Peek Vision: Portable diagnostics for eye health
Andrew is a Longitude Prize Advisor and Panel member of our Discovery Awards.
In 2011 I commenced a PhD at the International Centre for Eye Health at the London School of Hygiene & Tropical Medicine. My wife, one-year-old son and I moved to Kenya to lead the follow-up of a major cohort study of eye disease, following up to 5,000 people in 100 different locations across the Great Rift Valley.
It is an understatement to say it was challenging: Two-thirds of the locations had no road access or electricity, and our two vans were carrying a team of 15 people and over £100,000 worth of fragile eye equipment. This was all necessary to be able to carry out high quality measures of eye disease and answer some important questions for eye services planning.
What we discovered was that in the most difficult to reach locations we would find long queues of people waiting to see us, people who had been unnecessarily blind for years from preventable or treatable diseases.
Despite the locations having no roads, electricity and often no water, nearly all the locations had good phone signal. This got me thinking.
Surely we could harness this connectivity to deliver eye care in a new way?
Together with a brilliant team of developers, engineers and ophthalmologists we developed a suite of smartphone-based tests to see if we could replace some of the standard equipment being used, in the hope that we could make it more portable and easier for non-specialists to use. Our ultimate goal is that the most high-risk individuals can be reached and treated.
The cohort study formed the control arm for our testing, and we built, tested and validated our portable eye examination kit, or Peek, against the reference standard tests in the field. We did this in the hands of users who would eventually become “Peek Screeners.”
Peek now consists of four key components:
- Software diagnostic apps (such as our vision test)
- Hardware such as Peek Retina, our adapter that enables the retina to be viewed with a smartphone
- Systems that connect the diagnostic test and image data to healthcare workers, enabling remote decision making and increasing the opportunities for those living at a distance from the service providers to be linked up and contacted for further follow up or treatment.
- Implementation know-how – providing programme design, integration and training with partners on the ground.
Testing children in Kenya
In 2015 we completed a pilot where teachers in Kenya used Peek Acuity, our app to determine visual clarity, to screen children.
25 teachers were able to screen 21,000 children in nine days, identifying 900 with visual impairment.
We are now in the process of screening 300,000 children in the same region and preparing the methodologies to scale and integrate into government programmes.
Diagnostics for eyesight – and AMR
The solutions to effective and sustained eye care are complex, as is the challenge of antimicrobial resistance. Any set of solutions will need to find a way of being scaled at pace and sustainably. This will require a wide variety of expertise and disciplines from laboratory science, implementation science, business development, behavioural change science, NGOs, government and the private sector to come together behind a common goal.
Unity behind a mission can be a very powerful solution builder. The Longitude Prize has established the mission and I look forward to seeing the power of collaboration and new thinking solve one of the biggest problems we face today.
"If you want to build a ship, do not first assign tasks of collecting wood. Instead, first teach people to long for the endless immensity of the sea." - Antoine de Saint Exupery
Image credit: Andrew Bastawrous