At Saswad tehsil in Pune district, 71-year-old Shiva, who was recently diagnosed with diabetes, decided to drop in at a mobile eye-screening camp. His images, along with those of 30 others, were sent to Dr Parikshit Gogate, consulting ophthalmologist at his clinic in Pune. That’s where retina specialist Dr Supriya Phadke ran them through an AI tool that uses machine learning and deep learning algorithms to analyse retinal images and eye data, often achieving over 90% accuracy in identifying early structural damage. That’s how she found that Shiva had early signs of glaucoma.
“Such mobile eye-screening initiatives are particularly valuable in areas where ophthalmologists are scarce and access to fundus imaging — a diagnostic technique to capture detailed, high-resolution photographs of the retina — and specialist care is limited,” says Dr Gogate. A new study published in the Lancet Primary Care journal suggests that recent advances in AI may provide a more viable option in such cases.
Why is the study significant?
For low- and middle-income countries, where glaucoma is frequently diagnosed only at an advanced, vision-threatening stage, these findings are particularly significant. “The AI operates on relatively low-cost fundus cameras (which photograph the interior of the eye). These can be run by trained non-physician staff and dramatically reduce the burden on scarce specialist services. Where diabetic eye screening infrastructure already exists, glaucoma screening can be added at minimal incremental cost. In our view, AI-enabled glaucoma triage offers a realistic path to earlier detection at population scale, including in settings where specialist access is limited or unavailable,” Afonso Lima-Cabrita, Department of Ophthalmology, Unidade Local de Saúde Santa Maria, Lisbon, Portugal and lead author of the study, told The Indian Express.
What’s glaucoma and why should you get tested for it?
Glaucoma is a condition when fluid builds up in the front part of your eye, increasing the pressure on it and damaging the optic nerve. It is the leading cause of irreversible blindness worldwide and often goes undiagnosed until vision loss is advanced. However, it can be prevented with early diagnosis and treatment.
Glaucoma poses a substantial public health challenge with India accounting for 20 per cent of global glaucoma cases, making it the second-most affected country worldwide. It is responsible for vision loss in approximately 1.2 million people, accounting for 5.5 per cent of the nation’s total blindness. A major concern is that nearly 90 per cent of glaucoma in India remains undiagnosed, as per the report.
Why is glaucoma underdiagnosed?
Dr Gogate recommends routine screening as traditionally glaucoma is under-diagnosed. “For example, one of the forms of glaucoma, called normal-tension glaucoma, can result in optic nerve damage and vision loss despite eye pressure remaining within the normal range (10-21 mmHg). It is believed to be caused by factors like poor blood flow to the optic nerve, low blood pressure or a weak nerve structure. Some may have a condition where the pressure inside the eye is higher than normal — above 21 mmHg — but without damaging the optic nerve or vision loss. It is primarily caused by an imbalance in the fluid production and drainage in the eye. It is because of this variability that glaucoma has traditionally been both under-diagnosed and over-treated,” says Dr Gogate.
What the study says about efficacy of AI tool
The study was carried out at a single screening centre in Lisbon, Portugal in 2023, where 671 adults, aged between 55 and 65 were screened via the AI tool. The images were also independently graded by six glaucoma experts.
