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Faster evidence, faster action: a new approach to test solutions for eye care access

20 Jan, 2026

An international team of researchers has developed a faster, more practical way to find out what really works to improve access to eye care. The approach is based on testing community-led solutions and embedding the research into existing programmes using Peek software.

One of the first tests of this new methodology, carried out in Meru County, Kenya, has now been published in The Lancet Global Health. The study was conducted within eye health programmes led by CBM Christian Blind Mission and the Kenyan Ministry of Health as part of Kenya’s Vision Impact Project. 

The multidisciplinary research group included the Ministry of Health, the Kenya Medical Research Institute (KEMRI), CBM, AIC Health Ministries, the College of Ophthalmology of Eastern Central and Southern Africa (COECSA), the International Centre for Eye Health at the London School of Hygiene & Tropical Medicine, and Peek Vision. 

Across many eye health services, a persistent challenge is that a large proportion of people who are referred for eye care do not make it to their appointment. In Meru County, only around one in three people aged 18–44 who are referred for eye care attend their referral.

The research team began by consulting people in this age group who had missed their referral, asking them for their ideas on what would help them attend. Their top suggestions were receiving clearer information at the time of referral and extra text message reminders the day before and on the day of the appointment.

The team then tested these community-led ideas against the standard approach in a randomised controlled trial embedded within the Peek platform. People referred for eye care were automatically enrolled and randomly assigned to receive either the standard referral process or an enhanced approach, which included clearer information and extra SMS reminders. 

The results showed that the enhanced approach was more effective. Among those who received the enhanced package, 39% attended their appointment, compared with 32% of those who received the standard approach.

Crucially, the new methodology allowed the research team to reach strong conclusions much faster than would be possible using a conventional clinical trial. After just four weeks, the study’s automated analysis showed a 99% probability that the enhanced approach was better than standard care. This meant the team could be highly confident in the findings and could move quickly to roll out the improvements more widely, saving time and money compared to standard trials (which typically run until a predetermined number of people have been included, even when it’s not necessary).

Still from a video animation. A split screen shows a laptop on the left displaying a bar chart with the 'B' bar greater than the 'A' bar. On the right there are a group of people looking at their phones with message bubbles above their heads.

 

Because the trial was embedded within the Peek system, many tasks were easily automated. Peek software enrolled and randomised participants, sent the appropriate SMS messages, and analysed attendance data on a weekly basis to assess whether the new approach was working. This considerably reduced administrative effort while maintaining scientific rigour.

David Munyendo, CBM Kenya Country Director and study co-author, said: “This approach makes it much easier for us to test what works within eye health services and act quickly on the results. By embedding these tests into the Peek platform, we can generate rapid, reliable evidence and use it straight away. Given the scale of our work in Kenya and beyond, this has real potential to improve access to care for large numbers of people.”

The Meru County research forms part of a wider multi-country initiative to develop faster, more affordable ways for eye health services to evaluate what works, without the significant time and financial commitment required by traditional trials.

Study co-author Prof Andrew Bastawrous, Peek Vision CEO and Professor at the International Centre for Eye Health, said: ​​“Trials typically take a long time to set up, are expensive to run, and the solutions are proposed by researchers. In this study, the ideas came from people who were most often left behind, and the results were rapid. We’re looking forward to supporting more programmes with tools that help services respond quickly to real, nuanced needs.”

Peek Vision is now working to fully integrate this new methodology into its product, so all Peek partners will ultimately be able to rapidly and reliably test different ways to increase access to eye care services within their own programmes.

The research was funded by the UK’s National Institute for Health Research (NIHR), using UK Official Development Assistance funding, and Wellcome Trust under the NIHR-Wellcome Partnership for Global Health Research.

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