AI in eye care: what are the opportunities and limitations in Africa?

Jun 22, 2023

A woman undergoes an eye examination using of a smartphone at a temporary clinic by International Centre for Eye Health at Olenguruone in the Mau Summit 350km (217 miles) west of Kenya's capital Nairobi, October 29, 2013. The organisation is running clinics for 5000 eye patients using a new application "Peek Vision" that enables doctors to give patients a full eye examination using smartphones. The phone diagnoses and conducts cataract scans, basic eye tests, and uses the phone's flash to illuminate the back of the eye for signs of disease. It also sends all recorded data of a patient along with their location to a doctor for analysis. REUTERS/Noor Khamis (KENYA - Tags: HEALTH SOCIETY SCIENCE TECHNOLOGY)

A woman in Kenya undergoes retinal imaging to screen for optic nerve diseases. Image: REUTERS/Noor Khamis (KENYA - Tags: HEALTH SOCIETY SCIENCE TECHNOLOGY)

Dr. Princess Ifeoma Ike

Public Health Optometrist/CEO Princess Vision Eye Clinic Limited Abuja, Nigeria and Global Shaper, Abuja Hub, World Economic Forum

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This article is part of: Annual Meeting of the New Champions

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AI is revolutionizing eye care, particularly in developing nations like Africa.
We examine the potential risks and opportunities for this disruptive technology.
Millions of lives can be improved, but we must use the technology responsibly.

Healthcare is one industry that expects to gain significantly from the fourth industrial revolution's (4IR) explosion of disruptive technology. Healthcare experts' ability to diagnose, treat, and care for patients is being revolutionised by artificial intelligence (AI) as it has the potential to significantly increase access to eye care, particularly in developing nations like Africa.

What is the current eye health landscape in Africa?

Uncorrected r efractive errors, glaucoma, and cataracts constitute some of the eye diseases and visual impairments that are prevalent in Africa. However, the continent faces several challenges in providing adequate eye care coverage. Limited access to trained eye care professionals, inadequate infrastructure, and high costs contribute to a significant treatment gap. Because of this, many people who have eye conditions go undiagnosed and untreated, which causes avoidable visual impairments and decreased quality of life.

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What is the potential of AI in eye care?

AI has the potential to address the challenges faced by eye health systems in Africa. By leveraging machine learning (ML) algorithms and computer vision techniques, AI can improve access, diagnosis, and treatment outcomes. Some potential applications of AI in eye care include:

Telemedicine and remote consultations: AI-powered telemedicine platforms can connect patients in remote areas with eye care specialists. This enables remote consultations, diagnoses, and treatment recommendations, reducing the need for physical travel and overcoming the shortage of eye care professionals in rural areas.
Automated diagnostics and screening: AI algorithms can analyse retinal images or fundus photographs to detect early signs of diseases such as diabetic retinopathy, age-related macular degeneration, and glaucoma. Automated diagnostics can greatly enhance early detection rates, allowing for timely interventions and preventing irreversible vision loss.
Customised treatment plans: AI can analyse patient data, including medical history, genetic information, and lifestyle factors, to develop personalised treatment plans. By considering individual variations, AI can optimise treatment outcomes and minimise adverse effects.

What are the potential limitations or risks associated with the adoption of AI in eye care?

While the adoption of AI in eye care holds significant promise, it is important to consider potential limitations and risks associated with its implementation. Acknowledging these concerns ensures that AI is utilised in a responsible and ethical manner, promoting patient safety and equitable access to care. Some of the key limitations and risks include:

