The comparison between Arclight loupe and handheld Slit lamp in anterior segment eye disease diagnosis

Immaculate Atukunda; Rebecca Claire Lusobya; Andrew Weil Semulimi; John Mukisa; Abubakar Kalinaki; Caroline Nalukenge; Pamela Okwir Apio; Denis Erima; Charles Batte; David Mukunya; Juliet Otiti-Sengeri; Obaid Kousha; Andrew Blaikie

doi:10.2147/MDER.S550130

The comparison between Arclight loupe and handheld Slit lamp in anterior segment eye disease diagnosis

Immaculate Atukunda^*, Rebecca Claire Lusobya, Andrew Weil Semulimi, John Mukisa, Abubakar Kalinaki, Caroline Nalukenge, Pamela Okwir Apio, Denis Erima, Charles Batte, David Mukunya, Juliet Otiti-Sengeri, Obaid Kousha, Andrew Blaikie

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: Early diagnosis of eye diseases improves outcomes and reduces blindness. However, diagnostic capacity in resource-poor settings is limited by a shortage of trained and equipped healthcare professionals. The Arclight device is a user-friendly, cost-effective diagnostic tool for both anterior and posterior segment eye diseases that requires minimal training. Studies have shown it to be effective for assessing the fundal reflex and performing fundoscopy; however, its accuracy and acceptability for anterior segment eye disease are still unknown.

Methods: This was a cross-sectional study carried out at Mulago National Super Specialised Hospital, where 21 ophthalmic clinical officers (OCOs) were recruited from surrounding districts. Each participant evaluated eleven patients with anterior segment pathologies and one normal case using the Arclight loupe and a handheld Slit Lamp. The diagnosis and the proportion of correctly identified conditions were recorded. Focus group discussions were held to assess the acceptability of using the devices. Discussions were transcribed verbatim and analysed using latent and manifest content analysis.

Results: Of the 21 participants, 13 (61.9%) were female, with a median age of 39 (IQR: 33– 49), and had practiced for 6 to 10 years, representing 76.2%. The majority of conditions were correctly identified by both the Arclight (71.2%) and handheld slit lamp (72.3%). Pterygium was the most accurately diagnosed condition (100%) with the Arclight. Based on themes from Sekhon’s framework and the Technology Acceptance Model, the Arclight device was found to be highly acceptable and easy for OCOs to use.

Conclusion: The performance of the OCOs in diagnosing anterior segment diseases with the Arclight is comparable to that of a handheld Slit lamp. It was also found to be an acceptable device for diagnostic purposes. In conclusion, the Arclight device is a suitable, low-cost alternative to the handheld Slit Lamp, especially in resource-limited settings.

Original language	English
Pages (from-to)	553-564
Number of pages	12
Journal	Medical Devices: Evidence and Research
Volume	18
DOIs	https://doi.org/10.2147/MDER.S550130
Publication status	Published - 11 Nov 2025

Keywords

Diagnostic accuracy
Low-cost medical devices
Portable ophthalmic devices
Technology acceptance
Blindness

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Atukunda, I., Lusobya, R. C., Semulimi, A. W., Mukisa, J., Kalinaki, A., Nalukenge, C., Apio, P. O., Erima, D., Batte, C., Mukunya, D., Otiti-Sengeri, J., Kousha, O., & Blaikie, A. (2025). The comparison between Arclight loupe and handheld Slit lamp in anterior segment eye disease diagnosis. Medical Devices: Evidence and Research, 18, 553-564. https://doi.org/10.2147/MDER.S550130

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title = "The comparison between Arclight loupe and handheld Slit lamp in anterior segment eye disease diagnosis",

