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CHAPTER 1

INTRODUCTION

This system is a Non-invasive and cost effective system that can be used to
detect the presence of thyroid in the patients. Thus this system is an effective
substitute for the invasive and costly systems like blood test, fine needle biopsy
and ultrasound that are used to diagnose thyroid in human body.
The method used here for the diagnosis of thyroid is the detection of volume
change on the body surface that can be considered as the edema or the fluid
accumulation on the body surface. The method for detection of volume change is
called the plethysmography. We use light for detecting the volume change and this
it is called the Photoplethysmography method. Thus the major advantage of this
method is that, this is a non-contact method.
The second method used for diagnosis is the image processing technique.
The images of the skin are taken from the thyroid patients and processed using
Mathworks MATLAB. Thus we can get the information about the texture of the
skin. Thus this helps in diagnosis of thyroid

1.1 ABOUT THYROID

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Figure 1.1 VEP System

1.2 VEP WAVEFORM REPRESENTATION

The VEP waveforms are represented on graphs using amplitude and time
(latency) measurements. Amplitude measured in micro volts (v) indicates the
integrity of neural structures including axons conducting information along the
visual pathways. Latency measured in milliseconds (ms) indicates the time the
electrical signal takes to travel from the retina to the Visual cortex. The
combination of amplitude and latency measurements is helpful in determining the
health of Visual pathways.
There is a prominent negative component at peak latency of about 70msec
(N1), a larger amplitude positive component at about 100 msec (P1) and a more
variable negative component at about 140 msec (N2).The major component of the
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VEP is the large positive wave peaking at about 100milliseconds . Figure 1.2
shows the VEP waveform representation.

Figure 1.2 VEP Waveform representation

1.3 IMPORTANCE OF EARLY VISION TESTING

Over 285 million people in the world are visually impaired, of whom 39
million are blind and 246 million have moderate to severe visual impairment
(WHO, 2011). It is predicted that without extra interventions, these numbers will
rise to 75 million blind and 200 million visually impaired by the year 2020. More
commonly referred to as lazy eye, amblyopia is decreased vision that results
when one (or both) eyes sends a blurry image to the brain, inhibiting development
of the vision system.

According to the U.S. Preventive Services Task Force, amblyopia is the most
common vision problem in children; an estimated 4 out of every 100 children
under age six have amblyopia. Prevent Blindness America says that only 1 in 5
children in the U.S. have a vision test before kindergarten. The Childrens Eye
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Foundation estimates that 4.5 million adults are legally blind or visually
incapacitated in at least one eye due to amblyopia that was left untreated.

1.4 ANATOMY OF THE EYE

The eye is a hollow, spherical organ about 2.5cm in diameter. It has a wall
composed of three layers, and its interior spaces are filled with fluids that support
the walls and maintain the shape of the eye. The eyes are so important that four-
fifth of all of the information the brain receives, come from the eyes.

Light reaches the eye by first passing through the cornea which filters it, and
begins focusing the image. The anterior chamber contains a viscous substance
called aqueous humour that keeps the front of the eye firm and slightly curved.
Light travels through the pupil, which compensates for changing light conditions
by contracting or relaxing.

The muscles responsible for these movements are in the iris. Subsequently,
the lens squeezes or stretches to focus the rays of light on the retina. Figure 1.3
shows the Anatomy of the eye.
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Figure 1.3 Anatomy of the eye

The light continues through the vitreous humor, the clear gel that makes up
about 80% of the eyes volume, and then, ideally, back to a clear focus on
the retina, behind the vitreous. The small central area of the retina is the macula,
which provides the best vision of any location in the retina.

The retina is a multi-layered sensory tissue that lines the back of the eye as
shown in above figure. It contains millions of photoreceptors that capture light rays
and convert them into electrical impulses. There are two types of photoreceptors in
the retina: rods and cones

Electrical impulses are sent through the optic nerve, along the visual
pathway, to the occipital cortex at the posterior (back) of the brain. Here, the
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electrical signals are interpreted or seen by the brain as a visual image. Actually,
then, we do not see with our eyes but, rather, with our brains. Our eyes merely
are the beginning of the visual process. Figure 1.4 shows the process of vision.

Figure 1.4 Process of vision

1.5 OPTIC NERVE

The optic nerve is the second of twelve paired cranial nerves but is
considered to be part of the central nervous system, as it is derived from an out
pouching of the diencephalon during embryonic development. The eye's blind
spot is a result of the absence of photoreceptors in the area of the retina where the
optic nerve leaves the eye.

Each human optic nerve contains between 770,000 and 1.7 million nerve
fibers, which are axons of the retinal ganglion cells of one retina. In the fovea,
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which has high acuity, these ganglion cells connect to as few as 5 photoreceptor
cells; in other areas of retina, they connect to many thousand photoreceptors.
Damage to the optic nerve typically causes permanent and potentially severe loss
of vision, as well as an abnormal pupillary reflex, which is diagnostically
important.
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1.6 OBJECTIVE

The objective of this project is to develop sweep VEP system to enable

faster measurement and reduced recording time of VEP which provides a faster
estimation of visual acuity in preverbal children. In normal VEPs the each checker
board pattern is displayed for 1 min and 19 seconds, and only two checker board
patterns are used, so the result may not be accurate and also the patient needs to
concentrate for more time. In Sweep one Checker board stimulus is displayed for
only 1 second and a total of 9 different checker board patterns are displayed for a
period of 10 seconds which makes the patient comfortable as they are not in need
to look at the stimulus for long time and this technique will be more helpful in
case of infants.
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