Eyeworld

26 Ophthalmology Business • March 2016 with physicians or eyeglass makers. "Getting that prescription from a doctor not in the same building as you or even in the same city … we're using technology to change the way people are getting glasses," Dr. Zhou said. Dr. Spier, who has tried out this device, said if it turns out to be ac- curate enough, it could "change the eyecare market in a fundamental way. We will test the functionality of the SVOne Enterprise in our practice in early March," Dr. Spier said. As for a device that could elimi- nate an in-person exam with a doc- tor, Dr. Spier said he thinks younger, healthy, asymptomatic patients often don't need a comprehensive eye exam just to get glasses. As a patient gets old- er, entering the years of early cataract development and presbyopia, then a more regular eye exam should be nec- essary even if he or she is asymptomat- ic, Dr. Spier said. Another application, which Smart Vision Labs has patented but does not yet have a timeline for its develop- ment, is a smartphone-based corneal topographer. Dr. Zhou thinks medical uses of smartphone technology will continue to increase, and Dr. Spier agreed. "Anything that could be put on a smartphone that is accurate, people will use," he said. "The smaller the device, the better, short of something where you need absolute fixation, like for surgery." OB Reference 1. Ciuffreda KJ, et al. Evaluation of the SVOne: A handheld, smartphone-based autorefractor. Optom Vis Sci. 2015 Dec;92(12):1133–9. Editors' note: Dr. Zhou and Dr. Spier have financial interests with Smart Vi- sion Labs. Contact information Spier: sbern18@comcast.net Zhou: yaopeng@smartvisionlabs.com "They have to hold their head, but I don't think there's much of a differ- ence for the patient," he said. While SVOne might seem pretty handy from an optometric angle, Dr. Spier finds the device useful for an ophthalmologist as well. "Ophthalmologists do refractions just as much as optometrists do," he said. "We're getting the same infor- mation, but we're using it differently. They're going to take the same infor- mation and they're going to prescribe glasses. … We're going to use that information to potentially make a de- cision about cataract surgery or LASIK or whatever." Given the use of autorefractors in an ophthalmic practice, Dr. Spier said having an extra one available has been beneficial if a desktop version breaks and when there's a backup. "We often see more than 100 patients a day," Dr. Spier said. "We can use SVOne to move things along." Dr. Spier said the size and cost of the device is advantageous for volun- teer work as well. Volunteering his medical services annually in Grenada for up to 7 years, Dr. Spier said last year was the first year he took a traditional autorefractor with him. "We brought one down and it worked, but it was a huge box," he said. This year, Dr. Spier said he looks forward to bringing SVOne with him instead. At the end of February, Smart Vision Labs launched a new, similar device that also measures refractive errors, but unlike SVOne, it does so without an operator. "It's a self-operating vision test," Dr. Zhou said of the new technology. Dr. Zhou said the intent of a de- vice like this is to make vision testing more convenient and accessible, ulti- mately leading to more people expe- riencing corrected vision. He said that results, regardless of where the test is taken, could be shared over the cloud SVOne, which weighs less than 1 pound, uses the Shack-Hartmann wavefront sensor and has a sphere range of –10 D to +10 D and cylinder range of –5 D to +5 D with a data ac- quisition time of 5 seconds per eye. The big question, Dr. Spier said, is "Is SVOne accurate?" According to a study published in the journal Optometry and Vision Science in December 2015, funded by a grant from Smart Vision Labs and the Pilot Health Technology Initiative of New York City, refractive errors in young, healthy patients measured using SVOne were not significantly different from those measured with retinoscopy, subjective refraction, the KR-1W Wavefront Analyzer (Topcon Medical Systems, Oakland, New Jersey), or the Righton Retinomax 3 (Right Group Manufacturing Co., Tokyo). Dr. Spier said he wanted to see how the device would perform in older patients and in eyes with pathology, like cataracts or glaucoma. Taking a random sampling of the first 30 pa- tients in the office one morning, Dr. Spier said they compared how both SVOne and a traditional autorefrac- tor performed in testing for refractive errors. "We showed an excellent cor- relation between the device and our desktop autorefractor," he said of the unpublished research. As for the functionality of it, Dr. Spier said SVOne was a little more particular when it came to alignment compared to traditional autorefractors. "It's a little bit more challenging for the technician because … getting the eye perfectly aligned with the instrument can be one of the bigger challenges with these things where you're trying to do measurements on the eye," he said. As for the patient experience, Dr. Spier said SVOne doesn't have a chin rest for the patient like most desktop autorefractors, but he doesn't think that's a problem. continued from page 25

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