Affordable vision screening for developing communities

A key barrier to bringing vision care to developing communities is the lack of affordable testing tools. EssilorLuxottica’s ClickCheck™ is breaking down that barrier. We speak to Patricia Koh, trained optometrist, head of technical innovation and the developer of the tool to find out more.

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Q: Hi Patricia, thank you for taking time out to speak with us. Before we talk about the ClickCheck™, can you tell us how vision screening works?

A: Vision screening is usually done in four stages:

  1. History taking – first, we want to understand if you have any pre-existing health conditions or eye injuries.
  2. Vision acuity chart – an eye chart is used to check how well you see far away objects. If you are above 38 years old, we will test how well you can see near objects too. This will tell us whether you’re suffering from refractive errors or possible eye diseases.
  3. Objective refraction – a vision screening tool (either a retinoscope or auto-refractor) is then used to estimate the degree of refractive error.
  4. Subjective refraction – finally, the optometrist uses a trial lens to finetune the degree of refractive error. It is often a trial and error process before a prescription is given.

The ClickCheck™ allows us to combine Steps 2 and 3 to reduce the time needed to determine refractive errors.

Q: That is a lot of time saved! Can you tell us what else is so groundbreaking about the ClickCheck™?

A: Weighing lighter than a smartphone at 130 grams, the ClickCheck™ is a portable vision screening tool that is only a fraction of the price of bulky auto-refractors which cost anything from US$2,000 to US$20,000.

It is easy for anyone to use and does not require electricity to work. It is also a lot more efficient, taking about a minute for vision screening, while retinoscopes usually take between 8 – 15 minutes on average.

To top it off, the ClickCheck™ received three wins – gold in the Medical & Healthcare category, silver in the Social Impact category and a special Jury’s Chair award – at the 2020 International Design Excellence Awards, one of the most prestigious design awards programs in the world today.

Q: Who came up with the idea and how were you involved?

A: In 2016, we launched the See Change Challenge to encourage people within and beyond the vision care industry to uncover creative solutions that could improve vision care access for underserved communities.

I was part of the team which assessed all the entries from around the world, and we selected the idea by design consultancy firm TEAMS Design as the winner. Following that, we worked closely with TEAMS Design, our inclusive business arm, 2.5 New Vision Generation and our research & development team, to enhance the idea, source for suitable suppliers, and develop the ClickCheck™ into a working prototype which we piloted in India and Indonesia.

Q: What’s your ambition for the ClickCheck™?

A: We hope to get the ClickCheck™ into the hands of every primary vision care provider and NGO working in vision care. You can place an order for the tool here.

Q: What do you think the future of vision screening will be like?

A: From manual retinoscopes to automated refractors, vision screening tools have evolved greatly over the years. Start-ups are now experimenting with portable auto-refractors, although cost is still a challenge.

But as technology improves, I wouldn’t be surprised if remote vision screening is possible in the near future. Over the last few years, our Base-of-the-Pyramid (BoP) Innovation Lab has developed and piloted, with rapid market acceptance, an on-demand teleconsultation platform to connect rural primary vision care providers to qualified optometrists who remotely oversee the refraction process in real time. A home delivery model is also being developed in India where customers can make appointments for at-home vision screenings, facilitated by teleconsultation.

My dream is for AI technology to predict refractive errors before they develop and prescribe necessary preventive measures - that would really transform the future of vision care from prescriptive to preventive.

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