Andrew Bastawrous: Get your next eye exam on a smartphone

109,945 views ・ 2014-04-30

TED


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There are 39 million people in the world
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who are blind.
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Eighty percent of them
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are living in low-income countries such as Kenya,
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and the absolute majority
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do not need to be blind.
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They are blind from diseases
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that are either completely curable or preventable.
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Knowing this, with my young family,
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we moved to Kenya.
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We secured equipment,
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funds, vehicles, we trained a team,
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we set up a hundred clinics throughout
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the Great Rift Valley
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to try and understand a single question:
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why are people going blind,
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and what can we do?
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The challenges were great.
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When we got to where we were going,
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we set up our high-tech equipment.
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Power was rarely available.
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We'd have to run our equipment
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from petrol power generators.
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And then something occurred to me:
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There has to be an easier way,
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because it's the patients who are the most in need
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of access to eye care
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who are the least likely to get it.
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More people in Kenya,
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and in sub-Saharan Africa,
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have access to a mobile phone
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than they do clean running water.
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So we said, could we harness
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the power of mobile technology
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to deliver eye care in a new way?
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And so we developed Peek,
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a smartphone [system] that enables
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community healthcare workers
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and empowers them to deliver eye care everywhere.
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We set about replacing traditional hospital equipment,
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which is bulky, expensive and fragile,
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with smartphone apps and hardware
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that make it possible to test anyone
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in any language and of any age.
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Here we have a demonstration
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of a three-month-old having their vision
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accurately tested using an app and an eye tracker.
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We've got many trials going on
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in the community and in schools,
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and through the lessons that we've learned in the field,
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we've realized it's extremely important
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to share the data in non-medical jargon
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so that people understand
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what we're examining and what that means to them.
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So here, for example,
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we use our sight sim application,
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once your vision has been measured,
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to show carers and teachers
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what the visual world is like for that person,
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so they can empathize with them and help them.
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Once we've discovered somebody has low vision,
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the next big challenge is to work out why,
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and to be able to do that,
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we need to have access to the inside of the eye.
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Traditionally, this requires expensive equipment
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to examine an area called the retina.
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The retina is the single part of the eye that has
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huge amounts of information about the body
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and its health.
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We've developed 3D-printed,
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low-cost hardware
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that comes in at less than five dollars to produce,
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which can then be clipped onto a smartphone
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and makes it possible to get views
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of the back of the eye
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of a very high quality.
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And the beauty is, anybody can do it.
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In our trials on over two and half thousand people,
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the smartphone with the add-on clip
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is comparable to a camera
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that is hugely more expensive
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and hugely more difficult to transport.
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When we first moved to Kenya,
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we went with 150,000 dollars of equipment,
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a team of 15 people,
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and that was what was needed to deliver health care.
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Now, all that's needed
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is a single person
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on a bike with a smartphone.
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And it costs just 500 dollars.
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The issue of power supply
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is overcome by harnessing the power of solar.
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Our healthcare workers travel
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with a solar-powered rucksack
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which keeps the phone charged and backed up.
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Now we go to the patient
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rather than waiting for the patient never to come.
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We go to them in their homes
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and we give them the most comprehensive,
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high-tech, accurate examination,
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which can be delivered by anyone with minimal training.
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We can link global experts
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with people in the most rural,
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difficult-to-reach places
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that are beyond the end of the road,
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effectively putting those experts in their homes,
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allowing us to make diagnoses
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and make plans for treatment.
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Project managers, hospital directors,
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are able to search on our interface
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by any parameter they may be interested in.
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Here in Nakuru, where I've been living,
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we can search for people
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by whatever condition.
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Here are people who are blind
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from a curable condition cataract.
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Each red pin depicts somebody
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who is blind from a disease that is curable
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and treatable, and they're locatable.
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We can use bulk text messaging services
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to explain that we're coming to arrange a treatment.
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What's more, we've learned that this is something
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that we haven't built just for the community
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but with the community.
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Those blue pins that drop represent
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elders, or local leaders,
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that are connected to those people
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who can ensure that we can find them
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and arrange treatment.
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So for patients like Mama Wangari,
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who have been blind for over 10 years
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and never seen her grandchildren,
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for less than 40 dollars, we can restore her eyesight.
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This is something that has to happen.
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It's only in statistics
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that people go blind by the millions.
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The reality is everyone goes blind on their own.
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But now, they might just be
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a text message away from help.
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(Applause)
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And now because live demos are always a bad idea,
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we're going to try a live demo.
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(Laughter)
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So here we have the Peek Vision app.
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Okay, and what we're looking at here,
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this is Sam's optic nerve,
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which is a direct extension of her brain,
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so I'm actually looking at her brain as we look there.
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We can see all parts of the retina.
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It makes it possible to pick up diseases
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of the eye and of the body
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that would not be possible without access to the eye,
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and that clip-on device can be manufactured
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for just a few dollars,
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and people can be cured of blindness,
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and I think it says a lot about us as a human race
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if we've developed cures and we don't deliver them.
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But now we can.
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Thank you.
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(Applause)
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