80-85 percent of our sensory perception, cognition, learning, and information processing is derived from or facilitated by vision. 43 million people worldwide are living with blindness, of whom 8 million are in India. However the bigger tragedy is that a substantial part of these afflictions could have been prevented, or treated.

Early detection and treatment are of course the most critical elements in the mitigation of visual impairment. In addition, self-help tools and aids, awareness building, and proactive care can augment the efforts of the healthcare system to improve existing outcomes. Digital technology, artificial intelligence (AI) in particular, can play a valuable role in all these areas by rendering assistance to practitioners, patients, and the larger eyecare ecosystem.

Expanding the capacity of eyecare systems

Artificial intelligence solutions are on course to transform the diagnosis, treatment and management of eye disease.

AI-based eyecare solutions are available for a range of purposes, from screening and diagnosis to risk assessment, prognosis, and also oculomics. Eyecare systems in developing economies have started their AI journey by using the technology for screening diabetic retinopathy, a major cause of blindness. The use of AI could dramatically increase the screening capacity of the under-resourced and overburdened healthcare system, improving access to timely treatment, which is crucial for preventing blindness and visual impairment.

Similarly, AI solutions are showing real potential to streamline the workload of practitioners by talking to patients first to triage cases and decide who needs immediate medical attention. They can also be used to automate routine tasks such as summarising clinical notes or extracting health data from patients’ medical records.

Machine learning / deep learning models are capable of processing massive datasets to discover disease patterns, identify risk factors, and also predict serious eye diseases, such as cataract, glaucoma and ocular hypertension, based on symptoms. By analysing a patient’s medical and family history, and lifestyle information along with imaging data, AI algorithms can craft a personalised treatment plan that improves treatment outcomes while minimising risks and side effects. Another AI-based application, facial landmark detection, is under clinical validation for spotting problems such as cataract and red eye by studying the eye’s frontal images.

Enabling and educating to create inclusivity

Infrastructure and enablement are the pillars of an inclusive environment for people with disabilities. Creating accessible physical infrastructure will takes time, but in the meantime, AI brings hope for speedier enablement. AI “copilot” apps help blind persons cross roads safely by recognizing traffic signs and indicating when it is safe to walk. AI assistants speaking multiple languages are already assisting the visually impaired by answering queries or offering guidance; trials integrating image recognition capabilities into mobile apps could take enablement to a new level: by uploading a photograph or image, users can get almost any information they need, from directions to recipes to the location of objects around them. Similarly, the integration of AI solutions into smart glasses that can be instructed through voice commands, has the potential to make visually impaired persons more independent.

Digital public infrastructure for healthcare can be used to bring the power of AI to make preventive eyecare accessible to everyone across the country, anytime and anywhere. For example, Infosys Foundation in partnership with LV Prasad Eye Institute launched a mobile app SightConnect for everyone in India. Anyone can download the free app and use it proactively to identify any eye-related issues like refractive errors (near and distance vision) using visual acuity tests. We are now seeing that those with visual problems in the interior parts of the country are able to quickly identify eye issues with the help of the app and are able to consult and take preventive actions quickly.

Facilitating collaboration between groups

The eyecare ecosystem and technology providers can come together to improve delivery is the digital eye bank. Using high-quality digital images, eye bank staff can consult (busy and geographically dispersed) medical experts online for a telemedical review of corneal tissue, to get a timely evaluation without the cost and logistics of physically transporting the corneas. This would also reduce wastage of corneas in India, where 40 percent of the 40,000-odd corneas collected in a year are discarded because of poor awareness, unsuitability, or logistical difficulties.

Stephen Hawking once said that addressing the many barriers faced by people with disabilities would unlock their potential to contribute to the world. By enabling and empowering both visually impaired individuals and eyecare systems, digital public infrastructure, powered by AI, takes us many steps closer to that goal.