I first reported on the company Eyoto last year. Since its launch in 2013, as a spinout from my old alma mater Aston University, the Birmingham-based company Eyoto has evolved from software developer to equipment manufacturer and provider of technology solutions. Their speciality is in image processing, computer vision, machine learning, semi-automation, artificial intelligence and ophthalmic user interface design.
Since the lockdown, interest in new ways of providing care remotely, to minimise patient and clinician contact while maximising access to expertise, has never been stronger. Against this backdrop, Eyoto last year launched its Theia slit lamp system and a new semi-automated way of inspecting and verifying ophthalmic lenses, the Atlas. Both systems were on display at this year’s Mido conference and, for the first time, were set up for full user testing. This meant delegates were not only able to undertake a full slit-lamp assessment with the Theia, but were also challenged to ‘beat the Atlas’ with a traditional automated focimeter.
Theia
Named after the Greek titan Theia, goddess of sight, the new slit-lamp system removes the need for an optometrist to be present in the same room as a patient or even at the same time. The Theia remote digital optical imaging system features a high resolution camera and screen, with full image and video capture capability. Small enough to sit on a standard optical equipment table, it delivers the same quality eye health examination as if the optometrist were with the patient. A locally based technician might easily be trained to use the instrument, and to undertake lid eversion or instill dye as required, and the results be viewed by a remote optometrist in real-time or reviewed at a later time.
The system can also be operated remotely by the optometrist. Fully encrypted for patient data security, it exports the images and video to a patient management system. Theia’s remote-control panel allows a clinician to operate each element of the device independently (figure 2). These include the movement of the device in three planes (X, Y and Z axes), via a remote joystick. This allows independent control of:
- Rotation of the light source
- Rotation of the camera
- Diffuse light intensity
- Slit height, slit width and brightness.
Available magnification of 6, 10, 16 and 25 times allows viewing of most required structures. There is a Wratten filter, a blue light option and a red-free filter, to aid fluorescein examination and the identification of blood vessels, and retinal viewing is possible using a Volk attachment. There are also pre-programmed operations, such as alignment with the right or left eye, full slit height or a 1x1mm parallelepiped, at the touch of a button on the remote-control.
The image resolution is high enough to allow captured images to be digitally zoomed by using a viewing tool such as Windows photo viewer. Images, or indeed videos, can be exported onto any patient management platform. The files can then be viewed at a later time or shared as part of an enhanced and expedited referral/diagnostic process. All data exported is encrypted for full security and a Volk lens attachment is available.
Atlas
Many readers may remember their student days when taking a summer job in an eye care practice meant many hours ‘doing the checking.’ While automated lens meters have certainly made lens inspection and verification much more efficient than was possible with manual focimetry and a keen eye, high volume inspection is still time-consuming and prone to error.
The new Atlas system from Eyoto (figure 3) objectively checks un-cut, semi-finished, finished, or mounted lenses to local standards and tolerances. It delivers rapid and accurate power measurement and lens surface inspection, including adjustable zonal scratch detection. The system improves operating margins and increases productivity in lens verification, while being simple to operate. It removes human error, subjective decision-making, or variation between operatives, which can result in customer returns and loss of trust.
The Atlas provides an immediate ‘yes/no’ result based on user-defined tolerance settings, whether that be ISO or ANSI. Standards and tolerances are fully customisable within the dedicated cloud portal, with the option to create customer-specific quality categories. Indeed, this cloud portal feature means that results on every inspection may be accessed from anywhere else around the world for remote quality control.
Suitable for a practice lab or a high turnover facility, the Atlas unit may check in excess of 400 jobs in a single eight-hour day. This capacity was clearly why Eyoto were confident enough to offer delegates at Mido the opportunity to try and outpace Atlas with a traditional lens meter.