3. In the future, advances in the development of ever smaller and thinner medical probes and catheters should be expected, as well as broad utilization of OCT devices to become as common as ultrasound scanning devices are in todays society. Evanescent waves also occur in the context of other types of waves, such as sound waves and quantum-mechanical waves (associated e.g. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in Some carry light into the body, and some carry light reflected . Springer, Berlin, Lakshminarayanan V et al (2015) Smartphone science in eye care and medicine. These factors make fiber optic sensors ideally suited for a broad variety of invasive and noninvasive applications in the life sciences, clinical research, medical monitoring, and diagnostics. How an optical fiber guides light depends on the nature of the light and the structure of the optical fiber. Nowadays, it is not only optics but also photonics that are used extensively in a myriad of medical applications, from diagnostics, to therapeutics, to surgical procedures. The mirror had a central perforation through which the doctor could view the ear. The mathematical expression (Eq. Todays head mirror has withstood the test of time and is still routinely used by ophthalmologists and otolaryngologists, particularly for examination and procedures involving the oral cavity. 13.7. It is invaluable for diagnosis and treatment of retinal tears, holes, and detachments. Ever since, optical fiber technology has been the subject of considerable research and development to the point that today light wave communication systems have become the preferred method to transmit vast amounts of data and information from one point to another. Image observed at the back of the eye (5) (Images courtesy of Heine). Since then, lasers have become an integral part of modern medicine [7]. Illumination was provided by a burning alcohol and turpentine lamp was shone to a speculum mounted on the distal end and made to fit to the specific anatomy of the desired body opening to be inspected (see Fig. Images are accurately transmitted by preserving the relative position of the fibers at each end of the bundle. This mode becomes dominant in wave propagation where the cross-sectional area of the transmission line is small compared to the signal wavelength. 13.25b. However, microwave networks are used for fast transfer at high electromagnetic wave frequencies (but lower than light). Related terms . Properties of electromagnetic wave 1. tailored to your instructions. L. Voss, Leipzig, MATH Table13.2 summarizes the key general applications for optics in medicine. There are two types of laryngoscopes: direct and indirect laryngoscopes. Photograph of the Jansen compound microscope (c. 1595). Many of the optic medical instruments in use today were developed in the nineteenth century and, with the advent of optical fibers and laser light sources in the mid twentieth century, a new generation of medical devices, instruments, and techniques have been developed that have helped modernize medicine and perform task unimaginable only a few decades ago. Modern endoscopes (both flexible and rigid) make use of fiber optic imaging bundles to achieve image transmission. . Depending on the intended application, the FOFP end faces can be coated with a specific spectral filtering, phosphorescent, or anti-reflective coating. Katzir A (1990) Selected papers on optical fibers in medicine, SPIE milestone series, vol MS 11. As a consequence, examinations were limited to times of the day and year when there was adequate bright daylight. A step index fiber is composed of a core and cladding that have different refractive indices and , respectively. However, earlier models relied on miniature flat or rod lenses to guide images from the objective end to the eyepiece as shown in Fig. Coherent bundles are used for conveying an image from one end to the other by the effect created by the grouping of the individual light conducted by each fiber which is perceived in the eye of the observer as a full image. The patient sits in front of the device and the lenses within a phoropter refract light in order to focus images on the patients retina at the right spot to compensate for each individual eye refractive errors. In general, many of the basic optical medical instruments have in common the goal to provide both a more direct illumination and optical magnification of the area under examination. The blades in a laryngoscope help provide leverage to open wide the mouth and throat, as well as to keep the tongue in place and avoid a gag reflex. Fiber optics are made of thin strands of glass and only transmit light. As shown in Fig. 13.12) consists essentially of two systems: one for illumination and another for viewing. They are between 700 nm (nanometers) and 1 mm. Optical communications system The optical power of these lenses is measured in 0.25 diopter increments. 