3nethra takes ophthalmology to India

06 Mar 2013

Rugged, economical optical pre-screening system takes eye care to rural communities.

Despite its rapidly-growing and often favorably mentioned high-tech economy, India continues to suffer vision problems – in the sense that the country is believed to have at least 12 million blind people and many more with limited or deteriorating vision.

These figures come from Forus Health, an accessible health technology systems developer based in Bengaluru (formerly Bangalore), India's third most populous city. The company developed the versatile 3nethra, a pre-screening ophthalmic device that can diagnose multiple eye-related problems. Nethra is the Hindi word for eye.

The 3Nethra system was on show at Photonics West in San Francisco, last month, being demonstrated on the stand of Edmund Optics, which is a supply and marketing partner of Forus Health: the 3Nethra is partly based on optical components developed by Edmund Optics.

Vision in India

Forus adds that India’s blind population constitutes more than 25% of the estimated 45 million cases worldwide, but more than 80% of the cases of classified blindness in India are believed to avoidable. It has been found that diseases such as diabetic retinopathy, cataracts, glaucoma, cornea problems and refractive errors constitute 90% of blindness across the country.

For a population approaching 1 billion, there are only 14,000 ophthalmologists practice in India and a mere 800 ophthalmologists graduate every year. India’s ophthalmologist to patient ratio is approximately 1:60,000, which is much worse in rural areas.

Typically, only around 7-10% of Indians at various stages of blindness are screened and treated. The country’s current vision care system needs expensive diagnostic devices for screening (single device for every problem), coupled with the availability of high skilled ophthalmologist during screening. This increases cost of service substantially and hence limits scalability. As a result, the rural market remains grossly underserved.

Rugged and portable

3nethra is a low cost, portable, and highly integrated ophthalmology device for pre-screening and identification of potential eye diseases. The device helps in screening for five eye diseases: cataract, diabetic retina, glaucoma, cornea issues, and refractive index measurements.

It has a retinal camera with inbuilt refractometer that captures the images of the retina and, through it’s image processing algorithm, generates an automatic report about the problem it has detected.

The ruggedized system, which can easily be transported to rural communities for a temporary eye-check clinic, works by scanning both the anterior and posterior segments of the eye in five minutes, without dilation. The system provides an automated “Normal" or "Need to See a Doctor" diagnosis report, which is useful especially during early onset of an eye disease when patients do not experience any perceptible symptoms.

The system also connects primary care centers to secondary or tertiary care centers over telemedicine for remote diagnosis. Moreover the device is low-cost and hence greatly reduces direct and indirect cost of screening, making it available to rural populations.

'For our community'

Rayarchetty “R.J.” Venkatramanan, who is head of manufacturing and knowledge at Forus Health, told optics.org, “The Forus company name literally means for us – as in my community and me.

"We are an innovation-driven technology enterprise and we strongly believe that healthcare solutions for emerging countries need to be different both in terms of development and deployment. Our innovative products combine with our comprehensive software solutions to enable not only screening at the patient's doorstep but to facilitate treatment, as well.

"By deploying the 3Nethra system, ophthalmic doctors can focus their time on patients who are urgent cases. And our telemedicine connectivity will help eye doctors to offer remote diagnoses for rural patients without having to leave their hospitals.

"It’s relatively easy to use the 3Nethra: operators only need to be familiar with basic eye anatomy, as well have operational computer knowledge and sufficient soft skills to communicate with patients in the local language. They do not need to be very tech-savvy or have any advanced training on ophthalmology as a paramedic. And the efficiency of this device in non-conducive rural environment is maintained with its rugged construction and design.”

About the Author

Matthew Peach is a contributing editor to optics.org.