Vision care for everyone

This eye-for-innovation story is about M2S Korea, a pioneer currently disrupting the process of vision examination in South Korea with a rapid assessment solution that includes connected devices, advanced AI algorithms, and mobile apps. What they have done, if you’ll pardon the pun, is truly visionary.

They have leveraged eye tracking to combine a bunch of vision exams into a single VR application. Right now, they are collaborating with the government of South Korea on a pilot project to address vision-related issues caused by aging. I hope by the time you finish reading about their innovation that you might agree with me on my vision for the M2S solution, and how it could help any government broaden its national health services to provide more people with access to rapid and preventative care — especially low-income earners and the elderly, who all too often remain outside the primary-care bubble.

For this story, I conducted the interview with Martin Sungju Baek, the company's director of strategic planning, via email. I don't know if you could strictly call that an interview, but I can say that M2S is a model for the democratization of vision care.

A global issue

According to the World Health Organization (WHO), 2.2 billion people live with a vision impairment. Nearly half of these conditions can be treated, or at least could have been with access to the proper care — that’s roughly 1 in every 8 people on the planet living with a preventable vision deficiency. And like so many other issues UNESCO’s SDGs aim to address, people located in low- and middle-income regions are four times as likely to have an unaddressed vision impairment than people in high-income regions.

Vision impairment is on the rise. The increase is in part due to aging populations; factors like excessive work and smartphone use aggravate the problem, as does air pollution. Genetics and ethnicity play a role, albeit one that we cannot modify — not yet anyway. At the same time, we do have control over some lifestyle-related risk factors — such as smoking and nutrition. Access to clean water and sanitation facilities come into play, with women, people with disabilities, and low-income earners more at risk than others.

Superaging in South Korea and a pilot project for vision care

The combination of the lowest global birth rate (0.9 children per woman compared with a global average of 2.4 [2019] — see the World Bank stats) and one of the world's highest life expectancy rates have resulted in a South Korean population that is aging faster than any other developed country. And while the national health insurance system is comprehensive, the government is looking to tech and tech innovators like M2S to help it cope with age-related health issues.

Superaging refers to countries where more than one in five of the population is over the age of 65. South Korea is set to become superaged by 2030.

Today, there are about 250 or so large health centers spread throughout South Korea. Their primary purpose is prevention, providing care for the country's 52 million people. One particular center, located in Bucheon (the second-most densely populated city after Seoul, which is just a 20-minute drive away), is currently the site of a healthcare pilot — the VR/AR Public Service develop and supply project. This government-funded program aims to integrate vision services into primary care, making them accessible and free of charge to everyone over 60.

And that’s where our partner M2S comes in.

The VROR EYE Dr. healthcare device developed by M2S leverages eye tracking enabled VR to rapidly perform a comprehensive vision check-up and deliver follow-up therapies — winning a Best of Innovation award in the health and wellness category at CES 2021.

This compact solution delivers ten different eye examinations and a range of therapies for rehabilitation and prevention of common conditions such as
presbyopia — a vision impairment brought on by age-induced lens hardening and decreased lens elasticity. Other tests include pupil reflex, macular degeneration, and color blindness. Using traditional methods, any one of these tests takes about 10-15 minutes to complete, often taking place in specially equipped rooms, and requiring multiple appointments. With the M2S solution, a person can run through 7 tests in just 30 minutes without requiring any specialist help from a qualified ophthalmologist. Instead, specialist time can be spent on diagnosis, using the analysis delivered by the M2S solution to prescribe appropriate therapies.

In total, the VROR EYE Dr. can perform ten essential eye exams.

A brighter future — shifting focus to prevention

The benefits of the VROR EYE Dr. solution don't end with rapid assessment. The solution also enables therapy because it supports all kinds of remedial exercises, like eye-muscle strengthening and relief for eye strain that help prevent cognitive decline and eye diseases brought on by aging. But I believe the long-term benefit lies in the mobility factor of untethered VR. These types of headsets enable therapy and follow-up anywhere, at any kind of community center or in the home — significantly broadening the possibilities for care and ensuring that as many people as possible gain access to services.

The system architecture

M2S has chosen the Pico Neo 2 Eye VR headset powered by Qualcomm’s 845 Snapdragon processor and native Tobii eye tracking to fulfill the technical requirements of their solution. In addition to its performance capabilities, the Pico headset is lightweight, promoting comfort, which helps adoption — an important consideration for non-digital natives. Data is stored in a secure cloud and a mobile app presents easy-to-understand color-coded reports so that individuals can immediately understand their progress and clinicians can follow up and prescribe appropriate therapies.

The role of eye tracking

In the same way that eye tracking is an essential technology for understanding the brain, which you can read about in some of my other innovation stories
Finding the keys to scalability — democratizing brain-health assessment and Cognitive performance through decades of life — test, analyze, refine, repeat, Tobii’s technology is fundamental to the democratization of vision care. Eye tracking provides M2S with detailed data about eye movement and characteristics such as pupil size for their tests. And I am hoping that M2S will be able to further develop their solution and build new applications with our advanced middleware solution —
Tobii Ocumen — which delivers high-level data filters. Even though I’ve been working with eye tracking in VR for a while now, I still find it amazing how the ability to measure such tiny movements can have such a wide-reaching impact and help solve some of the world’s most significant issues.

The three phases of disruption

When we collaborate with pioneers and disruptors like M2S, a familiar pattern emerges. The first phase is solving the problem. For assessment cases like this one, the disruptors initially transform the grunt work of manual screening and analysis into a digital process — reducing time to completion, freeing up expertise to focus on remediation and follow-up, and broadening access to services.

The second phase of disruption is data analysis. The transformation of a manual process into a digital one often generates tons of data. But it’s not just any old data. Tobii’s eye tracking for example generates consistently reliable metrics and this is because our technology always measures a person’s eye movements and calculates what they look at in the same way over and over — it’s systematic. By storing this data on a centralized server, each time a person carries out an assessment, the results can be compared with previous tests — in an instant — using software to present the data in the form of digestible visuals and graphs.

The third phase is a deeper analysis across demographical borders. Over time, it’s possible to use machine learning and AI techniques to analyze the data to extract new insights. For example, it might be possible to compare how people in different geographical regions respond to a given treatment. Categorizing insights by age group or other relevant factors may help experts uncover new findings, leading to improved therapies, enhanced testing, and better outcomes for everyone.

What’s next?

With a proven solution to vision assessment, I’d say that the pilot in Bucheon, places M2S in the second phase of disruption. The government of South Korea is planning to expand the solution to all 250 centers across the country, supporting an incredible 2 million visits a year assessment. At that point M2S will enter the third phase of disruption, delivering an ophthalmic disease determination system supported by medical data analysis and AI. In addition to their vision assessment solution, M2S is currently collaborating with Korea University Medical Center on a neurodiagnostic instrument for the assessment and therapy of certain brain diseases. If all goes according to plan, we can expect commercialization sometime in 2022.

As I wrote this piece, the importance of government policy struck me, and how the judicial placement of funds together with the right technology can solve big problems. How affordable and accessible eye care can push focus from cure to prevention and reduce the burden of an aging nation with declining vision. I hope the South Korean transformation will have a far-reaching impact, way beyond their own borders, so that many countries implement similar care programs, and we can start talking about healthcare democratization on a global scale.

As a finishing note, I want to extend my gratitude to Martin for taking the time to answer my many questions and for his strategic insight that not only helps solve a crucial global issue but is a source of inspiration. To find out more about the innovative VROR Eye Dr., you can visit the M2S website.