Eyes on the Future: AI’s Promise to Restore Sight in Africa

Every five seconds, someone loses their vision, with the World Economic Forum (WEF) reporting that uncorrected refractive errors, glaucoma, and cataracts are among the most prevalent eye diseases and visual impairments in Africa. According to Seva, a global non-profit organisation focused on eye care, despite the widespread challenge of avoidable blindness, eye care services remain gravely understaffed within the already strained health systems across the continent.

In terms of numbers, the World Health Organisation (WHO) estimates that one in every six blind individuals worldwide resides in Africa, with an additional 26 million people facing varying levels of visual impairment. Cataracts are responsible for approximately 50% of avoidable blindness in Africa alone and can be treated with a straightforward, cost-effective 15-minute surgery. However, only 14% of those needing cataract surgery receive it, while more than 80% of individuals with short-sightedness receive no treatment.

A TREATABLE CONDITION, YET UNTREATED

Data from World Economic Forum (WEF) indicates that over 30 million people undergo cataract surgery each year, making it one of the most common and effective medical procedures for preventing avoidable blindness. However, limited access to trained eye care professionals, inadequate infrastructure, and high treatment costs contribute to a significant gap in eye care services. Consequently, many individuals with cataracts remain undiagnosed and untreated, leading to avoidable visual impairments and a decreased quality of life.

According to Dr. Solomon Asacha, a senior cataract surgeon at Lions SightFirst Eye Hospital, cataracts remain a major cause of reversible blindness in Kenya and constitute a significant portion of the patient caseload. For over two decades, the hospital has operated as a comprehensive eye care centre in Kenya and is the only hospital in East and Central Africa with a dedicated cornea bank.

Furthermore, the increased reliance on digital devices has led to a rise in computer vision syndrome. “During the COVID-19 pandemic, screen time soared,” Dr. Asacha explains. “We now advise patients on appropriate screen usage, provide lubricating eye drops, and recommend blue-light filtering glasses to help alleviate these effects.”

The growing prevalence of cataracts, glaucoma, and other vision-related disorders has led to an increased demand for ophthalmic devices utilised in surgical procedures, diagnostics, and vision correction. In the Middle East and Africa, the need for filtering glasses, contact lenses, corneal topographers, refractive lasers, retinal cameras, and ophthalmic microscopes presents significant opportunities for major players such as Johnson & Johnson Vision Care, Alcon, and Carl Zeiss Meditec. According to ResearchAndMarkets, this market is projected to expand from US$2.18 billion in 2023 to US$3.03 billion by 2031, with a compound annual growth rate (CAGR) of 4.2%.

A GAME CHANGER FOR EYE CARE

Dr. Rizwana Peerbhoy, General Manager of Lions SightFirst Eye Hospital, a specialty clinic of Lions Eye Hospital, describes advancements such as cornea banks as “a game-changer.” Corneas harvested from donors can now be preserved for up to two weeks, offering opticians a critical window to restore sight for those in need. However, the demand for this service remains high, with over 3,000 patients currently awaiting transplants.

What if we could harness artificial intelligence (AI) to predict, prevent, and even reverse visual impairment outcomes with unprecedented accuracy? AI is becoming an essential tool for screening diabetic retinopathy, performing cataract surgeries, modelling 3D imaging, and managing patients. Its advancements in detecting and diagnosing visual impairments, enhancing patient management and monitoring, and expanding telehealth services could significantly improve access to care and outcomes.

AI-POWERED SOLUTIONS IN ACTION

One potential application of AI in modern eye care is the utilisation of AI-powered telemedicine platforms. Through smartphone applications or web-based services, patients can upload images of their eyes for analysis by AI algorithms. These algorithms can screen for common eye conditions, provide preliminary diagnoses, and monitor disease progression over time. This remote monitoring capability is particularly beneficial for patients with chronic eye diseases who require regular check-ups

Peek Vision, a UK social enterprise, has effectively utilised AI in Africa with its Peek Acuity platform for visual acuity tests and early detection of eye conditions. Their Peek Retina smartphone attachment transforms phones into retinal imaging devices for precise diagnoses. Additionally, Peek Solutions employs AI to develop personalised treatment plans, enhancing patient adherence and health outcomes. These initiatives demonstrate AI’s positive impact on eye care and encourage further investment in the sector.