13.2). A further improvement to Von Troltschs early auriscope is Bruntons device which was first described in an 1865 Lancet article. It continues with the fundamentals of wave propagation and waveguiding of all kinds; the essentials of propagation along optical fibers; and the concepts underlying integrated optics systems. Pergamon Press, Oxford, Bozzini P (1806) Lichtleiter, eine Erfindung zur Anschauung innerer Teile und Krankheiten. The law that states "When visible light of high frequency electromagnetic radiation illuminates a metallic surface, electrons are emitted" is known as _____. It can be observed the metal tip speculum, the rear objective lens for viewing, as well as the middle horn used to direct light from a candle or lamp. The retinoscope consists of a light, a condensing lens, and a mirror (Fig. An aging population puts additional demands on healthcare since older people are more vulnerable to illness and chronic diseases. EMR includes radio waves, microwaves, infrared, visible light, ultraviolet radiation, X-rays, and gamma rays. 13.9). In digital X-rays, a fused fiberoptic taper is used to guide the light image from a scintillator an electronic CDD detector array for processing and visualization. For this, he is also recognized as the original inventor of the laryngoscope. An indirect ophthalmoscope provides a stronger light source, a specially designed objective lens, and opportunity for stereoscopic inspection of the interior of the eyeball. If your intended use exceeds what is permitted by the license or if A direct laryngoscope (Fig. Their major advantage lies in the fact that they are thin and flexible so they can be introduced into the body for both remotely sense, image and treat. Mirror-based laryngoscopy for the investigation of laryngeal pathology was pioneered back in 1858 by Johann Czermak, a professor of physiology at the University of Budapest. EMR is a form of energy that is made up of oscillating electrical and magnetic fields. From: Encyclopedia of Modern Optics (Second Edition), 2018. The intrinsic physical characteristics of optical fiber combined with its versatility in remote sensing make it an attractive technology for biomedical applications. 13.36. Optical fibers are used most often as a means to transmit light between the two ends of the fiber and find wide usage in fiber-optic communications, where they permit transmission over longer distances and at higher bandwidths (data rates) than wire cables. For example, over a distance of two kilometers, copper wire would experience a great deal of degradation in quality, while there would be virtually none over the same distance using fiber-optic cable. Couple this with the fact that in many parts of the underdeveloped world there is not enough doctors, hospitals, clinics, and instrumentation available to support local populations. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. A fiber-optic cable is one or more optical fibers enclosed together in a sheath or jacket. National Center for Applied Physics, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia, Department of Electronics, University of York, Heslington, United Kingdom, Department of Physics and Astronomy, Texas A&M University, College Station, Texas, USA. Examination is best carried out in a darkened room. Optical fiber is classified as multimode or single mode. 13.18). After [18]. Given their EM immunity, intrinsic safety, small size and weight, autoclave compatibility and capability to perform multi-point and multi-parameter sensing remotely, optical fibers and fiberoptic-based devices are seeing increased acceptance and new uses for a variety of biomedical applicationsfrom diverse endoscopes, to laser-delivery systems, to disposable blood gas sensors, and to intra-aortic probes. Endoscopes are used to view the stomach and intestines, perform biopsies, and even provide medical treatment. One more interesting feature about optical fiber cable is that the light signals which enters from the side has a minimal chance of traveling along the cable. Nowadays, total annual births are approximately 135 million/year, while deaths are around 56 million/year, but expected to increase to 80 million/year by 2040. In the nineteenth century, endoscopy was very rudimentary and relied on the insertion of long, rigid metal tubes into body cavities. The light is an electromagnetic radiation included in the electromagnetic spectrum. Initially conceived as a medium to carry light and images for medical endoscopic applications, optical fibers were later proposed in the mid-1960s as an adequate information-carrying medium for telecommunication applications. In use, the patient sits and faces the physician. Now you might expect a beam of light, traveling in a clear glass pipe, simply to leak out of the edges. A direct laryngoscope