Web-Based Primary Eye Care Analyzer for future Tele-Eye

Health Care System

Zuhaira Ilyana Bt Zainuddin, Kevin Loo Teok Aik, Rabab Alayham Abbas Helmi
Faculty of Information Science and Engineering, Management & Science University

Mohd Zaki Awg Isa

Faculty of Health and Life Sciences, Management & Science University

Mohd Zaki Awg Isa

MSU Centre of Excellence in Vision and Eyecare, Management & Science University

Rabab Alayham Abbas Helmi

Information Technology and Innovation Center, Management and Science University

Correspondence authors:
[email protected]

Abstract
Primary eye care (PEC) is a vital component in the primary health care system. It includes the promotion
of eye health, the prevention, and the treatment of eye conditions that may lead to visual impairment and
blindness. Early detection of vision problems provides early intervention and proper rehabilitation of those
who are already visually impaired or blind. This study aimed to provide helps to eye care practitioners to
aid early diagnosis and to do the calculation of refraction error, simulation, and analysis of prescription for
the patients. The Tele-eye health web-based program consists of a primary eye care system, practitioner
modules, and patient modules to assist a simulation for patient care, training, health promotion,
educational purposes, reporting, and future research. This web-based Tele-eye health program for primary
eye care analyzer allows eye care practitioners and optometrists to aid for early diagnosis of eye and vision
problems and use for future telemedicine practice.

Keywords:
Web-based eye care analyzer, Tele-eye health, Optometry practice, Vision problems, Prevention of
blindness

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 Introduction
Background of the study
International Association for Prevention Blindness (IAPB) (2020) stated that 90 percent of vision
loss is treatable or preventable. It is estimated that by the year 2050, vision loss will reach 1.7 billion people
worldwide. However, one of the major issues is undiagnosed and untreated vision problems. In many
countries, primary eye care is part of the health care system (Pointer, J. S.,2014). It is also part of
comprehensive eye care in delivering eye care services to the people by eye care practitioners and
optometrists. It is targeted towards preventing blindness and visual impairment and providing services to
address ocular morbidity (Reddy, Sagili & Thanigasalam, Thevi, 2017). In some countries, primary eye care
may require training that may necessitate the involvement of medical officers or highly skilled eye care
practitioners (Faeza, F., 2020). In Sub-Saharan Africa, it was estimated that 18 million people with eye
diseases are at risk of getting blindness (Gudlavalleti, Murthy & Raman, Usha, 2009). With the increase in
visual impairment and blindness in Malaysia, primary eye care provides early detection of eye and vision
problems that help early diagnosis, intervention, and rehabilitation (Rabie & Zaki, 2020; Shafa et al., 2020;
Zainal M, Goh PP., 1997). Tele-eye health is an emerging tool in providing eye care services to the people.
It helps in providing accessibility to eye care services (Keil S, Franklin A, Crofts K, Clery L, ColeHamilton I.
2001; Mohidin N & Yusoff S.,1998). During the Covid-19 pandemic, all countries worldwide implemented
lockdown or movement control order. In Malaysia, the Malaysian Government in March 2020 was
announced the implementation of the Movement Control Order (MCO) to stop the spread of Covid-19
disease. Due to that, many people have problems to get proper eye check-up. However, telemedicine
practice, particularly for eye health care is not available in Malaysia.
Many systems available in Malaysia are used either for the practice-based system. The system used
by many eye care practitioners or optometrists is focused on a patient database, inventory system, and
point of sales. The systems such as Rapid Optical System, Blink OMS, and Vision Plus are examples of
database systems to record patient information, sales, and inventory activities (Szyrkowiec et al., 2017;
Blenk, A. Basta, M. Reisslein, & W. Kellerer., 2016). These systems can only do the basic things such as fill
the power of patient spec and fill information about the patient such as name, identification number, phone
number, and patient address. The eye practitioners or optometrists need to manually fill all the data
manually, such as patient background, patient history, preliminary and entrance test information,
refractive examination data, post-refractive examination data, final prescription, and sales activities. These
essential data are insecure and exposed to non-confidentiality issues.
Furthermore, they do not provide the friendly diagnostic ability to faster, help early diagnosis and
analyse the data input. Thus there is a need to develop a secure, quick analyser for eye health assessment,
ocular health examination, and diagnosis of eye and vision problems and can be used for telemedicine. This
project aims to provide the general public with better access and proper eye consultation and check by
qualified eye care practitioners or optometrists.

Materials & Methods

The project consists of few phases to design a web-based eye care system and analyser. Figure 1
and Figure 2 show the methodology and phases used in this project.

Phase 1: Review of Related Product

This phase aims to review related products' benefits and drawbacks of specific goods and services
for the web-based model. An observation and interview were conducted to understand how the
optometrist does the patient's eye examination using the available system and manually. The element of
discovery is very important to take place market, user, and design. The process continued collecting data
and observation and lastly every data collected will be compiled.

Phase 2: Requirement
The objective in this phase was to define the system inputs, outputs, processes, and interfaces in
more detail. The existing system and manual of eye examination process available at MSU Eye Centre were

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studied, and the requirement for a web-based development was evaluated and determined. Table 1 shows
a requirement for the development of a web-based primary eye care system and analyser.

