Unusual apps: NETRA and CATRA
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Unusual apps: NETRA and CATRA

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  • Not just academic curiosity but potential for large impactWe call our tool NETRA: near eye tool for refractive assessmentsuch as nearsightedness/far/astigmatismBasic idea is to create a unique interactive lightfield display near the eye and is possible due to the highresolution of modern LCDs.
  • In this paper, we show a self-optometry solution. You look at a cell phone display thru a clip-on eye piece, interactively align a few patterns, hit calculate and get data for your eye prescription.
  • 2 billion people have refractive errorsAnd half a billion in developing countries worldwide have uncorrected vision that affects their daily livelihood. They don’t have access to an optometrist or it simply too expensive. While making and distributing of lenses has become quite easy now, surprisingly there isstill no easy solution for measuring eyesight.Can we use a fraction of the 4.5B cellphone displays to address this problem?
  • In 1960s, photography equipment was really crappy. They were expensive and bulky equipment, require specialized training, with high maintenance costs and they were not smart at all. But the worse thing about photography in that time is that you must go to a specific place to take the picture and then go back to get the results.
  • Well, today things changed. Each one of us carries at least 3 cameras: two eyes and a cell phone camera. Cameras are everywhere. They became cheap, accessible and easy-to-use without losing in accuracy.
  • Now, if you think about optometry today, the devices are expensive and bulky, they require specialized training, have high maintenance costs and they are not smart at all. Some of them do not even communicate with facebook. But the worse thing is that you must go to a specific place to take the eye exam and then go back to get the results.
  • So, we propose the increase of accessibility for optometry solutions by using high end scientific devices: cell phones. An smartphone screen today has the pixel size of 30 micrometers. At this resolution, the smartphone is not a phone anymore it is a scientific tool. With 4.5 billion phones out there, we can scale optometry and find half a billion people that today do not know that they need glasses.
  • The most accurate method is based on a so called SH WS. It involves shining a laser at the back of the retina and observing the wavefront using a sophisticated sensor.We ask user to generate a spot diagram. But navigating in a high dimensional space ischallenging so we come up with a strikingly simple approach to let the user interactively create the spotdiagram.We are first to make connection between Shack Hartmann and Lightfields (and it goes well with recentwork in computational photography about ALF and Zhang/Levoy). Connection to Adaptive optics/Astronomy. The way that this device works is that, it shines a lasers in the eye, the laser is reflected in the retina and comes out of the eye being distorted by the cornea. These light rays reaches an array of lenses that focus them to dots in a sensor. The device measures how much this dots deviate from the ideal case. Since it uses lasers, the device is expensive and requires trained professionals
  • For a normal eye, the light coming out of the eye forms a parallel wavefront. The sensor has a lenslet array and we get a spot diagram of uniform dots.This lenslet should remind you of a lightfield camera, and in fact Levoy and others showed last year that there is a close relationship between the two.In addition, Zhang and Levoy, plus our grp has shown the relationship between wavefront sensing and lightfield sensing.
  • When the eye has a distortion, the spot diagram is not uniform.And the displacement of the spots from the center indicates the local slope of the wavefront. From the slope one can integrate and recover the wave shape.
  • NETRA uses an exact inverse of this sensor. We get rid of the laser and we instead show the same spot diagram in a cellphone display. For normal eye, it will appear as a dot to the user.And then we replace the sensor for a light field display. If the user sees a single red dot, he does not need glasses, but if he sees more than one, he interacts with this display.
  • For eye with distortion, the user will interactively displace the 25 points so that he will see a single spot. Of course changing 25 spot locations is cumbersome, but we realize that there are only 3 parameters for eye-prescription and we help the user navigate thru this space efficiently.But if you think about these theory, you will realize that we have the dual of the shack-hartmann. First we though out the laser.
  • For eye with distortion, the user will interactively displace the 25 points so that he will see a single spot. Of course changing 25 spot locations is cumbersome, but we realize that there are only 3 parameters for eye-prescription and we help the user navigate thru this space efficiently.But if you think about these theory, you will realize that we have the dual of the shack-hartmann. First we though out the laser.
  • The human eye is like a camera. It has lenses, sensors and also aberrations. The human eye is composed of two main lenses: the cornea, which is main responsible for converging light rays to the retina; and the crystalline lenses, which is responsible for our ability of focus far and close by changing its shape.