and its insertion into a human throat for examination. Fiber-optic cable is also much less susceptible to noise and electromagnetic interference than copper wire. It consists of a handle and a head (Fig. Ear specialistssuch as otolaryngologists and otologistsuse otoscopes to diagnose infections of the middle and outer ear (otitis media and otitis externa). Other future capabilities brought on by optics will be in the form of the so-called lab-on-a-fiber or LOF for short [10], where optical fibers are combined with micro- and nano-sized functionalized materials that react to specific physical, chemical, or biological external effects and can thus serve as elements to build multi-function, multi-parameter sensing devices. Each guided mode is a pattern of electric and . Fiber Optics. 13.20) consists of a handle containing batteries, an integrated light source, and a set of interchangeable blades for easy reach and placement into a patients throat. Aspect of a modern ophthalmoscope. Visible and infrared light can carry more data than radio waves, but has always been confined to a hard-wired, fiber-optic cable. fiber amplifiers and fiber lasers. We have seen how the field of optics is in itself a subset of a more complex and interdisciplinary area of research known as Biophotonics. The work presented in this paper shows that Fiber Bragg Grating (FBG) optical fiber sensors can potentially be used as receivers in a long-range guided wave torsional-mode pipe inspection system. It is also called auriscope. A direct ophthalmoscope produces an upright (unreversed) image with 15 magnification. A range of diffraction gratings is available for selecting specific wavelengths for such use. A coherent optical fiber bundle. 5, optical instrument. Table 2. Finally, they are capable of transmitting large amounts of data over long distances without . Hence, they are used extensively as laser-delivery probes, as well as imaging conduits in optical coherence tomography (OCT). electromagnetic spectrum, the entire distribution of electromagnetic radiation according to frequency or wavelength. Then, in the 1960s, with the development of semiconductor lasers, light emitting diodes (LEDs) and lasers, modern medical optics began to take shape and, coupled with the availability of optical fibers, a new generation of medical instruments and techniques began to be developed. Photograph of different styles and shapes of drawn coherent optical fiber bundles. Image magnification or reduction can be achieved by tapering the cross section of the bulk plate during the manufacturing process. It consists of simple circular concave mirrormade of glass, plastic, or metalwith a small opening in the middle, and mounted on an articulating joint to a head strap made of leather or fabric. Prof. Hirschowitz tests first prototype fiber optic endoscope using clad fibers in February of 1957, and then introduces it to the American Gastroscopic Society in May of the same year. Subsequently, Arab scholars Yaqub ibn Ishaq al-Kindi (801873) and Abu Zayd Hunayn ibn Ishaq alIbadi (808873) provided a more comprehensive study of the eye in the ninth century in their Ten Treatises on the Eye and the Book of the Questions of the Eye. 13.32). An indirect laryngoscope consists of a combination of a small mirror mounted at an angle on a long stem and a light source. Another important use is in optical fiber technologies where fibers are designed to provide optimum performance at specific wavelengths. for details of this license and what re-use is permitted. Light reflection and refraction between two media with different indices of refraction. But it is in reality light and its interaction with living tissues that is at the center of what makes optics in medicine possible. Curtis fabricates the first clad optical fiber from a rod-in-tube glass drawing process. An aligned reflex means correct vision (Source: Heine). It can also be used for transillumination, dermatologic inspection, examination of the eye, nose, and throat and as an overall handy light source. It is also used to transmit light on the interior during surgeries. Mndez, A. As discussed in this section, optics is a useful, practical, versatile, and powerful technology that, throughout history, has helped human kind perform visual examination, diagnostics, and therapeutics on both the sick and healthy. A French obstetrician named Levert, who was fascinated with the intricacies of the larynx and dabbled with mirrors, is credited with conceiving the idea for the head mirror back in 1743. This aerial image is usually produced by a strong positive lens ranging in power from +13 diopter to +30 diopter that is held in front of the patients eye. Optical astronomers use both angstroms (0.00000001 cm, or 10-8 cm) and nanometers (0.0000001 cm, or 10-7 cm). Wave motion can be defined as a recurring disturbance advancing through