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Monitoring glaucoma at home may be a possibility soon

Monitoring glaucoma at home may be a possibility soon
. At present, glaucoma test require regular hospital visits and use expensive, specialist equipment. @Shutterstock

A new study suggests that, in the future, glaucoma eye tests could be performed at home. This will go a long way in tracking progression of the disease.

Written by Jahnavi Sarma |Published : November 28, 2020 3:46 PM IST

Glaucoma, a chronic condition that affects the cells at the back of the eye, is the leading cause of irreversible blindness across the world. According to eye specialists, it is responsible for 1 in 10 cases of serious sight impairment in the UK. People who have glaucoma, or at risk of developing the degenerative condition, need lifelong monitoring. They have to go in for regular eye tests, twice yearly, for life to track the progression of the disease. This is essential to prevent blindness. At present, these examinations require regular hospital visits and use expensive, specialist equipment. Now a new study suggests that glaucoma eye tests can be performed accurately at home by patients themselves.

Visiting a clinic for tests not always feasible

But it is not always possible for many patients to regularly visit hospitals and clinics for various reasons. It is especially problematic for the elderly and those with some chronic ailments. Aging populations make this hospital-only model of patient-management unsustainable, and many clinics are already overstretched, with appointments routinely delayed or cancelled. In the UK today, around 20 people a month are going blind as a result of this appointment backlog.

COVID-19 pandemic has made the situation worse

This situation has been compounded by the COVID-19 pandemic, since the inability to sanitise equipment between use has led to all routine sight assessments being suspended in the UK. The long-term effects of this are unknown, but experts suggest that further increases in appointment delays and avoidable blindness appear inevitable.

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Monthly tests essential to track aggressive forms of glaucoma

Even if routine assessments are ever fully resumed, it is also thought that the current system of annual hospital visits is insufficient to track the most aggressive forms of glaucoma. Multiple studies have already suggested that more frequent (e.g., monthly) glaucoma eye tests could substantially improve clinical outcomes: allowing high risk patients to be treated sooner and more appropriately. A new study from City, University of London adds to a body of evidence suggesting that the solution to all these problems may lie in home-monitoring. The research involved 20 NHS glaucoma patients from across England and Wales who were provided with a prototype, tablet-based eye test ('Eyecatcher') for six months. Using the device, they were asked to run the home glaucoma eye test themselves, testing each of their eyes once a month.

Simple to use home test to track progression

Similar to conventional eye tests for glaucoma, patients looked at a central cross presented on the device and pressed a button when they saw a flash of light, which appeared at different locations and was of variable intensity. The computer's front-facing camera also recorded them during the test, and artificial intelligence (AI) was used to perform facial recognition and head-/eye-tracking, to ensure people performed the test correctly. Accuracy was assessed by comparing measurements made at home to conventional 'gold standard' assessments performed in clinic at both the start and end of the study. Adherence was quantified as the percentage of tests completed.

Effective and accurate

The study found that 98% of home tests were completed successfully (high adherence), and that the data from the home-monitoring tests were in strong agreement with the gold standard clinical assessments (high accuracy). The use of home-monitoring data was also shown to reduce measurement error when combined with current clinical data (by over 50% in 90% of eyes). This could potentially allow cases of rapid sight loss to be detected months or even years earlier. This is the first study in the world that suggests glaucoma eye tests can be performed accurately at home by patients themselves. Future studies will examine whether home-monitoring is sustainable over longer periods and is capable of detecting rapidly progressing cases of glaucoma.

(With inputs from Agencies)