Overcome the barriers of vision care in Africa using smartphones

项目摘要/摘要 在全球范围内，6.71亿人有未矫正的屈光不正，其中1.61亿人有距离 由于未矫正的屈光不正(URE)造成的视力损害。尿毒症引起的远视力障碍 尤其影响儿童和青壮年，限制他们的教育活动和社交生活。尽管 屈光不正患病率较低，非洲URE致盲患病率是#年的6倍 世界上的高收入地区。这表明非洲在获得眼科护理方面存在广泛的差距， 会带来长期的负面影响。事实上，每百万人中只有2.5名眼科医生 撒哈拉以南非洲的人口，而全球平均水平约为每百万名眼科医生32名。创新型 需要以社区为基础的方法来解决提供所需医疗保健的日益沉重的负担。 响应赠款机会，改善低收入和中等收入国家获得医疗保健的机会 移动健康，我们建议开发一个人工智能驱动的移动应用程序来测量屈光不正 并通过在埃塞俄比亚进行实地测试进行验证。凭借其相对简单的协议，该应用程序可以 人们只使用智能手机来测量近视屈光不正，而不需要任何手机附件。 因此，它克服了成本和可获得性的主要障碍。最近对这款折射应用程序的一项研究显示 在美国和中国的一项多中心研究中，屈光度的临床测量与临床测量具有良好的一致性。vt.给出 在R21阶段，人工智能算法在代表不足的非洲族裔人群中的偏见和不准确性， 我们将在非洲起源的人脸数据集上训练自定义神经网络，以制作当前版本的应用程序 更适合黑皮肤的非洲人。我们将通过以下方式验证APP在埃塞俄比亚的折射测量 将其与标准临床测量进行比较，并确定视力的改善 基于APP的屈光矫正带来的敏锐度。在对移动技术进行验证后 在医院环境下提供负担得起的眼镜，我们将进一步评估社区视力保健计划 在R33阶段，包括视力测试和配发眼镜。社区志愿者将接受培训 使用该应用程序进行视力筛查，并将在埃塞俄比亚农村进行现场测试，以确定 以社区为基础的近视筛查方法在现实世界中的敏感性和特异性。与 作为移动健康解决方案的一部分，我们准备对服务不足的非洲的眼睛护理产生重大影响。

PROJECT SUMMARY / ABSTRACT Worldwide, 671 million people have uncorrected refractive error out of which 161 million people have distance vision impairments due to uncorrected refractive error (URE). Distance vision impairment due to URE especially affects children and young adults, limiting their educational activities and social life. Although the prevalence of refractive error is lower, the prevalence of blindness due to URE in Africa is 6 times as that in high-income regions of the world. This indicates widespread disparities in access to eye care in Africa, which leads to long term negative effects. As a matter of fact, there are only 2.5 ophthalmologists per million population in Sub-Saharan Africa, against a global mean of about 32 ophthalmologists per million. Innovative community-based approaches are needed to tackle the increasing burden of providing the needed healthcare. In response to the grant opportunity to improve healthcare access to low and middle-income countries using mobile health, we propose to develop an AI-powered mobile application for measurement of refractive error and validate it by performing field tests in Ethiopia. With its relatively simple protocol, the app can allow lay people measure myopic refractive error using only a smartphone, without needing any phone attachments. Thus, it overcomes the main barriers of cost and accessibility. A recent study on this refraction app showed good consistency with clinical measurements of refraction in a multi-center study in the US and China. Given the bias and inaccuracies of AI algorithms in people of underrepresented African ethnicities, in the R21 phase, we will train a custom neural network on face datasets of African origin to make the current version of the app more suitable for dark-skinned Africans. We will validate the app measurements of refraction in Ethiopia by comparing it with standard clinical measurement, and also by determining the improvements in the visual acuity resulting from the app-based refractive correction. After the validation of the mobile technology for prescribing affordable eyeglasses in hospital settings, we will further evaluate community vision care programs in the R33 phase, including vision testing and dispensing of eyeglasses. Community volunteers will be trained to perform vision screening with the app and a field test will be performed in rural Ethiopia to determine the sensitivity and specificity of community-based myopia screening approach in real-world settings. With the mHealth solution, we are poised to make significant impact on the eye care in under-served Africa.