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Publications

Effectiveness of an mHealth system on access to eye health services in Kenya: a cluster-randomised..

The Lancet Digital Health

"There is limited access to eye health services in many low-income and middle-income populations. We aimed to assess the effectiveness in increasing service utilisation of the Peek Community Eye Health (Peek CEH) system, a smartphone-based referral system comprising decision support algorithms (Peek Community Screening app), SMS reminders, and real-time reporting."

The Lancet Digital Health 2021; 3: e414–24. DOI: 10.1016/S2589-7500(21)00083-2

Effectiveness of an mHealth system on access to eye health services in Kenya: a cluster-randomised.. photo

Effective refractive error coverage: an eye health indicator to measure progress towards UHC

Ophthalmic and Physiological Optics

"In 2015, all United Nations Member States adopted seventeen Sustainable Development Goals (SDGs), to be achieved by 2030. One of these – SDG 3 – relates specifically to health, and includes a target (3.8) to “achieve universal health coverage, including financial risk protection, access to quality essential health‐care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.”..."

Ophthalmic Physiol Opt. 2020 Jan;40(1):1-5. doi: 10.1111/opo.12662.

From research to scaling-up programs: case study of Peek school eye health program in Trans-Nzoia...

Journal of Ophthalmology of Eastern Central and Southern Africa

"There are barriers to accessing eye health services by children especially in Low and Middle Income Countries (LMIC), where the prevalence of visual impairment is highest. We report the process of scaling up the Peek school screening program that was initially tested in a randomized clinical trial in Trans-Nzoia county, Kenya..."
TheJournal of Ophthalmology of Eastern, Central and Southern Africa, 24(1) (July 2020)

Thirty Year Projected Magnitude (to 2050) of Near and Distance Vision Impairment...

Ophthalmic Epidemiology

"Recent global, regional and country-level prevalence estimates for blindness and vision impairment will be important when designing future public health policies. The aim of this paper is to contribute to this discussion by estimating the productivity impact of known effective interventions to treat all preventable cases of vision impairment at the global, regional and country-level up to 2050. We also provide estimates of potential reduction in the number of people with vision impairment, as well as averted vision-impaired years up to 2050."

Ophthalmic Epidemiol. 2019. DOI: 10.1080/09286586.2019.1700532

 

Thirty Year Projected Magnitude (to 2050) of Near and Distance Vision Impairment... photo

Development and Validation of a Smartphone-based Contrast Sensitivity Test

Translational Vision Science & Technology

"Contrast sensitivity (CS) testing is an important measure of visual function reflecting variations in everyday visual experience in different conditions and helps to identify more subtle vision loss. However, it is only infrequently used. To make this more accessible, we have developed and validated a smartphone-based CS test."

Trans Vis Sci Tech. 2019; 8(5):13, https://doi.org/10.1167/ tvst.8.5.13

Development and Validation of a Smartphone-based Contrast Sensitivity Test photo

Peek Community Eye Health - mHealth system to increase access and efficiency of eye health services

BMC Trials

"We aim to evaluate a M-health system (Peek CEH) geared towards reducing avoidable blindness through early identification and improved adherence to referral for those with eye problems and reducing demand at secondary care for conditions that can be managed effectively at primary care level."

BMC Trials volume 20, Article number: 502 (2019)  https://doi.org/10.1186/s13063-019-3615-x

Peek Community Eye Health - mHealth system to increase access and efficiency of eye health services  photo

Implementing a School Vision Screening Program in Botswana Using Smartphone Technology

Telemedicine and e-Health

"Child eye health is a significant public health issue in low- and middle-income countries, such as Botswana, and the need for eye care requires a well-integrated and innovative approach. Traditional vision screening tools are costly, difficult to transport, and reliant on highly trained eye care professionals. Novel smartphone-based vision screening technologies, however, are low cost, portable, and easily operated by trained novice users. Peek Vision is a mobile health (m-Health) organization that creates smartphone applications that screen for visual acuity, generate referrals to eye care professionals, and send phone notifications to those being screened."

Telemedicine and e-Health https://doi.org/10.1089/tmj.2018.0213

Implementing a School Vision Screening Program in Botswana Using Smartphone Technology photo

Rapid Assessment of Avoidable Blindness: looking back, looking forward

British Journal of Ophthalmology

"The Rapid Assessment of Avoidable Blindness, or RAAB, is a relatively simple and low-cost survey methodology to provide data on the prevalence and causes of visual loss. The aim of this article is to reflect on the achievements and challenges of RAAB, and to describe the future developments that are needed to ensure that it remains a relevant and widely used tool. To date, at least 331 RAABs have been undertaken in 79 countries, and these surveys provide an important source of information on visual loss at both the local and global level..."

