Public Funding for Okulo Ltd

OKKO Health is an eye care digital health company, based in Bristol, and making medical-grade apps that eye specialists can prescribe so that people who live with long-term eye disease can safely monitor their vision between in-person appointments. The current product is for macular degeneration and diabetic eye disease, which are both leading causes of avoidable blindness in the UK and in developed nations. The current lack of ability to self-monitor vision between any hospital or optometrist/optician visits means that sight-threatening changes go unnoticed for weeks or months, by which point treatment is often ineffective. With the help of home-monitoring of vision, patients will be able to identify when problems arise and seek prompt treatment to preserve their vision and keep seeing well into the long term. OKKO's app blends vision science behind simple video games, that the patient 'plays' 3 times weekly, in order to generate data about their eye health, that their eye specialist can also review remotely. This project is about further developing the technology and the systems around it, to ensure that this technology is safe, cost effective and can reach as many people as possible globally in the coming years. In particular, OKKO will upgrade their CE-mark, develop a scalable system that allows the product to be prescribed in different languages by doctors in different countries, and also understand the evidence and benefit-based pricing structure that will allow OKKO to grow as a successful company and be reimbursed by health providers like the NHS and private insurance in international markets.

OKKO Health is a software medical device company developing companion apps for people with chronic eye disease. The app consists of short games which use vision science technology to measure visual function through the data produced. This project is to develop an AI product to identify the very early visual symptoms indicative of either development or worsening of macular disease by using smartphone data only, so that vision assessment and monitoring can be shifted from the hospital to the home and so that in-person appointments with hospital eye specialists can be prioritised for those who need them. This will enable personalised eye care; leading to more efficient use of limited highly pressurised resources and optimise vision outcomes for patients through early and prioritised treatment (currently, 50% of UK blindness is avoidable with early treatment). OKKO's core work has been highly innovative, because unlike others, they do not simply replicate the eye chart onto a phone screen. This is because the eye chart was designed for prescribing accurate glasses, and it is very poor at picking up early eye disease, or monitoring progression of eye disease. Instead, OKKO's team translate aspects of established vision science currently contained in expensive equipment into accessible, straightforward puzzle games on a smartphone/tablet so that hospital-grade measurements can be gained at home. This project will use real-world smartphone data to create the AI algorithm trained by high-quality clinical decisions from the doctors in Nottingham and Oxford NHS and international sites. We will work with the University of Bristol and the Macular Society charity to make the smartphone AI's interface with patients user-friendly and meaningful.

Okulo Ltd (trading as OKKO Health) develop smartphone software for home-monitoring of vision. This project is to drive the development of a technological system and corresponding patient pathway to allow AI-driven home-monitoring of vision for patients who would otherwise have had to come for in-person hospital eye clinic appointments. This project will develop diagnostic biomarkers from app data and research ways to optimise their uptake in the NHS and beyond. This will increase both the environmental sustainability and the financial sustainability of the NHS. This responds to the acute COVID challenge that we now need to triage/monitor vision away from hospital clinics. The mass cancellation of in-person appointments means that our patient population face sight loss if a deterioration in their condition is not picked up early enough in time for treatment. In the project we will work closely with NHS units and with University of Bristol staff. The proposed project isn't just about developing connected and clever technology, but it's about co-designing with patients and their families, and doctors, nurses and hospital administration systems a brand new digital pathway of care that will revolutionise the experience of eye care for all of us when we need it.

This project is to drive the development of a technological system and corresponding patient pathway to allow AI-driven home-monitoring of vision for patients who would otherwise have had to come for in-person hospital eye clinic appointments, specifically for those living with macular disease. This project will develop diagnostic biomarkers from app data and research ways to optimise their uptake in the NHS and beyond. This will increase both the environmental sustainability and the financial sustainability of the NHS. This responds to the acute COVID challenge that we now need to triage/monitor vision away from hospital clinics. The mass cancellation of in-person appointments means that our patient population face sight loss if a deterioration in their condition is not picked up early enough in time for treatment. In the project we will work closely with Nottingham hospital, City University and with charity Macular Society. The proposed project isn't just about developing connected and clever technology, but it's about co-designing with patients and their families, and doctors, nurses and hospital administration systems a brand new digital pathway of care that will revolutionise the experience of eye care for all of us when we need it.

Due to COVID-19, all routine face-to-face eye care appointments have been suspended (both in hospital ophthalmology and in community opticians). Since routine appointments comprise approximately 80% of all eye care appointments, and in 2019 eye units became the busiest hospital outpatient speciality, this is a major disruption for the NHS as a whole, and the 6 million patients in the UK who live with eye disease. The eye chart is a fundamental aspect of assessing eye health, and, founded by eye specialists, OKKO are a certified software medical device company that creates technology to provide this on smartphones (using pictures, not letters, via a simple, accessible video game interface that has been co-developed by children as young as 3 years old and adults up to 85 years!). Our patent-pending and CE-marked technology to date has been concentrating on chronic disease in adults. However, the cancellation of NHS eye appointments means that there's now huge demand for the product in paediatrics and also in urgent care, so we have been redeveloping our core tech for this purposes: 1. Home-monitoring children's vision for those undergoing at-home patching treatment for lazy eye (amblyopia) 2. For one-off urgent use during tele-ophthalmology video consultations Our technical work is nearly complete for our iOS product on Apple devices, however we urgently need to create an Android version for Samsung and Huawei phones, in order to meet NHS demand in an equitable way. In addition, we must urgently create an automated 'on-boarding' procedure for easy registration online. This means quickly doubling the size of our tech team to build the necessary stable and scalable platform. Last year NHS England had 7.86 million eye care appointments, just 3.7% which were seen by tele-health means (usually a telephone call to check on the patient's symptoms post-surgery).Given COVID-19, a full roll-out of tele-health is now essential, but the limiting factor is the ability to accurately measure sight in the home.OKKO's patent-pending technology specifically meets this need, and it's integration could ramp up the ability to deliver proper eye care during COVID and mitigate the effects the growing backlog of cancelled appointments and the continued impact of social distancing (ie doctors with asthma/diabetes who are shielding could instead be running clinics from their home). With the correct product acceleration, our technology could be used to raise the tele-health in ophthalmology to 50% by late 2020 and utilise the eye specialists who are shielding.

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The measurement of sight is the front door to eye care, but currently this relies upon a professional. As such, remote-monitoring of eye disease is not currently possible. The lack of patients' ability to self-monitor on a regular basis can result in a delay in identifying a deterioration in sight. Late treatment makes eye disease much more difficult to treat, and often results in permanent visual impairment.OKKO Health capture interaction data from the touch screen while patients play carefully designed video-games. This project is to provide the accelerated financial support to drive forward the data-capture potential of our game and to build in machine learning (artificial intelligence). With the capability to generate 'big data' and build up a visual profile for an individual patient -- OKKO are working towards generating the first digital biomarkers of eye disease, so that deteriorating eye disease can be picked up at the earliest possible opportunity.This technology will allow eye doctors/specialists and hospitals to remotely monitor patients via an online portal, preserving expensive in-person appointments with doctors/specialists for those patients who are most in need. Essentially, we will provide a tech solution to support eye hospitals who simply do not have enough eye specialists to meet the ever-increasing patient demand.Ultimately, this will allow OKKO to work with hospitals to personalise the medical care that patients with eye problems receive, preserve good sight in those who live with a diagnosis, and drive down the costs of health systems like the NHS delivering quality eye care services at scale.The current project will build the wider tech infrastructure around OKKO's gaming apps, alongside increasing the data supply and the ability to derive insights using artificial intelligence.