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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

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

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

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

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


"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

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

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

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

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

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

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..."

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

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

Smartphone Fundoscopy


"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

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..."

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

iPhones for eye surgeons


"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

“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