  • So, in a perfect vision system, the light coming from a point at infinity will converge to a single point at the retina. A subject with perfect vision see clearly from infinity to up to 10cm.
  • Myopes cannot see far. Therefore, all the rays coming from a point at infinity, converges before the retina. The Accommodation range for those people is shifted to close, so they can closer than regular individuals.
  • The correction for myopia includes a divergent lens, which brings the focal point back to the retina by shifting the Accommodation range.
  • Hyperopes cannot see close. All the rays coming from a point at infinity, converges behind the retina. The Accommodation range for those people is shifted to the far field, so they can actually see “beyond infinity”. This remembers-me some other story, but let keep the focus here.
  • The correction for myopia includes a convergent lens, which shifts the Accommodation range back to the regular indivudial.
  • The correction for myopia includes a convergent lens, which shifts the Accommodation range back to the regular indivudial.
  • We need to measure the difference between the subject’s farthest focal point wrt infinity.
  • And this is measured in diopters which is 1 divided by this distance.
  • So, lets start with an eye with myopia. Remember, they cannot see far, so a red point at infinity for them will look like a red blur.
  • Using Shceiner’s principle, if we put two pinholes in the field, this will instead create two distinct dots.
  • Instead of a distant point source, we put an LCD display behind the pinholes. If we draw two spots exactly under these pin-holes, we create a virtual point at infinity.
  • So, as we move the two red circles toward each other, the virtual point gets closer to the subject and he sees the two red dots getting closer.
  • When this two red circles overlaps for the subject, we can compute d based on the spot displacements
  • Which is the distance between the eye and this virtual point.
  • Turns out that the inverse of D is the refractive power required for this person to see clearly objects at infinity. In other words, the lens that will shift the accommodation range of this subject back to the regular one.
  • In case of a perfect eye using the system, since the subject can see far, he will see the two points overlapping in his retina, meaning that he does not need glasses.
  • Hyperopes focal point is behind the retina.
  • When they move these spots away from each other, we are moving the virtual point beyond infinityAnd buzz lightyear will entually see they overlap, and when this happens, we can compute the…
  • convergent lens required to shift their accommodation range to the normal stage.
  • The version that I showed to you uses pinholes to encode the apperture.
  • However, if we change these pinholes for lenses, we can increase the light and also the number of testing points in the corneal surface, meaning that we can actually create a map of one’s refractive error. As you can see the pixel pitch directly affects the precision of creating virtual depth as well as refraction estimation.
  • And number of clicks required for alignment indicates the refractive error
  • In practice we display lines on the screen and the subject overlaps these lines by pressing the buttons of the cell phone or in the computer.
  • Two main benefitsNo moving partsBlur into a more objective alignment problemUnfortunately, the lightfield and virtual point analogy does not extend to astigmatism and we can also compute ‘focal range’ rather than just relaxed state. Vitor will cover this.”ThanksRamesh, There is a third condition called astigmatism
  • which is anangle-dependent refractive error. An astigmatic subject has two main focal lengths in perpendicular meridians. One …
  • Stronger and one weaker
  • Think of a cornea with the shape of an american football creating a cylindrical aberration with unknown focal length and axis.
  • The required correction is now a function of measured angle. In order to measure the farthest point for these guys, we need to evaluate Cylindrical component, the Spherical component, and the angle theta on the equation. However, the interpolation of refractive powers between C and S leads to a situation where the pattern drawn on the screen matters.
  • As you can see in this video, the astigmatic lenses create a deviation on the path of the pattern, and they may never overlap, turning the alignment task into a 2D search for some angles.
  • However, if we drawn lines perpendicular to the measured angle, the alignment task is again an 1D search. The deviation still exists, but the pattern makes the task easier.
  • So, we do the alignment task for a few meridians
  • By showing oriented lines on the display.
  • In the end, we best fit the sinusoidal curve over the four measured values to estimate the astigmatic parameters.
  • In the end, we best fit the sinusoidal curve over the four measured values to estimate the astigmatic parameters.
  • Ours is the only system where one can estimate not only the farthest point
  • one can focus but also
  • the nearest point without any mechanically moving parts. So, in order to measure the closest reading point
  • We draw a pattern on the screen that induces accommodation. In this way, when we move A and B closer on the screen,
  • the user will try to focus on a closer object. We can move this virtual point all the way to the nearest discernable point.
