How does the C-Eye system work?

Operation of C-Eye system is based on visual contact with the device. The patient focuses his or her sight on an appropriate element displayed on the screen for a determined period of time (at least 0.6 s – the time can be adjusted). After this time, the element is selected. This allows the patient to communicate with the environment, answer questions or even write on the virtual keyboard. Additionally, the C-Eye system contains an extensive task and exercise resource for neurorehabilitation.

How much does the C-Eye system cost?

There are two versions of the device: C-Eye Personal for individual users and C-Eye II PRO for rehabilitation centres and hospitals. The device is adapted individually to the needs of every client, therefore its price is not fixed and depends on the version and the required set of functionalities.

How much does an examination using the C-Eye system cost?

Each centre has its own pricing policy as far as assessment/rehabilitation sessions using the C-Eye system is concerned.

Can the C-Eye system be used at home?

Yes, C-Eye is available in two versions. C-Eye Personal is intended for individual use at home.

Can C-Eye Personal be used by more than one person?

No, C-Eye Personal is intended for one person. If you want to use the device with many patients, you need to purchase C-Eye II PRO with an appropriate license.

Can children use the C-Eye system?

It is very easy to teach or conduct therapy with children using C-Eye. Children are successful in using the C-Eye system and achieve very good results.

Does the C-Eye system enable the assessment whether the patient is in a vegetative state or a minimally conscious state?

Yes. Patients in a vegetative state react only to sudden visual stimuli and their eye fixation time is very short. On the contrary, patients in a minimally conscious state (MCS) are able to fix their gaze and follow the elements on the screen with their eyes. If the patient is able to fix his or her gaze on one point on the screen and select the chosen answer, it means that he or she is at least in a minimally conscious state.

Have there been any scientific studies or clinical trials with the system?

Yes, scientific research was conducted with the use of the prototype version of C-Eye. Apart from scientific publications, a doctoral thesis was written about the examination of post-coma patients with severe brain injury using the system (thesis by Agnieszka Kwiatkowska, Institute of Psychology of the Kazimierz Wielki University in Bydgoszcz). Currently, a clinical trial with the use of the C-Eye system is taking place in Górnośląskie Centrum Rehabilitacji “REPTY” in Tarnowskie Góry. The trial is coordinated by Prof. Józef Opara.

Is the efficiency of the therapy using the C-Eye system confirmed by leading figures in the world of medicine?

Yes, as of today the C-Eye system is recommended by the following specialists: Krzysztof Nicpoń MD, PhD (neurologist), Prof. Agnieszka Maryniak (child psychologist, University of Warsaw), Prof. Józef Opara (President of the Polish Society of Neurorehabilitation, head of the Department of Clinical Rehabilitation Department at the Institute of Physical Therapy of the Nervous and Locomotor System of the Jerzy Kukuczka Academy of Physical Education in Katowice), as well as Prof. H. Reichmann (Carl Gustav Carus Hospital in Dresden, a neurologist specializing in the therapy of post-stroke patients).

Is C-Eye suitable for use under hospital conditions, e.g. on ICUs?

Yes, the simplicity of operation and the intuitive user interface, and especially the medical device certificate, ensure that the C-Eye system is suitable for work in medical facilities, including hospitals and in intensive care units.

Do you have any information/data about the innovative character of the C-Eye system as a method of rehabilitating patients with CNS disorders?

We have an opinion about the innovative character of C-Eye as a tool for neurorehabilitation based on the visual channel. We regularly assess the current state of knowledge about the use of eye-tracking technologies in this field.

Is C-Eye necessary for my loved one?

C-Eye significantly facilitates everyday contact with people in states of reduced consciousness. Furthermore, thanks to the regular exercises from the neurorehabilitation panel we can prevent the disappearance of synaptic connections in the brain and ensure continuous mental activity.

Is it necessary for the patient to remain in the centre in order to check whether he or she can use the C-Eye system?

