Objective Refraction with Self-operable, Lightweight Autorefractor

Industry Project

Over a billion people worldwide suffer from poor vision, because they do not have access to eye care professionals. PlenOptika has developed the portable QuickSee system to automatically measure eye refractive errors and monitor changes over time, eliminating the need for an eye care professional to perform these tests. To improve access to eye care globally, PlenOptika proposes upgrading QuickSee by making it lighter and therefore easier for children and the elderly to use, and implementing a feedback system to help users take measurements faster and more reliably.

The goal of this work was to develop QuickSee Lite 2, an ultra-portable, self-operable version of QuickSee (handhold objective autorefractor) that retains the clinical accuracy of the current model that could be used to improved access to vision care for health disparity populations (e.g., children, elderly, special needs patients) terrestrially, and to be validated for detecting/monitoring long duration space flight-associated changes in hyperopic shift (surrogate for ocular axial length change) when self-operated by an astronaut.

Potential terrestrial impact

More than a billion people worldwide are impaired by poor vision due to poor vision from uncorrected refractive errors (UREs); uncorrected vision problems cost the global economy over $200 billion annually in lost productivity. A major bottleneck exacerbating this health care crisis is the global shortage of eye-care providers (ECPs), which is especially severe in low-resource settings. Whereas the USA has one ECP for every 5,500 people, parts of Africa have less than one ECP for every 1,000,000 people. Though many organizations are working to train additional ECPs, this approach is difficult and slow to scale. QuickSee Lite 2 will serve to increase ECP efficiency, reduce training requirements, and enable minimally-trained personnel to facilitate vision care. Lighter hardware, more intuitive user operation/experience, and more robust design are highly advantageous for screening vision in children, elderly patients, and patients with disabilities. By reducing access barriers, regular vision screening can become to prevalent and may the overall quality of life, opportunity for education and physical activities, and reduces the risk of serious ocular diseases later in life.

Potential space impact

Under long exposure to microgravity, hyperopic shift in the vision of astronauts is well documented, which affects near vision - a crucial ability needed to operate a space vehicle. Although the observed hyperopic shift can be corrected with eyeglasses, the time course of this progression is poorly understood and of high interest. A barrier to elucidating the phenomena is due to current approaches used to measure ocular axial length, such as high-frequency ultrasound, which have poor repeatability. Technologies that are highly repeatable are readily available in the clinic such as autorefractors and optical biometers, do not meet the portability (desktop form factors, 50 pounds) and durability (sensitive to shock and movement due to internal moving parts) requirements for space flights. QuickSee Lite 2 will help highlight the hyperopic shift and its time course under static and varying microgravity conditions such as long-duration space flight or stationing at a Martian/lunar outpost - data which has not been previously obtained. We are actively searching for potential Human Research Program (HRP) collaborators for this work.

Implementation pathway

The updated mechanical design, form-factor, and eyecup PD-alignment modifications (hardware), redesigned printed circuit boards (PCBs; electronics), and the on-board user interface for QuickSee and off-board user interface for QuickSee Lite 2 (software), have undergone both verification and validation, and are being directly implemented into production through our Quality Management System Engineering Change Order process. We plan for some of these improvements to be implemented into the existing commercial QuickSee during Q3-Q4 2020, and the substantial form-factor redesign to influence our future technology pipeline. PlenOptika is further developing and implementing these improvements through its own direct investments and through technology translation/commercialization grant applications. The final design of the QuickSee Lite 2 and it is intended use will be registered with the Food and Drug Administration (FDA) will be applied for, and it be folded into our marketing and sales efforts.

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