  • When the user is not able to focus anymore, the visual system give up and the user start seeing more than one pattern.
  • As I sad before, this is possible because we can draw whatever we want in the display. We tested many patterns, static and dynamic, including visual cryptography.
  • Turns out that the best pattern to induce accommodation is the sinosoidal curves aligned perpendicular to the measurement angle.
  • As a summary, our method has two steps. First measures the farthest point in focus in many angles using lines and the second step measures the nearest point using sinusoidals oriented on the angle of astigmatism.
  • Reading charts appear to be an easy solution, this method has too many problems. Sharpness of legible text is very subjective. The brightness of the chart has to be very carefully chosen otherwise the pupil size will change, increasing depth of field, and allowing user to recognize even lower rows.The trial lenses + the lens frame the doctor will use also cost over $150% Reading chart tests involve using a frame or a phoropter. The doctor will swing a sequence of lenses in front of your eye and ask for which lens allows you to see the lower rows on the reading chart.
  • For better precision, there are many kinds of solutions, some really clever. The beauty of netra is that it avoids moving parts or shining lasers, and all intelligence is in the software.
  • Since we are relying on the user interaction, the subject has to be aware of the alignment tasks. So, very young Children may not be able to run the test. Instead of just one eye, one may use both eyes to exploit convergence. And of course, the resolution of NETRA itself is a function of the resolution of the display. With a 326 dpi display, resolution is 0.14 diopters and presciption glasses come in increments of 0.25 diopters. So our system is already sufficiently accurate.
  • NETRA matches Retinoscopy
  • About 8 million worldwide are blind (worse than 3/60 vision) because of uncorrected refractive error, mostly from the developing world…3million from India. About 22.5 million worldwide are blind because of cataracts, 19 million in the developing world, 14 million in India. From lowered productivity to less independence in conducting simple tasks, the burden of blindness is well known. This can be solved if they had access to a diganostic test and glasses, but they don’t have access to an optometrist or it simply too expensive.While making and distributing of lenses has become quite easy now, surprisingly there is still no easy solution for measuring eyesight.Can we use a fraction of the 4.5B cellphone displays to address this problem?
  • NETRA uses an exact inverse of this sensor. We get rid of the laser and we instead show the same spot diagram in a cellphone display. For normal eye, it will appear as a dot to the user.And then we replace the sensor for a light field display. If the user sees a single red dot, he does not need glasses, but if he sees more than one, he interacts with this display.
  • NETRA uses an exact inverse of this sensor. We get rid of the laser and we instead show the same spot diagram in a cellphone display. For normal eye, it will appear as a dot to the user.And then we replace the sensor for a light field display. If the user sees a single red dot, he does not need glasses, but if he sees more than one, he interacts with this display.
  • NETRA uses an exact inverse of this sensor. We get rid of the laser and we instead show the same spot diagram in a cellphone display. For normal eye, it will appear as a dot to the user.And then we replace the sensor for a light field display. If the user sees a single red dot, he does not need glasses, but if he sees more than one, he interacts with this display.
  • Power for user intelligence can overcome very cumbersome and expensive devices. But unlike other condition eye screening is quite challenging.Modern solutions may provide students a fighting charge is a very rewarding.
  • New wireless eyecare ecosystemAnybody can take netra to patients, load .. Mobile partners, Deliver ..Because it is mobile and deskilled, breaks the barrier to entry, takes eyecare to remote areasDecouple diagnostics from delivery
  • Thanks XXXNETRA is a clip-on device that you attach to your cell phone. You look close, press some buttons, you hit calculate and it gives you the prescription for glasses. It’s a 2-dollar device that measures nearsightedness, farsightedness and astigmatism with the same accuracy that doctors have in their clinic.To understand what happened here, let’s think about the evolution of photography.

