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Oculostaple: A Medical Device Revolution

medical_device

Oculostaple is a tool that is designed to restore vision in people with drooping eyelids, or ptosis. Ptosis can have any number of causes, from Myasthenia gravis (an autoimmune, neuromuscular disorder) to a stroke, a tumor, or simply old age.

It was designed by undergraduate students at Georgia Tech, Drew Padilla, Jacki Borinski, and Mohamad Ali Najia. Najia is now the CEO of the Oculostaple company.

The device works by simultaneously cutting away excess muscle and sealing up the cut that it creates. Before, correcting the issue was the result of a surgery that took about 45 minutes in an operating room. With Oculostaple, drooping eyelids can be resolved with local anesthesia in a doctor’s office, in a procedure that lasts about five minutes. It will also decrease the cost of each individual surgery by about $5,000.

Due to its impressive features, the Oculostaple recently received second place in the National Institute of Health Design by Biomedical Undergraduate Teams (DEBUT) Challenge. The award, given to undergraduate students, was based on the impact the new invention would have on clinical care, the significance of the problem being addressed, the ingenuity of the design, and the creation of a prototype.

It’s not widely available just yet – the Oculostaple team is working with the Global Center for Medical Innovation (GCMI) to create it into a marketable medical device that will eventually be completely disposable.

GCMI is a nonprofit organization that brings together players in the medical device community to help “enhance their product development, shorten time to market, and potentially achieve significant cost savings” in the process of bringing the devices to market. Oculostaple also won first place last year at Georgia Tech’s fall Capstone Design Expo, and second place at its Inventure Prize competition.

While 200,000 Americans undergo surgery to correct drooping eyelids each year, the possibilities for this new device extend far beyond helping Americans be able to see better (and drive safer). Ophthalmologists throughout the medical community are excited for the device, which will make this surgery easy to perform. As the Oculostaple website states, it “also has broad applicability in laparoscopic, gastrointestinal, and biopsy procedures.”

Imagine the possibilities in treating diseases in poorer countries with the creation of technology like this. Gastrointestinal problems are common in third world countries, as people don’t always have access to clean water. Oculostaple could mean safer, faster, cheaper, and more effective treatment for a wide range of problems.

This surgical clamp removes the problem that sometimes occurs in eyelid surgery: the doctors accidentally cut their own sutures as they are trying to cut off excess muscle. Now, both parts of the procedure can be done simultaneously.

In an interview with Charlie Bennett, Najia described the process of how the device came to be, from the beginning, running tests on microwaved pieces of chicken skin, to redesigning the concept again and again, to being halfway out of the stadium with his teammates when their first place at their school’s Capstone competition was announced. Through it all, he said, “I think it’s been a very worthwhile endeavor.”

The development of a revolutionary device is an excellent example of how people throughout the medical community are working everyday to make a healthier world. Whether they are seasoned medical professionals or undergraduate students, they can make a difference, and they are.

– Emily Dieckman

Sources: Devices, NIH, Georgia Institute of Technology, News Medical, North Avenue Lounge, Oculostaple
Photo: Flickr

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Smartphone App for Affordable, Accessible Eye Exams

Smartphone App for Affordable, Accessible Eye Exams
Vision and eye health is undeniably vital to individual health. Visual incapacitates are debilitating not only for personal health but for economic opportunity as well.

Despite the importance of eye health, provision of visual health care is severely lacking in many developing countries. Much of the statistical data points to a link between poverty and vision impairment. Poverty has been shown to precipitate visual impairment, and such impairments can then cause loss of financial opportunity as well as expenditure on healthcare.

Visual healthcare is generally costly, and this leads to a lapse in treatment. An estimated 80 percent of blindness cases globally are preventable, given proper care. In the United States, the high costs of eye healthcare result in almost half of adults requiring these facilities to forego them. Putting off necessary eye exams for financial reasons hinders the early diagnosis of potential health concerns, as well as their timely treatment.

These issues of costly eye healthcare are relevant in places where visual health is accessible at all. In developing countries, access to an ophthalmologist or professional care can be fairly limited. On a global average, there are only 30 ophthalmologists per million people; in resource-poor countries, this number can be as low as one eye doctor per one million persons.

The efforts to seek a solution to this problem have unsurprisingly revolved around Internet and cellphone technology. With the advent of medical services offered through smartphone apps and webpages, smartphone technology is making an impact in the field of visual healthcare as well. Peek (Portable Eye Examination Kit) visions is one such smartphone app. Winner of the 2014 Digital Design award by the London Design Museum, the app features enhanced capabilities and features that make this app the next best thing to an eye doctor visit.

