Quadrant Eye (YC W21) – Tackling online eye exams and at-home eyecare

Hey HN --

This is Quinn and Kristine of Quadrant Eye (https://www.quadranteye.com). We’re a cataract surgeon and software engineer duo who are spearheading the at-home eyecare revolution. Our goal is to provide comprehensive eyecare to people at home, and as a first step, we're tackling online glasses/contact lens prescriptions renewals.

I (Quinn) started the company after I took care of a grandfather who tragically went blind during the Covid lockdown. This could have been prevented if he had had access to reliable at-home eyecare. During my training, I had seen countless similar scenarios play out around the country, but to have it happen in my own clinic was the last straw.

Eyecare is a weird and tricky space. On the one hand, there are legitimate reasons why eye doctors and their patients are tied to a physical office, and they mostly center on bulky hardware limitations (e.g. the slit lamp biomicroscope.) On the other hand, there are actually few legitimate reasons healthy people without eye disease need to be making routine in-office visits. In fact, the American Association of Ophthalmology (AAO) recommends that folks with healthy eyes, good vision, and no risk factors for eye disease get a comprehensive exam just once in their 20s and twice in their 30s.

With this context, it’s absolutely wild that while millions of people are overexposed to eyecare via unnecessary pupillary dilations and air puff tests (which by the way are wildly inaccurate,) millions more can’t access even basic eyecare services, including refractions (aka the measurement of one’s eye prescription.) After all, 24% of U.S. counties have no optometrists or ophthalmologists!

Online eye exams are a first step toward addressing this pervasive access and resource allocation problem. We’re building our own version (feel free to play around with the prototype but please access via deskop/laptop only: https://app.quadranteye.com/va/creditcard) which is an asynchronous exam that assesses your vision and eye health; the exam results, along with a glasses/contact lens prescription uploaded by the patient, always get reviewed by an offsite MD/OD. Our online exam is live and we've been renewing prescriptions for a few weeks now!

Unfortunately, online eye exams are limited in their scope and utility -- for one, they are unable to measure essential eye vitals such as pupillary response and eye pressure. These exams also happen to be extremely controversial, especially since they disrupt the traditional "go into the eye doctor's office, renew your prescription, buy your glasses/contacts from your eye doctor" model. For evidence that the $18B domestic optical industry stirs up strong emotions, check out this previous HN thread: https://news.ycombinator.com/item?id=21653437 (and dang tells us there have been many others!)

We believe online eye exams are a good catalyst for change, but they are definitely just a stepping stone. We’ve got our eyes on a much bigger vision — true at-home eyecare, including the ability to measure eye vitals — and we’re excited to have everyone follow along!

Thanks for reading and see you in the comments below. :)

Cheers, Quinn and Kristine

P.S. We’re in the middle of a redesign and would love your feedback on how to improve the flow + ux!

P.P.S. We can't talk much about the details right now, but if you want to be notified when we roll out the beta version of our comprehensive exam (which includes hardware,) please fill out this survey: https://qhqh.typeform.com/to/whuiAFHo

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