Remaining in the centre for several days is recommended as it enables a more objective assessment of the patient’s condition. However, this is not obligatory, as it is possible to make an appointment with the consultant to check whether interaction of the patient with C-Eye is possible. It must be noted that the success of the assessment session largely depends on the physical and mental condition of the patient.

When does neurorehabilitation using C-Eye bring most benefits?

The best results are achieved when working with C-Eye at home, at a time of the day when the patient is most reactive. The systematic and regular repetition of the therapeutic sessions is a crucial aspect of the rehabilitation process.

Can the C-Eye system be used without the supervision of skilled therapists and physicians?

Yes. However, it is first necessary to read the instruction manual and the method guide provided with the C-Eye system.

Are the infra-red diodes in the eye-tracker safe?

Yes, C-Eye is a medical device, with the appropriate safety certificates. The infrared light used in the C-Eye system is not dangerous for the patient, even during long-term work with the device (of course when it is used in accordance with its intended use and as described by the User Manual provided with it).

What is the maximum length of a session with C-Eye?

The experience of therapists shows that the optimal session time ranges from 15 minutes (first presentation sessions) to 60 minutes (for patients regularly using C-Eye). The frequency of the sessions should be selected individually for each patient, according to the patient’s condition and preferences. It is recommended to use C-Eye every day.

Can C-Eye be used as a trustworthy communication tool for solving legal disputes?

Yes, C-Eye includes a range of tests confirming the consciousness of the patient as well as a set of communication tools unanimously indicating the intentional answer of the patient.

How can I be sure that the patient understands my questions? How can I check that the answers are not selected by accident?

Working with the C-Eye system is based on the rule of repetition of the selected answers. If the patient selects the same answer several times, it is a sign that he or she understands the question. In such a case, we try to fulfil the patient’s request, for example when he or she selects “I’d like to listen to my favourite music” two or three times consecutively, we answer his or her request and play appropriate tracks. Such actions by the therapist not only motivate the patient to make further efforts but also form feedback that he or she is understood and retains some kind of power in spite of all the limitations.

What does C-Eye consist of? How does it differ from C-Eye II PRO for rehabilitation centres?

C-Eye consists of an electronic device with specially-designed software, allowing it to be steered by touch and vision. C-Eye II PRO intended for rehabilitation centres and hospitals includes an additional module (Patient State Assessment), options and functionalities to aid physicians and therapists in diagnosing and conducting professional therapy. Additionally, C-Eye II PRO has an extended license (for working with one or with many patients) and has a different eye-tracker (the interface tracks the patient’s eyes). Every C-Eye device is also equipped with a special arm on wheels, enabling work with a patient in any position.

Is the C-Eye system installed on a personal computer or other device, such as a tablet?

The C-Eye system is a complete device. It is impossible to separate the software from the hardware. After buying C-Eye, the user does not need any additional equipment.

Is it necessary to customize the C-Eye system to suit each patient?

Yes. Personalised configuration of the C-Eye system positively influences the precision of the device and the effectiveness of the therapeutic work.

What types of exercises are available in the C-Eye system?

The C-Eye system offers many different types of exercises, from visual stimulation to neurorehabilitation tasks. It is possible to work on the linguistic functions, visual-spatial functions, memory, thinking or communication skills.

To what degree does C-Eye support communication?

Communication with the use of C-Eye can take three forms: writing on the virtual keyboard, pictograms (for patients having lost the ability to read and write) and pre-prepared text messages. Thanks to C-Eye it is possible to understand the needs of the patient – whether he or she feels pain, wants something to eat or drink or feels like listening to music.

Is it possible to type in any text using vision in the C-Eye system?

Yes, the system is equipped with two keyboards: basic and modular (in both the keys are in alphabetical order). Moreover, both keyboards have the text saving option, thanks to which the system will suggest the ending of the sentence if it has previously been typed in.

Can the patient listen to music or browse photographs on his/her own?