space with or without the use of a physical medium. Therefore, the maximum light-collection efficiency occurs for large-diameter-core fibers and large-NA fibers. The otoscope is one of the medical instruments most frequently used by primary care physicians [15]. The compound microscope was developed around the late 1590s by Hans and Zacharias Janssen, a father and son team of Dutch spectacle makers, who experimented with lenses by placing them in series inside a tube and discovered that the object near the end of the tube appeared greatly enlarged (see Fig. The refracted ray of light propagates along the interface, not penetrating into the lower-index medium, as shown in part Fig. A research team has now made a major advance toward the dream of . All are electromagnetic waves are transverse 2. http://www.aslms.org/aslms/history.shtml, Choy DS (1988) History of lasers in medicine. 13.17). As shown in Fig. Besides being used for visualization of the glottis and vocal cords, a direct laryngoscope may also be used during surgical procedures to remove foreign objects in the throat, collect tissue samples (biopsy), remove polyps from the vocal cords, perform laser treatments and, very commonly, as a tool aid to facilitate tracheal intubation during general anesthesia or in cardiopulmonary resuscitation. The idea is that such device can then be used in the field (on remote locations or those where little medical infrastructure is available) and take snap magnified pictures of disease samples and transmit them to medical labs via mobile communication networks, and screen for hematologic and infectious diseases in areas that lack access to advanced analytical equipment. Oil candles in the ancient world gave way to wax ones and alcohol burning lamps in the fifteenth through the nineteenth centuries until the development of electricity and the introduction of the electric lamp by Edison. The material of the book covers topics on wave nature of lightreflection, refraction, polarisation, diffraction, dispersion and scattering of electromagnetic waves. 1 shows the electromagnetic spectrum which allows us to locate the radiation used in optical fiber transmission. Figure13.21 shows a photograph and illustration of his original laryngoscope device. There are also cases where a light field can be decomposed into an evanescent and a propagating part. Hence, in order to carry a reasonable amount of light for illumination purposes, or to transmit and image, hundreds to thousands of optical fibers need to be assembled into bundles. The most commonly used otoscopes in emergency rooms and doctors offices are monocular devices. 3) Not susceptible to interference. This chapter is published under an open access license. https://doi.org/10.1007/978-3-319-31903-2_13, DOI: https://doi.org/10.1007/978-3-319-31903-2_13, eBook Packages: Physics and AstronomyPhysics and Astronomy (R0). Permissions team. This section illustratesthrough several application and product examplessome of the benefits and uses of biomedical fiber sensors, and what makes them such an attractive, flexible, reliable, and unique technology. Schematic of a basic medical optical instrument. The otoscope is a valuable tool beyond its primary role as an examination tool for detecting ear problems. His observations were published in the Royal Philosophical Magazine and Journal of Science in 1855 [21], and they constitute the first physiological records of the human voice as based upon observations in the living subject. The Macintosh blade is the most widely used of the curved laryngoscope blades, while the Miller blade is the most popular style of straight blade. Diffraction gratings are used in spectroscopes to separate a light source into its component wavelengths. For a circular fiber, considering only meridional rays, the entrance and exit angles are equal. The error of refraction is then corrected by using a phoropter, which introduces a series of lenses of various optical strengths until the retinal reflex focuses at the right position on the retina. By changing these lenses, the examiner is able to determine the spherical and cylindrical power, and cylindrical axis necessary to correct a persons refractive error. In general, it could be said that optics has been and will continue to be an enabling technology to further the development and advancement of medicine and the healthcare industry as a whole. Considering Snells law for the optical fiber, core index n c equals to unity. Among these optical instruments we have the otoscope, the ophthalmoscope, retinoscope, laryngoscope, and even basic devices such as the head mirror. We can use this light to send information . Endoscopy, for its part, will continue to evolve and more sophisticated and smaller devices will be developed that will combine more functions (from the standard illumination and visualization) with direct