Abstract
Purpose :
Cup-to-disc ratio (CDR) screening is essential to detect glaucoma risk early to prevent blindness. However, screening requires costly equipment and specialized skills that are limited in under-resourced areas, especially in the global health setting. Our study explores whether the Arclight device, a low-cost, solar-powered, easy-to-use combination ophthalmoscope, anterior segment loupe, and otoscope, can be used effectively by non-ophthalmologists to screen for abnormalities in the global health setting of Ensenada, Mexico.
Methods :
63 patients (120 eyes) ranging from 2 to 85 years old were examined by 2 non-ophthalmologist medical students using the Arclight and an ophthalmologist using a direct ophthalmoscope. Both parties were blinded to the other’s exam findings. Tests included an optic disc exam and an estimation of the cup-to-disc ratio. Statistical analyses were conducted to determine the correlation between the Arclight exam and the ophthalmologist's gold standard exam.
Results :
Using the Arclight, the optic nerve could be seen in 60 of 63 (95.2%) patients. The three patients’ whose optic nerves could not be seen included 1 patient with severe cataracts and 2 patients who were uncooperative for exam. CDRs measured by the Arclight had a mean of 0.30 ± 0.12 for OD and 0.31 ± 0.11 for the OS, while CDRs measured by the direct ophthalmoscope had a mean of 0.31 ± 0.12 for OD and 0.31 ± 0.13 for OS. The measurements were moderately correlated (r = 0.60 for OD and 0.69 for OS) and did not have any statistically significant differences in means (p = 0.78 for OD and 0.88 for OS). Similarly, when CDRs were stratified into ≥0.5 and <0.5, the Arclight measurements positively correlated with the direct ophthalmoscope measurements (r = 0.35 for OD and 0.46 for OS) with no statistically significant differences observed between the two methods of measurement (p = 0.64 for OD and 0.86 for OS).
Conclusions :
Our study demonstrates the Arclight device to be a low-cost yet effective alternative to the traditional ophthalmoscope in a global health setting. Widespread use of the device to screen for optic nerve pathology offers the opportunity to strengthen eye health services in many low-resourced regions of the world.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.