Although AI has been regarded as a futuristic concept, Altris AI’s innovative platform, which employs advanced optical coherence tomography (OCT) imaging technology, has played a critical role in assessing the risk of developing glaucoma. This condition can lead to blindness if not diagnosed and treated early. It is particularly crucial in Africa, where access to specialized eye care is often limited, as it supports healthcare professionals in making timely and informed decisions regarding patient treatment.

Mobile applications are revolutionising vision testing, particularly in remote or underserved areas where access to traditional eye care facilities may be limited. OptikosPrime has collaborated with Sightsavers and eye health stakeholders in Africa to enhance smartphone-based vision testing. Using advanced algorithms, the OptikosPrime app analyses phone images to assess users’ eyesight and provide results that closely resemble those obtained through evaluations conducted by trained optometrists or opticians.

Automated AI diagnostics can analyse retinal images to detect early signs of diseases such as diabetic retinopathy, agerelated macular degeneration, and glaucoma. In Rwanda, the Rwanda Diabetes Association has partnered with Cybersight AI to equip four clinics with advanced AI screening cameras that utilise the latest Orbis tool to diagnose diabetic retinopathy (DR). This technology enables opticians to assess patients within minutes, thereby enhancing outcomes and satisfaction.

NAVIGATING THE CHALLENGES

While the benefits of AI in eye care are significant, several challenges and ethical considerations must be addressed. These include data privacy, algorithmic bias, and the collaboration between humans and machines. Strong protocols are essential to protect patient data and ensure compliance with regulations. Additionally, AI algorithms should be trained on diverse datasets to prevent exacerbating healthcare disparities, particularly for the African population, ensuring equitable access to healthcare services.

Integrating AI into existing electronic health record (EHR) systems can be intricate, yet successful integration is essential for seamless operations. Collaboration between AI systems and human experts is vital for making accurate diagnoses and delivering patient-centred care. Eye care professionals must also be trained to effectively comprehend and interpret AI results, incorporating them into their clinical practice.

A GLIMPSE INTO THE FUTURE

The future of artificial intelligence (AI) in eye care is promising, with ongoing advancements anticipated to revolutionise the detection, monitoring, and treatment of eye conditions such as diabetic retinopathy and age-related macular degeneration (AMD). AI is increasingly significant in ophthalmology, with algorithms now capable of analysing and interpreting complex eye scans with remarkable accuracy. This technology aids physicians in predicting risks and personalising patient care.

Surgical innovations are at the forefront of advancements in eye care. Techniques such as laser-assisted cataract surgery and Minimally Invasive Glaucoma Surgery (MIGS) exemplify these developments. Laser-assisted cataract surgery reduces the need for stitches and accelerates recovery, resulting in a more comfortable treatment experience. Meanwhile, MIGS effectively lowers intraocular pressure with fewer complications and quicker recovery times compared to traditional methods. The integration of robotic assistance in surgeries is also anticipated to enhance success rates and minimise the risks associated with eye operations.

Emerging technologies, such as predictive analytics and oculomics, are at the forefront of vision technology. Oculomics employs ophthalmic biomarkers to forecast systemic health conditions, while AI-driven predictive analytics can examine a patient’s medical history, lifestyle, imaging data, and genetic information to make informed predictions regarding their eye health.

Innovative technologies such as bionic eyes and artificial retinas are being developed to restore vision in blind patients by stimulating nerve cells to create visual perceptions. Additionally, 3D-printed digital contact lenses are emerging as another exciting frontier in eye care innovation. Virtual reality (VR) and augmented reality (AR) are also set to revolutionise eye care by enhancing diagnostic and therapeutic processes. Technologies such as VR-based vision therapy exercises and AR-enhanced eyewear promise personalised treatment experiences tailored to individual patients needs.

The future also encompasses portable and home-based devices that facilitate the monitoring and management of eye health for patients. Devices such as Peek Retina allow users to capture retinal images using their smartphones, thus enabling remote diagnosis and treatment. Similarly, the Netra device operates as a binocular-like headset that connects to an app for diagnosing refractive errors, streamlining eye exams and enhancing accessibility.

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