Digital technology, tele-medicine and artificial intelligence in ophthalmology: A global perspective

Abstract

The simultaneous maturation of multiple digital and telecommunications technologies in 2020 has created an unprecedented opportunity for ophthalmology to adapt to new models of care using tele-health supported by digital innovations. These digital innovations include artificial intelligence (AI), 5th generation (5G) telecommunication networks and the Internet of Things (IoT), creating an inter-dependent ecosystem offering opportunities to develop new models of eye care addressing the challenges of COVID-19 and beyond. Ophthalmology has thrived in some of these areas partly due to its many image-based investigations. Tele-health and AI provide synchronous solutions to challenges facing ophthalmologists and healthcare providers worldwide. This article reviews how countries across the world have utilised these digital innovations to tackle diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration, glaucoma, refractive error correction, cataract and other anterior segment disorders. The review summarises the digital strategies that countries are developing and discusses technologies that may increasingly enter the clinical workflow and processes of ophthalmologists. Furthermore as countries around the world have initiated a series of escalating containment and mitigation measures during the COVID-19 pandemic, the delivery of eye care services globally has been significantly impacted. As ophthalmic services adapt and form a “new normal”, the rapid adoption of some of telehealth and digital innovation during the pandemic is also discussed. Finally, challenges for validation and clinical implementation are considered, as well as recommendations on future directions.

Digital Ophthalmology in the UK – Diabetic Retinopathy Screening and Virtual Glaucoma Clinics in the National Health Service

“…The integration of artificial intelligence (AI) systems into routine image analysis tasks is a key part of the current digital revolution in medicine [2]. Screening for diabetic retinopathy is an ideal subject for the immediate application of AI into daily practice, as vast collections of digital images to train AI systems exist and recently developed AI systems have proven to be as good or better than human specialists in interpreting retinal images and identifying disease amenable for treatment [31].…”

“…However, healthcare systems worldwide have only recently started the transition from the traditional analogue model of "face-to-face" medicine to digital medicine in daily practice. This process is now turbocharged by the COVID-19 pandemic, which in many countries resulted in a sudden and substantial reduction of face-to-face medicine to the bare minimum [1,2]. Ophthalmology is particularly suited for the digital transition, as imaging plays a central part in the assessment and treatment of most eye diseases [3].…”

Artificial Intelligence in Nutrients Science Research: A Review

“…In clinical medicine, IoT has a significant application in relation to telemedicine procedures [ 20 , 21 ], which are becoming more and more widely used, especially during the COVID-19 pandemic. Important applications of IoT can also be seen in the provision of detailed information on food products available on the market [ 22 ].…”

Artificial Intelligence to Reduce Ocular Health Disparities: Moving From Concept to Implementation

“…The emergence of artificial intelligence (AI) in medicine has raised hopes that this technology, which has demonstrated the ability to make medical diagnoses from images, might reduce inequalities in access to ophthalmologic diagnosis and ultimately care. 3 Although the applications of AI in ophthalmology are myriad, the motivating use case here would be for secondary prevention of blindness as a force multiplier to enable ophthalmologist-level diagnosis to reach places where health systems cannot meet the clinical need using existing resources. A secondary goal might be to improve the efficiency of care delivery in both high-and low-income regions.…”