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Medical devices
Original article
Comparative evaluation of a novel solar powered low-cost ophthalmoscope (Arclight) by eye healthcare workers in Malawi
  1. Rebecca Blundell1,
  2. David Roberts2,
  3. Evridiki Fioratou1,
  4. Carl Abraham3,
  5. Joseph Msosa4,
  6. Tamara Chirambo5,
  7. Andrew Blaikie6
  1. 1 School of Medicine, University of Dundee, Dundee, UK
  2. 2 Department of Ophthalmology, Ninewells Hospital, Dundee, UK
  3. 3 Department of Optometry, Malawi College of Health Sciences, Lilongwe, Malawi
  4. 4 Lions Sight First Eye Unit, Kamuzu Central Hospital, Lilongwe, Central Region, Malawi
  5. 5 Eye Department, Nkhoma Hospital, Nkhoma, Malawi
  6. 6 Global Health Implementation, School of Medicine, University of St Andrews, St Andrews, UK
  1. Correspondence to Dr Andrew Blaikie, Global Health Implementation, School of Medicine, University of St Andrews, St Andrews KY16 9TF, UK; ab312{at}st-andrews.ac.uk

Abstract

This study compared a novel low-cost solar powered direct ophthalmoscope called the Arclight with a traditional direct ophthalmoscope (TDO). After appropriate training, 25 Malawian eye healthcare workers were asked to examine 12 retinal images placed in a teaching manikin head with both the Arclight ophthalmoscope and a traditional direct ophthalmoscope (Keeler Professional V.2.8). Participants were scored on their ability to identify clinical signs, to make a diagnosis and how long they took to make a diagnosis. They were also asked to score each ophthalmoscope for ‘ease of use’. Statistically significant differences were found in favour of the Arclight in the number of clinical signs identified, correct diagnoses made and ease of use. The ophthalmoscopes were equally effective as a screening tool for diabetic retinopathy, and there was no statistically difference in time to diagnosis. The authors conclude that the Arclight offers an easy to use, low cost alternative to the traditional direct ophthalmoscope to meet the demands for screening and diagnosis of visually impairing eye disorders in low-income and middle-income countries.

  • ophthalmoscopes
  • blindness
  • diabetic retinopathy
  • optic nerve diseases
  • culturally appropriate technology

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bmjinnov-2017-000225

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    Footnotes

    • Contributors RB, EF, CA and AB conceived the idea for the study and planned the study. RB, EF, CA, JM and TC secured ethical approval and executed the study. RB, EF and AB analysed the data. RB, DR and AB wrote the initial manuscript. AB is responsible for the overall content as guarantor. All authors edited the manuscript. RB and AB submitted the manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests AB is seconded to the University of St Andrews from NHS Fife. The University owns a social enterprise subsidiary company, for which AB acts as an unpaid adviser. The social enterprise business sells the Arclight to users in high resource countries with all profits being used to fund distribution and education exercises of the device in low-income countries via the University’s Global Health Implementation Team.

    • Ethics approval University of Dundee & St Andrews Research & Teaching Ethics Committees (URTEC) and University of Malawi College of Medicine Research and Ethics Committee (COMREC).

    • Provenance and peer review Not commissioned; externally peer reviewed.