Anyone who’s had an eye exam in the past few decades has stared into an autorefractor—the device, the size of microwave oven and costing up to $20,000, that bounces an infrared beam off the retina to determine the correction needed for an image to come into focus. New York City startup Smart Vision Labs has developed a $3,950 handheld replacement, the SVOne, that utilizes an iPhone’s camera, processor, and wireless connection to examine patients anywhere and manage their cases online.
The 0.9-pound silver slab is about the size and shape of a paperback, with an eyepiece on one end and an iPhone, included, on the other. Not only is the SVOne more convenient for eye doctors to use in their offices, it can bring eye exams to the billion people on earth who can’t see simply because they don’t have access to a doctor.
“An iPhone’s camera capabilities and processing are just as good as the technology we were using over 10 years ago at an advanced research lab,” says Marc Albanese, one of Smart Vision Labs‘ two cofounders. He’s not even talking about the latest iPhone, but rather the two-year-old 5s.
A smartphone also provides an Internet connection, so test results and exam notes can be automatically uploaded. Smart Vision Labs is getting ready to roll out a new cloud platform that allows doctors to track exam records and share them with patients from a web interface—everyone from well-heeled U.S. clients to children in the developing world.
The SVOne isn’t just a smaller autorefractor. It’s a more sophisticated device called a wavefront aberrometer—the same type that guides a laser during Lasik surgery. The SVOne projects a grid of about 100 red dots on to the patient’s retina. The iPhone’s camera takes photos of the dots as light reflects back, and Smart Vision’s app measures the change in the pattern. If the spots have drifted outward from the original grid, the patient is farsighted; if inward, nearsighted. If the pattern has become an oval, the patient has astigmatism (an irregular shape to the cornea or lens).
Because it takes so many measurements across the eye, the SVOne can also spot conditions like night blindness, which comes from blurriness at the edge of the cornea. Light passes through that part when the pupil dilates in the dark, creating a fuzzy halo around objects.
Smart Vision Labs will soon add an attachment that makes the SVOne into a lensometer to measure the prescription of someone’s current glasses. The SVOne can also be set up to display an eye chart to the patient.
It’s a handheld optometrist or ophthalmologist office, including the records department. “You can give prescriptions out to patients pretty much anywhere,” says Albanese. “Our system allows you to capture it, prescribe it, and now you have this patient as part of your own network.” Physicians are taking the SVOne on visits to nursing homes and schools, for instance.
Smart Vision Labs grew out of work that Albanese and his cofounder Yaopeng Zhou did as engineering grad students at Boston University, where they developed a microscope for examining the retina that used aberrometer technology. In 2012, Zhou realized that they could combine that tech with an iPhone to build a small, inexpensive device to perform mobile eye exams around the world.
Smart Vision Labs won a $1 million prize in the 2013 Verizon Powerful Answers competition because of how the device could help the poorest of the poor to see. But Smart Vision Labs is not a charity. The company has raised an additional $6.1 million from investors, and most of the 200 SVOne models it has sold have gone to doctors in the U.S.
Service is part of the company mission, though. Last summer—while still finalizing the device—Albanese and others began taking the SVOne into the field, doing eye exams for the impoverished in Haiti and Guatemala. “That was the first time we really used it in a real-life setting,” says Albanese. They also brought boxes of old, donated eyeglasses to match people with the best specs on hand. Since then, the SVOne has been used in about 20 countries, including Ecuador, Gambia, India, and the Dominican Republic. Smart Vision Labs has sold some devices to Community Enterprise Solutions, a nonprofit that fosters entrepreneurship in developing countries.
Off the grid, the SVOne runs in field mode, storing the results of exams and uploading them later when it gets online. But few places are offline anymore. “When we were in Haiti, I had coverage,” says Albanese. “You have countries in Africa that have completely leapfrogged over landlines.” Some charity groups are especially interested in the cloud component of the SVOne. “[They] are trying to create more of an ecosystem, where someone gets tested, and there’s a record of them, and you can track them over time,” Albanese says.
Sadly, Smart Vision Labs has found some of the neediest people at home. Albanese tells the story of doing an SVOne exam for an 18-year-old woman in Brooklyn who, since breaking her glasses, hadn’t been able to see more than three feet in front of her. “This is in New York City!” he says. “How is this happening?”