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How this new device could prevent New Zealanders from losing their vision

NOTED logo NOTED 10/10/2018 Vomle Springford
a close up of a clock: eye © Bauer Media eye

On World Sight Day the message is 'eye care everywhere', so it's timely that an Auckland team is developing a new device that could make getting your eyes checked for common causes of blindness a simple part of your regular medical check-up.Going blind is not something most of us think about often, but for Auckland bioengineer Dr Ehsan Vaghefi, it’s what drives him.

Preventing blindness has become an obsession for Vaghefi, due to his father’s experience; his dad was just nine-years-old when he went blind because of juvenile glaucoma. If detected early, it can be treated but the technology to screen for it did not exist at the time.

Vaghefi says his father never let his disability stop him from achieving – he has a doctorate in law and is still a practising lawyer today.

a man smiling for the camera: Dr Ehsan Vaghefi. © Bauer Media Dr Ehsan Vaghefi.

“But growing up, even if your disabled parent is the most able person you know, you can still see the shortcomings. I remember the days my dad was taking me to school, like any other father would, but it was me who was watching the road for cars, it was me guiding him to school.”

Vaghefi says it affected him two ways: “First, I never wanted a child to have a disabled parent if the disability is avoidable and second, I never wanted a child to go blind.”

“My father’s blindness shaped my career and passion for life really.”

After gaining a biomedical engineering degree in Iran where he zealously attended any lecture related to eyes and vision, he did his Masters in Australia focusing on ophthalmic imaging (medical imaging of the eye) and also contributed to a project on bionic vision, before coming to New Zealand for his doctorate.

The culmination of his passion and research is Toku Eyes with Dr David Squirrell, a University of Auckland start-up designing an innovative, portable device called the MyIScope. It uses laser-based technology to image eyes for four common causes of blindness and replaces the need for several different testing devices by combining them into one.

As part of his PhD project, Vaghefi experimented with new ways to image eyes – “science being science, lots of things did not work”. He tried an MRI-based method but it was too expensive. That’s where the lasers came in.

“The reason I chose lasers was because they’re very cheap to operate and cheap to produce. I saw promise in the technology, and after initial animal studies, I applied it to human eyes, which led me to the current MyIScope technology.”

The MyIScope is so promising it’s just received nearly $1million from the Ministry of Business, Innovation and Employment’s Endeavour Fund to take the design into its first pre-clinical trial. The idea is the device could be used as part of a routine medical check-up; currently, getting an eye check is self-initiated and has to be done at an optometrist or eye clinic.

“Unfortunately, many diseases of the eye progress slowly so people might not notice it for a while, and when they do notice it, they say ‘well, I can still function, I’m fine for a bit longer’. But by the time they get around to it, it’s just too late.”

Glaucoma, for example, gradually damages the optic nerve at the back of the eye and it’s estimated half of those with the disease don’t realise they have it, according to Glaucoma NZ. If left untreated, the damage is irreversible.

Political journalist Patrick Gower, 40, had no idea he had glaucoma until he went to see an eye specialist about a separate issue. Fortunately, he’s been able to delay blindness with treatment.

But not everyone is in a position to pay for screening. This is another aim of the MyIScope, to bring the cost of an eye exam down – the biggest barrier to vision care, says Vaghefi. It’s expensive for multiple reasons, one being the screening devices are manufactured in the U.S and Japan, and he'd like toget the MyIScope made in New Zealand.

“The other aspect is that several devices are needed for detecting different pathologies – you need several expensive devices. That adds up and the optometry practice or eye clinic naturally passes on the cost to the customer.”

These devices also need a trained optometrist or ophthalmologist to use them and interpret the results, says Vaghefi, but the MyIScope is aimed to be simple enough that community health provider nurses could be trained to use it.

Being a portable size and more affordable to manufacture and operate, it can be targeted at remote communities and lower-socio economic areas of New Zealand.

There are still a lot of cases of preventable blindness, Vaghefi says. An Auckland study he was involved in found 30 per cent of the participating school children had never had their eyes examined. For Māori and Pasifika students, the rate was about 60 per cent.

“We also found 10 per cent of the schoolchildren had some sort of pathological vision loss. That is shocking, and it’s been bothering me even more, when we have an optometry profession in this country and yet in the city that I live in, there are children that are going blind simply because they haven’t had a simple eye exam.”

Early detection in children is important, as it can hinder their academic development.

Vaghefi would like to see the device go further than New Zealand too, to developing countries where vision loss, due to lack of basic eye screening services, is prevalent.

“I really hope through this research, I can make a difference. If I could prevent one child from losing his or her vision because we have detected the disease early on, that would be the best reward for me.”

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