Phase 3: Design
The design phase involves developing one or more designs that can be used to achieve the desired
outcomes. For this project, the researcher used MS PowerPoint to do the design and prototype. This phase
also generated a variety of different outputs, including sketches, flowcharts, and more.

Phase 4: AUP Development

This project used Agile Unified Process (AUP) method because AUP can proactively resolve the
project risk associated with the user’s requirements and emphasize accurate documentation. There are
four phases in AUP: inception phase, elaboration phase, construction phase, and transition phase. The
researcher has tried to keep the Agile UP as simple as possible, both in its approach and description. Agile
methods emphasize face-to-face with real-time communication compared to written documents. The serial
nature of AUP is captured in its four phases that are shown in Figure 2.

Inception.
This phase aimed to identify the project's scope and a potential framework for the system to be
developed. To complete this phase, the researcher gathered the problem statement from the current
system that they used in Eye Centre MSU. From the problem statement, the researcher will get the objective
of this project: to develop web-based applications containing data collected from the patients to centralize
the data and user requirements to ensure that the project meets the objective and scopes.

Elaboration
In this phase, the researcher provides the architecture for the system to be developed. The
researcher will ensure that the researcher can develop a system that satisfies the requirement and
understands a vast majority of the requirements. Most of them are only briefly described in Inception and
focus on what to be achieved. The best way to do that is to create, design, and implement the diagram that
will show the functions, databases and prototype for this system. During this phase, the researcher will also
prepare for the construction phase by providing a stable basis for the design and implementation effort.
Figure2 shows a class diagram used for the elaboration method.

Construction
The detailed design of the required framework for development, execution, and operations to build
the intended system was constructed. The researcher will create the system using the design documents
as my guide. In this phase also the researcher will make sure the system is ready for pre-production testing.

Transition
The primary goal for this phase is to roll out the fully functional system to a user. During this phase,
the researcher will focus on correcting defects and modifying the system to fix the previously unidentified
problems. This transition phase is to evaluate the developed system to ensure quality. The validating
process is also taken to ensure the system works as designed and verified the requirements are met. Later,
the deployment and configuration methods were used to deliver the system, execute the plan, manage
access, and track artifact versions over time to control and manage changes to make the system available
to end users.

Phase 5: Analysis
The goal was to build a working mobile application on a regular, incremental basis that meets the
user's highest-priority need to examine a web-based application. The complete implementation of this
web-based application testing was carried out before deploying the application to know if it is fully
functional.

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Phase 6: Publish
This phase was done to complete the web-based application implementation before publishing it
to see whether it is fully functional or not for users.

Results and discussion

A Web-Based Primary Eye Care Analyser for Grading and Classifications by Smart Optometry
System was developed (Figure 4). A web-based system was assessed in various tests to ensure the program
meets its objective with all the elements of the program present and working according to the intended
functions. For the testing of the system developed, the developer focuses on testing small pieces of code,
such as a class that a developer is writing. Critical parts in testing are to ensure that the elements that have
been build work as expected and operated smoothly when combined with other parts of the application.
Such testing helps support the management of the application over time by ensuring that changes do not
inadvertently affect other parts of the system.
A web application can be a valuable tool for any business. Planning, developing, and promoting a web
application is the only way to ensure that the web app will be successful. A Web-Based Primary Eye Care
Analyzer for Grading and Classification by Smart Optometry System (Table 2) is a successful web
application that will take a “customer-centric” approach and aim to keep users top priority at all times. This
web-based primary eye care system and analyser help optometrists to provide better primary eye care
services to the public. The consistent standard of practice can help more Malaysians have healthier and
comfortable vision in the future and reduce the prevalence of undiagnosed vison problems. For MSU Eye
Centre, it is a great improvement over the manual system that currently available. It generates examination
reports and also provides the facility for searching the details of the patients and takes care of all the
information related to patients that come up to the eye centre. The web-based system helps to speed up
the process and better way of managing eye examination and investigation for complicated eye and vision
problems. This web application.
Conclusion
A Web-Based Primary Eye Care Analyzer for Grading and Classification by Smart Optometry
System is an application that provides a patient-centric approach and helps in early diagnosis and
intervention for Malaysians to have a healthier and comfortable vision.

Acknowledgments
The authors acknowledge the support of Management & Science University.

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References

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Table and Figure

Figure 1: Development phases of web-based primary eye care system analyser

Table 1: User Requirements

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Figure 2: UAP method used in developing a web-based primary eye care system analyser

Figure 3: Class diagram

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Figure 4: Interface of A web-based Primary Eyecare Analyser

Table 2: Final function of Web-Based Primary Eye Care Analyser

Functions Result Functions

Status Status

Add Users Objective: To ass Add Users

new users for the
system
Result: Able to meet Success Result: Able to meet
the requirements of the requirements of
the objective the objective
Add Patients Objective: To add Add Patients
new patients for the
system
Result: Able to meet Success Result: Able to meet
the requirements of the requirements of
the objective the objective
Add Examination Objective: To add Add Examination
new examination of
the patients
Result: Able to meet Success Result: Able to meet
the requirements of the requirements of
the objective the objective

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