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Sheila K West, Harran Mkocha, Chris Bradley, Robert W Massof; Using head mounted display technology to document the prevalence of trachoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4457.
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© ARVO (1962-2015); The Authors (2016-present)
Mass drug administeration (MDA) of azithromycin is a key component of the SAFE strategy (Surgery, Antibiotics, Facial cleanliness, and Environmental improvements) for elimination of trachoma. WHO guidelines for MDA depend on the prevalence of follicular trachoma in 1-9 year olds at district level. To visually document follicular trachoma, two people are currently required: one to evert the patient's eyelid and the other to take a high resolution photo with a camera. Advances in head mounted display (HMD) technology present us with the opportunity to enable a single person to perform both steps, reducing the overall cost for diagnosing and treating trachoma.
We developed an app for the Samsung Gear VR, a headset in which a Samsung smartphone (in our case the S8) can be inserted. The user sees a video image of the world around him through the smartphone's camera while simultaneously being in virtual reality (VR). A foot pedal connected by bluetooth to the headset is used to take photos hands-free, enabling the user to simultaneously flip an eyelid and take a photo of it. Our app includes a barcode reader that is used at the beginning of any session to scan a barcode identifying the patient. This patient ID is then automatically associated with any images taken of that patient's eyelid. Once a photo is taken, our app presents an enlarged version of the image in VR on a cinematic display, enabling the user to examine the photo and decide whether to save or delete it. Head movements control a cursor that allows the user to navigate through the app. We tested our app in the Kongwa district of Tanzania.
We tested the HMD and our app on 60 children aged 9 or younger in Tanzania. Testing led to many minor changes in the app's design, including turning off autofocus, changing the format in which images were saved, and modifying the footpedal to make it more reliable.
Current head mounted display technology can be successfully leveraged to enable a single person to simultaneously evert a patient's eyelid and take a photo of it, which has the potential of reducing the cost of diagnosing and treating trachoma.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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