Ornate-India project to tackle avoidable blindness caused by diabetes
Hyperglycaemia, more commonly known as high blood sugar levels, is the defining characteristic of diabetes, a condition which occurs when the body can no longer maintain a normal blood glucose level.
Having consistently raised levels of blood sugar and blood pressure can also cause damage to the blood vessels leading to the retina, which is known as diabetic retinopathy.
The global diabetes epidemic is at particularly high levels in India, where research shows diabetic retinopathy is the leading cause of vision impairment and blindness in working-age adults.
Diabetic retinopathy is treatable if caught in time and so measures to implement early detection and intervention could drastically reduce the number of people living with sight loss.
However, with a vast population spread across great distances and with limited resources, retinal screening in India is costly and logistically difficult which means there is no systemic process currently in place.
The Ornate-India team aim to tackle this by evaluating cost-effective measures for screening for diabetic retinopathy.
The project aims to trial a new handheld camera capable of low-cost eye screening, as well as blood and urine tests that will detect risks of complications from the disease.
By harnessing advances in smartphone technology and using handheld cameras instead of expensive screening equipment, the researchers hope to reduce the cost of screening and enable greater access to rural areas. It is possible that screening in this manner could be carried out by a healthcare volunteer. A possible further step is to incorporate machine learning to create a triage framework for the scans, meaning that patients would only have to be referred to a human expert if the results were inconclusive or identified them as at risk.
If successful, the hope is that these advancements could be reverse adopted in the UK to reduce NHS costs.
An estimated £14 billion year is spent on treating diabetes and its complications in the UK and current screening procedures for diabetic retinopathy involve the use of expensive equipment that can only be operated by trained professionals. Many of these costs could be saved if screening was decentralised and required only a handheld camera.
The UCL Institute of Healthcare Engineering firmly supports this strategy in line with our wider belief in the importance of bi-directional global learning and the benefits of reserve adopting frugal innovations from low-income countries.
These ideas were recently discussed in a parliamentary meeting at the House of Commons to celebrate the launch of the Ornate-India project, which was attended by the Institute’s Director, Dr Sebastien Ourselin and our Eyes for Life engineering lead, Dr Christos Bergeles.
The project’s lead applicant, Prof Sobha Sivaprasad (left), said, “The potential patient impact of this project is vast; over 70 million people in India alone suffer from diabetes, with complications from diabetic retinopathy unfortunately one of the most common yet avoidable causes of blindness. By improving early detection, this research may be able to drastically reduce the chances of sight loss for patients all over the globe.”
Lord Kamlesh Patel of Bradford OBE, chair of the International Advisory Committee for the project, commented in Eastern Eye that, “This is not the UK going to India and saying ‘we’ll tell you how to do it’. It’s about shared partnership and learning from each other. This is going to be an example of how we share data across continents and how we make that work in policy and practice.”
The £6,000,000 grant, “Ornate India- the UK-India collaboration to increasing research capacity and capability to tackle blindness due to diabetic retinopathy”, was awarded by the Global Challenges Research Fund (GCRF) from Research Councils UK (RCUK). The grant is hosted at Moorfields Eye Hospital by lead Prof Sobha Sivaprasad. The UCL Institute of Healthcare Engineering will collaborate on this project through Dr Christos Bergeles. Other collaborators include researchers from India and other UK universities, such as Oxford University and Imperial College London.