Introduction

Exercise and training is one of the most common and oldest ways to increase the performance of the human body. We exercise and learn since birth, in school, in sports, in every situation of life. This process can be optimized and developed to achieve even higher increases in our bodily functions. Here we think first and foremost of sports. 

However, this training can also be used to improve or, in the ideal case, completely compensate for weaknesses, disabilities or limitations.

The SmartMedo GmbH team deals with such methods. We develop training systems to help people with weaknesses, disabilities or limitations to cope with them better or to compensate them completely. 

With the use of the latest technologies, it has become possible to make these therapies simple and comfortable for the patient. The training is no longer strenuous, of short duration and therefore does not involve any stress. 

Through the training system we have developed, the visual function of the eye and the visual perception of the brain are trained and improved. This very important sensory function is threatened and limited by countless diseases. One of the most common is age-related degeneration of the central retina. This is called age-related macular degeneration or AMD.

Age-related macular degeneration (AMD)

AMD is the most common cause of severe visual impairment in industrialized countries. Hardly any other condition in our society has such a serious effect on those affected. Visual acuity is drastically reduced and a central scotoma, i.e. a central visual field loss, may develop.

Not infrequently, this leads to a high degree of visual impairment, making even simple tasks enormously difficult. Think of any activity from your everyday life and try to perform it with your eyes closed - a frightening idea. In addition, the risk of a potential disease increases rapidly with age. From the age of 50, two to three percent already suffer from AMD, while at 80 the proportion skyrockets to a quarter. The reason for this is the changing metabolism, which leads to pathological changes in the retina and surrounding structures. The real crux of this disease, however, is that despite exhaustion of all therapeutic measures, there is often a progressive deterioration.

The Medical Eye Trainer (M.E.T.)

To counteract this deficiency, the development of the Medical Eye Trainers (M.E.T.) was started in 2014. This is an application that can be installed on mobile devices, which in an initial pilot study was able to demonstrate significant success in the therapy of age-related macular degeneration.

The study on the M.E.T.

The interface of the software is designed as follows: In the center is a laughing smiley, which serves as a fixation point for the patient to ensure optimal gaze direction. The screen is divided into four independent rows. A pattern of white and black squares runs in each of them. To achieve maximum stimulation of the eye, the directions of movement of successive rows are exactly opposite. This stimulus pattern is precisely matched in size and speed for optimal stimulation of the eye.

As could be proven in a study (link to the study), this impressively simple concept is a very effective form of training. In the study, subjects suffering from age-related macular degeneration were instructed to complete daily exercise sessions with the program. One eye is completely cut off from light by covering it, while the other eye is presented with the stimulus for a period of 90 seconds. Data obtained after the three-month therapy, together with additional feedback from the subjects, showed that visual acuity for long distances was increased by an average of 38%. 38 % . This represents a highly significant improvement. Not a single patient complained of deterioration - on the contrary, subjective visual comfort was described as greatly improved.

Also, all patients wanted to continue with the training after completion of the treatment. Two potential explanations can be found for these excellent results: 

On the one hand, improved visual performance can be achieved by shifting the fixation point away from the destroyed center to peripheral, i.e., outer, areas of the retina not damaged by the disease - briefly called: Fixation shift.

On the other hand, the strong and alternating stimuli acting on the eye cause a reorganization and increased cooperation of neurons in the retina. This optimizes signal processing, which leads to increased visual performance.

Synopsis

So, in summary, the M.E.T. is a cost-effective and easy-to-use support for AMD therapies. First improvements start quickly and motivate the patients. They are given the feeling of actively fighting against their disease and thus regaining their quality of life. In fact, the joy at the results achieved was so great that not a single participant in the study was willing to return the device needed for treatment after it ended. No one wanted to accept the risk of a renewed deterioration in visual performance - not with a time commitment of just 90 seconds per day.