Dr Tung Hoang receiving the First Prize from the Hanoi Medical University PhD Conference, 2024.
Conceived and developed in Melbourne, Eyeonic’s online visual field testing app is drawing international academic attention and achieving great success beyond this continent. With the guidance of Professor Simon Skalicky, Vietnamese ophthalmologist Dr Tung Hoang recently completed a study demonstrating Eyeonic’s potential to help manage the growing burden of glaucoma in his homeland.
Their story affirms the power of collaboration, innovation, and perseverance.
Glaucoma is the leading cause of irreversible blindness, and the cases are on the rise – the number of people with glaucoma worldwide will increase to 111.8 million in 2040, disproportionately affecting people residing in Asia and Africa.1
In low-resource settings, the lack of accessibility to eye care often leaves glaucoma undiagnosed or inadequately treated. It was this missed opportunity that inspired the inception and development of Eyeonic, an Australian company that offers online visual field testing, overcoming the limitations of conventional tests performed on expensive, bulky machines. The Eyeonic system provides visual field (VF) testing on any computer or tablet, with no extra equipment required.
A recent milestone was achieved with the completion of a research project on glaucoma clinical monitoring in Vietnam. The project, which compared Eyeonic online visual field testing with standard automated perimetry testing, was led by Dr Tung Hoang, an active glaucoma specialist in Hanoi. In response to his presentation of this project at Hanoi Medical University, Dr Hoang was honoured with the First Prize out of all the PhDs performed; testament of this eye health issue gaining recognition across various healthcare settings.
WHERE IT STARTED
Dr Hoang comes from a medical family in Vietnam; his mother was also an ophthalmologist. Inspired by her spirit of perseverance through challenges, and with a strong desire to change the way glaucoma is managed in his country, Dr Hoang chose to study glaucoma management in Australia. Despite all the hurdles, he became the first ophthalmologist from Vietnam to undertake a glaucoma fellowship in Australia.
During the fellowship, he built a strong friendship with Prof Skalicky, who introduced him to the Eyeonic online visual field platform. Recognising the significance of its potential impact in Vietnam, where VF machines are scarce outside major centres and much of glaucoma is undiagnosed due to accessibility and usability issues with instrument-based testing technology, he made the decision to conduct his PhD project studying the Eyeonic application in Vietnam. Dr Hoang asked Prof Skalicky to be his supervisor.
Associate Professor Simon Skalicky (left) and Dr Tung Hoang (right).
A PROJECT WITH CHALLENGES
The project presented several challenges, one of the first being language. Impressively, this was overcome with the translation of the Eyeonic app voice instructions into Vietnamese through Microsoft language services using artificial intelligence. And according to Prof Skalicky, “native speakers were amazed by the authentic, life-like voices generated”.
More hurdles followed, from securing ethics approval to assembling a diverse patient cohort; and from explaining to numerous people about the novel application to identifying a local supervisor.
The VF testing was performed on a diverse cohort including individuals with glaucoma and normal controls. It involved conducting conventional VF glaucoma tests using machines alongside Eyeonic tests on a laptop. Patients would return for follow-up tests at three or six months, and also perform the tests at home. A team of optometrists played a major role in assisting with data collection throughout the process.
Having determined a minimum requirement of 120 eyes with 30 for each stage of glaucoma: normal, mild, moderate, and severe, Dr Hoang and his team ended up testing 168 eyes of 87 patients throughout 2023.
The data was analysed with assistance from Dr Deus Bigirimana from Australia and Menus Nkurunziza from Burundi, demonstrating the power of collective determination regardless of geographic and time zone differences.
THE RESULTS
Dr Hoang discovered that patients in Vietnam “loved the Eyeonic app for the experience and for the way it made VF measurements easy to take at home”.
According to the results of this study, the app showed “very impressive accuracy” and there was “strong agreement” between the Eyeonic tests and the conventional machine-based tests.
The test-and-re-test repeatability between three- and six-months was also highly similar to the baseline results.
Dr Hoang’s project also found that the homebased test results were consistent with those generated in-clinic.
His project concluded that Eyeonic online visual field testing is deemed to have the potential to be an alternative for standard automated perimetry in glaucoma screening and monitoring.
Method highlights.
THE NEXT STEPS
Dr Hoang and his Eyeonic online visual field research will be showcased in an upcoming Australian Society of Ophthalmologists conference in Hanoi. At the ASO Vietnam Expo, the strength of the relationship between Australian and Vietnamese ophthalmology will also be highlighted, as well as the continuing support and co-operation.
Associate Professor Ashish Agar, Vice- President of the ASO and Convenor of the conference, said Dr Hoang’s research exemplified the ways in which Australian ophthalmologists support regional partners. “From providing Fellowship training to enabling cutting edge clinical research in their own community, Australia’s engagement with ophthalmology in Vietnam has been transformational on many levels, and the ASO is proud to be supporting Tung,” he said.
Following his PhD, Dr Hoang plans to be involved in the commercial roll out of Eyeonic online visual field testing in Vietnam.
“Machine-based visual field testing will not compare with the accessibility and affordability that the Eyeonic system offers, and that our country needs as the glaucoma caseload is identified in the years to come,” he observed.
Reflecting on the project Prof Skalicky described Dr Hoang as “an emerging thought leader in ophthalmology in Vietnam”.
Together, they have exemplified the transformative power of collaboration, teamwork, and perseverance in shaping the future of ophthalmology research and care.
Sophie Noble is the Social Media and Marketing Manager at Eyeonic.
Reference:
- Tham, Y.C., Li, X., Cheng, C.Y., et al., Global prevalence of glaucoma and projections of glaucoma burden through 2040: A systematic review and meta-analysis. Ophthalmology. 2014 Nov;121(11):2081–90. DOI: 10.1016/j.ophtha.2014.05.013.
