Fight for Sight funded researchers develop home test for glaucoma

Researchers funded by Fight for Sight and Glaucoma UK have, for the first time, developed a vision test for glaucoma that can be performed at home.

As part of a recent study published in the prestigious American Journal of Ophthalmology, 20 NHS glaucoma patients from across England and Wales were provided with a prototype of a tablet-based eye test called ‘Eyecatcher’. For six months, they were asked to run the test themselves, testing each of their eyes once a month. 

Glaucoma is the name for a group of chronic eye conditions that cause progressive sight loss due to damage of the optic nerve – the neural pathway that connects the eyes to the brain. Around 500,000 people are living with glaucoma in the UK, and it is the leading cause of blindness worldwide.

People with glaucoma, or who are at risk of developing glaucoma, require regular eye tests and trips to the hospital to track the progression of the disease and these tests call for expensive, specialist equipment, resulting in huge costs to the NHS. Fight for Sight’s Time to Focus report found that treating glaucoma is costing the health service £94 million every year. Ophthalmology in general also accounts for the highest number of outpatients of any medical specialty and prior to Covid-19 it was already under pressure with an existing backlog of patients. Scientists at City, University of London, hope that home monitoring for glaucoma will help to relieve some of the strain that the NHS is under, while at the same time improving patient care. 

The data showed that 98% of home tests were completed successfully, and the results from the home-monitoring tests agreed strongly with conventional vision measurements made in clinic, using ‘gold standard’ equipment.

Further analysis showed that combining home-monitoring data with conventional, hospital data resulted in substantially better estimates of visual ability overall (an improvement of measurement precision of over 50% in 90% of eyes). This could potentially allow instances of rapid, irreversible sight loss to be detected months, or even years earlier.

Dr Pete Jones from the Division of Optometry and Visual Sciences at City, University of London was the first author of this study. He said: “There has been a long-standing, growing need for effective home monitoring of glaucoma, and this has only been exacerbated by Covid-19. The results of this study show that we already possess the skills and technology to make home-monitoring a reality. Simple, pragmatic technologies like Eyecatcher could help ease the burden on the NHS, and allow for more sustainable and intelligent monitoring for glaucoma, and across eye-care more generally.” 

Chief Executive at Fight for Sight, Sherine Krause said: “We are so pleased to have funded the development of the ‘Eyecatcher’ technology which represents an exciting breakthrough in the future of glaucoma testing. This study shows how investing in eye research can potentially lead to huge savings for the NHS and makes care much more accessible for people with eye conditions. Eye research is more important than ever in the age of the Covid-19 pandemic and Brexit and we must continue to fund research for new, more efficient treatments and cures for the leading causes of blindness and sight loss."

The ‘Eyecatcher’ home test is similar to a conventional “visual field” test for glaucoma. It requires patients to look at a central cross presented on the tablet and press a button when they see a flash of light appear. The tablet’s camera records the user as they perform the test, and artificial intelligence (AI) is used to perform facial recognition and head-/eye-tracking, to ensure people perform the test correctly. 

This home-monitoring study builds on another study published recently in the British Journal of Ophthalmology, looking at whether Eyecatcher could be used as a means of rapidly ‘triaging’ new referrals to hospital glaucoma departments. That study was funded by the same Fight for Sight grant, and likewise showed promising results.

The team at City University will next examine whether home-monitoring is sustainable over longer periods, is suitable for children, and whether it is capable of detecting rapidly-progressing cases of glaucoma. They are also looking for industrial partners to help make the technology widely available.