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“How will Technology and AI change optometry? "


“Technological advances in healthcare will continue to enable optometrists to provide even better care for our patients in the future. Instrumentation will continue to advance both our diagnostic and treatment capabilities to benefit our patients. The use of telemedicine advanced rapidly during the COVID pandemic, largely by necessity. ICO has been a leader in developing the safest protocols and guidelines for when such technologies should and should not be used. ICO has also been involved in

advancing the training of remote technicians so they can assist optometrists by providing the most reliable data from the remote instrumentation. We took this leadership role because it is apparent this technology is advancing and becoming a tool for optometrists to utilize when applied appropriately. We want our ICO students to be at the leading edge of understanding and gaining experience with this technology.

Diagnostic tools are currently being developed that can predict the likelihood of systemic disease progression well before they are visible to us. We are doing some of the earliest work on these developments via research protocols currently underway. The amount of data that can be quickly and effectively analyzed using Artificial Intelligence (AI) is astounding. Our students and faculty were able to interact with a few of these tools in November, during ICO’s first Technology Summit, which included a presentation on generative transformers, telehealth and the power of AI. These tools will advance how we practice optometry, and we will continue to integrate them into our curriculum as they develop. During ICO’s November CE Program, some of these new technologies were presented. 

If you’d like to learn more about telehealth, check out our research highlight on page 32 and to learn more about the Tech Summit, flip to page 26. We will need to proceed with care as we take on these new tools, but when used correctly, we can continue to improve healthcare. ”

Ali Tafreshi

Topcon Healthcare Innovation Center

“I think optometry is at the forefront of healthcare, not just eye care. I believe that the eye can transform health care. It's a window into the body and is often a harbinger of other health issues. There are a lot of changes that can be detected earlier in the eye than anywhere else. The OCT scan optometrists perform is already collecting high-resolution volumetric pieces of information. We are ready to make this information even more valuable. Currently, we 

are working on developing models that will ensure that diseases are caught through an eye scan. Today, with technology, we can measure those changes even before they can be seen. These models will be able to predict systemic cardiovascular and neurological diseases through an eye exam alone.

Optometrists hold the key to changing healthcare because in many cases, patients will see them earlier and more frequently than most other healthcare providers. So much can be predicted just through one eye exam. I believe that power is transformative.

Because the eye is a direct extension of the brain and the circulation is part of the bodies cardiovascular system, it can be monitored with micron-level precision and at a resolution that is unprecedented. AI can then effectively take all that volumetric data and analyze it quickly and intelligently and connect it to other clinical data in the EHR to predict diseases.

As a result,  Ai will enable optometrists to provide faster, better, more consistent care to patients. This type of care will in turn make them more effective clinicians and give them a significant advantage over those who are not willing to accept this technology. We want to make sure at the same time, that optometrists understand the technology they are working with.

As a technology company, our goal is to make sure that we develop these solutions in a very responsible way. That means putting guardrails around how we deliver the technology and who we deliver it to. We do this not just because the FDA requires it but also because we need to ensure that the clinical science is verified and validated properly. Because we are working with machine learning, the models drift over time and these drifts must be addressed effectively and in a timely manner at specific sites. Our technology must be carefully evaluated on site. It must be a partnership between us and the optometrists.

To effectively implement this technology, optometrists must have an understanding of how these AI models are helping them make decisions. If the model is changing or drifting, they need to understand why that's happening. They need to ask; is the patient population changing, or perhaps the images are not good quality, or perhaps there was a change in the software. This needs to be a back-and-forth conversation in order to ensure quality technology.

I believe we must empower optometrists. If we can intelligently analyze and connect the information they collect, optometry becomes essential to all health care.”

Michael Chaglasian, OD, FAAO

Chief of Staff


“In many ways, we’re still in the early days of AI and optometry. There is so much tremendous work being done by several key companies that will have a positive impact on optometry.

I find there's some confusion on the role of AI in health care and how AI will affect our role as caregivers. Using AI might not be too different than being given a report from a diagnostic OCT-imaging instrument that didn't exist 20 years ago. When OCTs emerged into eyecare, 

they revolutionized traditional exam techniques and optometrists had to learn how to use the information appropriately. Granted, future AI information will be much more impactful and possibly misleading, depending upon the specific development. Currently, I have too much information to thoroughly analyze my patients, I don't have enough time, and I don't even have enough expertise, and I'm a recognized expert in at least one area of optometry. Thus, I believe that clinicians need an appropriately constructed AI tool to guide them in their patient care.

The need for optometrists and AI is more likely to change how we provide patient care and not necessarily eliminate jobs (except those that are mundane and repetitive). The bigger question is will we be able to effectively meet the growing demand in eyecare and healthcare? AI can be part of the solution to this problem.

Optometrists need to position themselves today to be prepared for a paradigm shift in patient care delivery. With AI, optometrists will be able to deliver more efficient and more accurate health care decisions for their patients. This is the direction that the rest of medicine is moving towards, and optometry is and should be a part of medicine. I believe AI will help our patients and our careers in the long run.

To ensure that we can use this tool effectively, there must be oversight. As these tools are being developed, the FDA is actively involved. From what I've seen in AI and some of the books that I've read, these tools are being developed very thoughtfully, very carefully, and slowly. The transition won't be overnight, and it should not be without validation and a lot of thought by appropriate leaders in this area. But optometrists should embrace this changing health care.

I believe the physician will always be in charge. The optometrist, as is the case now, is going to have to analyze data provided by a new source called AI or machine learning or deep learning or all of the above. I don't think of AI as this big, ugly animal that's going to take over the world, but instead as a tool that accurately and thoroughly analyzes key health indicators to generate important health insights. I would love to rely on an AI-generated piece of information that I can consider, and use (or not use). We should just as importantly train our students and our optometrists to use AI information appropriately. That education must go hand in hand with these advances. I’m excited for these new insights, not scared.”

“The need for optometrists and AI is more likely to change how we provide patient care and not necessarily eliminate jobs.” 


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Spring 2019 Editor's Note

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