Correcting Eyesight with Virtual Reality and Lean Startup

Lean Healthcare Helped This Entrepreneur Correct His Vision

Health-tech entrepreneurs are rightfully cautious about inputting life-altering MVPs into play. Their new products are often bound by both ethical standards and industry regulations. But as Vivid Vision Founder and CEO James Blaha explained in a recent webcast with Lean Startup Co. faculty member Hisham Ibrahim, innovative health-tech leaders can “move fast, break things,” and still protect patients and their providers.

James used Lean Startup to test his ideas on using games to treat amblyopia (commonly known as lazy eye) a condition he suffered from starting in childhood. Back then, he says, doctors put a patch over his good eye in order to strengthen the weaker one. Vivid trades patches for virtual reality (VR) headsets. The company produces a series of interactive exercises and assessments that both doctors and patients use to help correct lazy eye disorders.

Using Existing Consumer Hardware for Healthcare MVPs

New consumer technologies have been a boon to healthcare entrepreneurs. Founders are taking advantage of developments in phone apps and VR applications, for example, using hardware that’s produced at a higher volume and lower cost per unit than the healthcare industry is used to. “We can solve some of these problems a lot more cost-effectively than was possible with specialized hardware,” James says.

James wore a patch as a kid to correct his lazy eye, but when he turned nine, everything changed. “The [doctors] told me I was too old to continue treatment, that I wouldn’t be able to use my weaker eye, and I wouldn’t have depth perception,” he says. He didn’t realize there were other solutions until years later when he watched a TED talk by another lazy eye sufferer, Susan R. Barry, who gained 3-D vision as an adult. Her talk inspired James, who’s a programmer, to research treatment for the disorder. Five years ago, he used VR hardware to make his first prototype based on what he’d learned. “I ended up seeing in 3-D for the first time,” he says.

Inspired by the breakthrough, he launched a crowdfunding campaign. The campaign exceeded his expectations, cementing the real need for a new solution to correcting lazy eye. “That kickstarted the business,” James says.

Vivid released the first version of their software to 200 people with lazy eye, beta testers who reported back on their experiences. “The biggest thing we learned was that people don’t have a very clear idea of exactly what’s going on with their vision,” James says. That finding prompted him to move his business model from focusing on the patient to working through doctors.

Five years ago, @jamesblaha used VR hardware to make his first prototype based on what he’d learned. “I ended up seeing in 3-D for the first time.” Share on X

Overcoming Provider Paranoia

In speaking with ophthalmologists, James learned that doctors were afraid of automation while feeling frustrated with their outdated tools. He also noted that many ophthalmologist practices are small businesses (“Sixty percent of optometrists are independently owned and have fewer than 10 employees,” James says), resulting in limited money to invest in new devices. The doctors wanted to know how any new tool would benefit both their patients and their bottom line. “Patient outcomes are a necessary first step, so if they don’t believe it’s going to help the patient, it doesn’t matter how much it costs or how much it’ll make them,” James says.

For the first six to eight months, Vivid offered clinics a deal on two units. They ended up getting great feedback from a handful of clinics, says James. He adds that the response to their product helped him understand that “the way [doctors] use it in their practice was very, very different than our initial vision that we as programmers [and patients]… put together. We really had to hear the doctor’s perspective and how they work with their patients day-to-day to redesign it.”

They overhauled the interface. The resulting package includes a computer, VR headset and the software, plus a clinical support team (two optometrists and two vision therapists full time). The support team trains doctors on setting up and using the tools, via video chat and remote desktop control.



Partnering with Academics to Turn Research into Products

James was surprised by how easy it was for Vivid to collaborate with academics at universities on the research for his product. He suggests other health-tech entrepreneurs seek similar partnerships. “People in academia and in medicine, they need programmers and entrepreneurs more than the other way around—and that’s not to devalue the researcher’s work—but there are all these researchers who want to see their ideas go into use in the real world,” James says. It takes a combination of expert business, technical, and medical knowledge to turn research into a tangible product.

“There are lots of people at these universities who will work with entrepreneurs to translate their research into products that actually reach people. I think people with business and technical skills are really needed in medicine.” Share on X

Moving Fast and Breaking Things” in a Regulated Industry

James admits that Vivid’s momentum has slowed down as they’ve become more established. “There are requirements for the software we’re making because now we have approvals in Europe and in the US and Australia, and each country that we’ve gotten regulatory approvals in has added slightly different requirements and documentation and quality control.” He adds that once customers have worked Vivid into their routines, the company can’t just change the product overnight without telling them; they have to be sensitive about releasing patches for bugs. Vivid makes sure to test different elements in different markets. “A lot of times decisions that were made in one market work their way over to the US, or vice versa,” he says.

Vivid continues through new build-measure-learn cycles by using some of their early adopter clinics as beta testers. They give these customers context for the beta builds, James says, telling them, “This is a test build. It’s experimental. There are some features that are brand new that we’ve never really tried before. We just want to get your feedback.”