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When Smartphones Do a Doctor’s Job: A simple, cheap way to measure eyesight may face resistance.
MIT Technology Review ^ | September 13, 2013 | Antonio Regalado

Posted on 10/03/2013 7:02:59 PM PDT by neverdem

screen grab of EyeNetra app

Eye app: A smartphone displays a measurement of the refractive error of a person’s eyes.

Vitor Pamplona isn’t a doctor. He’s not even an optician. He can’t write you a prescription for glasses, or sell you a pair. Still, he’s pretty sure he’s going to disrupt the $75 billion global eye-care market.

At EyeNetra, the startup he cofounded, goofy curiosities like plastic eyeballs line the shelves, and a 3-D printing machine whirs in the background. It’s printing out prototypes of a device that will attach to your smartphone and, in a minute or two, tell you what kind of eyeglasses you need.

The device, called the Netra-G, is based on some clever optics and software Pamplona came up with—a way to measure the refractive error of the eye using a smartphone screen and an inexpensive pair of plastic binoculars. The whole setup might cost a few dollars to make. It does the job of a $5,000 instrument called an autorefractor.

More important, just about anyone could use it. That’s where the disruption comes in—and the trouble. Right now, only doctors or optometrists can prescribe glasses or contact lenses. Pamplona, a brash Brazilian programmer who arrived in the U.S. a few years ago, thinks that won’t always be the case. “We’re changing medicine by providing the user the right to measure themselves,” he says. “We see doctors as more of a coach.”

Mobile phones are giving rise to a new class of clip-on diagnostic devices that could challenge doctors’ monopoly on diagnosing disease, not just errors in vision. Since doctors’ fees account for over 20 percent of U.S. health-care spending—and fully 3 percent of the country’s GDP on their own—such devices could potentially slash costs as well.

eye netrax table

EyeNetra has received more than $2 million in financing from the outspoken Silicon Valley investor Vinod Khosla, who last year antagonized doctors by calling what they do “witchcraft” and predicting that 80 percent of their work diagnosing and prescribing could be done by machines.

Khosla’s investment fund is also backing several other similar ventures, including AliveCor (see “Your Heartbeat on an iPhone”), which sells a heart monitor that attaches to an iPhone, and Cellscope, a company developing a phone camera that could let parents diagnose a child’s ear infection (see “Parents Could Skip the Doctor’s Office with This Device”.)

Pamplona invented the Netra while studying in an MIT lab specializing in computational photography. That technology uses computers to bend the limits of traditional photography—it’s led to cameras that that see around corners or that can focus at every distance, all at once (see “Light-Field Photography”).

The prototype device he developed to measure how well your eye focuses light consists of a viewer that a user places against a smartphone screen. Spinning a dial yourself, you align green and red lines. From the difference between what you see and the actual location of the lines, an app calculates the focusing error of your eyes. It’s like a thermometer for vision.

Using the device, a person might figure out his or her prescription and then, from the very same app, order glasses from an online store like Warby Parker. The price of an eye exam and a new prescription can run from $50 to $150. Optometrists also make money selling glasses.

After running into Pamplona at a conference last year, Dominick Maino, an optometrist based in Chicago, wrote a column in his industry’s newsletter telling colleagues it was time to “panic … just a little.”

Maino thinks Netra can “give a good prescription, most of the time.” But an optometrist—there are 40,000 in the U.S.—looks at your eye health overall and can deal with complex cases. “He wants to put much more power into the hands of the individual, which isn’t a bad thing,” Maino says of Pamplona. “But you can’t write the doctor out of the equation. There’s a lot more to a great pair of glasses than an objective measure of refraction.

Euan Thomson, a partner at Khosla Ventures, says of all the challenges mobile-health companies must face, the most difficult “is going to be that act of diagnosis by the doc.” In the U.S., doctors usually don’t get paid unless they see a patient. “Payments are all based on patient visits,” he says. “Yet much of mobile health is around avoiding the need for patients to go in to the doctor.”

Because of such obstacles, Khosla’s firm has been advising its companies not to shoot directly for U.S. consumers, at least at first, and instead to work closely with doctors. EyeNetra, based outside Boston, has been testing its device in India, where it may prove easier to find a market. In India, about 133 million people are blind or can’t see well because they don’t have access to eye exams or glasses. What’s more, optometry isn’t regulated as heavily there as it is in the U.S.

However, Thomson says all Khosla’s mobile diagnostics companies, including EyeNetra and AliveCor, will eventually need to reach consumers directly, because that would give them access to millions or billions of electrocardiograms or glasses prescriptions. That could open new avenues for both medicine and marketing.

