Using AI to Democratize Eye Care: A Vision for Underserved Populations

By Campion Quinn, MD

Eye care has historically been a privilege rather than a right in many parts of the world. Access to specialists, diagnostic tools, and timely interventions often depends on geography, income, and healthcare infrastructure. However, artificial intelligence (AI) has emerged as a transformative tool, offering the potential to level the playing field. By harnessing the power of AI, we can extend eye care to underserved populations, both in the United States and globally. Let’s explore how.

The Problem: Barriers to Eye Care

Imagine a rural community in the Midwest or a remote village in sub-Saharan Africa. In both cases, residents may need to travel hundreds of miles to reach an ophthalmologist. Many lack the resources or time to make the journey. Consequently, conditions like diabetic retinopathy (DR) and glaucoma go undiagnosed until vision is irreparably lost.

In the U.S., the disparity is stark. Urban centers boast high densities of specialists, while rural areas face a dearth of providers. Globally, over 2.2 billion people experience vision impairment, and nearly half of these cases could have been prevented with early intervention. The need for innovative solutions is urgent.

The Promise of AI: Case Studies and Real-World Applications

One compelling example comes from Singapore, where the Singapore Eye Lesion Analyzer (SELENA+) has revolutionized DR screening. This AI tool, integrated with the Singapore Integrated Diabetic Retinopathy Program (SiDRP), uses deep learning algorithms to analyze retinal images. By doing so, it can identify referable DR cases with 94.7% sensitivity, comparable to trained human graders but at a fraction of the time and cost [1].

Closer to home, AI-driven teleophthalmology initiatives are gaining traction. For instance, portable fundus cameras paired with AI algorithms allow primary care clinics in rural areas to screen for conditions like DR and macular degeneration. Patients no longer need to travel long distances for a diagnosis; instead, their retinal images are analyzed instantly, with results sent to specialists for review if needed. This approach reduces delays, lowers costs, and increases access to care.

How AI Works: A User-Friendly Analogy

To understand AI in eye care, think of it as a highly trained assistant. Imagine teaching a diligent student how to identify the signs of DR by showing them thousands of retinal images, some healthy and others diseased. Over time, this student becomes exceptionally skilled at spotting patterns. That’s essentially what AI does. By learning from vast datasets, it can analyze new images with remarkable accuracy. 

Challenges and Considerations

While the potential is immense, implementing AI in underserved areas isn’t without challenges. First, there’s the issue of infrastructure. Remote regions often lack reliable internet, electricity, or trained personnel to operate AI tools. Second, ethical considerations around data privacy and consent must be addressed. Third, physicians may worry that AI could replace their roles. However, AI should be seen as an ally, augmenting human expertise rather than replacing it.

 The Path Forward

For physicians considering integrating AI into their practice, the key is collaboration. Partnering with AI developers, public health organizations, and local governments can help overcome barriers. Educational initiatives to familiarize practitioners with AI tools are equally important. By demystifying AI and showing its practical benefits, we can ensure its acceptance and effective use.

 Conclusion: A Clearer Vision for All

AI is not a panacea, but it is a powerful tool in the fight against vision impairment. By democratizing access to eye care, we can ensure that geography and income no longer dictate who gets to see clearly. Whether through tools like SELENA+ or portable diagnostic kits, the message is clear: the future of eye care is inclusive, accessible, and driven by innovation. For physicians, embracing AI is not just an option—it’s an imperative.