British Journal of Ophthalmology http://dx.doi.org/10.1136/bjophthalmol-2019-314015

Rapid Assessment of Avoidable Blindness: looking back, looking forward photo

Hearing and vision screening for preschool children using mobile technology, South Africa

Bulletin of the World Health Organization

"...we implemented an mHealth-supported screening programme in which children’s hearing and vision services were provided by Community Health Workers in preschool centres. We describe this community-based service-delivery model and evaluate its success in terms of acceptability (consent return numbers), coverage (number of eligible children screened), quality indicators (duration of tests and number of hearing tests conducted under conditions of excessive noise levels), community-based second screening attendances and diagnostic centre referral attendances..."

Bull World Health Organ 2019;97:672–680

Hearing and vision screening for preschool children using mobile technology, South Africa photo

Mortality during 6 years of follow-up in relation to visual impairment and eye disease [...]

BMJ Open

"The objective of this study was to investigate the association between VI and 6-year mortality risk within the Nakuru Eye Disease Cohort Study, a cohort of elderly Kenyan people."

Mortality during 6 years of follow-up in relation to visual impairment and eye disease [...] photo

Rapid assessment of avoidable blindness for health service planning

Bulletin of the World Health Organization

"The World Health Organization (WHO) Universal eye health: a global action plan 2014–2019 calls for the generation of evidence on the magnitude and causes of visual impairment as well as on eye care services, to plan towards universal eye health. The Rapid Assessment of Avoidable Blindness (commonly called RAAB) is cited in the document as a standard method for generating this epidemiological evidence."

Bulletin of the World Health Organization 2018;96:726-728. doi: http://dx.doi.org/10.2471/BLT.18.217794

Rapid assessment of avoidable blindness for health service planning photo

Prevalence and causes of visual impairment among schoolchildren in Mekelle, Ethiopia

Cogent Medicine

The aim of this study was to estimate the prevalence and causes of visual impairment (VI), among primary school children in Mekelle, Ethiopia and the feasibility of teachers conducting vision screening in school using a smart phone application: Peek Acuity.

Cogent Medicine, 5:1, 1-9, DOI: 10.1080/2331205X.2018.1554832

Prevalence and causes of visual impairment among schoolchildren in Mekelle, Ethiopia photo

Study protocol: Effectiveness of a novel mobile health education intervention (Peek) [...]

Trials

"The hypothesis is that higher proportion of children with uncorrected refractive errors in schools allocated to the Peek educational package will wear their spectacles 3–4 months after they are dispensed, and a higher proportion of children identified with other eye conditions will access services, compared with schools receiving standard school screening..."

Trials 2017 18:168

Spectacle Compliance and Its Determinants in a School Vision Screening Pilot in Botswana

Ophthalmic Epidemiology

"The effectiveness of school eye health programmes relies on many factors, including compliance with spectacle wear. The objectives of this study were to determine spectacle compliance in a school vision screening pilot programme in Botswana, and investigate factors predictive of compliance."

Ophthalmic Epidemiology, DOI: 10.1080/09286586.2018.1523441

Spectacle Compliance and Its Determinants in a School Vision Screening Pilot in Botswana photo

mHealth Possibilities in a Changing World. Distribution of Global Cell Phone Subscriptions

Journal of Mobile Technology in Medicine

"(mHealth) is changing the way patients are accessing healthcare worldwide.
Mobile cellular network coverage is growing to the point of ubiquity and mobile devices are advancing continually in to more sophisticated hand held computers..."

Journal MTM 2:1:22-25 2013

How the smartphone is driving the eye-health imaging revolution

Expert Review of Ophthalmology

"We review the latest progress in creating ophthalmic imaging devices based around smartphones, which are readily available to most practicing ophthalmologists and other medical professionals..."

Expert Review of Ophthalmology, 9:6, 475-485

Results of Automated Retinal Image Analysis for Detection of Diabetic Retinopathy from Nakuru [...]

PLoS One

"Safe and reliable automated analysis of retinal images may support screening services worldwide. This study aimed to compare the Iowa Detection Program (IDP) ability to detect diabetic eye diseases (DED) to human grading carried out at Moorfields Reading Centre on the population of Nakuru Study from Kenya..."

PLoS ONE 10(10): e0139148

Acceptability, Usability, and Views on Deployment of Peek, a Mobile Phone mHealth Intervention [...]

JMIR Mhealth Uhealth

"Shortages in ophthalmic personnel, the high cost, and the difficulty in transporting equipment have made it challenging to offer services, particularly in rural areas. Peek offers a solution for overcoming barriers of limited access to traditional ophthalmic testing methods and has been pilot tested on adults in Nakuru, Kenya, and compared with traditional eye examination tools..."

JMIR Mhealth Uhealth 2016;4(2):e30

Smartphone-based screening for visual impairment in Kenyan school children

The Lancet Global Health

Childhood visual impairment is a major public health concern that requires effective screening and early intervention. We investigated the effectiveness of Peek school eye health, a smartphone-based sight test and referral system versus standard care.

The Lancet Global Health VOLUME 6, ISSUE 8PE924-E932, AUGUST 01, 2018

Smartphone-based screening for visual impairment in Kenyan school children photo

The global inverse care law: a distorted map of blindness

British Journal of Ophthalmology

"Statistical analysis can be used to interpret and give meaning to data, however, the ability to interpret large quantities of data and it's resulting statistical reporting is not always straightforward..."

