A global problem

Physicists go medical

Multifunctional glasses which measure light effects and eye movements at the same time.

A close look at myopiad

Short-sightedness is reaching pandemic proportions. The reasons for this are unclear. As part of a research project sponsored by the FreeNovation program of the Novartis Research Foundation, two scientists from Basel try to shed light on this phenomenon by collecting data in an innovative way.

Text by Goran Mijuk, photos by Jan Räber

Roman Schmied and Vanessa Leung.

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A global problem

Physicists go medical

Published on 26/10/2020

Vanessa Leung and her husband Roman Schmied like to go for long hikes. It is the time when the two physicists can relax and let their minds wander after a week of hard work at the University of Basel.

It was during one of these trips – some four years ago, before the birth of their daughter – that the two discussed the rapid rise in shortsightedness, which is feared to already affect every third person on the planet by now.

Suffering from myopia themselves, they wondered whether it could be possible to elucidate the reasons that cause this eye condition and find new ways to help rein in the growing myopia crisis.

Research on the sensor-studded glasses requires a lot of hard work and painstaking precision. Vanessa Leung and Roman Schmied have developed a unique device that could shed light on the causes of the myopia boom.

A global problem

Alarm bells had been sounded a few years earlier in 2015, when an article published in Nature reported that the “myopia boom” seemed to affect an increasing number of young people, especially in South East Asia.

While only some 10 to 20 percent of Chinese suffered from myopia after the Second World War, Nature reported new research suggesting that up to 90 percent of young adults in China are shortsighted. In neighboring South Korea, studies showed that more than 96 percent of 19-year-olds are affected.

Outside Asia, the situation is equally dire. According to the United States National Eye Institute, myopia prevalence has risen to nearly 50 percent over the past 40 years. A similar situation is developing in Europe.

Looking for causes

The reasons for this phenomenon are far from clear. While researchers had long believed that myopia was a genetic condition, later findings suggested that eye fatigue triggered by long periods of reading, for example, may cause the eye to lose its focusing power and rob people of the ability to see things clearly that are at distance.

But even this popularly held view has been turned upside down in recent years. Around the turn of the millennium, ophthalmologists started to notice that myopia could be triggered by how much time people spend outside.

In two recent separate studies, researchers in the United States and Australia found that children who spent less time outdoors were at greater risk of developing myopia because their exposure to light is lower. Some doctors then started to suggest that, to reduce the risk of developing myopia, children should stay outdoors for at least three hours per day, exposing themselves to at least 10 000 lux, a unit of light intensity that ranges from 0.0001 on a moonless night to 100 000 in direct sunlight.

An intense walk

“There is a growing body of literature centering on the rise in myopia,” said Vanessa Leung when we met her and her husband at their lab in Allschwil, where the University of Basel has rented some space in the sprawling industrial quarter just outside Basel. “But many of these studies are struggling to pinpoint a root cause for myopia. There is also a lack of data that correlate the different potential causes.”

Is it just one or many factors that cause the eye to lose its ability to focus? How could these causes be established? How could data help mend this situation and how could these data be gathered?

These were some of the many questions that Leung and her husband discussed during their long hiking trip in Western Switzerland that took them above Lake Geneva with its stunning views of the Alps.

Their brainstorming was all the more intense as they had just learned about FreeNovation, a research platform that was established by Novartis in 2016 with the goal of providing young researchers like themselves with the opportunity to pursue out-of-the-box ideas no one else dared to follow.

Space for unorthodox ideas

Such start-up-like platforms with room for “crazy” ideas are becoming more and more important. The need for breakthrough innovations is rising and many industry leaders realize today that conventional research frameworks may not provide the breeding ground for truly revolutionary concepts.

“Switzerland has a strong education and research network, particularly in the realm of biosciences,” says Hans Widmer, who runs the FreeNovation program for Novartis. “But there is a need to invest in grassroots projects which are highly original but may face difficulties getting funding because the chance of success is unknown.”

Every year, some 16 billion Swiss francs are spent on research and development in Switzerland. More than half of this money comes from the domestic industry, followed by the public sector, non-profit organizations and universities. However, the pressure to produce tangible results means that unorthodox ideas usually receive limited, if any, funding.

“While the research situation in Switzerland is actually very robust, Novartis felt there was a need of funding opportunities for projects that are selected purely on the basis of their originality, regardless of the career status of the proposing scientist,” Widmer says. “This is why the Novartis Research Foundation created this program.”

FreeNovation - A close look at myopia

The smart glasses track a person’s eye movements as well as the ambient light. The collected data can be securely transferred to a computer or hand-held device, where they are analyzed by an intelligent software.

Physicists go medical

FreeNovation was a perfect playground for Vanessa Leung and Roman Schmied, as well as other researchers from various fields ranging from digital health and glycobiology to tissue engineering and biomaterials research, to pursue scientific ideas outside of the beaten path.

Under normal circumstances, the odds in favor of physicists Leung and Schmied receiving funding for a medicine-related project would have been limited at best; not only because they were relative newcomers to the field, but also because they had thought of an unconventional approach to myopia, which might have raised eyebrows in the ophthalmology establishment.

“We realized early on that we need quantitative data on how the eye responds to modern lighting and visual environments,” says Vanessa Leung. “So we thought of a concept for smart glasses during our hike. Something that didn’t exist before.”

Their idea was that these glasses should both measure eye movements and sense the environment. The sensor-equipped glasses would collect real-world data, which would then be processed by an intelligent software that would generate fresh insights into what triggers myopia, paving the way for new solutions as to how the boom could potentially be stopped.

Gathering data

After hatching the idea, Vanessa Leung and Roman Schmied, like many other applicants across Switzerland who had heard of FreeNovation, sent in a blinded, three-page summary to the judging panel.

After a relatively straightforward review process, Leung and Schmied were picked to participate in the program, along with a dozen other investigator groups.

“We didn’t expect to get this grant,” said Roman Schmied. “But once we got the chance to work on it, we went full throttle.”

Equipped with a research stipend and free to work on the project for 18 months, the couple started to design their smart glasses.

Working initially with an existing eye tracker that is normally used in marketing to measure the eye movements of customers reading magazines or looking in a shop window, the two created additional sensors that measure ambient light. In addition, they designed a software to identify relationships between eye movements and the eye’s response to modern lighting and visual environments.

Collaboration

Not long after they started to work on the project, Leung and Schmied, whose daughter was born just after they received the grant in late 2016, had developed the first prototypes.

These somewhat bulky, yet high-tech glasses quickly allowed them to get together with ophthalmologist Peter Maloca from Moorfields Eye Hospital in London, and carry out tests with adult volunteers.

As part of the ensuing pilot study, 15 clearsighted and shortsighted people used the glasses for about one hour while walking, reading and looking into the distance.

The outcome was encouraging. “In general, we found that we could collect most measurements with an acceptable accuracy,” says Vanessa Leung. “This included light intensity, pupil size, and blinking rates.”

However, the two realized that the device was not able to collect accurate measurements of the distance at which the volunteers were looking. This prompted them to improve the glasses with a laser distance sensor, which now allows for distance measurements with much better accuracy.

Next steps

With the improved glasses, Vanessa Leung and Roman Schmied have tested the device in a trial with young children in Hong Kong.

“We’ve come a long way thanks to FreeNovation, which has given us the opportunity to work in an important medical field that not only affects us personally but also millions of others,” says Roman Schmied. “As a team, as a married couple with children, we have grown over time and now hope to take this to the next level.”

A close look at myopiad

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