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Eye test brings equality

Andrew Bastawrous

A billion people across the globe suffer from readily treatable eyesight problems. At least a third of them live in places where modern optical treatment never reaches, but that is rapidly changing, thanks to the inspired vision of British ophthalmologist Andrew Bastawrous.

Peek Vision – devised by Andrew Bastawrous – has delivered nearly a quarter of a million eye tests to people living in rural Kenya, before expanding to multiple locations across Africa and Asia. In remote parts of Pakistan, over 20,000 people a month are being screened, with the opportunity to visit an ophthalmologist or optometrist to receive professional eye care.

Peek is an easy-to-use, mobile phone-based technology for identifying people with eye conditions and connecting them to services, often sight-restoring services. By skilfully adapting a smartphone with an app that provides a measure of visual acuity and a visual representation of the result, Bastawrous and his researchers and engineers have created a system that can be operated in the field by a non-expert, meaning many more people with vision problems are detected. An expanded version of the app provides data analysis, SMS reminder functionality and other features.

Bastawrous initially conducted trials of the technology in Kenya, Botswana and India. In all, over 350,000 people worldwide have now been screened, with those needing treatment connected to the appropriate medical care.

We’re deliberately choosing difficult places to work, but beyond that we’re choosing populations who have the least ability to access or pay for eye-care services. It’s about leaving no one behind.Andrew Bastawrous

“What we’re doing is providing a solution that helps identify those individuals who are currently invisible, but go beyond identifying them to ensure that they reach the service that can meet their need, and then tracking whether that service has worked for them,” he says.

“We’re deliberately choosing difficult places to work, but beyond that we’re choosing populations who have the least ability to access or pay for eye-care services. It’s about leaving no one behind.”

The inspiration to bring clear sight to millions of people around the world started when Bastawrous was a schoolboy in the UK struggling with poor marks. One day a simple eye test and a pair of lenses transformed his entire world. “They sent me outside to describe what I could see and I just remember being totally blown away that this world that had been soft suddenly came into this really sharp, vivid focus,” he recalls. “It completely changed my life. That moment, I will never forget.

“When I got my first pair of glasses a couple of weeks later, I saw what my parents’ faces actually looked like, I saw what my friends looked like. My performance at school changed totally.”

The metamorphosis from living in a world of blur to one of crisp distinction has never left Bastawrous. Today, it has blossomed into a team inspired by a vision to deliver the same miracle to the hundreds of millions who live beyond the reach of modern optometry.

A second revelation in his personal journey came when, as a young teenager, he visited his parents’ homeland of Egypt. In Cairo, he witnessed hundreds of children who looked just like him except for the spectacles, gleaning a perilous living from the city rubbish dumps. He was stunned by the random unfairness of fate.

His sharpened eyesight took him through medical training as an eye surgeon and into Britain’s National Health Service (NHS).

In low- and middle-income countries, there are hundreds, often millions, of people who either lose their sight or have already lost it and are missing the opportunity to have it restored.Andrew Bastawrous

Deep inside, however, Bastawrous felt a growing sense of frustration and disempowerment that he was unable to help the multitudes everywhere who needed their sight restored.

“In low- and middle-income countries there are hundreds, often millions, of people who are beyond the reach of basic eye-care services and, as a consequence, either lose their sight or have already lost it and are missing the opportunity to have it restored,” he explains.

According to Bastawrous, some 1.1 billion people worldwide are living with a vision impairment that has not been addressed. In many cases, a pair of glasses or a cataract operation can easily fix the problem.

In 2011, he quit his NHS job and moved to Kenya in pursuit of a dream to deliver better sight to the millions in optically disadvantaged regions. Treating more than 5,000 patients in the countryside, he quickly realized the main problem was one of access: vision problems were rife in the rural population, eye-care specialists were few and diagnostic services hard for people to reach. Outside the cities, villages lacked roads and medical services. But most had mobile phone services.

Five years later, Bastawrous received a Rolex Award for Enterprise that changed the scope of his entire project.

Today, he and his team are well on the road to meeting the needs of the sight-impaired internationally, with particular attention on people least able to access or afford eye care. In Pakistan alone, the target population numbers some 30 million people needing eye care. “There isn’t an end to this journey. And it requires an attitude of ‘better never stops’,” Bastawrous says.

Peek’s vision self-check app, Peek Acuity, was launched on Google Play in 2016 and is now a certified medical device available in more than 190 countries to anyone who wants to check eyesight.

A part of the Rolex Perpetual Planet initiative, Bastawrous’ project is commendable for sharing practical science and technology universally for the betterment of humanity.


Vision for Africa

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