abstract = "Introduction: Early diagnosis of eye diseases improves outcomes and reduces blindness. However, diagnostic capacity in resource-poor settings is limited by a shortage of trained and equipped healthcare professionals. The Arclight device is a user-friendly, cost-effective diagnostic tool for both anterior and posterior segment eye diseases that requires minimal training. Studies have shown it to be effective for assessing the fundal reflex and performing fundoscopy; however, its accuracy and acceptability for anterior segment eye disease are still unknown. Methods: This was a cross-sectional study carried out at Mulago National Super Specialised Hospital, where 21 ophthalmic clinical officers (OCOs) were recruited from surrounding districts. Each participant evaluated eleven patients with anterior segment pathologies and one normal case using the Arclight loupe and a handheld Slit Lamp. The diagnosis and the proportion of correctly identified conditions were recorded. Focus group discussions were held to assess the acceptability of using the devices. Discussions were transcribed verbatim and analysed using latent and manifest content analysis. Results: Of the 21 participants, 13 (61.9\%) were female, with a median age of 39 (IQR: 33– 49), and had practiced for 6 to 10 years, representing 76.2\%. The majority of conditions were correctly identified by both the Arclight (71.2\%) and handheld slit lamp (72.3\%). Pterygium was the most accurately diagnosed condition (100\%) with the Arclight. Based on themes from Sekhon{\textquoteright}s framework and the Technology Acceptance Model, the Arclight device was found to be highly acceptable and easy for OCOs to use. Conclusion: The performance of the OCOs in diagnosing anterior segment diseases with the Arclight is comparable to that of a handheld Slit lamp. It was also found to be an acceptable device for diagnostic purposes. In conclusion, the Arclight device is a suitable, low-cost alternative to the handheld Slit Lamp, especially in resource-limited settings.",

keywords = "Diagnostic accuracy, Low-cost medical devices, Portable ophthalmic devices, Technology acceptance, Blindness",

author = "Immaculate Atukunda and Lusobya, \{Rebecca Claire\} and Semulimi, \{Andrew Weil\} and John Mukisa and Abubakar Kalinaki and Caroline Nalukenge and Apio, \{Pamela Okwir\} and Denis Erima and Charles Batte and David Mukunya and Juliet Otiti-Sengeri and Obaid Kousha and Andrew Blaikie",

note = "Funding: The study was funded by the Makerere Research \& Innovations Fund 3 (MAKRIF/CH/02/21). Matched funding was also secured from the University of St. Andrews in Scotland for purchasing Arclight medical devices. AWS was a research fellow of the MakNCD program(D43TW011401) supported by the Fogarty International Centre of the National Institutes of Health. JM was a Ph.D. student awarded under the Nurturing Genomics and Bioinformatics Research Capacity in Africa (BRECA) grant (U2RTW010672) from the Fogarty International Centre of the National Institutes of Health.",

year = "2025",

month = nov,

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doi = "10.2147/MDER.S550130",

language = "English",

volume = "18",

pages = "553--564",

journal = "Medical Devices: Evidence and Research",

issn = "1179-1470",

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Atukunda, I, Lusobya, RC, Semulimi, AW, Mukisa, J, Kalinaki, A, Nalukenge, C, Apio, PO, Erima, D, Batte, C, Mukunya, D, Otiti-Sengeri, J, Kousha, O & Blaikie, A 2025, 'The comparison between Arclight loupe and handheld Slit lamp in anterior segment eye disease diagnosis', Medical Devices: Evidence and Research, vol. 18, pp. 553-564. https://doi.org/10.2147/MDER.S550130

TY - JOUR

T1 - The comparison between Arclight loupe and handheld Slit lamp in anterior segment eye disease diagnosis

AU - Atukunda, Immaculate

AU - Lusobya, Rebecca Claire

AU - Semulimi, Andrew Weil

AU - Mukisa, John

AU - Kalinaki, Abubakar

AU - Nalukenge, Caroline

AU - Apio, Pamela Okwir

AU - Erima, Denis

AU - Batte, Charles

AU - Mukunya, David

AU - Otiti-Sengeri, Juliet

AU - Kousha, Obaid

AU - Blaikie, Andrew

N1 - Funding: The study was funded by the Makerere Research & Innovations Fund 3 (MAKRIF/CH/02/21). Matched funding was also secured from the University of St. Andrews in Scotland for purchasing Arclight medical devices. AWS was a research fellow of the MakNCD program(D43TW011401) supported by the Fogarty International Centre of the National Institutes of Health. JM was a Ph.D. student awarded under the Nurturing Genomics and Bioinformatics Research Capacity in Africa (BRECA) grant (U2RTW010672) from the Fogarty International Centre of the National Institutes of Health.

