About 15 years ago, a close family member had repeated bouts of vertigo that would lead to frequent hospitalisation. Except that back then, no one knew it was vertigo atleast right off the bat. It took a battery of tests - an MRI, a CT scan, audiometry, and some blood draws to find out why she was having extreme dizziness and nausea that would last for days. Vertigo is one of the more commonly occurring neuro-vestibular conditions. It causes extreme dizziness, triggered by imbalances in the inner ear, brain or some sensory pathway. In addition to vertigo, a billion people worldwide suffer from conditions like epilepsy, migraine, concussion and ADHD. Most of these conditions, if diagnosed early, can be treated far more effectively. However, these conditions are also not easy to detect and require multiple tests for doctors to figure out what's going on. But this startup chose to focus on the one organ, which is a gateway to understanding neurological conditions - the human eye. 

Founded in 2015, Cyclops Medtech is building clinical and wearable diagnostic and rehabilitation products for neuro vestibular disorders using eye tracking technology. Cofounder Niranjan Subbarao says, "Early stage and predictive diagnosis is largely monopolised by imaging protocols, which are expensive to set up and use. What my team and I discovered is that there are a range of neurological conditions that can be diagnoses early by either bypassing these methods or working in tandem with them, and in a non-invasive manner - which is tracking the movements of the human eye. It is actually a common barometer to gauge the health of the individual and reveals a lot about what's going on in the human body." While there are several startups that are specialising in diabetic retinopathy and retinal imaging to detect conditions, tracking eye movement is a relatively unexplored area, and this is where Cyclops Medtech believed they can make a sizeable difference. They were keen on building an extensive dataset, a complete technology stack and applications harnessing analytics that can help detect and diagnose neuro-vestibular conditions non-invasively. Subbarao is a career professional in the marketing and communications area, and has worked with companies like Kestone Integrated Marketing Services, Avyaya Integrated Brand Solutions and founded Avyaya Medicon, which specialises in medical content and conferencing. He met Dr. Dorasula R Srinivas, an ENT surgeon and vestibular specialist; and Dr. Ravi Nayar, who was the Dean at a leading hospital chain - and cofounded Cyclops Medtech. 

The first two-and-a-half years was spent in developing an exclusive technology stack for eye tracking, which is the foundational layer of a three-tier approach. The team has built the hardware to capture eye movement, which is a homegrown pair of eye goggles. The second layer is image processing and deep learning software that can extract data from eye movements and build analytics. Multiple applications can be built using these data points, on the foundational technology stack, the first of which is BalanceEye that tracks imbalance and dizziness. This product can help understand and differentiate the cause for dizziness in either the central or peripheral ear and brain, allowing clinicians to narrow down on the issue more accurately. A lot of what Cyclops Medtech has built wouldn't be possible without AI - the foundational layer uses AI to enable eye tracking, head tracking, pupil movements, gaze tracking, pattern & fingerprint recognition, disease modelling and prediction. AI enables the extensive analytics layer that is powered by a database of 500,000 eye images - among the largest in India. 

BalanceEye is the first of many products that will be built on the tech stack, says Subbarao. While the initial model requires a qualified clinician to monitor for results but the team is currently working on a prototype that allows for a first-level clinical assessment, which will then be verified by a specialist. This feature will be executed through an app that will also sync with conventional telemedicine apps for federated data to be assessed independently by experts. This further cuts down the time for diagnosis, and empowers individuals to manage their health more proactively and at their convenience. 

The medical device industry in India is a lucrative one - likely to grow to $65bn by 2024, with multinational players and SMEs. In addition, 100% FDI is permitted in this sector (for greenfield and brownfield projects), making it a highly competitive space. Subbarao admits that when they started out in 2015, the process to build a medtech product from scratch was undoubtedly harder, especially building a prototype and finding embedded design systems. In the past few years, these processes have become inordinately easier. The change in perception of electronic design firms (EDAs) towards startups has also helped their cause. In addition, the Medical Devices (Safety, Effectiveness and Innovation) Bill in May 2020, exacerbated by the need to mass-produce medical products to manage the pandemic, has greatly encouraged innovators to develop their own products instead of plug-and-play software solutions. Availability of capital has also enthused manufacturers and electronic design firms to work with startups, adds Subbarao. Today, Cyclops Medtech has been installed in over 300 locations including hospitals like Manipal, Aster, Columbia Asia and St John's Medical College and Hospital Bangalore, as well as Tier 2/3 towns and cities like Morbi, Miraj, Madurai, Imphal, Bargarh, Shillong and Islampur. The device is also CE-certified, permitting it to be sold in multiple overseas markets like Europe, Middle East, Latin America and Asia. Over the next few years, Subbarao is hopeful of building more products on the tech stack and open the APIs to developers for product development. Thanks to the core tech stack built by the team, upto 25 neurological conditions can be detected with less than 0.1% margin of error in detection. This technology and its related product suite will especially be useful in rural and semi-rural areas, adds Subbarao, and hopes to make headway in government hospitals and PHCs.