The app can diagnose a variety of common visual health concerns, from cataracts and glaucoma to retinopathy and nerve disease. The app uses the Peek Retina accessory, which goes over the built-in cellphone camera. The camera in the phone can then show the retina imaging when held over someone’s eye.

The retinal imaging can be stored and shared with a healthcare professional through the app’s database. Diagnosis and further information on the patient can also be stored in their database. The app also offers Peek SightSim, which is an innovative vision testing program. This eye test is like a vision test in an ophthalmologist’s office, but it doesn’t rely solely on recognition of English letters. The app can then show the doctor an adjusted image of how his patient can see, according to the test administered. The images can also be geotagged, to assist physician follow up.

Currently, one healthcare worker can assist 1,000 patients per week, as per clinical trials. The app is being further enhanced to make it even more affordable and accessible. The adapter for retinal imaging has been made quite small and portable. The current specifications allow for untrained people to assess certain visual ailments, including myopia and far-sightedness.

The Peek Vision team has started a campaign to fund further research and clinical trials to make the app more efficient. Donors can also choose to fund specific regions in desperate need of visual healthcare.

Additional refining of the app and the details of its usage is crucial for the success of the app; however, the very development of this app has brought us a step closer to combating preventable blindness globally.

– Atifah Safi

Sources: International Council of Ophthalmology, Amazon, Peek Vision
Photo: Eye Clinic Of Austin

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OneDollarGlasses Makes Eyewear Available for All

OneDollarGlasses-Eye-Wear
Across the globe, about 150 million people need corrective lenses, but cannot afford them, impeding their ability to work, study and provide for their family. Yet OneDollarGlasses aims to change this.

OneDollarGlasses was started in 2009 by Martin Aufmuth when he saw a pair of glasses sold for US$1 in Germany and questioned why the First World had US$1 glasses but the Third World did not. With that in mind, Aufmuth created the first pair of OneDollarGlasses with bent spring steel wire frames and hardened polycarbonate lenses.

No tools are required to assemble the OneDollarGlasses before putting them on and, most importantly, they cost US$0.80 to make. Today, OneDollarGlasses works with seven developing countries and has greatly improved the lives of many.

Their first project was in Rwanda. Rwanda is densely populated and of the 11.4 million inhabitants, only 11 are ophthalmologists. There, Alfmuth teamed up with a German team of students called Enactus Munich to train local opticians and merchants.

Next, OneDollarGlasses went to Burkina Faso where they faced a low literacy rate and a language barrier. The Enactus students took the lead on training 10 micro-opticians who since then have sold over 1,600 pairs of glasses.

OneDollarGlasses then went to work in Nicaragua in Central America. In Nicaragua, more than 80 percent of the population lives on fewer than US$2 a day. In 2014, OneDollarGlasses sent trainers to San Carlos, and by spring, glasses were being sold.

One pair was given to a woman named María Sandoval on her 99th birthday by her family. With +6 diopters on both eyes, it was the first time she had seen the world in full detail.

In April 2014, Alfmuth presented OneDollarGlasses to the United Nations Conference on Trade and Development. He received praise at the end of his presentation and several countries described his foundation as “groundbreaking.” OneDollarGlasses has it all: low cost to produce, cheap to buy and a huge demand.

– Hannah Resnick

Sources: Empowering People, Enactus, Essilor, OneDollarGlasses, UNICEF, Venture Beat
Photo: Quora

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3 Lessons Learned about Eye Care in Rwanda

Eye Care in Rwanda

Rwanda is one African country poised to dramatically improve visual healthcare for its citizens. Since the 1990s, it has improved its mortality rate caused by infectious diseases, doubled its life expectancy and experienced significant economic development. Rwanda created a national vision plan in 2002 when it signed the World Health Organization’s  VISION 2020 initiative. The aim of the initiative is to eradicate preventable and treatable blindness by raising awareness, securing resources and facilitating the planning and implementation of the initiative.

Of the 285 million people in the world who are visually impaired, 87% live in low- and middle-income areas. With 32,700 per million people living with visual impairments, Africa is one of those areas. Still, almost 80% of visual impairments—that often lead to blindness if untreated, such as cataracts, glaucoma, trachoma as well as refractive error (myopia, hyperopia, presbyopia and astigmatism)—can be prevented or treated. If not, blindness throughout the world will double by 2020, and the developing countries will shoulder the burden, according to WHO.

Visual impairments reduce the quality of life and people’s productivity. Eye care is part of a comprehensive primary healthcare plan that helps to reduce injuries, and improve educational outcomes and access to employment opportunities. All these improvements contribute to economic growth and development.

Recently, WHO examined the national plan for eye care in Rwanda, focusing on progress made, as well as current and future needs. The result was a reflection of three lessons learned.

First Lesson: A single national plan optimizes the provision of eye care.

