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Macuject is an Australian digital health startup helping prevent blindness by supporting eye care professionals in achieving the best possible outcomes for their patients with diseases such as age-related macular degeneration (AMD).
Our presentation will give an overview of the eye's structure, straightforward steps to ensure the health of your eyes, AMD, its treatment, and how our software helps make individualised decisions. It is sure to be a real eye-opener!

After that, we’ll switch lenses to discuss our technology stack, primarily focusing on our Majestic Monolith powered by Rails 7! As a MedTech startup, the experience doctors have when interacting with our app can have a considerable impact. Over the past year, we've improved that experience dramatically through using Hotwire. We’ll share how our small team is gradually replacing our React frontend with Hotwire while rapidly building eye-popping new features.

With Turbo Frames, Turbo Streams, and Stimulus, Hotwire lets us rethink when to use JavaScript and allows us to use just the amount we need, where we need it. It allows us the flexibility we want, with all the functionality we need, in a Rails-friendly paradigm that's a delight to work with.

What do you call a Deer with no eyes? We have no Eye-Deer, but we look forward to seeing you at our talk!

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In this presentation at RubyConf AU 2024, Bianca Power and Bradley Beddoes from the Australian digital health startup Mackie discuss their efforts to prevent blindness, particularly focusing on age-related macular degeneration (AMD) and their technology stack built around Ruby on Rails. The session is divided into two parts: an overview of AMD and an introduction to Hotwire's advantages in their software development process.

**Key Points Discussed:**
- **Introduction to AMD:** Bradley highlights that AMD affects about 200 million people worldwide, leading to blurred central vision, particularly impacting individuals in their 50s and older. Risk factors include age, family history, and smoking.
- **Eye Anatomy and AMD:** Detailed explanations of the eye’s structure, particularly focusing on components like the vitreous humor, retina, and macula, which are crucial for vision and are affected by AMD.
- **Current Treatments:** While no cure exists, intravitreal injections are the standard treatment. Mackie aims to improve the scheduling efficiency of these treatments through their software.
- **Importance of Domain Knowledge:** Emphasizing the need for software teams to understand the medical domain when developing solutions, enhancing collaboration between technical teams and medical experts.
- **Transition to Hotwire:** Bianca discusses their successful transition from a React frontend to Hotwire, pointing out how it allows for simpler development and effective real-time updates in their application, improving user experience for ophthalmologists.
- **Patient Records Management:** Illustrating how their platform manages patient data, it uses Turbo Streams for real-time updates, allowing clinicians to see live changes without needing to refresh pages.

**Significant Examples:**
- Real-life administration of injections to treat AMD is depicted, showcasing the seriousness and urgency of managing such treatments efficiently.
- The use of Hotwire is described as crucial for maintaining speed and simplicity in their development process, allowing their small team to create a highly functional application.

**Conclusion and Takeaways:**
The talk concludes with an emphasis on the significance of understanding the medical context in software development. By leveraging Hotwire, Mackie aims to create software that significantly contributes to their mission of ending preventable blindness through improved patient care and technology solutions.

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