Wednesday, 20 August 2014

An Eye Phone to Fight Blindness


Why you should care

Because ophthalmologist Andrew Bastawrous is on a mission to prevent and treat blindness — with a smartphone.
Andrew Bastawrous may have a solution. The 34-year-old ophthalmologist from the London School of Hygiene and Tropical Medicine invented the Portable Eye Examination Kit, or PEEK, a mobile app and clip-on hardware that transforms a smartphone into a pocket-size optical clinic. He recently launched a pilot study involving 5,000 people in Nakuru, Kenya, which is scheduled to wrap up in March. Hoping to make PEEK available around the world, Bastawrous is also planning trials in Tanzania, Botswana and India.
PEEK’s mobile app and clip-on hardware transform a smartphone into a pocket-sized optical clinic.
In Nakuru, Bastawrous will compare PEEK’s photos to those taken by state-of-the-art hospital equipment that costs around $160,000 and requires a team of trained personnel to operate. In contrast, an eye specialist with minimal training can use PEEK — which costs only about $500 — to gather detailed information. The phone screen displays a simple vision test (expected to hit app stores next month) while the camera scans the eye for cataracts. Meanwhile, the camera’s flashlight can be used to check for glaucoma and other diseases. PEEK also stores contact information and GPS data for each patient, which can then be emailed to doctors. For now the app works only on Androids, but Bastawrous plans to make PEEK available across platforms.
Color headshot of Andrew facing foward smiling wearing a white shirt
ANDREW BASTAWROUS
SOURCE: NOOR KHAMIS/CORBIS
Few people realize that blindness can be prevented or treated in more than 80 percent of cases. “One of the most common reasons people remain blind is they believe nothing can be done,” he said. “It’s very important for us to challenge those perceptions.”
For Bastawrous, reaching that goal has meant moving to a remote Kenyan village, wife and 1-year-old in tow, even though he barely speaks a word of Swahili. What’s driving him? People like the woman in her 90s who had been living blind and alone for more than 10 years before PEEK detected her cataracts. After an operation to remove them, she saw a man she didn’t recognize outside her house. It was her son. The whole village erupted into singing and dancing. “Those moments really make everything worthwhile,” Bastawrous said.
By the time Bastawrous was deciding which university to attend, his childhood friend was making a living washing cars. He came to a hard realization.
Thoughtful and soft-spoken, Bastawrous developed a keen awareness of privilege and poverty during summer vacations in his parents’ native Egypt. While his father, an orthopedic surgeon, saw patients during the day, Bastawrous played ball with his neighbor. “We were the same, really,” he said, “but each year I came back, we became more and more different.” By the time Bastawrous was deciding which university to attend, his childhood friend was making a living washing cars.
He came to a hard realization. “It wasn’t fair. I could have been in his position if circumstances were different,” he said. “I had this strong desire to share with people who hadn’t been given the same opportunities.”
So he did. Bastawrous specialized in ophthalmology at the University of Leeds so he could serve developing countries, where eye diseases are a major problem. He had learned to value his eyesight early on, when his first pair of glasses transformed him from a failing student straining to read the blackboard to one of the best in his class. “Suddenly the world changed,” he said. “It’s a really impactful moment that’s never gone away.”
After graduate-level fieldwork took him everywhere from Sri Lanka to Sierra Leone, Bastawrous launched his Ph.D. project to monitor the eye diseases of 5,000 people in Nakuru. The Kenyan government would eventually use his data to develop a national eye health system. His head spun as he mapped the logistics of transporting a fully equipped, fully staffed eye hospital to remote villages with no road access or electricity.
“Then it dawned on me,” he said. He used his smartphone for everything, from checking train times to sharing photos. What wasn’t possible with a smartphone? Imagining all the ways he could revamp its existing features into optical instruments, he rushed to tell his wife, also a doctor. “She probably thought I was slightly crazy,” he laughed.
Developing mobile apps was foreign territory, but it didn’t take Bastwarous and his wife long to find an app designer and engineer in their extended circle of friends.
Woman being examined by smart phone app being held to her face
An eye examined through PEEK
The hard part came in October 2012, when the couple and their infant son left home for Nakuru. “It was the six hardest months of our life,” Bastawrous said. Homesick and unable to speak Swahili, he struggled to build and train a team of 15 local hospital staff members to use both PEEK and conventional eye exam equipment. He felt crushed when PEEK failed its first test run — and the rampant poverty he witnessed shook him to his core.
One of the most common reasons people remain blind is they believe nothing can be done. It’s very important for us to challenge those perceptions.
But Bastawrous “plugged away and managed to see through those difficult times,” said Vineeth Kumar, an eye surgeon and consultant for PEEK. Learning from the project’s early failures, the team made hundreds of improvements. When Kumar visited Bastawrous last year, he was “mindboggled” by PEEK and the team members’ clockwork efficiency.
“Being a team leader isn’t easy in a country where you actually don’t belong — convincing the team you’re doing it for the people,” Kumar said.
How, then, does Bastawrous do it? He listens, Kumar said. And overall, he’s “just a genuine man,” said friend and Manchester family physician Chris Scales. “He’s very serious about his work, but he doesn’t take himself very seriously.” Earlier this year, Bastawrous and his wife raised more than $16,000 to cover eye treatment costs — by running a 5K … blindfolded.
There’s more work to do, but Bastawrous stays focused on a philosophy that’s guided his project from the beginning. “In Kenya, there’s an underlying assumption things can’t change,” he said. “What I’d really love to do is help people believe things can be better.”
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