tissue analysis and laser treatment. It uses a penetrating form of EM radiation to take pictures inside your body. If the reflex line is oblique instead of vertical, then astigmatism is present. Electromagnetic interference is when the operation of one electronic device is disrupted when it's in the presence of an electromagnetic field in the radio frequency (RF) spectrum caused by another electronic device. Hence, the magnification factor M is inversely proportional to the working distance P. In the sections to follow, we shall describe the basic optical operating principles and uses of such devices. Thorac Cardiovasc Surg 36(Suppl 2):114117, CrossRef 3.5 you will learn about the basic construction of waveguides. These materials in turn will react to specific biological or chemical substances (analytes) and induce an optical signal change proportional to the given analyte concentration. Glass optical fiber bundles are of two types: incoherent and coherent. The lenses are selected to allow clear visualization of the structures of the eye at any depth and compensate for the combined errors of refraction between patient and examiner. Please check the 'Copyright Information' section either on this page or in the PDF Ear Nose Throat J 68(7):494502, Garca M (1855) Observations on the Human Voice. with tunneling phenomena), but this article focuses on evanescent waves in optics. 13.23. A fused fiberoptic faceplate (back) and taper ( Some future innovations can already be witnessed today in the form of optical devices used in combination with smart portable cell phones [11, 12]. He ultimately fastened the mirror to his forehead as is still currently practiced by some doctors. This allowed the doctor to look down the center of the beam of light, thus eliminating shadow effects and parallax (difference in the apparent position of an object viewed along two different lines of sight) ( The angle 13.37). Longer wavelengths with lower frequencies make up the radio spectrum. The piece is cut into two pieces, machined and the ends polished resulting in a fused fiber optic taper. The English philosopher Robert Bacon (12141294) described in 1268 in his Opus Majus the mechanics of a glass instrument placed in front of his eyes. The mirror is either semi-transparent or has a hole through which the practitioner can view the patients eye. Typical individual fiber element sizes range from as small as 4 to 25m or larger. A period of significant activity and innovation in medical optics occurred from the mid-1800s through the early 1900s, when a variety of early medical instruments such as otoscopes, ophthalmoscopes, retinoscopes, and others, as well as improved illumination systems were developed. Given the present R&D activity worldwide based on optical and photonic techniques it should be no surprise to expect a broader utilization of optically based solutions across the healthcare industry and medical profession. Thin plates are then sliced from the fused boule, ground and polished to the desired thicknessranging from ~100mm down to a practical limit of 50m. Scand J Prim Health Care 20:242243, Kravetz RE (2002) The otoscope. A retinoscope is an optical hand-held device used by optometrists to measure the optical refractive power of the eyes and whether corrective glasses might be needed and the associated prescription value. In medicine, optical fibers have been considered for illuminating and imaging applications since the 1920s. A step index fiber is composed of a core and cladding that have different refractive indices and , respectively. Figure13.19 shows a photograph of phoropter which consists in double sets (one for each eye) of rotating discs containing convex and concave spherical and cylindrical lenses, occluders, pinholes, colored filters, polarizers, prisms, and other optical elements. The term nsin is defined as the numerical aperture or NA for short. Fiber optics can also be combined with other elements such as electrical contacts, fluidic/pneumatic contacts and . An x-ray is simply a form of EM wave used for internal photography. 13.1, the world population has experienced continuous growth since the end of the Great Famine and the Black Death back in 1350, when the total population stood at merely 370 million. In the next drawing stage, a multitude of mono fibers are stacked together and drawn in the furnace to produce a multi-fiber rod. German physician Hermann von Helmholtz is credited with the invention of the ophthalmoscope back in 1851, which he based on an earlier version developed by Charles Babbage in 1847. The mirror is positioned over the physicians eye of choice, with the concave mirror surface facing outwards and the hole directly over the physicians eye. In the third stage, several multi-fiber rods are stacked together to perform the so-called multi-multi drawing process. Phys Med Biol 42(5):967979, Fujimoto JG