Remote home vision monitoring of macular disease

Moorfields Eye Hospital NHS Foundation Trust is one of the largest providers of ophthalmology services in Europe, seeing around 800,000 outpatient appointments per year pre-COVID-19. It provides care for minor eye conditions, acute emergencies, chronic conditions, day case surgery and complex tertiary and highly-specialised care, from a network of more than 20 sites in England.

Situation

The COVID-19 pandemic led to the suspension of most elective eye care services which put patients with macular disease at risk of harm due to missing their regular follow-up clinic appointments. Patients with macular disease can lose stability or reactivate unpredictably, so timely identification of deterioration to allow intervention is crucial to avoid loss of sight. Distortion of the visual image is a key identifier that the condition may be worsening.

Aspiration

To produce a solution for remote vision monitoring specific to macular disease.

Solution and impact

Initially this was a pilot project supported by Moorfields digital/clinical lab undertaken by a clinician as part of the Topol fellowship scheme. However, the service has been scaled up during the COVID-19 crisis.

The Alleye app is suitable for those patients with visual acuity better than 6/24. The testing procedure is rapid and accessible, and the results are immediately available for the clinical team to review allowing detection of visual deterioration between clinic appointments. Patient training has been supported through video consultations with the clinical team who can walk patients through the app and troubleshoot.

As of August 2020, Moorfields was monitoring 250 patients using the app. Visual deterioration has been detected remotely in 13 of those patients, leading to expedited treatment in 10. The app has the potential to scale further, supporting more reactive management strategies that are not reliant on set clinic schedules. This in turn could reduce the overall number of hospital appointments and potentially allow patients who are at lower risk to be monitored on fully-remote pathways.

Functionality

Alleye is a mobile app used to detect, characterise, and track progression of central or paracentral visual distortion in patients with age-related macular degeneration and diabetic macular oedema.

Capabilities

  • Measures vision (visual distortion)
  • Proven to be as accurate as conventional measures of visual distortion in peer-reviewed research
  • Fast and easy to use with a step-by-step tutorial
  • Accurate and repeatable results
  • Creates a visual representation of results for explanation to patients
  • Includes simulated representation that helps explain results to patients

Scope

A quantitative method of measuring the effect on vision of progression of age-related macular degeneration and diabetic macular oedema.

Key figures/quotes 

The Alleye app was superior to the Amsler grid in detecting AMD-related lesions in a recent study.

Find out more

Read more on the Alleye website

Published literature

Learn more about mobile e-health self-monitoring test for macular diseases on the European Vitreo Retinal Society website

Read about how the app enables patients to self-monitor vision changes on the Retinal Physician website

The American Academy of Ophthalmology website has more on replacing the Amsler grid here

The Open Ophthalmology Journal website features a case study about self-monitoring here

Key contact

Alleye technology

technology@alleye.io

Peter Thomas, director of digital innovation and consultant paediatric ophthalmologist, Moorfields Eye Hospital

peterthomas2@nhs.net