The Ministry of Health coordinates all partners’ efforts to align with the national vision plan. The Ministry makes certain that providers complement each other’s resources and strengths. International nonprofit partners coordinate with each other and private eye care clinics and hospitals to ensure accessibility to a variety of services across the country.

Some of the work that the nonprofit partners provide is funding for disease burden studies, building eye care clinics, supporting scholarships to train eye care specialists and standardizing the eye care curriculum for nurses.

Examples of coordination of services include:

  • Vision for a Nation, a U.K. charity, provides low-cost or free eye glasses to those in need.
  • The Fred Hollows Foundation, an Australian charity, began working in 2004 in the Western Province of Rwanda when the only other available eye care service was a mobile service.
  • The Christoffel Blinden Mission, headquartered in Germany, locates their services in the Southern Province of Rwanda, and among other services, performs specialized pediatric surgery.

Second Lesson: Better access to primary eye care and vision insurance has increased the demand for more advanced eye care at the secondary and tertiary levels.

Most of the population is currently enrolled in the Rwanda Community Based Health Insurance Policy set up in 2010. This policy provides affordable eye care and reimbursement for consumable products.

As Rwandans benefit from accessible primary eye care through insurance, awareness of further eye care needs to grow. Now, there are more instances of cataract operations and treatment for glaucoma.

Treatment for eye diseases, such as trachoma, has risen dramatically in the last five years. In 2009, treatment for eye diseases was not among the top ten reasons for seeking eye care. In 2014, it was the second leading cause of treatment.

Third Lesson: A comprehensive strategy, one that includes prevention of eye disease and a supply chain of glasses and lenses, is still needed.

Rural areas are still underserved. Almost 50% of the population lives in rural areas of poverty and are unable to afford private eye care services. In any case, rural areas still do not have adequate eye care services as most eye care resources are situated in the capital of Kigali. Another startling fact is that for the 10.5 million people in Rwanda, there are only 18 ophthalmologists and most of them live in the capital.

Task shifting is one solution to the lack of trained professionals through the Rwandan three-year ophthalmic technician training course, but more trained eye care professionals will be needed.

The demand for eye care services may be increasing not only due to more awareness and accessibility to services but also due to an aging population, as the life expectancy doubled since the 1990s to age 63. Among the eye problems associated with age is presbyopia, which usually requires prescription lenses such as bifocals.

WHO feels confident that these lessons learned will provide a basis to overcome barriers to progress and continue to improve the planning, implementation and provision of services to meet the eye care needs of the people of Rwanda.

– Janet Quinn

Sources: WHO 1, WHO 2, WHO 3, Vision for a Nation, CBM, Hollows
Photo: The Fred Hollows Foundation

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Are Smartphones the Solution to Eye Care in Developing Countries?

Smartphone-Eye-Care

Armed with a $20 smartphone and his own ingenuity, Dr. Hong Sheng Chiong, founder of OphthalmicDocs, is fighting preventable blindness.

With 90% of the world’s visually impaired and blind living in developing countries, access to affordable eye care equipment is out of reach for most visually impaired people. OphthalmicDocs seeks to end that struggle by developing inexpensive, effective eye care equipment that allows doctors to diagnose patients properly using a smartphone camera.

After experiencing developing-world medicine and the need for such affordable eye care firsthand in Kenya, Nepal and Malaysia, Dr. Hong worked with a team to develop the OphthalmicDocs Fundus, a universal smartphone retinal imaging adapter. Able to take high-quality retinal images of both the front and back of the eye, the Fundus functions as a portable retinal camera.

In the interest of making the device widely available, OphthalmicDocs created a free 3D printable template of the device that allows anyone to download, print and assemble a Fundus retinal camera within four hours, regardless of their global location.

A device that would ordinarily cost $10,000 is now accessible for a production cost of $33. Working hand-in-hand with developments in affordable smartphone manufacturing and distribution, as well as sites that connect users to 3D printing technology in their region, OphthalmicDocs’ technology has the potential to revolutionize eye care.

OphthalmicDocs also developed an open-source eye care app. This free app offers a variety of visual tests, includes a patient management system and can work with external adapters to acquire ocular images.

Other devices in the works from OphthalmicDocs include a clip-on adapter meant to convert smartphones into slit lamp microscopes and MAGcro, a universal macro lens for use with smartphones and tablets.

According to the World Health Organization (WHO), 285 million people around the world are visually impaired and 39 million are blind. WHO also found that a staggering 80% of visual impairments arises from preventable causes. However, with global access to free retinal camera technology, these statistics could be phenomena of the past.

– Emma-Claire LaSaine

Sources: Huffington Post, OpthalmicDocs, WHO
Photo: Bionicly