Where Eye Care Is A Luxury, Technology Offers Access

Enlarge this image toggle caption Andrew Thomas Ryan/MIT Media Lab Andrew Thomas Ryan/MIT Media Lab

For millions of people in the developing world, one thing stands between them and a job or an education: a good pair of glasses. Quality eye care is often a luxury in areas where health services are scarce. So researchers and entrepreneurs are looking for breakthrough technologies to bring the cost of glasses and eye exams way down.

One group thinks that smartphones could help provide needed access to vision health care. Researchers at EyeNetra, a Massachusetts Institute of Technology spinoff company, are working on a device that would turn the phones into eye exam machines.

"Our goal, really, is to empower millions and millions around the world by bringing eye care to people's homes in a way that was never possible before," says EyeNetra's David Schafran.

EyeNetra has developed a $2 scope that health care workers can clip onto a smartphone. The patient stares through the eyepiece and follows colored lines that appear on the screen. Software installed on the phone translates responses into a measurement of "refractive error," which optometrists need to make a pair of glasses.

Schafran says it's just a question of leveraging the power of the smartphone.

"The phone is actually doing everything," he says. "It's projecting the images, and it's also doing the calculations — that's where all the smarts are."

EyeNetra is testing these devices in clinics all over the world. The hope is they will be accurate enough to change optometry both in developing countries and maybe even in more affluent areas.

'Science Helps,' But It's No Doctor

There is skepticism. The classic eye exam starts with an automated reading by an expensive machine, which EyeNetra aims to replace. Next, your doctor follows up with a series of questions like, "Which lens helps you see better: No. 1 or No. 2?" Kuldev Singh, an ophthalmologist at Stanford University, says for the patient to be happy, that second, subjective test is crucial.

Enlarge this image toggle caption Courtesy of Centre for Vision in the Developing World Courtesy of Centre for Vision in the Developing World

"Science helps, but I don't think there's a substitute for actually checking to see if the patient is satisfied with the refraction that any automated device will find," Singh says.

EyeNetra says relying on the automated exam can be just as accurate — and makes the exam cheaper and more accessible.

Liquid Lenses

But once patients get their prescriptions, they still have to get the glasses made. EyeNetra's developers envision a network of providers that would use the prescription to provide the patient with glasses.

But in some places, patients are actually building their own eyewear. The Centre for Vision in the Developing World is collaborating with Dow Corning to make cheap glasses with lenses made of liquid silicon. Dow Corning's James Stephenson says the glasses are equipped with a little pump that can adjust the shape of this liquid lens.

"The user basically looks through the glasses," he says. "They cover up one eye, and they literally turn the pump until the object comes into very clear vision."

The biggest downside with these glasses — initially called Adspecs — is that they're pretty clunky looking. The developers are working on a sleeker, more stylish version.

Nothing Beats A Complete Eye Exam

According to their creators, these are promising technologies. But those who work in the developing world caution that many patients don't even know that they could see better, so they don't ask for help. And Singh says that when it comes to eye care, it's also important to go beyond the need for glasses.

According to Singh, these new technologies are "not a substitute for a complete exam that checks the eyes for potentially blinding diseases, like glaucoma and macular degeneration."