Using AI and technology to help manage eye patients

We’re a victim of our own success when it comes to treating ageing patients with diabetic retinopathy and macular degeneration, but AI and a hand-held scanner may be part of the answer.

Auckland District Health Board Ophthalmologist Dr David Squirrell says these patients create the much of the demand across those with chronic eye diseases. “People with diabetic retinopathy and macular degeneration, for example, need frequent re-assessment, and their treatment may go on for years.”
He describes this as a significant challenge on scarce resources and says we need a new way of triaging and managing patients. To help meet this challenge, Dr Squirrell and his colleagues from the University of Auckland have created a spinout company – TokuEyes – to deliver innovative technology for eye diagnosis.

“We’ve had great support from MedTech CoRE, benefitting from their knowledge, guidance and networks. We’ve also received seed funding from the University of Auckland Inventor’s Fund, and a Smart Ideas grant from the Ministry of Business, Innovation and Employment.”

Dr Squirrell says the current treatment model has significant obstacles for both specialist and patient. “We have limited numbers of ophthalmologists. Diagnosis and treatment of eye disease is currently concentrated around eye clinics or private practices which require expensive instruments to examine the eye.

“This has created accessibility and affordability problems, particularly for poorer communities in more rural areas. We’re failing Māori and Pacific Island people. There’s limited community-based care in low decile areas which creates barriers to care for those patients at greatest risk of vision loss.”

But a combination of AI and hand-held technology may help overcome these issues, enabling specialists to work smarter and more efficiently. “A retinal photograph for diabetic retinopathy is currently read by a human, but with an AI classifier that workload could be reduced by 80 percent, with patients being triaged more rapidly. This could also help deliver more customised treatment,” he says.

It will also save patients spending what can be a day getting to and from treatment. “Some patients have to travel some hours to get treatment. Some also need another person to drive them home after treatment. That can mean one treatment session needs a whole day from two people.”

Dr Squirrell sees this new technology as offering huge scope for breaking down such barriers for clinician and patient.

“We have a new camera that is completely portable and easy to use. At $7,000 each, they could be loaned out to GPs and health centres around the country. We could take the technology to the patient at a local health centre, a marae or temple to screen for the common causes of blindness.

“Our challenge now is translating this into a useful tool that delivers multiple, high-quality images that are pulled together in summary format for the clinician.”

Dr Squirrell says AI and this hand-held camera can help maximise our finite resources. He says while such change is sometimes viewed negatively it actually empowers clinicians, making much more effective use of their skills while minimising treatment obstacles for patients.

By Prue Scott

David Squirrell