Unusual apps: NETRA and CATRA Unusual apps: NETRA and CATRA Presentation Transcript

  • 1
    Health Power to the People
  • NETRA: Interactive Display for Estimating Refractive Errors and Focal Range
    Vitor Pamplona Ankit Mohan Manuel M. Oliveira RameshRaskar
    2
  • 3
    Millions have poor vision, but are not getting corrected…
    Kenya
    2B have
    refractive errors
    0.6B have URE
    4.5B have a
    cell phone
    India
    6.5 Billion
    people
    3
  • Photography in 1960s
    Photo: IllanaTamir
    Photo: Roboppy
  • Today, cameras are everywhere
    Photo: Tyler
    Photo: Derek K. Miller
    Photo: John Kannenberg
  • Optometry Today
    Corneal Topographer
    Wavefront Aberrometer
    Phoropter
    Trial set of lenses
    Lasers
    Snellen chart
  • NETRA: low-cost easy-to-use clip on for cell phones
    Do the test at home, by yourself, in 2 minutes
  • Shack-Hartmann Wavefront Sensor
    Wavefrontaberrometer
    Expensive; Bulky, Requires trained professionals
    8
  • Shack-Hartmann Wavefront Sensor
    Laser
    Spot Diagram
    Planar Wavefront
    Sensor
    Microlens Array
  • Shack-Hartmann Wavefront Sensor
    Laser
    Spot Diagram
    10
    Sensor
    Displacement = Local Slope of the Wavefront
  • NETRA= Inverse of Shack-Hartmann
    11
    Spot Diagram on LCD
    Cell Phone Display
    Eye Piece
  • 12
    Inverse of Shack-Hartmann
    User interactively creates the Spot Diagram
    Spot Diagram on LCD
    Displace 25 points but 3 parameters
  • 13
    Inverse of Shack-Hartmann
    User interactively creates the Spot Diagram
    Spot Diagram on LCD
    Displace 25 points but 3 parameters
  • Human Eye
    Retina
    Human Eye
    Cornea
    (~40D)
    Crystalline lens
    (10~20D)
    14
  • Human Eye
    Accommodation
    Retina
    Human Eye
    Cornea
    (~40D)
    Crystalline lens
    (10~20D)
    15
  • Perfect Vision System
    Infinity
    Subject
    can focus
    at infinity
    Human Eye
    Accommodation Range
    Normal Vision
    10cm
    Infinity
    16
  • Myopia (nearsightedness)
    Infinity
    Subject
    cannot focus
    at far distances
    Wrong
    focal point
    Human Eye
    Accommodation Range
    Normal Vision
    Myopia
    10cm
    Infinity
    17
  • Myopia Correction
    Infinity
    Subject
    can focus
    at infinity
    Divergent Lens
    Human Eye
    Accommodation Range
    Normal Vision
    Corrected Myopia
    Myopia
    10cm
    Infinity
    18
  • Hyperopia (farsightedness)
    Infinity
    Wrong
    focal point
    Human Eye
    Accommodation Range
    Normal Vision
    Myopia
    Hyperopia
    10cm
    Infinity
    19
  • Hyperopia Correction
    Infinity
    Convergent Lens
    Human Eye
    Accommodation Range
    Normal Vision
    Myopia
    Hyperopia
    10cm
    Infinity
    20
    Corrected Hyperopia
  • Hyperopia Correction
    Infinity
    Convergent Lens
    Human Eye
    Accommodation Range
    Normal Vision
    Myopia
    Hyperopia
    10cm
    Infinity
    21
    Corrected Hyperopia
  • Refractive Errors and Shifted Range
    Perfect vision
    Need to measure
    Myopia
    Hyperopia
    10cm
    Infinity
    22
    1m
    33cm
    Distance
  • Refractive Errors and Shifted Range
    Perfect vision
    Myopia
    Hyperopia
    10cm
    Infinity
    23
    1m
    33cm
    Distance
    -10D
    0D
    -3D
    -1D
    +1D
    +3D
    Diopter
    Diopter = 1/Distance
  • Relaxed Eye with Myopia
    Eye
    Red pointat infinity
    Blurred
    point
    Focusing Range
    perfect vision
    myopia
    hyperopia
    ~10cm
