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When I look at the Arclight device today, with over 50,000 devices distributed across more than 60 countries and used on all seven continents, it is amazing to think that it started only 15 years ago with one simple but ambitious idea.
The first prototypes were created by optometrist William J Williams. The technical challenge was straightforward: could an ophthalmoscope, anterior segment loupe and otoscope be combined into one small, affordable device without losing the clinical function of traditional, more expensive tools?
Collaboration helped turn that idea into reality. Seed funding from The Fred Hollows Foundation supported development of the original Mk1 Arclight, released in 2012. William’s work then brought him together with colleagues at the University of St Andrews, including myself, and the device developed through clinical evaluation, user feedback and successive rounds of redesign to today’s Mk5.
Many of the components have changed since the first version, but the principle has remained the same: diagnostic equipment, particularly for lower-resource settings, should be designed around the realities of the people and places in which it will be used.
In the early days, the Arclight team was very small and our focus was on evaluating the device itself. We needed to demonstrate that, despite its low cost, simplified design and unconventional appearance, it could provide clinically useful examinations and support teaching. That evidence helped build confidence in the device and informed successive redesigns.
As interest grew internationally, we learned that having a good product is only one part of the implementation challenge. Partners also need confidence in its quality, availability and the support around it.
Since 2021, Arclight has operated through St Andrews Medical Innovations Ltd (SMI), a wholly owned subsidiary of the University of St Andrews and a not-for-profit social enterprise. Any surplus is reinvested to further the aims of the Arclight Project. This structure has allowed us to build the infrastructure needed to support Arclight at scale, from manufacturing and quality to supply and distribution.
Today we have a secure and resilient supply chain, established manufacturing partners and robust systems supporting consistent product availability. SMI is also certified to ISO 13485:2016, the internationally recognised quality management standard for medical devices, with formal systems covering design, development and manufacture, traceability, risk management and post-market surveillance. These may not be the most visible parts of the story, but they are fundamental: people need to be able not only to afford Arclight, but to depend on it.
Another major lesson has been that putting a device into someone’s hands is not enough. The real value comes when people have the skills and confidence to use it, recognise what they are seeing and know what to do next.
We have therefore developed an educational package around Arclight: simulation tools, clinical demonstration videos, universal cartoons and animations, digital tools for live demonstrations, and tailored workshops for different health workers and eye conditions.
I have been fortunate to travel widely, working alongside local clinicians, educators and organisations to develop and deliver training for doctors, nurses, community health workers, students and other frontline healthcare professionals. Those experiences have shaped how we support implementation.
Increasingly, we use a train-the-trainer model, working with local clinicians and educators so that skills can continue to spread through existing health and education systems long after an initial workshop has finished.
What this looks like varies from place to place. In Madagascar, for example, we have worked with CBM Global, CBM Ireland and local partner SALFA to bring childhood eye screening into primary healthcare. Health workers and community health agents have been trained to use Arclight with young children, including during routine vaccination services. Between October 2024 and June 2025, more than 34,000 children were screened, helping identify serious eye conditions early and connect children with further care.
In Mongolia, our work with Orbis International has included developing and refining training in the fundal ‘red’ reflex examination for newborn and infant eye assessment.
Similar approaches have been developed with Kilimanjaro Christian Medical Centre in Tanzania and CureBlindness in Bhutan, using adaptable teaching resources so local teams can continue delivering training in culturally relevant ways.
These partnerships have reinforced something all of us in the team feel strongly about: sustainable impact comes not from distributing devices alone, but from listening to local partners, adapting to their systems and investing in the people who will continue the work.
Our latest device, the Arclight Mk5, reflects the same philosophy.
It does not look dramatically different from previous versions, and that is deliberate. Rather than redesigning for the sake of novelty, we concentrated on practical improvements that make the device easier to depend on.
The Mk5 improves long-term power management and introduces standard USB-C charging – small changes perhaps, but important for a device that may be stored or used in very different environments.
Just as importantly, user feedback now feeds through our formal quality system, with defined requirements, risk assessment, testing and inspection before changes reach production.
We now work with ministries of health, universities, NGOs and training programmes around the world. Arclight resources feature within World Health Organization eye-care guidance and training materials, and the device is available through international procurement frameworks used by UN organisations.
What excites me most is seeing Arclight become part of something bigger: a training programme, a community screening service, a university curriculum or a pathway that helps a patient reach specialist care earlier. A device on its own cannot improve eye care; it has to sit alongside knowledge, people, partnerships and systems.
Fifteen years on, the principle behind Arclight has not changed. We still believe useful medical technology does not have to be complicated, and we still learn enormously from the people using it. What has changed is everything around that idea: the research, quality systems, secure supply chain, training programme and partnerships needed to support it at scale.
The original challenge was to show that an effective diagnostic tool could be radically simpler and more accessible. Our challenge now is broader: to make sure that wherever Arclight is needed, people have both the tools and the skills to use them – and can depend on us to support them.
