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Artificial intelligence in eye care

Artificial Intelligence (AI) has attracted a huge amount of interest and excitement over the past 10 years. The most publicised application is in relation to language processing, for example as with ‘ChatGPT’, but other applications are almost infinite and include transportation and traffic management (including facilitating self-driving cars), increasing energy efficiency, aiding public safety, crime detection, facial recognition and object detection. AI also has widespread applications in the management of large datasets, analysis of data, identifying patterns, and data-driven diagnosis and decision-making.

It is in this latter context that AI is having a great impact in medicine and surgery – and especially in ophthalmology. Any medical specialty that uses digital imaging such as pathology, radiology and ophthalmology will be revolutionised by AI. In ophthalmology, as in other medical specialties, imaging has transformed diagnosis and patient management since the first X-Ray. Now, with CT and MRI scanning, ultrasonography, corneal imaging and retinal optical coherence tomography (OCT) to name just a few examples, being able to analyse very large datasets and utilise machine learning (ML) to improve diagnosis and management is a huge advantage for doctors and other health-care professionals. For example, with regard to corneal conditions such as keratoconus (see below scans), which can be difficult to diagnose in the early stages, AI can use information from very large databases with deep learning (DL) to improve diagnosis and predict which patient could be at risk of developing the condition in later life. A decision to treat the patient – or monitor closely can then be made.

These scans demonstrate keratoconus:

A scan which demonstrates keratoconus

 

A scan that demonstrates a patient with keratoconus

 

I have included 3 scientific review articles below (and in the reference section of this website) written by colleagues of mine at Moorfields Eye Hospital, London, in collaboration with scientists and physicians around the world, for those who might like to learn more about this exciting technology.

  1. Artificial Intelligence in Cornea, Refractive Surgery, and Cataract: Basic Principles, Clinical Applications, and Future Directions
    – Radhika Rampat, Rashmi Deshmuhk, Xin Chen, Daniel S W. Ting et al.
    – Asia-Pacific Journal of Ophthalmology; Volume 10: Number 3, May/June 2021, p268-281.
  2. Artificial intelligence and deep learning in ophthalmology
    – Daniel She Wei Ting, Louis R Pasquale, Lily Peng, John Peter Campbell et al
    – Br J Ophthalmol. 2019;103:167-175
  3. Deep learning in ophthalmology: The technical and clinical considerations
    – Daniel S W Ting, Lily Peng, Avinash V Varadarajan, Pearse A Keane et al.
    – Progress in Retinal and Eye Research;72: (2019) 1-24

Gavin Conway

Overall I am very happy with the result which has taken my vision from -6.25 to near 20/15 vision. Clinically I highly rate the experience with the Moorfields team who were very attentive and were always on the end of the phone and available for me to come in.

I would have rated 5, but for the recommendation that Moorfields be more open with future patients about the repair time for Lasek which in my case was 3 weeks . Whilst some documentation does say final prescription settles in 3-4 months, its at odds with other documentation which suggests taking 1 week off. For patients who need to go back into work after 1 week there needs to be more discussion around what ‘functional vision’ is, and its impact. Sharing repair times on an average basis is not comforting to those who fall out of this, and referring back to the governments ‘driving standard’ as gospel is irresponsible.

All the best
Gavin
p.s Special Thanks to Jenny who was wonderful throughout.

Frances Street

I came to Moorfields as they specialise in the treatment of eye care in general and are highly respected worldwide for their expertise. I researched Professor Gartry online and saw that he was very specialised within his field and do not believe I could have gone to anyone else in the UK who is as highly experienced to carry out my LASIK eye surgery as he is, this therefore made me feel much more confident to have my procedure carried out by him under the care of Moorfields than at a high street facility which can be more commercially driven. Any questions I asked to any of the staff at Moorfields whether a general enquiry or a specific question relating to me and my treatment was answered without hesitation. Follow up care was excellent and reassuring.

Rachel Smith

I experienced excellent service and support from Professor Gartry and all his staff – both clinicians and his office team. The nursing staff at Moorfields were also very good.

My only constructive piece of criticism is that I felt a bit ‘abandoned’ in the waiting room at Moorfields before I went through for surgery. There was quite a gap between my arrival and being seen – nearly an hour I think. I’m sure this is normal but it would have been helpful if one of the nurses or the receptionist had told me on arrival roughly how long I would be waiting. This would have managed my expectations and made me feel more relaxed, as it’s quite an anxious time and I felt I had to chase staff to find out what was happening.

However, this is a small point and my general experience has been hugely positive – and I’ve had an amazing result from the surgery. Thank you!

Andrew Fenton

Arrived to get both eyes corrected for short distance, however Prof Gartry advised on,y getting one eye corrected (dominant) and the other can therefore continue coping with reading. I now have airforce vision (2 better than 20:20) and am pleased to be wearing normal sunglasses! Whole experience has been fantastic and I’m delighted!

Amine Haq

Initially, I was worried about the mono vision technique, but I am quite happy, going on 4 months ! Thank you Professor Gartry !

Rachel Peirse

I am more than delighted with the outcome of my LASEK surgery. I had myopia of -10 and -2 astygmatism when I first came to see Professor Gartry. A year after having LASEK surgery in both eyes I had a prescription of -1.25 myopia in my right eye and -4.75 in my left. I was pleased with the huge difference it had made to my vision but wondered whether it would be possible for the vision in my left eye to be closer to the vision in my right. Professor Gartry was able to retreat the left eye to balance the two and now I am -1 in both eyes! I understand that retreatments are rarely necessary after LASEK treatment so I was unlucky in that respect but feel extremely lucky to have been recommended Professor Gartry, to have been under his care and to have near perfect vision now. I can’t recommend him highly enough.

Jason B

From my initial consultation through to my final check up – Professor Gartry and his team have been wonderful. I had Lasek surgery, so I was prepared for a longer recovery time, and at the 3 month check up I am better than 20/20. Lasek has been life changing, and the world has become more beautiful.

Joanne Woodward

I am totally thrilled with my new eyesight, it’s truly a revelation and I cannot thank Professor Gartry enough. It had long been a dream of mine to wake up in the morning and be able to see properly but being so long sighted I wasn’t sure anything could be done for me. However, now my wish has been granted and the results are life changing – I no longer need glasses for anything! I will be eternally grateful to Professor Gartry and his team.

Salina Cole

I had my surgery done in September 2016 and it is the best decision I have made. David was brilliant and I would recommend and have done to my friends. I really liked the way he explained everything and answered all my concerning questions. He has a great understanding and he himself has had it done. I was not made to feel pressured into having it anything done and all the staff that work for David were really friendly and helpful. On the day everything was explained about the procedure and aftercare and surgery staff all made me feel relaxed. I really liked the way David talked me through what he was doing and what to expect, as this made me feel relaxed. The surgery itself was painless and I couldn’t believe that afterwards I could see. I had a strong prescription of -7.0 in both eyes and an astigmatism. On my check up after two days I had 20/20 vision and was driving after three days. I highly recommend David and his team. Thank you.