“What’s at the center of all this is the information, not the device,” says Thomson. The debate will be over who gets to interpret that information.

TOPICS: Culture/Society; News/Current Events; Technical

1 posted on 10/03/2013 7:02:59 PM PDT by neverdem
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To: neverdem


2 posted on 10/03/2013 7:06:45 PM PDT by andyk (I have sworn...eternal hostility against every form of tyranny over the mind of man.)
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To: neverdem

I get my eyes checked at the ophthalmologist every few years, but Japan, fortunately, never climbed on the doctor’s only bandwagon as far as eyewear is concerned. Any shop that sells glasses has a setup to check your vision and they’ll do it free. From start to finish, eye exam included, a new pair of glasses is a two hour (at most) experience.

3 posted on 10/03/2013 7:07:26 PM PDT by Ronin (Dumb, dependent and Democrat is no way to go through life - Rep. L. Gohmert, Tex)
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To: neverdem

Proper eye exams by a trained professional catches a lot of
issues besides myopia. Glaucoma, diabetic retinopathy and
a lot of other vision threatening conditions exist that DIY
amateurs will miss.

4 posted on 10/03/2013 7:35:12 PM PDT by nvscanman
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To: neverdem

Hmmm...I dunno. I remember there was once a man named Navin R. Johnson who also promised a breakthrough in optometry...

5 posted on 10/03/2013 7:43:13 PM PDT by DemforBush (Of all the Thompson gunners, Roland was the best.)
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To: DemforBush

+1 LOL

6 posted on 10/03/2013 7:48:33 PM PDT by Half Vast Conspiracy (Proportionally, Ft. Hood is to Ft. Worth as Washington Navy Yard is to Arlington, VA.)
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To: Ronin

But how much are the glasses? How do they compare with say Costco. (Costco does eye exams for around $50)

7 posted on 10/03/2013 8:01:21 PM PDT by aquila48
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To: Ronin
"Dumb, dependent and Democrat"

I first heard that characterization almost 13 years ago, at the Free Republic March for Justice near the Washington Monument, Oct 31, 1998. The speaker was Joyce Smith, a black woman from Houston. She was a "community organizer" of the good kind.

8 posted on 10/03/2013 8:08:34 PM PDT by StopGlobalWhining
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To: aquila48

About the same. Anywhere from that much, all the way up. The lenses are pretty cheap, it’s the frames you pay out the nose for.

Actually, the lenses can get really pricey too, depending on what you buy. They have all kinds of weird ones, unbreakable, UV resistant, for computers, for driving, onward and upward...

9 posted on 10/03/2013 8:14:34 PM PDT by Ronin (Dumb, dependent and Democrat is no way to go through life - Rep. L. Gohmert, Tex)
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To: Ronin

My last pair of glasses was 8,000 yen, including the eye exam. But like I said, you can go in, get a free exam, take the results, go to another shop, buy the glasses there, and nobody cares. All eye glass shops give free exams, so it’s no skin of their nose.

10 posted on 10/03/2013 8:16:14 PM PDT by Ronin (Dumb, dependent and Democrat is no way to go through life - Rep. L. Gohmert, Tex)
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To: neverdem

Doesn’t Apple have an iPhone attachment that can replace your tired wornout eyes with ieyes?

11 posted on 10/03/2013 8:22:19 PM PDT by philetus (Keep doing what you always do and you'll eventually get what you deserve)
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To: nvscanman

And what if that’s not what we want? What if all you want is A PAIR OF GLASSES without a “trained professional” snooping in your business and potentially putting labels on your record that’ll buy you a one way rail trip?

12 posted on 10/03/2013 11:21:32 PM PDT by Fire_on_High (RIP City of Heroes and Paragon Studios, victim of the Obamaconomy.)
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To: neverdem

People that voted for Obama (twice)shouldn’t be playing optometrist.

13 posted on 10/04/2013 1:56:36 AM PDT by Minutemen ("It's a Religion of Peace")
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To: Fire_on_High

They’re your only get one pair.
Ignore them at your own risk. I’m a firm believer
in people being allowed to self destruct in any
fashion they choose. Just don’t bitch and whine when
your eyesite fails.

14 posted on 10/05/2013 12:01:12 AM PDT by nvscanman
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To: nvscanman

Well, here’s the thing. I need glasses...really could use em. It would help protect that most vaunted of groups, “other people”.