Reliance on data quality and representativeness: AI algorithms depend on high-quality and diverse datasets to achieve accurate and reliable outcomes. In eye care, the availability of comprehensive and diverse datasets can be a challenge, especially in resource-constrained settings. If the data used to train AI algorithms are incomplete, biased, or unrepresentative of the population, it can lead to inaccurate diagnoses and treatment recommendations, potentially exacerbating healthcare disparities.
Over reliance on technology: While AI has the potential to enhance eye care, it should never replace the role of human healthcare professionals. The risk lies in an over-reliance on AI systems, which may result in the neglect of essential human judgement, empathy, and clinical expertise. It is crucial to view AI as a tool that complements and augments human capabilities, fostering collaboration between AI systems and healthcare professionals.
Ethical and legal considerations: The use of AI in eye care raises ethical concerns related to privacy, consent, and security of patient data. The sensitive nature of medical information necessitates robust data privacy and security protocols to protect patient confidentiality. Additionally, clear guidelines and regulations are needed to address issues such as algorithm transparency, accountability, and liability in case of AI-related errors or adverse outcomes.
Generalisation and bias: AI algorithms are prone to bias, particularly if the training data is biased or incomplete. In eye care, this can manifest as disparities in diagnosis, treatment recommendations, and access to care. To ensure fairness and equity, efforts should be made to train AI algorithms on diverse and representative datasets that accurately reflect the demographics and specific characteristics of the African population.
Technological infrastructure and accessibility: The successful deployment of AI in eye care relies on robust technological infrastructure, including high-speed internet connectivity, advanced imaging systems, and reliable telemedicine networks. However, many regions in Africa face challenges in terms of infrastructure development and accessibility. Without adequate infrastructure, the potential benefits of AI may not reach all populations, exacerbating existing disparities in access to care.

How can we overcome challenges and ethical considerations?

While the potential benefits of AI in eye care are substantial, several challenges and ethical considerations must be addressed:

Data privacy and security: AI relies on vast amounts of patient data, including sensitive medical information. Robust data privacy and security protocols must be implemented to protect patient confidentiality and comply with relevant regulations.
Algorithm bias and equity: To ensure equitable access to eye care, AI algorithms must be trained on diverse datasets that accurately represent the African population. Addressing algorithm biases and ensuring fairness in AI outputs are crucial to prevent exacerbating existing healthcare disparities.
Human-machine collaboration: AI should be viewed as a tool to augment human capabilities rather than replace healthcare professionals. Collaboration between AI systems and human experts is essential to ensure accurate diagnoses, appropriate treatment decisions, and patient-centred care.

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How can collaboration and policy recommendations help?

To maximise the potential of AI in eye care, collaborations between governments, healthcare institutions, technology developers, and international organisations are vital. Key policy recommendations include:

Investment in infrastructure: Governments should prioritise investments in healthcare infrastructure, including the development of telemedicine networks, high-quality imaging systems, and reliable internet connectivity.
Capacity building: Training programmes should be established to enhance the skills of eye care professionals in utilising AI technologies effectively. Continuous professional development and upskilling initiatives will ensure a competent workforce capable of embracing AI advancements.
Regulatory frameworks: Clear and comprehensive regulatory frameworks should be established to govern the use of AI in eye care. These frameworks should address data privacy, algorithm transparency, and accountability to ensure patient safety and ethical practices.
Research and development: Increased investment in research and development is necessary to further explore the potential applications of AI in eye care. Collaborative efforts between academia, industry, and healthcare institutions can drive innovation and optimise AI algorithms for the African context.
Case studies and success stories: Highlighting successful implementations of AI in eye care across Africa can inspire further adoption and investment. Sharing case studies of AI-powered telemedicine platforms, automated diagnostics, and personalised treatment plans can demonstrate the positive impact on eye health outcomes. For instance, Peek Vision, a UK-based social enterprise, has successfully implemented AI technology in eye care across a few countries in Africa. Through their telemedicine platform, Peek Acuity, they enabled visual acuity tests in low-resource settings, leading to early detection and appropriate referrals. Their smartphone attachment, Peek Retina, transformed smartphones into retinal imaging devices, aiding in the diagnosis of eye conditions. Additionally, Peek Solutions utilised AI algorithms to develop personalised treatment plans for patients, improving adherence and outcomes. These successful implementations demonstrate the positive impact of AI in eye care and inspire further adoption and investment in Africa.

In summary, the 4IR presents a unique opportunity to transform eye health systems in Africa through the application of AI. By harnessing the power of ML and computer vision, AI can enhance access, diagnosis, and treatment outcomes for individuals with eye health issues. However, it is essential to address challenges related to data privacy, algorithm bias, and human-machine collaboration while establishing robust regulatory frameworks. Collaborations and policy initiatives that prioritise infrastructure development, capacity building, and research can unlock the full potential of AI in eye care. With careful implementation and a patient-centred approach, AI has the potential to revolutionise eye care coverage in Africa and improve the lives of millions affected by visual impairments.

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