Globally, there is a need to develop new healthcare delivery models/technologies to cater for the needs of rapidly ageing patient populations. Glaucoma is an example whereby approximately 70% of patients are above 60 years old and, due to increasing average-life- span, are facing a longer time of reduced quality of life due to vision loss. Additionally, glaucoma is often detected only when one’s vision is already irreversibly impaired. This is unfortunate as early detection can allow clinical intervention that will ultimately maintain the elderly’s independence and quality of life. Currently, diagnosis and monitoring of glaucoma uses perimetry (or visual field testing) as one of the primary measures. However, current perimetry methods have major drawbacks. As part of the SPIN Program, we aim to develop a novel, Smart, User-friendly, Portable and Reliable Automated (SUPRA) perimetry device that can measure visual field that will assist early detection of glaucoma. Such a device will potentially allow perimetry services to be provided by general-practitioners, polyclinics or eldercare facilities.

The SUPRA is just one of a few medical devices being co-developed which will eventually form part of a robust multi-modal platform to make eyecare more accessible to the community.

This includes:

• A low-cost portable non-mydriatic fundus camera
• Portable anterior segment and slit lamp camera
• Portable photo-gonioscopy camera
• Non-contact tonometry device to measure intra-ocular pressure
• Self-administered, automated visual acuity testing
• Gait and visual field analysis in the prevention of falls

Glaucoma is the leading cause of irreversible blindness worldwide and one of the commonest chronic age-related eye diseases. Glaucoma will affect more than 100 million individuals by 2040 – with 1 in 8 going blind. There is no cure for glaucoma, and life-long eye drops are often required to lower the intraocular pressure (IOP) and keep the disease under control. In the United States alone, sales for glaucoma eye drops is estimated to reach US$2.2billion by year 2023 (C.A.G.R of 2.5%). Studies have shown that between 50% and 80% of glaucoma patients were non-adherent to their eye drops. Common factors for poor compliance include: complex eye drop regimes, poor physician-patient communication, knowledge gaps, forgetfulness, eye drop bottle exhaustion before follow-up visits, economic factors, and lack of feedback/signs from using the eye drops. Similar high rates of non-adherence have also been found in other major studies worldwide which are mostly using patient feedback surveys, and suggests a huge need for a solution to measure and improve medication adherence among glaucoma patients. To our knowledge, currently, there is no technology which directly determines and track adherence to eyedrops. Our primary aim is to develop and conduct proof-of-concept study for a novel glaucoma eyedrop adherence system, EyeDEA, comprising an App, Box and Card to address a multi-factorial issue.

We hypothesize that EyeDEA is a practical solution that improves patients’ adherence to their eye drops regimes by:

1. Improving patients’ understanding of their medication regimes
2. Bridging doctor-patient-caregiver communication gaps,
3. Making the storage and use of eye drops an ease using a box with a built-in reminder system,
4. Identifying and analyzing data regarding gaps in patient compliance to eye drops use,
5. Rewarding patients for being compliant to their eye drops through incentives, and
6. Simplifying the process of replenishing eye drops when they run low.