Eye scans lay out a path to spotting chronic health conditions

When you go for an eye check-up, you probably expect to squint at some tiny letters, compare some red and green lights (“One or two? Three or four?”) and find out whether you’re at risk of conditions such as glaucoma or cataracts.

What you might not expect is for your eyes to reveal if you’re at risk of diabetes or Alzheimer’s – or other chronic health conditions that at first seem unrelated to the eye. But far more than even a window to the soul, the eyes can indeed tell us about these conditions, in an approach known as oculomics.

When Dr Dan Daly and Dr Robin Taylor founded Occuity in 2019, the pair had a vision to develop oculomics devices that would make detecting chronic health conditions as easy as tests at your high street opticians.

With oculomics being a relatively new area, the founders, who are now CEO (Daly) and CTO (Taylor), first focused their energies on developing a handheld device that supports glaucoma detection, the PM1, to demonstrate that its core technologies were sound. But the PM1 turned out to be much more than just a proof of concept, winning the engineering team the Royal Academy of Engineering’s 2025 Colin Campbell Mitchell Award.

Glaucoma is most accurately detected by adjusting eye pressure readings with corneal thickness measurements taken with an ultrasound pachymeter. This is an uncomfortable and time-consuming process, typically requiring anaesthetic eye drops and a trained practitioner. The PM1 requires neither and its measurements take just a few seconds. In practice, an optometrist can simply hold it a couple of inches from a person’s eye, and it begins to scan, before displaying the results on its screen.

“What we’re trying to do is eliminate a lot of the barriers to care that these existing devices have seen,” explains Jamie Serjeant, Occuity’s Lead Engineer, “whether that’s requiring training and practitioners, or [tests] being quite intimidating and not very nice for the patient experience.”

Guinea pigs in the garage

The PM1 applies the principles of a confocal microscope, the kind with which biologists might peer at fluorescently labelled cells, in miniature. Confocal microscopes have an exceptionally tight focus and high spatial resolution, with the ability to reconstruct 3D images by scanning micrometre-thick slices of the sample. Relying on complex optics and a pinhole system to limit depth of field, they are also “very large, very expensive, very high power”, explains Taylor.

Getting the same effect with a handheld device called for an entirely different setup. The team ingeniously repurposed low-cost optical devices common in the telecoms industry. Optical fibres replicated the effect of the much more expensive pinhole systems, to block out-of-focus light. Another key component is a small module called a bi-directional (bi-di) transceiver, comprising a low-power laser source and optics that both transmit and receive returned laser light.

The final piece of the puzzle was a scanning system developed entirely in-house by Taylor – the part of the device that would enable it to produce 200 high-resolution scans of the eye per second.

With the pandemic looming not long after the company’s beginnings, Occuity’s early prototyping was forced into Taylor’s garage over lockdown, with off-the-shelf components resembling “optical Meccano”. He and his dog were the first guinea pigs to test the first prototype, an integrated, handheld device for which Taylor machined all the components, handassembled the electronic boards and 3D printed the enclosures.

Not long after, Daly and Taylor hired a team and a proper office space, to take the early hand-built prototypes into a viable, scalable product. This involved taking a tactical approach to sourcing components. Off-the-shelf parts might do just fine in some places. Others had to be custom-made, for example where Occuity’s core IP was, to ensure greater precision than industry standards.

“There is a tiny screw that is custom inside PM1,” laughs Serjeant. “But that’s a funny example because we got close to sourcing most parts off the shelf. It just made me laugh, that at the end of the day, that’s what we had to do to get it to market.”

The path to oculomics

Serjeant describes the PM1 as establishing a “design language”. It prioritises patient comfort, usability and simplicity. “We relish trying to get rid of as many buttons as possible,” says Serjeant.

This philosophy will underpin Occuity’s move towards bringing oculomics devices to market. They will incorporate many of the PM1’s design elements and core technologies, such as the bi-di and the scanning system, but combine them in new ways.

Oculomics hinges on the optical transparency of the eye and its makeup of fluids. These resemble “blood without the blood cells”, according to Taylor, carrying many of the same proteins and biomarkers found in the bloodstream. Among these are compounds associated with diabetes, known as advanced glycation end products (AGEs), along with amyloid plaques, which are a hallmark of Alzheimer’s disease.

But first, the company will release the AX1, which measures the eye’s axial length – the distance between the retina and cornea. Excessive growth in axial length during childhood is the most common cause of myopia (shortsightedness). With the ability to measure this, clinicians will be able to identify myopia earlier and more accurately, rather than relying on people (especially children) to notice changes in their vision and refer themselves.

The AX1 looks identical to its PM1 cousin, opening up the possibility of screening in schools or in high street shops. Yet it is a “far more complex device”, Taylor says, with greater precision requirements. “If PM1 is what got our name out, AX1 is the moment we grew up,” says Serjeant.

With Occuity in touching distance of beginning the final clinical trial for the AX1, and the PM1 already being sold globally through 19 regional distributors, the foundations are laid for its oculomics work. Catching disease progression early could be just around the corner – through a simple eye scan at your high street optician.