Yes, it is possible after connecting an external memory (e.g. a USB flash drive) containing multimedia files to the port in the C-Eye system. A sound player and photograph browser are available in the Communication and Entertainment module.

Is it possible to create your own lessons or exercises?

Yes, you can create your own exercises with photographs, pictures and sounds in the Multimedia communication editor in the Communication and Entertainment Module.

Is it possible to customize the C-Eye system (is it possible to ask the patient a question which is not included in the original software)?

Yes. The templates and Multimedia communication editor enable the customisation of the device and messages.

Is it possible for paralysed patients (with functional vision) to use C-Eye for multimedia (watching films, listening to music) and to open them on their own?

The C-Eye system gives the patient access to a sound player, audiobooks, photo browser and e-books (PDF, RTF, TXT files). Thanks to C-Eye, the patient can look at family photos and listen to favourite music; it is enough to connect an external USB memory (flash drive, portable hard drive) and create slide shows with descriptions, open the text reader or music player.

Is C-Eye equipped with Internet access?

No, C-Eye is a medical device intended above all for rehabilitation purposes. We want to ensure the stable and fault-free operation of the device during its whole lifetime. Access to the Internet would result in a risk of malware infection and would require the development and use of additional security measures.

Why are the messages and pictograms in black and white?

Colours often distract the patients. Therefore, to avoid excessive stimulation, the messages are written in black font on a white background. The same situation applies to the pictograms. Also the contents of the messages and pictograms are clear – they must be unambiguous to the patient.

Do you offer a dust cover for C-Eye?

C-Eye is delivered in a cardboard box with a handle. Currently, we don’t offer dust covers for the device.

How can I learn to operate C-Eye?

C-Eye is a very intuitive device, with a touch user interface which is very transparent and clear to use. The device is delivered together with a detailed User Manual and a Method Guide.

Is it difficult to install/configure C-Eye?

The C-Eye system does not require installation: it is ready for use. All that is required is to press the power button. The configuration of the device is very simple. After turning on the device, you need to accept the license agreement, enter some basic personal data and ensure a suitable position for the patient in relation to the device – so that the patient’s eyes are in the field of vision of the camera (in the middle of the field, if possible). The camera preview is available in the therapist’s menu (in the side menu).

Is the device difficult to operate? Will an older person have a problem using it?

C-Eye is very intuitive and even an older person should have no problems using it.

Should a vision test be conducted during the first meeting?

It depends on the patient. It is recommended to devote the first meeting to familiarising the patient with the equipment (describe the elements of the device, the aim of the work, etc.). Then you can try to perform several simple exercises, which will help check whether the patient is capable of working with the device.

To what should I pay special attention during the first meetings?

It is important to configure the selection (eye fixation) time – it should be short at first, so that the patient can get accustomed to it. Also a background colour suitable for the patient must be chosen (pastel colours are recommended). It is important to perform sessions with the C-Eye device at a time day comfortable for the patient.

Will the patient answer the questions immediately?

Very often the reactions of patients with reduced consciousness are delayed; therefore, we should give them more time to answer. Let them look at the content on the screen. Give them time to think and do not give any hints.

How should I respond when the patient does not want to do the exercises from the neurorehabilitation panel?

The basic rule is that you need to explain to the patient why he or she has to do the exercises, what is their goal and what benefits can rehabilitation with the C-Eye system bring.

When is it necessary to change the selection time?

Preferably when we notice that the patient can easily select the elements on the screen. In such a case, we can increase the time level by one.

How can I check whether the patient intentionally fixes his or her gaze?

The C-Eye system includes a special exercise for checking and strengthening eye fixation and saccadic movements. Furthermore, the intentionality of the eye fixation is verified by repetition of the exercises.

How does the patient select an answer on the screen?

In order to confirm the selection, the patient must fix his or her gaze in a determined place (a chosen pictogram or message) for a fixed period of time. An hourglass measuring time appears (in the form of a circle) and when it disappears, the answer is selected. The selection time can be shortened or lengthened, according to the patient’s needs.

