The potential of artificial intelligence and digital health in global eye health
Reviewed by Eliott Taylor

This article provides an overview of the current landscape of artificial intelligence (AI) and digital health in global eye health. Tan, et al. note that though significant progress has been made in global eye health over the last few decades, the total number of people worldwide with avoidable blindness is increasing. The authors suggest that AI and digital health have the potential to transform eye care, particularly in low- and middle-income countries (LMICs). Key global eye health initiatives, such as ‘2030 IN SIGHT’ and ‘The Lancet Global Health Commission on Global Eye Health’ advocate embracing technology but emphasise that it must be carefully applied to improve coverage, accessibility, quality, efficiency and affordability of eyecare. This review highlights that deep learning (a type of AI) has performed well when used as a diagnostic tool for conditions such as diabetic retinopathy, age-related macular degeneration, glaucoma, and retinopathy of prematurity. Tan, et al. emphasise the potential of natural language processing (another type of AI) to automate clinical interactions and interpret clinical information. The authors highlight that despite AI’s promise, AI systems have not yet been widely deployed in LMICs. This review also focuses on telehealth in ophthalmology – the implementation of which has been accelerated by the Covid-19 pandemic. Tan, et al. reference the potential for telehealth to improve eye care coverage by facilitating assessment in remote centres or within primary care. They highlight that there may be a role for augmented and virtual reality in training eye health workers, although note that costs associated with this technology are currently prohibitive. Tan, et al. identify a series of challenges that must be addressed to integrate digital health within eye health systems: regulatory barriers; infrastructural limitations; financial costs; cybersecurity risks; ethical concerns; and technical limitations. The authors call for collaborative action to leverage emerging technological solutions and suggest a global digital eye health task force to facilitate integration into eye health systems. To maximise the potential for AI and telemedicine within global eye health, sufficient emphasis on human factors evaluation is needed – focusing on usability, trust, human-computer interaction.

Artificial intelligence and digital health in global eye health: opportunities and challenges.
Tan TF, Thirunavukarasu AJ, Jin L, et al.
THE LANCET GLOBAL HEALTH
2023;11:E1432–43