Why an origami slit lamp? Keeping things in perspective

(all eye/vision related puns in this blog are totally intended)

Hi everyone, I’m Sneha, one of many culprits who hasn’t blogged yet – but I am now! I’m going into my fourth undergraduate year at Massachusetts Institute of Technology. I’m doing a public health internship at LVPEI this summer and happened to be here during ReDx, and I’m really glad I decided to participate. One of the most exciting aspects of my week so far is the connection I’ve made between my seemingly unrelated internship and the project I’ve been working on at this workshop.

Two weeks ago, I was at an LVPEI secondary center in Karamchedu (Prakasam district, Andhra Pradesh) surveying the knowledge, attitude, and practices of patients with regards to diabetes and diabetic retinopathy, at the levels of the secondary center, vision centers, and community (see __ for LVPEI pyramid**). The majority of people I surveyed said they only got their eyes checked when they experienced significant vision problems. This means that many eye problems, including refractive error that can be corrected with just a pair of spectacles, go unnoticed until severe.

The vision for the origami slit lamp, in my mind’s eye, is that it would be used just as easily as a visual acuity chart by a vision guardian, who is not a professional but a member of the community whose role is to refer people to a higher level of the pyramid of care if necessary (if I understand correctly; I did not interact with vision guardians during my rural visit). It is not intended to be just a low-cost foldable version of a portable slit lamp. I feel like we need to print a disclaimer on it: “Not intended for professional slit lamp examination by an optometrist or ophthalmologist.” That’s not to say that maybe one day this device will in fact reach that level of functionality; my point is that the way I understand it, that’s not really its purpose. The purpose is to increase the breadth of assessment that can be performed at the accessible community level by someone such as a vision guardian, so that more people with potential eye problems can be referred and fewer go unnoticed. It’s sometimes difficult to explain this to people, and even working on this project it’s sometimes easy to lose sight of the idea that we’re not trying to just recreate an existing portable slit lamp system with cheap and light materials, but designing a different slit lamp that meets our goals of ease to build and use.

It’s no simple feat to design a slit lamp that is functional (but how do we define that?) and sturdy, yet starts out as a flat sheet and is easily foldable like a Foldoscope**, but we’re trying!

On a completely different note, it has been a lot of fun meeting everyone and making new friends at the workshop! It’s only Thursday morning, but I already know I’m going to shed some tears come Saturday night.

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