Artificial Intelligence in Community Optometry: Need of the Hour

Ms. Shenbagam Narasimhan, M.Phil (Optometry)

Assistant Professor, Sushant University, Gurugram, India

 

Introduction:

Innovations are part of research; Novelty keeps changing from time to time, the known reality. One such advancement, inevitable one trending over a couple of years is the role of Artificial Intelligence (AI) in healthcare, particularly in Eyecare!

The role of Optometrists and Ophthalmologists are widely diversified starting from history taking, Refraction assessment to imaging, and fundus examination leading to another necessary diagnostics test. Recent advancement in imaging techniques plays a crucial role in detecting, diagnosing, and managing. Though all these have been successfully carried forward, there are challenges faced by eye care professionals like, such as an increase in the aging population, higher prevalence of degenerative diseases like Glaucoma, Macular degeneration, Vascular diseases like Diabetic retinopathy, where earlier diagnosis & management of these irreversible conditions becomes difficult. This in turn becomes a burden impacting the quality of patient care per se.

Therefore, early diagnosis and appropriate treatment of the above-mentioned ophthalmic diseases are of great importance to prevent avoidable visual loss and improve quality of life. ⁽¹⁾

AI, the present and future:

With the rise in emerging technologies, Deploying Artificial Intelligence in eye care will be a great boon. It will definitely serve as an additional tool kit in diagnostics and referral system toolboxes. Artificial intelligence (AI) is defined as the theory and development of computer systems able to perform tasks that normally require human intelligence, such as visual perception, speech recognition, or decision-making. ⁽²⁾ AI applies cognitive skills with the help of algorithms and machine learning (ML) and Deep learning (DL) software. Although AI in Ophthalmology has been largely overviewed in the last 3 years, only very few prospective studies have been carried forward globally. ⁽³⁾

By implementing these AI application systems, there will be a huge upsurge in community optometry in the below-specialised fields

1. Vision Screening for children
2. Driver Vision Screening
3. Diabetic Retinopathy Screening
4. Glaucoma Screening
5. Computer Vision Syndrome Screening
6. Retinopathy of Prematurity (ROP) Screening

The survey was done among Optometrists which revealed that Optometrists are optimistic about the implementation of AI in eye care, and it also has been found that the willingness to incorporate AI in clinical practice has increased due to the COVID Pandemic. ⁽²⁾

Does AI replace humans?

There are different stages of AI applications in eye care. Clinical data in eye care widely ranges from demographics, medical notes, recordings from medical devices, physical examinations, clinical laboratory findings, image acquisition, interpretation, and many more. A Series of stages like Programming, and coding (using Machine Language) are involved in every stage of patient data. The accuracy of AI along with the Decision Support system (DSS) ⁽⁴⁾ must be assessed before the implementation process. AI never replaces human optometrists or ophthalmologists. However, it just acts as an interface between community optometrists and hospital-based eye centres.

Conclusion:

In nutshell, the Role of AI is the need of the hour for the following major reasons

1. Reduces the number of man hours spent, coping with the need for the demand of trained eye care professionals
2. Training & Integrating the AI technology across all levels from the creators to disseminators
3. Plays a crucial role in detecting and diagnosing preventable blindness ⁽⁵⁾
4. Paves a humongous role in teleophthalmology particularly in remote areas, across the globe

 

References:

1. Balyen L, Peto T. Promising artificial intelligence-machine learning-deep learning algorithms in ophthalmology. The Asia-Pacific Journal of Ophthalmology. 2019 May 1;8(3):264-72.
2. Scanzera AC, Shorter E, Kinnaird C, Valikodath N, Al-Khaled T, Cole E, Kravets S, Hallak JA, McMahon T, Chan RP. Optometrist’s perspectives of Artificial Intelligence in eye care. Journal of Optometry. 2022 Sep 20.
3. Jiang F, Jiang Y, Zhi H, Dong Y, Li H, Ma S, Wang Y, Dong Q, Shen H, Wang Y. Artificial intelligence in healthcare: past, present and future. Stroke and vascular neurology. 2017 Dec 1;2(4).
4. Han JE, Liu X, Bunce C, Douiri A, Vale L, Blandford A, Lawrenson J, Hussain R, Grimaldi G, Learoyd AE, Kernohan A. Teleophthalmology-enabled and artificial intelligence-ready referral pathway for community optometry referrals of retinal disease (HERMES): a Cluster Randomised Superiority Trial with a linked Diagnostic Accuracy Study—HERMES study report 1—study protocol. BMJ open. 2022 Feb 1;12(2):e055845.
5. Ravindran S. How artificial intelligence is helping to prevent blindness. Nature. 2019 Apr 10.

 

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Author:-

Ms Shenbagam Narasimhan, PHD Scholar ( CT University, Ludhiana, Punjab) ,Working as Assistant Professor & Program coordinator of the Optometry department ,School of Health Sciences,Sushant University. I had completed my B. S (Optometry), M.Phil. (Optometry) at Elite School of Optometry (collaborated with BITS, Pilani) Chennai. Have 12 years rich clinical experience as senior consultant Optometrist in Speciality OPDs, Glaucoma Diagnostics including OCT, UBM, HRT and Visual fields at Sankara Nethralaya Chennai. Had the privilege to continue my career as lecturer in my mother institute Elite School of Optometry for over a decade. Have worked as Assistant Professor in Dept. of Optometry & Vision Science, AMITY University, Manesar. My area of interest in teaching is Research Methodology, Geriatric and Paediatric Optometry, Ocular Diseases & Diagnostics.  The work on “Diagnostic sensitivity of Ultrasound biomicroscopy  in identifying Clinical Aqueous Misdirection syndrome “ was presented as Poster Presentation in the International Conference ,ARVO , Hawaii  2018. Published an article Objective Retinoscopy – A clinical perspective; Delhi Ophthalmological Society, DOS times: 2020.Teaching is my passion and invoking the young minds with all that I know adds zeal to it even more. Grateful to the past & present institutions for all that am today.