failures were observed before the final design was realised. A design feedback loop lead to the discovery of a device that satisfied the specified requirements. The final ptosis crutch was tested, in the clinical setting, on 12 MG patients (43 ± 24 years). Results: The ptosis crutch was designed to fit onto the superior border of the spectacle frame. The ptosis crutch is adjustable along the x- axis to cater for the inter-individual variability of globe protrusion. The crutch bar is adjusted along the z-axis and elevated the ptotic eyelid by 1.96mm (±1.11mm). All of the participants indicated that they would be interested in using the ptosis crutch on a long-term basis. Conclusion: The immediate feedback on the ptosis crutch from the MG patients has shown a positive outcome for the device. Future work will include obtaining long term feedback on the ptosis crutch from all of the users as well as investigating manufacturing methods using materials with increased durability.en_ZA
dc.identifier.apacitationFindlay, M. (2017). <i>A modular and adjustable ptosis crutch as a non-surgical solution to elevating the upper eyelid of myasthenia gravis patients</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Division of Biomedical Engineering. Retrieved from http://hdl.handle.net/11427/24458en_ZA
dc.identifier.chicagocitationFindlay, Megan. <i>"A modular and adjustable ptosis crutch as a non-surgical solution to elevating the upper eyelid of myasthenia gravis patients."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Division of Biomedical Engineering, 2017. http://hdl.handle.net/11427/24458en_ZA
dc.identifier.citationFindlay, M. 2017. A modular and adjustable ptosis crutch as a non-surgical solution to elevating the upper eyelid of myasthenia gravis patients. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Findlay, Megan AB - Myasthenia Gravis (MG) is a treatable autoimmune disorder that affects the neuromuscular junction. MG is characterised by fatigable muscle weakness of voluntary skeletal muscles with the most commonly affected muscles being the eye and facial muscles. Patients of African genetic ancestry, particularly juveniles, are more likely to develop ocular muscle complications of MG compared to their European counterparts. MG ophthalmoplegic complications include persistent difficulty with moving the eyes and blepharoptosis, despite treatment. Blepharoptosis, or ptosis, describes the condition of a lowered upper eyelid(s), beyond its normal anatomic position. Surgical correction of ptosis is often contraindicated in MG patients with severe weakness of the muscles involved in eye closure and in patients with active disease. In these cases, a non-surgical solution to elevating the ptotic eyelid above the visual axis is required. Objective: To design a patient specific, modular and low cost ptosis crutch to elevate the eyelid(s) of myasthenia gravis patients. The ptosis crutch should be low cost, modular and adjustable in nature. Method: 16 MG patients (42 ± 23 years) volunteered to participate in the pre-design phase of the project. Initial eye measurements of each participant were taken using photographic measurement. A bottomup approach was followed for the design of the ptosis crutch. 3D CAD models of the modular ptosis crutch were created in SolidWorks, according to the measured dimensions and the predefined design parameters. The ptosis crutch was prototyped using 3D printing. Eightyseven design failures were observed before the final design was realised. A design feedback loop lead to the discovery of a device that satisfied the specified requirements. The final ptosis crutch was tested, in the clinical setting, on 12 MG patients (43 ± 24 years). Results: The ptosis crutch was designed to fit onto the superior border of the spectacle frame. The ptosis crutch is adjustable along the x- axis to cater for the inter-individual variability of globe protrusion. The crutch bar is adjusted along the z-axis and elevated the ptotic eyelid by 1.96mm (±1.11mm). All of the participants indicated that they would be interested in using the ptosis crutch on a long-term basis. Conclusion: The immediate feedback on the ptosis crutch from the MG patients has shown a positive outcome for the device. Future work will include obtaining long term feedback on the ptosis crutch from all of the users as well as investigating manufacturing methods using materials with increased durability. DA - 2017 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2017 T1 - A modular and adjustable ptosis crutch as a non-surgical solution to elevating the upper eyelid of myasthenia gravis patients TI - A modular and adjustable ptosis crutch as a non-surgical solution to elevating the upper eyelid of myasthenia gravis patients UR - http://hdl.handle.net/11427/24458 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/24458
dc.identifier.vancouvercitationFindlay M. A modular and adjustable ptosis crutch as a non-surgical solution to elevating the upper eyelid of myasthenia gravis patients. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Division of Biomedical Engineering, 2017 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/24458en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDivision of Biomedical Engineeringen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherBiomedical Engineeringen_ZA
dc.titleA modular and adjustable ptosis crutch as a non-surgical solution to elevating the upper eyelid of myasthenia gravis patientsen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPhilen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
thesis_hsf_2017_findlay_megan.pdf
Size:
3.23 MB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Masters