    infinity
    24
  • Relaxed Eye with Myopia
    Eye
    Pinholes
    Distinct
    image
    points
    Red pointat infinity
    Focusing Range
    perfect vision
    Scheiner’s Principle
    myopia
    hyperopia
    ~10cm
    infinity
    25
  • Relaxed Eye with Myopia
    Eye
    Display
    A
    Distinct
    image
    points
    Virtual red pointat infinity
    B
    Focusing Range
    perfect vision
    myopia
    hyperopia
    ~10cm
    infinity
    26
  • Relaxed Eye with Myopia
    Eye
    Display
    Move spots towardseach other
    A
    Distinct
    image
    points
    Virtual red pointat finite distance
    B
    Focusing Range
    perfect vision
    myopia
    hyperopia
    ~10cm
    infinity
    27
  • Relaxed Eye with Myopia
    Eye
    Display
    Move spots towardseach other
    A
    Points
    overlap
    Virtual red pointat finite distance
    B
    Focusing Range
    perfect vision
    myopia
    hyperopia
    ~10cm
    infinity
    28
  • Relaxed Eye with Myopia
    Eye
    Display
    Move spots towardseach other
    A
    Points
    overlap
    Virtual red pointat finite distance
    B
    Focusing Range
    perfect vision
    myopia
    hyperopia
    ~10cm
    infinity
    29
  • Relaxed Eye with Myopia
    Eye
    Points
    overlap
    Point at infinity
    Focusing Range
    perfect vision
    myopia
    hyperopia
    ~10cm
    infinity
    30
  • Relaxed Perfect Eye
    Display
    A
    Points
    overlap
    Virtual red pointat infinity
    B
    Focusing Range
    perfect vision
    myopia
    hyperopia
    ~10cm
    infinity
    31
  • Relaxed Eye with Hyperopia
    32
    Eye
    Display
    A
    Distinct
    image
    points
    Virtual red pointat infinity
    B
    Focusing Range
    perfect vision
    myopia
    hyperopia
    ~10cm
    infinity
  • Relaxed Eye with Hyperopia
    Move spots awayfrom each other
    Display
    Display
    A
    Points
    overlap
    B
    Virtual point“beyond” infinity
    Focusing Range
    perfect vision
    myopia
    hyperopia
    ~10cm
    infinity
    33
  • Relaxed Eye with Hyperopia
    Move spots awayfrom each other
    Points
    overlap
    Virtual point“beyond” infinity
    Focusing Range
    perfect vision
    myopia
    hyperopia
    ~10cm
    infinity
    34
  • NETRA: Using pinholes
    35
    Pinhole array
    Patterns on an LCD
  • NETRA: Using Lens to Increase Light
    Microlensarray
    Patterns on an LCD
    a
    f
    36
    t
    Pixel Pitch
    Virtual Depth
  • Interactive Method
    Farthest Focal Point
    (myopia, hyperopia)
    37
  • Interactive Method
    38
    Farthest Focal Point
    (myopia, hyperopia)
  • Interactive Method
    Farthest Focal Point
    (myopia, hyperopia)
    39
  • Overview
    40
    • Inverse of Shack Hartmann Wavefront Sensor
    • Hi-res displays + interaction
    • Measuring Spherical Error
    • No moving parts, lasers
    • Blur -> Alignment problem
    • ~ Lightfield Display for Single Eye
    • Astigmatism
    • Novel Patterns
    • Focal Range
    • User Study
  • Astigmatism: angle-dependent refractive error
    http://www.elizabethpope.co.uk/eyeinfo/astigmatism.html
    41
  • Astigmatism: angle-dependent refractive error
    http://www.elizabethpope.co.uk/eyeinfo/astigmatism.html
    42
  • Astigmatism: angle-dependent refractive error
    http://www.elizabethpope.co.uk/eyeinfo/astigmatism.html
    43
  • Refractive Power as a Function of Angle
    44
    Axis Cyl.
    Cylinder
    Unknowns:
    Sphere
  • Astigmatism
    Cross or points may never meet with a 1d search !
