Gamifying Vision: How Mobile Gaming Is Tracking Vision Degradation in Patients
By Allison Proffitt
June 16, 2021 | The Tilak Healthcare motto is “You play, we care.” The vision is to combine video games with medical expertise so that the same tools that are reliable and useful for doctors are also playful and fun for users. If Tilak can achieve that, Edouard Gasser says, the company tools will be “sticky” enough to have a longstanding impact on the healthcare process for patients.
Gasser is CEO of Tilak and hails from the video game industry. Before cofounding Tilak he was Studio Director at Gameloft Madrid, a company developing and editing videogames. While Gasser brings the video game expertise, his co-founder, Jose-Alain Sahel brings the medical expertise. Dr. Sahel is chair of the department of ophthalmology at the University of Pittsburgh School of Medicine and is a scientific co-founder on several companies focusing on innovative vision restoration and care.
In 2016, Gasser and Sahel met, and Sahel pitched his idea for a gaming tool to more frequently monitor his patients who had chronic diseases of aging. The result of that meeting was the first Tilak Healthcare product: OdySight, an app Gasser describes as a highly-engaging, clinically-validated, medical mobile game to help monitor patients with chronic eye diseases of aging such as AMD and diabetic retinopathy.
The app doesn’t diagnose eye disease and playing the games doesn’t claim to improve visual acuity. Instead, OdySight is available by prescription only for current patients and uses the phone’s camera and patient input to flag changes in patient vision.
The Patient Experience
Patients are introduced to the app by their retinal specialist who prescribes OdySight through a unique code that launches a secure download from the Apple or Google app store. The doctor puts in the patient baseline based on treatment thus far, and the first use of the OdySight app—1 to 3 minutes—usually takes place in the doctor’s office. That first use combined with the doctor’s entered data calibrates the app’s baseline visual acuity for the patient.
From there, the patient plays OdySight games regularly to continue tracking visual trends. A user session consists of two parts: medical modules and dynamic puzzle games. The two clinically-validated medical modules launch first when a user opens the app. One measures visual acuity; the other is an Amsler grid test, a tool for flagging problem spots in the field of vision. Completing the medical modules earns patients “energy” to play games: “a fantastic adventure composed of dynamic puzzles where you have to recompose an image,” Gasser explained.
The medical module, Gasser said, “is obviously less fun than the core gameplay, but it’s really easy to use and super short. It’s highly sensitive from a clinical standpoint. We have built a unique technology that measures the distance from your face to the screen to be sure that when you’re doing your test it’s always in the right conditions.” Users are guided by visual tutorials plus voice overs.
While the medical module is the only portion of the user experience that Tilak claims is clinically validated, Gasser said the app is collecting data during gameplay as well and comparing how a user interacts with the game to how they are scoring on the medical module. That connection is likely to get stronger and more telling over time.
The Doctor Experience
For doctors, OdySight is designed to be easy to incorporate into their clinical routines and not overly invasive. Doctors have a patient dashboard; color codes group users as inactive, active and well, or active and requiring medical attention. Tilak is wary of over-notifying doctors, Gasser said, and tries to limit doctor emails to twice a week.
One missed test within the medical module doesn’t raise red flags, but several bad results indicate a trend and trigger an alert to both the patient and the doctor.
“When there is a drop in visual acuity, usually what doctors say is you need to go see your ophthalmologist within 10-14 days. When you look at the lack of resources that you have in terms of number of ophthalmologists, and how hard it is to access treatment, you realize that having a tool that helps you monitor those changes is critical to optimizing the healthcare process,” Gasser explains.
According to OdySight case studies, the app alerts patients and doctors to changes in vision before they became obvious to patients. That need has been even more pronounced during the pandemic. “In France, we had a super meaningful case, especially during the COVID crisis… where actually OdySight detected a change in vision that led to an injection that was not planned at all by the traditional [medication schedule],” Gasser added.
Tilak received its C mark in September 2018 in France and now serves 350 French retinal specialists who have written 3,000 app prescriptions for patients. Users range from 40 to 94 years old, with the average patient user being 72.
Gasser said the OdySight app has given great peace of mind to patients with chronic vision diseases who are watching their vision deteriorate. “For most of them, sight is life! They are very anxious; they don’t sleep well because they know that from one day to another their vision can drop,” Gasser said. “They are really interested in monitoring their own sight and having OdySight is a huge tool to decrease the level of anxiety that is basically caused by the disease.”
Expanding into the US and Internationally
Tilak reached retinal specialists in France by doing a co-promotion with Novartis in 2019, the manufacturer of the treatments for these diseases. “Right now you have approximately 30% of the patients are dropping out of treatment,” Gasser said. Novartis wants OdySight to serve as a link between doctor and patient.
In December 2020, Tilak and Novartis expanded that partnership internationally. Worldwide, 650 million people are in need of regular visual acuity assessments, according to the World Health Organization (WHO). Novartis hopes that regular follow-ups between scheduled clinic visits using digital tools like OdySight may facilitate the improvement of patient care.
Tilak plans to be the leader in this new type of medicine in ophthalmology, Gasser said. “What we’re building with Novartis across the globe—in the US and also across Europe—we do want to become the number one platform to monitor vision remotely. We started with chronic eye diseases of aging, but we want to go beyond that.” In the future that could mean screening for onset of vision diseases or expanding into other ophthalmic diseases.
And Tilak isn’t limiting their vision to just ophthalmology. “We believe that medical gaming can have long standing impact on many types of diseases,” Gasser said. Next in view: gaming to prevent relapse for addiction patients.