HOW TO SAVE THE SIGHT OF MILLIONS OF PEOPLE?

RESEARCH IN FOCUS

Glaucoma is a chronic eye disease that leads to irreparable damage of the visual field. It affects more than 60 million people worldwide. Only an early diagnosis can prevent blindness. However, this requires expensive and non-transportable equipment, which means that a large part of the population in developing countries is deprived of this aid. Esmael Kedir, PhD student at the e-Media Research Lab of Group T Leuven Campus, has developed an affordable and mobile solution. At the annual conference of the European Association for Visual and Eye Research, he won the Best Paper Award in the Glaucoma Category.

Esmael Kedir

Esmael comes from Oromia, a region in Western Ethiopia. He went to school there and then studied Computer Science at Haramaya University (BSc) and Addis Ababa University (MSc). After graduation, Esmael became lecturer at Jimma University, a partner university of KU Leuven. The collaboration between the two universities brought Esmael to Leuven in 2016, first as a predoc, then as PhD student at Group T Leuven Campus.

“As a miracle there was a project that was, as it were, written for me”, Esmael explains. “As you know, the e-Media Research Lab is specialised in human centred systems that can be applied in various areas such as health care, learning, arts and entertainment. Shortly before my arrival, a proposal had been received from the Ophthalmology Department of the Leuven University Hospitals to develop a visual screening tool for the detection of a malignant eye disease: glaucoma. Not only did this offer fit in perfectly with the activities of the lab, it also enabled me to contribute to a better health care in my home country”.

Silent thief

What exactly is Glaucoma? Esmael describes it as follows: “Glaucoma is caused when pressure builds up inside the eye, damaging the optic nerve that connects the eye to the brain. If it is not treated in time, it may cause irreversible blindness. It is thought that 4.5 million people across the globe are blind because of glaucoma, making it the third highest cause of blindness worldwide. The condition is difficult to diagnose because symptoms do not appear straight away. Instead, they develop slowly over many years. That is why glaucoma is called ‘the silent thief of sight’. This means that many patients only seek treatment when they notice they are losing their sight, when significant damage has already occurred. Prevention through early detection is the only effective remedy for the time being”.

“That’s exactly where the problem lies”, Esmael continues. “In many countries, the detection equipment is not available to the inhabitants of poor rural areas. This gave us the idea to come up with an affordable and mobile solution. After a thorough study of the devices in the University Hospitals in Leuven, we decided to develop an Android app for a smartphone that can function as an alternative Glaucoma Easy Screener (GES)”.

Virtual Reality

Esmael’s tool consists of a virtual reality head set, a smartphone and a gaming joystick. “The smartphone sends light signals that vary in size and intensity to the headset. The test subject uses the joystick to indicate if he/she has observed something in the visual field. If it turns out that certain signals are systematically not or incorrectly responded to, the local nurse knows that something is wrong. What is more, the tool allows him/ her to determine where in the visual field the problem arises. The nurse can then refer the person in question to the hospital for the treatment of the disease in the making.”

For his research, Ismael works closely with the Ophthalmology Department of the University Hospitals in Leuven and the Medical Centre of Jimma University in Ethiopia. Several versions of his application have been tested and validated in Leuven. In addition to the clinical validation, usability tests have been carried out at Jimma University. The results are promising. In terms of specificity and sensitivity, Esmael’s tool easily achieves 85 to 90% of what the professional equipment in university hospitals can do”.

Affordable technology

Other critical success factors of Esmael’s tool are its user-friendliness and cost. “A complete test run on site takes about 10 minutes: 2.5 minutes for the test itself and the rest for explanation. The cost of the complete set, including the smartphone, is 200 euro, which is only a fraction of the price of the specialized equipment in hospitals”. Esmael is convinced that he has developed an affordable, accessible and effective testing platform that can significantly improve the quality of life and prospects of countless potential eye patients in Ethiopia and elsewhere in the world. “Even if the silent thief of sight is still sneaking around in the poor rural areas, he will soon be faced with an unexpected strong resistance”, Esmael concludes.

Yves Persoons