    45
  • Astigmatism
    Lines reduce the problem to a 1d search
    46
  • Interactive Method
    Farthest Focal Point
    (myopia, hyperopia, astigmatism)
    47
  • Interactive Method
    Farthest Focal Point
    (myopia, hyperopia, astigmatism)
    48
  • Interactive Method
    Farthest Focal Point
    (myopia, hyperopia, astigmatism)
    49
  • Interactive Method
    Farthest Focal Point
    (myopia, hyperopia, astigmatism)
    50
  • Interactive Method
    Farthest Focal Point
    (myopia, hyperopia, astigmatism)
    51
  • Measuring the Accommodation Range
    52
    Myopia
    Perfect vision
    Hyperopia
    ~10cm
    Infinity
    Step 2: Near limit
    Step 1: Far limit
  • Measuring the Accommodation Range
    53
    Myopia
    Perfect vision
    Hyperopia
    ~10cm
    Infinity
    Step 2: Near limit
    Step 1: Far limit
  • Measuring the Accommodation Range
    54
    Myopia
    Perfect vision
    Hyperopia
    ~10cm
    Infinity
    Step 2: Near limit
    Step 1: Far limit
  • Relaxed Eye
    Display
    A
    Points
    overlap
    Virtual Point at the far limit
    B
    55
  • Accommodated Eye
    Display
    Move points towards each other
    A
    Points
    overlap
    B
    56
    Virtual pointgetting closer
    Subject Accommodates
    to fix the “blur”
  • Accommodated Eye
    Display
    Move points towards each other
    A
    Points
    overlap
    B
    57
    Virtual pointgetting closer
    Subject Accommodates
    to fix the “blur”
  • Accommodated Eye
    Display
    Move points towards each other
    A
    Points
    overlap
    B
    58
    Virtual pointgetting closer
    Subject cannot accommodate more than the previous point
  • Patterns for Alignment Task
    59
    A
    B
    A
    B
    A
    B
    A
    B
    A
    B
    Displayed
    Subject view
    A
    B
    A
    B
    A
    B
    A
    B
    A
    B
    Displayed
    Subject view
    Visual
    Cryptography
    [NaorShamir94]
  • Patterns for Alignment Task
    60
    A
    B
    A
    B
    A
    B
    A
    B
    A
    B
    Displayed
    Subject view
    A
    B
    A
    B
    A
    B
    A
    B
    A
    B
    Displayed
    Subject view
    Visual
    Cryptography
    [NaorShamir94]
  • Summary of Interaction
    Accommodation Range
    Farthest Point
    (myopia, hyperopia, astigmatism)
    NearestPoint
    (presbyopia)
    61
  • Accuracy
    Sharpness Estimation is subjective
    Brightness affects results
    Pupil size variation and DoF
    Cost
    Trial Lens Set > $150
    Bulky
    Snellen chart
    Phoropter
    Trial lenses
    Reading Charts
  • Needs expert, Moving parts, Shining lasers
    * Phoropter-based: $5,000.00
  • Limitations
    Children
    Ability to align lines
    Single Eye test
    Other eye for convergence-forced accommodation
    Resolution is a function of the display DPI
    Samsung Behold II – 160 DPI – 0.35D
    Google Nexus One – 250 DPI – 0.2D
    Apple iPhone 4G – 326 DPI – 0.14D
    64
  • Media Coverage
    BBC
    CNN
    NBC
    MIT News
    O Estado de SP - Brazil
    Gizmodo
    NY Times
    Time - Wellness
  • Confidential
    66
    NETRA Prototypes Worldwide
    29 partners in 14 countries.
  • Clinical Testing Partners
  • NETRA Team at LVPEI, India
  • OneSight, Kenya
  • Validation: Side by Side Trials
    13 adults
    29 adults
    Tufts U. (Boston) NETRA vs Manifest Refraction
    LVPEI (India)
    NETRA vsRetinoscopy
  • Preventable Blindness
    71
    WHO 2004
  • CATRA: Cataract Screening Tool
    Unique, quantitative lens mapping for size and density of eye opacities
  • Testing the Presence of Cataracts
    73
    Blinking patterns on Screen
    Pinhole
    Lens
    Cell Phone Display
  • Point Spread Function Mapping
    74
    Blinking patterns on Screen
    Pinhole
    Lens
    Cell Phone Display
  • Point Spread Function Mapping
    75
    Blinking patterns on Screen
    Pinhole
    Lens
    Cell Phone Display
  • Traditional
    User Driven
    Mass-use Devices  Scientific Instruments
  • For the Future
    Ophtalmology for Masses
    >.5 billion URE. > 2.5 billion RE. -> Devices for all
    Quality of phones (resolution) will increase exponentially
    New features (recently cataracts, next Retinal Netra)
    Smart phones will take over the market in developing world countries like India in next 5 years.
    Hardware store
  • New Ecosystem
    Medical IT Systems
    EHR
    Eyecare
    Providers
    Delivery
    Diagnostic
    Asynchronous
  • NETRA
    http://eyenetra.com