PY - 2025/11/11

Y1 - 2025/11/11

N2 - Introduction: Early diagnosis of eye diseases improves outcomes and reduces blindness. However, diagnostic capacity in resource-poor settings is limited by a shortage of trained and equipped healthcare professionals. The Arclight device is a user-friendly, cost-effective diagnostic tool for both anterior and posterior segment eye diseases that requires minimal training. Studies have shown it to be effective for assessing the fundal reflex and performing fundoscopy; however, its accuracy and acceptability for anterior segment eye disease are still unknown. Methods: This was a cross-sectional study carried out at Mulago National Super Specialised Hospital, where 21 ophthalmic clinical officers (OCOs) were recruited from surrounding districts. Each participant evaluated eleven patients with anterior segment pathologies and one normal case using the Arclight loupe and a handheld Slit Lamp. The diagnosis and the proportion of correctly identified conditions were recorded. Focus group discussions were held to assess the acceptability of using the devices. Discussions were transcribed verbatim and analysed using latent and manifest content analysis. Results: Of the 21 participants, 13 (61.9%) were female, with a median age of 39 (IQR: 33– 49), and had practiced for 6 to 10 years, representing 76.2%. The majority of conditions were correctly identified by both the Arclight (71.2%) and handheld slit lamp (72.3%). Pterygium was the most accurately diagnosed condition (100%) with the Arclight. Based on themes from Sekhon’s framework and the Technology Acceptance Model, the Arclight device was found to be highly acceptable and easy for OCOs to use. Conclusion: The performance of the OCOs in diagnosing anterior segment diseases with the Arclight is comparable to that of a handheld Slit lamp. It was also found to be an acceptable device for diagnostic purposes. In conclusion, the Arclight device is a suitable, low-cost alternative to the handheld Slit Lamp, especially in resource-limited settings.

AB - Introduction: Early diagnosis of eye diseases improves outcomes and reduces blindness. However, diagnostic capacity in resource-poor settings is limited by a shortage of trained and equipped healthcare professionals. The Arclight device is a user-friendly, cost-effective diagnostic tool for both anterior and posterior segment eye diseases that requires minimal training. Studies have shown it to be effective for assessing the fundal reflex and performing fundoscopy; however, its accuracy and acceptability for anterior segment eye disease are still unknown. Methods: This was a cross-sectional study carried out at Mulago National Super Specialised Hospital, where 21 ophthalmic clinical officers (OCOs) were recruited from surrounding districts. Each participant evaluated eleven patients with anterior segment pathologies and one normal case using the Arclight loupe and a handheld Slit Lamp. The diagnosis and the proportion of correctly identified conditions were recorded. Focus group discussions were held to assess the acceptability of using the devices. Discussions were transcribed verbatim and analysed using latent and manifest content analysis. Results: Of the 21 participants, 13 (61.9%) were female, with a median age of 39 (IQR: 33– 49), and had practiced for 6 to 10 years, representing 76.2%. The majority of conditions were correctly identified by both the Arclight (71.2%) and handheld slit lamp (72.3%). Pterygium was the most accurately diagnosed condition (100%) with the Arclight. Based on themes from Sekhon’s framework and the Technology Acceptance Model, the Arclight device was found to be highly acceptable and easy for OCOs to use. Conclusion: The performance of the OCOs in diagnosing anterior segment diseases with the Arclight is comparable to that of a handheld Slit lamp. It was also found to be an acceptable device for diagnostic purposes. In conclusion, the Arclight device is a suitable, low-cost alternative to the handheld Slit Lamp, especially in resource-limited settings.

KW - Diagnostic accuracy

KW - Low-cost medical devices

KW - Portable ophthalmic devices

KW - Technology acceptance

KW - Blindness

UR - https://www.scopus.com/pages/publications/105021569980

U2 - 10.2147/MDER.S550130

DO - 10.2147/MDER.S550130

M3 - Article

SN - 1179-1470

VL - 18

SP - 553

EP - 564

JO - Medical Devices: Evidence and Research

JF - Medical Devices: Evidence and Research

ER -

The comparison between Arclight loupe and handheld Slit lamp in anterior segment eye disease diagnosis

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