et al (2002) Optical coherence tomography: an emerging technology for biomedical imaging and optical biopsy. Optical fibers have revolutionized medicine in many ways and continue to do so thanks to the advent of new surgical trends, as summarized in Table13.1. Since such radiation does not occur in fiber optic transmission, there is also no evidence of its impact on human health through fiber optics. In the case of imaging bundles, larger diameter fibers are used of 3050m in diameter. v is calculated as Eq. With optical frequency combs, technologies that employ radio and microwave frequencies such as clocks, computers and communications are now seamlessly connected to optical waves that oscillate at 10,000 times higher frequencies. where F The final diameter of the filament is controlled by the ratio of the speeds between the advancing preform and the drawn fiber. Another relevant and converging present trend is how biomedical devices and instruments are so extremely pervasive across the healthcare industry today. It is around this time that the so-called reading stones are being used as magnifying lenses to help read manuscripts. Health care providers use otoscopes to screen for illness during regular check-ups and also to investigate ear symptoms. Proc R Soc Lond 7:399410, Hirsch NP, Smith GB, Hirsch PO (1986) Alfred Kirstein Pioneer of direct laryngoscopy. Part of Springer Nature. Such interaction can be used to probe the state of such living matter for diagnostics and analytical purposes or, it could be used to induce changes on the same living systems and be exploited for therapeutic purposes. 2023 Springer Nature Switzerland AG. Historically, optics has been an enabling technology for the design and development of such medical devices and instruments. Academic, New York, Devroey D et al (2000) Do general practitioners use whats in their doctors bag? Optical fibers are not only useful for endoscopes, but can also be used to transmit light to tissue regions of interest either to illuminate the tissue so that it can be inspected, or if much higher power laser light is used, to directly cut or ablate it. A high degree of refractive power indicates that the light focus remains in front of the retina, in which case the eye displays myopia. In 1888 Prof. Reuss and Dr. Roth of Vienna used bent solid glass rods to illuminate body cavities for dentistry and surgery. remarkable entrepreneurship and business acumen leading to products and applications in numerous areas including optical fiber systems, medical optics, and femtosecond laser . 3. A seminal optical medical instrument development came in 1804 when the German born physician Philipp Bozzini (17731809) developed and first publicized his so-called light conductor (Lichtleiter), which enabled the direct view into the living body [4]. Optical fibers work on the principle of total internal reflection. At the entrance to the fiber, a conical region is defined by the so-called acceptance angle, which is the region in space where light can be effectively collected and coupled into the fiber for guiding. The Optical Receiver - It receives the transmitted light pulse (signal) and decodes them to be fit to use. The fundus consists of blood vessels, the optic nerve, and a lining of nerve cells (the retina) which detects images transmitted through the cornea, a clear lens-like layer covering of the eye. Path of light reflected of the cornea and iris (3). Typically, the initial drawn fiber is more of a solid rod with a 2mm diameter. 13.13) was very basic (made or cardboard, glue, and microscope glass plates) but it allowed him to place the eye of the observer in the path of the rays of light entering and leaving the patients eye, thus allowing the patients retina to be seen. The first solid-state laser was built in 1960 by Dr. T. H. Maiman at Hughes Aircraft Company. The medical field uses the same EM radiation type as a cancer treatment. This is called waveguide. New advancements in optics and photonics are driving the development of a new generation of imaging toolssuch as optical coherence and photo-acoustic tomographythat can readily provide two and three-dimensional images of diverse human body tissues and organs. The direct ophthalmoscope is used to inspect the fundus of the eye, which is the back portion of the interior eyeball. In Fig. 13.14). They are typically used for imaging applications bonded to cathode ray tubes (CRT) and LCD displays, image intensifiers, charged coupled device (CCD) or complementary metal-oxide semiconductor (CMOS) detectors, image plane transfer devices, X-ray digital detectors, among others. 13.38, when an X-ray source emits radiation energy (that would pass through the patient) the transmitted energy impinges on a scintillator plate which converts the radiation rays into visible photons. 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