To provide a doctor with the option to test a patient's eyes remotely, or patients to have their eyes checked remotely and then book an appointment with the closest doctor for an actual physical eye test.
Dyop Vision Associate - is a company in Atlanta, Georgia, headed by Alan Hytowitz, has spent 14 years creating Dyop Test, which is used to measure visual acuity.
As a vision scientist, Allan discovered that the 1862 letter-based tests used globally by optometrists and ophthalmologists are actually making people blinder in the 21st century. It literally makes eyeglass lenses exceedingly powerful, contributing to the major cause of the global epidemic of myopia.
A Dyop, short for dynamic optotype, is a spinning segmented ring used as a visual target (optotype). The strobic contrast of the equally sized gaps and segments of the spinning ring provides a constantly refreshed stimulus of the retina photoreceptors which emulates the kinetic stimulus of the visual saccade process. That kinetic retinal stimulus is essential for vision as it helps to avoid depletion of the photoreceptor response and can be used for measuring acuity and refractions based on the Dyop angular arc width (diameter). The smallest Dyop diameter where the direction of spinning can be detected is the acuity and refraction endpoint.
Originally, the client had a working version of the eye test algorithm in Windows. However, he would like to build a Dyop application that can run on any OS with any browser on any device. The core goal is to allow a doctor to login to the system and test a patient’s eyes remotely, or patients to have their eyes checked remotely and then, if problems are identified, book an appointment with the closest doctor for an actual physical eye test.
Development of a cloud version of the Dyop test for testing vision remotely with high measurement accuracy.
We transferred the Windows version of Dyop Test algorithm to the cloud to make it available on all smartphones, tablets and personal computers or laptops.
We’ve implemented 3 types of eye testing:
- The doctor controls the test sitting in the same room with the patient.
This is similar to the original Windows version of Dyop, if a doctor wants to use it on the computer or laptop next to the patient (in the same room). In this case, the doctor controls the process of testing.
- Doctor controls the test remotely.
The doctor shares a common code number with the patient for the testing. So, the patient can use it to open the Dyops test screen, however, the control functions are in the doctor's part of the application. The doctor monitors the entire procedure and receives a report after the test is completed.
- Patient self-test.
Patients can use the camera to scan the QR code from the laptop. Once connected, the patient can control the test from the second device.
The process of eye testing is very simple. The patient looks with each eye separately at the rotating rings and should answer which ring is rotating: left or right, or it is not clear. There are 3 main buttons for these options to control the process.
It is important that this type of eye examination is up to six times more accurate than a letter-based test. This makes the remote service of eye testing not only convenient but highly reliable.
It also saves the patients a lot of time, since it's not necessary to go to the doctor to find out they don't need glasses, and it makes regular checkups (such as the dentist once a year) easier, but it also allows the doctor to identify problems. So that the doctor can determine the patient's refraction without the patient coming to the office.
The application complies with the HIPAA and HL7 medicine standards.
Implementation of PWA technology. WebSocket protocol to establish real-time connection between the doctor’s and the patient’s devices.
For building a cross-platform application, we decided to apply PWA technology. We thought through all the pros and cons and decided that this solution fits perfectly to achieve our goal of running the application on both mobile and desktop devices, not depending on the operating system. From a technical point of view, this is a web application, but to the user it looks like a usual mobile application on a smartphone and a usual web application on the laptop or computer.
We applied the WebSocket protocol during a doctor's remote vision test to allow manipulating visual targets with a rotating ring (dynamic optotype) using control buttons, and the patients can see changes of the visual targets on other devices. This solution establishes real-time connection between the doctor’s and the patient’s devices.
The same technology has been applied to the case where a patient performs self eye testing to control the process from the other device via buttons, just as a doctor does.
Progressive web application
Director at Dyop Vision Associates, LLC, USA