But, trying to find something like the Japanese arrangement mentioned above simply can’t happen in America. Thus, I go without, because I refuse to be nagged by a smug horse’s ass in a white coat over my size, my heart rate, my blood pressure, and everything else he can find to badger me about.

With Obunglescare a reality, do you REALLY think a doctor as eager to pin a diagnosis on you to confirm your lack of value to the regime as any crooked mechanic is to find the slightest squeak or scuff he can slap you with a giant bill for fixing is your friend? Your ally? Someone who wants to help you, has your best interests at heart?

The guy who’ll do a measurement and say “This is what you need, it’ll cost you X, and we could check you for Y but it’s optional and costs Z.” is. Pity we don’t have any of those.

I plan to live good and die young. Bammy’s taking even that.

15 posted on 10/05/2013 1:20:08 AM PDT by Fire_on_High (RIP City of Heroes and Paragon Studios, victim of the Obamaconomy.)
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To: neverdem

now THATS affordable health insurance

16 posted on 10/05/2013 11:37:35 AM PDT by TomasUSMC
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To: onyx

17 posted on 10/05/2013 11:40:34 AM PDT by musicman (Until I see the REAL Long Form Vault BC, he's just "PRES__ENT" Obama = Without "ID")
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To: musicman

18 posted on 10/05/2013 12:14:35 PM PDT by onyx (Please Support Free Republic - Donate Monthly! If you want on Sarah Palin's Ping List, Let Me know!)
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To: nvscanman

I bet not. Those tests could all be automated. The legal monopoly on medicine needs to be broken. Let the market decide.

19 posted on 10/08/2013 4:37:24 AM PDT by 1010RD (First, Do No Harm)
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To: Fire_on_High

Damn...... you’re missing out on what America can do for you.

20 posted on 10/08/2013 4:47:42 AM PDT by bert ((K.E. N.P. N.C. +12 ..... Travon... Felony assault and battery hate crime)
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To: 1010RD

The problems with health care won’t be fixed until the government granted monopolies and cartels are ended. But they won’t do that, so plan on everything getting worse until it collapses.

21 posted on 10/08/2013 4:57:03 AM PDT by Orangedog (An optimist is someone who tells you to 'cheer up' when things are going his way)
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To: neverdem
Anything but those damn machines that they put up to your eyes to test your distance vision (think about it). I see pretty well for things three or more feet from my eyes, but closer than that and one eye shuts off. Getting a driver's license renewed isn't a chore, it's a journey into the unknown.

It's very difficult to fine an eye doctor who knows what to do when someone's situation falls outside the norm. I'd love to have a way to test my vision at home, then bring my results to an eye doctor who would actually work with me.

22 posted on 10/08/2013 5:10:32 AM PDT by grania
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To: 1010RD

Here is a link to a story showing what happens when the “legal monopoly
on medicine” is thwarted or ignored. It is one of many examples readily
found if searched for.

An unlicensed barber gives you a shitty will survive.
Unlicensed healthcare providers can easily kill you.

If YOU want to commit suicide by rubber chicken and
dry bones go’s a free country (sic). Just don’t
advocate for stupidity and luddism.

23 posted on 10/08/2013 8:11:04 PM PDT by nvscanman
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To: nvscanman

Your example proves my point. NJ licenses doctors and didn’t protect this woman from herself or a fake doctor. What were the regulators doing while this woman went to a man’s apartment for medical treatments? Is this now stopped in all of New Jersey or are people still doing stupid things?

What if there were no government regulations on doctors? What would happen? How would you go about getting medical care? How would the market respond and what opportunities would exist for entrepreneurs?

How do people make decisions with less than perfect knowledge?

Look up mavens for a start.

24 posted on 10/08/2013 8:25:29 PM PDT by 1010RD (First, Do No Harm)
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To: neverdem


25 posted on 10/08/2013 9:03:05 PM PDT by 4Liberty (Some on our "Roads & Bridges" head to the beach. Others head to their offices, farms, libraries....)
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To: 1010RD

It is not the job of the medical profession to protect people from
their poor choices though the attempt is still usually made. It is the
job of the legal system and the government to use the licensure
system for that purpose. And neither group can do much to help
such fools if they are stupid enough to let people perform surgery
on them in a private home or some other place that is OBVIOUSLY
not a real healthcare facility. The law did not and could not keep
this woman from choosing a stupid suicidal path. But it DID allow
them to charge the man and hold him accountable.

26 posted on 10/08/2013 11:03:44 PM PDT by nvscanman
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