Increasing access to eye care … there's an app for that. Peek: smartphone technology for eye health

International Journal of Epidemiology

"Peek...was developed and validated alongside a cohort study of eye disease in Nakuru, Kenya.1 In the cohort, the majority of participants with visual impairment were elderly, difficult to reach and had little or no access to eye care..."

International Journal of Epidemiology, Volume 45, Issue 4, 1 August 2016, Pages 1040–1043

Spectacle Wear Among Children in a School-Based Program for Ready-Made vs Custom-Made [...]

JAMA Ophthalmology

"In this randomized clinical trial of a school-based eye health program in India that included 460 children, the proportion of children wearing spectacles at follow-up included 139 of 184 (75.5%) in the ready-made arm vs 131 of 178 (73.6%) in the custom-made arm..."

JAMA Ophthalmology 2017;135(6):527-533

Clinical Validation of a Smartphone-Based Adapter for Optic Disc Imaging in Kenya

JAMA Ophthalmology

"This validation study compared the grading of optic nerves from smartphone images with those of a digital retinal camera. Both image sets were independently graded at Moorfields Eye Hospital Reading Centre..."

JAMA Ophthalmology 2016;134(2):151-158

Smartphone-Based Visual Acuity Measurement for Screening and Clinical Assessment

The JAMA Network

"Bastawrous et al, demonstrate, through the development of a tool with cross-cultural capabilities, the possibility of applying these tools in a robust and meaningful way to deliver value to patients wherever they may reside."

JAMA. 2015;314(24):2682-2683. doi:10.1001/jama.2015.15855

Development and Validation of a Smartphone-Based Visual Acuity Test (Peek Acuity) [...]

JAMA Ophthalmology

"Validation study conducted from December 11, 2013, to March 4, 2014, comparing results from smartphone-based Peek Acuity to Snellen acuity (clinical normal) charts and the Early Treatment Diabetic Retinopathy Study (ETDRS) logMAR chart (reference standard)..."

JAMA Ophthalmology 2015 Aug;133(8):930-7

Smartphone Fundoscopy

Ophthalmology

"More ophthalmologists than ever carry a smartphone with them on a daily basis. There are many ophthalmic applications (apps) and reference texts available on a variety of platforms..."

Ophthalmology , Volume 119 , Issue 2 , 432 - 433.e2

iPhones for eye surgeons

Eye

"In a survey of mobile phone ownership, 99% of health professionals own a mobile phone, with 81% of these being a smartphone..."

Eye 26343354 (2012)

Mobile health use in low- and high-income countries: an overview of the peer-reviewed literature

Journal of the Royal Society of Medicine

"The evolution of mobile phone technology has introduced new possibilities to the field of medicine. Combining technological advances with medical expertise has led to the use of mobile phones in all healthcare areas including diagnostics, telemedicine, research, reference libraries and interventions..."

J R Soc Med. 2013 Apr; 106(4): 130–142

The Nakuru eye disease cohort study: methodology & rationale

BMC Ophthalmology

"No longitudinal data from population-based studies of eye disease in sub-Saharan-Africa are available. A population-based survey was undertaken in 2007/08 to estimate the prevalence and determinants of blindness and low vision in Nakuru district, Kenya..."

BMC Ophthalmology, 2014 14:60

Towards a workflow driven design for mHealth devices within temporary eye clinics [...]

Engineering in Medicine and Biology Society (EMBC), 2015 37th Annual International Conference [...]

"Only a small minority of mobile healthcare technologies that have been successful in pilot studies have subsequently been integrated into healthcare systems. Understanding the reasons behind this discrepancy is crucial if such technologies are to be adopted. We believe that the mismatch is due to a breakdown in the relation between technical soundness of the original mobile health (mHealth) device design, and integration into healthcare provision workflows..."

Engineering in Medicine and Biology Society (EMBC), 2015 37th Annual International Conference of the IEEE

The Diabetic Retinopathy Screening Workflow: Potential for Smartphone Imaging

Journal of Diabetes Science and Technology (JDST)

"Complications of diabetes mellitus, namely diabetic retinopathy and diabetic maculopathy, are the leading cause of blindness in working aged people. Sufferers can avoid blindness if identified early via retinal imaging..."

Photometric Compliance of Tablet Screens and Retro-Illuminated Acuity Charts [...]

PLoS One

"This study photometrically characterised seven tablet computers (iPad, Apple inc.) and three ETDRS (Early Treatment Diabetic Retinopathy Study) visual acuity charts with room lights on and off, and compared findings with visual acuity measurement standards..."

PLoS ONE 11(3): e0150676

“When you meet people and you can solve their problem, it’s a great feeling - it is not just my joy, but the joy of the patient. And when you share their joy then that is double joy.”

Dr Hillary Rono

Ophthalmologist and Peek Kenya Country Manager