Portable hardware & software technologies for addressing ophthalmic health disparities: A systematic review

Abstract

Vision impairment continues to be a major global problem, as the WHO estimates 2.2 billion people struggling with vision loss or blindness. One billion of these cases, however, can be prevented by expanding diagnostic capabilities. Direct global healthcare costs associated with these conditions totaled $255 billion in 2010, with a rapid upward projection to $294 billion in 2020. Accordingly, WHO proposed 2030 targets to enhance integration and patient-centered vision care by expanding refractive error and cataract worldwide coverage. Due to the limitations in cost and portability of adapted vision screening models, there is a clear need for new, more accessible vision testing tools in vision care. This comparative, systematic review highlights the need for new ophthalmic equipment and approaches while looking at existing and emerging technologies that could expand the capacity for disease identification and access to diagnostic tools. Specifically, the review focuses on portable hardware- and software-centered strategies that can be deployed in remote locations for detection of ophthalmic conditions and refractive error. Advancements in portable hardware, automated software screening tools, and big data-centric analytics, including machine learning, may provide an avenue for improving ophthalmic healthcare.

Virtual Reality Hemifield Measurements for Corrective Surgery Eligibility in Ptosis Patients: A Pilot Clinical Trial

“…Virtual reality (VR) devices have recently gained attention in the vision care field as cost-effective screening tools. 12 , 13 VR-mediated perimetry is a promising strategy for visual field testing in ptosis patients, thereby providing an alternative device solution that is potable and has a lower footprint in identifying patients who would benefit from undergoing corrective surgery, while also allowing for automated record keeping and focusing on patient comfort. Furthermore, HTC Vive Pro Eye integrated eye tracking allows for measurement of gaze deviations and invalidation of eye motion-sensitive tests that are incorrectly attempted.…”

Virtual Reality Enables Rapid and Multi-Faceted Retinal Function Screening

“…Performing rapid vision testing across various clinical environments requires a portable, fast, and easy-touse technology that allows administration of several vision function exams from the same device. 12 Integrating a series of retinal health screening exams into one platform would allow for multimodal functional testing that can localize abnormalities to a speci c anatomical area of the retina while allowing for improved user feasibility within a single device platform.…”

“…[9][10][11] Local availability of specialized vision testing leads to faster disease identi cation/awareness and successful treatment of retinal diseases like diabetic retinopathy (DR) and AMD. 12 Several studies have demonstrated the clinically meaningful bene ts of empowering adult vision screening or monitoring in a primary care or community setting, particularly in identifying irreversible retinal diseases that could require immediate ophthalmic intervention, such as glaucoma, DR, and AMD. 13,14 The bene ts of implementing each test independently of a complete eye examination in a primary care setting have been variable.…”

Clinical report: Virtual reality enables comparable contrast sensitivity measurements to in-office testing (pilot study)

“…Although generalists, such as primary care physicians, have tools to assess vision, they are rudimentary and often miss signs of early-stage diseases 2 . The introduction of portable, digital technologies, such as virtual reality headsets, allows for the opportunity to create accelerated analogs of in-office vision tests 3 . Furthermore, these technologies can drastically reduce interoperator bias, such as lighting consistency and distance of a contrast sensitivity chart from a subject 4 .…”

“…2 The introduction of portable, digital technologies, such as virtual reality headsets, allows for the opportunity to create accelerated analogs of in-office vision tests. 3 Furthermore, these technologies can drastically reduce interoperator bias, such as lighting consistency and distance of a contrast sensitivity chart from a subject. 4 Results are therefore more standardized across participants, increasing the likelihood of reliable abnormality detection.…”