Digital revolution transforming the face of ophthalmic practice

The ophthalmic profession should broadly embrace the new wave of digital tools steadily making their way into clinical practice and which have the potential to greatly assist physicians in day-to-day patient care, said Béatrice Cochener- Lamard MD, PhD in her Ridley Medal Lecture delivered as part of the opening ceremony of the 40th Congress of the ESCRS.

In a wide-ranging lecture entitled “How the digital world is entering our practice”, Prof Cochener-Lamard, Professor and Head of the Ophthalmology Department in Brest University Hospital, France, focused on the diverse ways digital technologies such as telemedicine, machine learning, and artificial intelligence (AI) are profoundly changing the healthcare landscape for the benefit of physicians and their patients.

Prof Cochener-Lamard began her talk with a timely nod to Harold Ridley, the great IOL innovator, who she said would probably have understood more than most the rich possibilities of embracing new technological tools such as AI and machine learning.

She noted that AI has been frequently misunderstood and misrepresented as a potential threat to the role of the physician in general and the ophthalmologist in particular.

“One of the key challenges to overcome is that of human acceptance. That means we need to communicate better on the subject of AI, educate doctors, stop demonizing AI, share data of quality, and let the doctors decide what to ask of AI, because the critical point is AI has been designed to serve medicine and not to supplant the doctor,” she said.

Prof Cochener-Lamard noted digital tools have already made a major impact in transforming healthcare in the wake of the COVID-19 pandemic. She cited the massive upsurge in telemedicine applications that developed in France and elsewhere as a response to the need to see patients without exposing them to the risk of infection.

“We saw a real explosion of interest in telemedicine in France—which went from 1% of teleconsultations before the COVID-19 crisis to over 20% in April 2020,” she said.

As well as remote consultations, mobile ophthalmology cabin use can also play an important role in helping screen and monitor the ocular health of populations in remote and rural areas.

In terms of AI applications, the technology is currently advancing faster than public health measures and legal approvals, she said.

“We are facing key limitations in terms of bioethics, data protection, and also the distrust of the medical community, which is afraid of doctor substitution and of the transfer of competencies to other actors such as optometrists, opticians, or nurses,” she said.

Prof Cochener-Lamard said AI is particularly visible in three key domains in ophthalmology: registries and big data, imaging, and robotization. She detailed how each of these areas are transformed by AI but also highlighted some of the remaining challenges.

“There are some limits that we need to work around. We need to ensure the collection of good quality data that is systematic and accessible. We need to count on the support of national health authorities and academic societies because we need to develop health data hubs and obtain access to electronic medical records worldwide. We also need to define an economic model for AI and guarantee the integrity and cybersecurity of our medical data, as well as ensure access to bioethics for doctors and patients,” she said.