Thursday, 14 November 2013


Every five seconds, someone, somewhere in the world goes blind. Every minute, one more child goes blind – and 60% of these children die within a year.
There are up to 45 million people already blind across the world. Without effective intervention, this figure is set to rise to 76 million by 2020.  More than 90% are in the developing world. India suffers a worrisome 12%.  Cataract, Diabetic Retina, Glaucoma, Cornea and Refraction problems constitute 90% of blindness.
Most importantly, over 80% of this blindness is needless and can be easily prevented or treated. In rural India, a vicious cycle of poverty and limited resources play havoc with the lives, thus impacting the well-being of the nation as a whole.
Another major challenge in this segment of healthcare is identifying the population that needs treatment. Our current system needs expensive diagnostic devices for screening, requiring separate devices for each problem, coupled with the availability of highly skilled technicians and ophthalmologists during screening. This increases the cost of service substantially and hence limits scalability; this has resulted in a grossly under serving the rural market. Only around 7-10% of people at various stages of blindness are screened and treated as of today.
Dr Shyam Vasudeva Rao from Bangalore decided to crack this problem and after putting 1.5 years of hard work, he and his dynamic group of technocrats at ‘Forus Health’ designed revolutionary device ‘3nethra’ which is world first portable, intelligent, non-invasive, non-mydriatic eye pre-screening headhunt device which is extremely cost effective and can be operated by a minimally trained technician.  3netra can simultaneously detect 5 major and most common ailments; Cataract, Refraction, Diabetic Retina, Glaucoma, Corneal Problems.
Dr. Shyam has a doctorate in Real Time Embedded Systems, specialising in Parallel Computer Architecture from Indian Institute of Science (gold Medal) & has worked for CG Smith, Ericsson & Tata Consultancy Services and Philips. Working as a director of technology in Philips Innovation Campus Bangalore, he established the innovation framework for Consumer Electronics and Medical Systems division. Dr. Shyam is very passionate about offering low cost technological solutions aimed at rural health.
While elaborating the need for 3netra kind of solution Dr. Shyam says “About 8 years back, we had the opportunity of meeting Dr. G.Venkataswamy, founder of the world famous Aravind Eye Hospital, Madurai. He helped us realise the seriousness of blindness in India and also explained how Arvind Eye Hospital was using innovative methods to reach the poor. The discussion was overwhelming and we were very fascinated by the kind of service the Arvind Eye hospital was doing by almost serving 2/3rd of its customers for free. We wanted to use our technology background to solve our countries health problems. This made us work on the idea of needless blindness prevention as the first step”.
Using 3nethra, Forus Health aims to increase pre-screening efficiency for eyes related problems in rural India. The initial version of 3netra was aimed at adult and elderly patients but now Dr. Shyam’s team have developed a version with in-build refractometry for screening eye defects in small children. This is huge step forward for preventing needless blindness in young kids.
Dr. Shyam says “another major eye problem which we are currently working on is to detect retinopathy in prematurely born babies as the rate of blindness is extremely high if not diagnosed and treated within 48 hours of birth. We are building a version of 3netra to address this problem which will be available soon.”
In India, 3netra has been very effective in screening population, outside the hospitals, in camps, Kiosks, RTO office, wedding halls, social gathering etc. and the results were quite shocking.  In a year they screened around 300 thousand people but the alarming part was that, among those who were diabetic, 32 % of them had diabetic retina while the world average is 20%. This has major impact on the other organs as well and there is more than 90% correlation between diabetic retina and diabetic nephropathy or Chronic Kidney Disease (CKD).
If one does not know that they have CKD, and hence cannot manage this disease, then they could soon get into end stage and the treatment is putting them on dialysis. This looked like a much bigger problem that eye problems. Eye care and Kidney care are two very different things, the competencies are different, the hospitals are different, the market dynamics are different except that both have diabetes in common. And managing diabetes could manage DR as well as CKD.
So now Dr. Shyam and his team are working on project called ‘RenalyX’. It works with screening CKD and those having this problem, they will be put on a disease management and those unlucky ones who have reached end stage renal disease (ESRD) they are put on hemo-dialysis, which can be done in tire 2 and tire 3 towns as well as rural areas. The products and services are just getting developed and too early to count any success.

3netra has won multiple national and international awards for the technological innovation but what is more heartening is that it offers solution which is aimed at masses. Dr. Shyam adds “one of the key differentiator of Forus is that we are working on a problem & the products we develop are only a consequence. Our aim is to see how we can address needless blindness through technology.” Till date, Forus’ 3nethra has been exported and installed in more than 20 countries including France. 

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