Do I need a mouse and a keyboard to operate C-Eye?

The C-Eye system is equipped with a touch screen and the caregiver or therapist steers the device using touch. The device does not require a mouse or a keyboard.

Do I need to buy any additional equipment when buying C-Eye?

No, the system is complete and ready to use – both at home and in rehabilitation centres. The only accessory, always offered with the device, is an arm on wheels, thanks to which patients in any body position can use the C-Eye system.

Is it possible to participate in a C-Eye operation training session?

No.

Do you diagnose the patients?

No. C-Eye supports the supplementary assessment of the patient’s neurological condition in the field of cognitive functions and consciousness level.

Who are the intended users of the C-Eye system and who can use it?

The C-Eye system is intended mainly for patients with neurological disorders – following hypoxia, strokes, cerebral haemorrhages, craniocerebral traumas, as well as patients with cerebral palsy, aphasia, or SLA. The C-Eye system can be used not only by adults, but also by children with communicative barriers on various grounds – developmental disorders, intellectual disabilities, genetic diseases etc.

Is it possible to use C-Eye with only one functional eye?

Yes, the system can be used successfully in the monocular operating mode. It is possible to choose whether to work with the left or the right eye.

Is the C-Eye system suitable for someone after a stroke who can speak only a few words and cannot remember basic notions for longer periods of time?

C-Eye is completely suitable for post-stroke patients. The device includes a range of exercises aimed at improving the patient’s neurological condition. Exercises of the memory, visual-spatial functions and linguistic functions enable the efficient neurorehabilitation of the patient.

Can someone diagnosed as being in a vegetative state use the device?

You should certainly try. A total of 43% of the patients diagnosed as being in a vegetative state are actually at least in a minimally-conscious state. These patients can operate the C-Eye system. However, if it turns out that the patient is really in a vegetative state, he or she will not be able to operate the device. In such a case, there is no eye fixation or message reception, the patient has severe attention disorders.

Can the C-Eye system support the communication and development of children with cerebral palsy?

Yes. C-Eye is currently used in several centres providing therapy to children with various disorders. The therapists from these centres confirm the significant influence of C-Eye on the communication and development of children, including children with cerebral palsy.

Can someone lacking their lenses use the C-Eye system?

One of the key conditions for effective cooperation of the patient is a functional visual channel. If this condition is not met, we cannot guarantee that the system will work correctly.

Can someone who is deaf operate the C-Eye system?

Yes. We can concentrate on exercises of visual-spatial orientation and memory. The equipment not only reads the commands aloud but also displays them on the screen; therefore someone who is deaf can also use the C-Eye system.

Can the system be used by someone with motor aphasia?

Yes, patients with all types of aphasia can use C-Eye. Depending on the depth of their disorder, they may only require more time to learn how to use the system. It is worth pointing out that the device can significantly support the speech therapy process.

Can the device be used by someone with understanding disorders (sensory aphasia)?

Yes, we only need to change the scope of the tasks. We teach the patient to understand simple words and commands using C-Eye. The speech synthesizer, which reinforces the names of the objects in the memory, is an additional advantage.

Can the C-Eye system help patients with concentration disorders caused by hypoxia?

Yes.

Is the C-Eye device suitable for someone with Rett syndrome?

Yes. C-Eye supports the communication of patients with Rett syndrome and has a positive influence on the life quality of these patients, including children, thanks to the exercises available in the system.

Can someone in a coma use the device?

No, someone in a coma is not conscious. His or her eyes are always closed, which strongly confirms the impossibility of operating the C-Eye device.

Please note! Those patients in a coma must be distinguished from those suffering from eyelid drooping. In such a case, it is possible to help the patient by lifting their upper eyelids, remembering about suitable nutrition and nourishment of the eyeballs with artificial tears. In many cases, patients with drooping eyelids have successfully used C-Eye.