Technological innovation and artificial intelligence in ophthalmology and optometry

Technological innovation has always been fundamental to ophthalmology, as its main object of study ─the eye, is an organ of small structures, which requires specific equipment to be correctly observed. Technological advances have made it possible to incorporate several lenses, objectives, cameras, ultrasound, infrared sensors, lasers, etc.

Thanks to the technological revolution of recent years, ophthalmology is also using 3D imaging, virtual reality and, more recently, big data and artificial intelligence for data analysis. These tools have made it possible to obtain increasingly accurate and reliable results and, at the same time, to offer a more pleasant experience for patients undergoing tests and a greater flexibility for the specialists performing them.

Optometrist Núria Galceran discussed this technological innovation in one of the latest clinical sessions organised by ICR.

Latest innovations incorporated into the centre

At Institut Català de Retina we have several tools based on the technological developments listed above, and we are working on research projects to incorporate new ones. Some examples of technological innovation we are already working with are:

• Portable and more versatile machinery, such as a device to perform electroretinography tests and visually evoked potentials on patients for whom it is more difficult to cooperate, such as young children or people with mobility and communication difficulties. The device we use incorporates paediatric sensors and does not require dilation of the patient’s pupils to carry out the tests.
• Digitisation of the tests, by means of tools that incorporate technologies such as infrared or eye tracking, and which allow an increase in the precision and ease in analysing the results of tests such as the Lancaster Test, perimetry test or ocular motility, which until recently were carried out manually and approximately.
• Integration of several tests in a single device. At ICR we have multiple devices that allow us to perform more than one test using the same machine, such as an optical coherence tomography with a retinography, or an echography with a pachymetry and a biometry.
• Teleoptometry and telemedicine facilitated by portable devices, with which the specialist has remote control to obtain the results of the necessary tests. In the case of ophthalmology, the health professional can manipulate the device remotely and examine more thoroughly whatever they consider necessary. For example, there is a device that can diagnose diabetic retinopathy and the risk of developing it in patients with Type 2 diabetes without the need to be physically next to the patient. In optometry, there is software that makes it possible to track progress in the patient’s vision therapy performed at home; thus, their treatment plan can be adapted.

The emergence of artificial intelligence

Artificial intelligence has also entered the fields of ophthalmology and optometry. For now, it is essentially used for data analysis, as in the processing of the device BulbiCAM, a machine that uses virtual reality and helps the patient to carry out a visual field, in addition to increasing the accuracy of the results.

Currently, this technology can also be used to screen for diabetic retinopathy, classify lesions, monitor the progress of certain diseases, and generate graphs to track pathologies like age-related macular degeneration or macular oedema. Diagnostic and prognostic features for ocular pathologies are still being investigated with AI, as well as the estimated calculation of visual acuity according to the evolution of the disease, although it is expected that there will soon be tools that will facilitate this.

However, we must bear in mind that artificial intelligence has certain limitations, such as the lack of transparency in the learning algorithms it uses, the need for diversity of data to be taken into account (the diversity of the population should be reflected so that it is validated with scientific rigour) and the need for regulation that guarantees the security and privacy of patient data.

That is why, among other reasons, artificial intelligence must always be a complementary tool to the decisions made by medical professionals. It needs to be combined with ophthalmic technology, the scientific knowledge of specialists and an understanding of patients’ needs.

Will artificial intelligence replace doctors?

A common question after the emergence of this technological revolution is whether AI will eventually “take off our jobs” and replace people. The first studies have already been published comparing some of the tasks carried out by healthcare professionals with the performance of the same functions by this technology.

So far, the conclusions that have been drawn indicate that artificial intelligence can make a doctor’s job easier or complement it in a number of ways. The developers of this technology or even AI apps themselves claim that they will never be able to exclude the task of a healthcare specialist. Their aim is to help professionals to be more efficient, not to replace them.

More information

• Multicentre study “Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum”.
• “AI, Deep Learning, and the Detection of Systemic Diseases”, American Academy of Ophthalmology.