Evaluating the Arclight : a low-cost tool to strengthen eye care and training in low resource settings

This portfolio thesis for the Doctor of Philosophy (PhD) degree at the University of St Andrews, titled "Evaluating the Arclight: A Low-Cost Tool to Strengthen Eye Care and Training in Low Resource Settings," comprises five research papers published from 2018 to 2023. Objective: The primary aim of the research was to assess the diagnostic capability, ease of use, and educational impact of the Arclight ophthalmoscope in improving eye care delivery and training among health care workers and students in Malawi, Rwanda, and India. Methods: The methodology encompassed comparative evaluations of the Arclight against traditional ophthalmoscopes in training and clinical settings, its effectiveness in conducting red reflex assessments, and its utility in identifying amblyogenic risk factors. Additionally, the research considered the educational outcomes of Arclight workshops designed to enhance interprofessional collaboration and ophthalmic skills among healthcare students. Results: The findings underscored the Arclight's comparable diagnostic accuracy to traditional ophthalmoscopes, with a marked preference among users for its ease of use and practicality in resource-constrained settings. The educational evaluations revealed significant improvements in students' clinical skills and confidence in ophthalmic diagnosis post-workshop, highlighting the Arclight's role in fostering a collaborative learning environment. Implications for Future Research and Policy: The comprehensive evaluation of the Arclight ophthalmoscope sets a precedent for future research in frugal innovations within eye care, suggesting pathways for integrating such technologies into health systems to enhance eye care delivery. It also calls for policy reforms that recognise the value of low-cost diagnostic tools and interprofessional education in achieving Universal Health Coverage and Integrated People-Centred Eye Care, particularly in low-resource settings. Conclusion: The thesis demonstrates the Arclight ophthalmoscope's potential as a key tool in global eye care. Its simplicity, cost-effectiveness, and solar-powered design, coupled with the positive educational outcomes, advocate for its broader adoption in policy and practice. The research contributes valuable insights into the implementation of low-cost medical innovations for eye care, offering a scalable model to address global disparities in eye health services and training.