Eye care innovation in focus at parliament

Developments in artificial intelligence technology and an AOP push for IT connectivity between High Street optometry and secondary care were discussed at a meeting of the All-Party Parliamentary Group on Eye Health and Visual Impairment (22 May, Houses of Parliament).

MP for Battersea, Marsha de Cordova, opened the meeting by highlighting that there have been many eye health innovations in recent years.

“These include advancements in imaging that enable optometrists to take a detailed look inside the eye, detecting issues within the retina and optic nerve,” she said.

“In the future, AI will be able to detect eye diseases – enabling clinicians to focus on treating more complex patients and reducing pressure on secondary care,” she said.

While AI has the potential to transform eye care, de Cordova emphasised the need to be aware of some of the challenges associated with these developments.

“We will need to be quite cautious in how we approach this but I believe the UK can, and should, be global leaders in this space, particularly when it comes to eye health,” she said.

Professor Paul Foster, an ophthalmologist at Moorfields Eye Hospital, outlined how a clinical diagnostic hub at Brent Cross shopping centre had helped to address eye care waiting lists.

In the wake of the pandemic, Foster shared that around 10% of the NHS waiting list was comprised of ophthalmology patients.

Foster shared that the diagnostic centre at Brent Cross resulted in an additional 40,000 appointments per year. He added that the innovation enabled Moorfields Eye Hospital to clear its pandemic backlog within three months.

Foster is also hopeful about the role AI will play in easing the burden on eye care services.

He noted that AI algorithms have been developed that can detect retinal disease to the same level as expert human observers.

“This is really the start of incredibly powerful new disease surveillance technology,” he said.

“I hope that these artificial intelligence algorithms will help us bypass the bottleneck that we now have for reviewing the clinical data,” Foster shared.

AOP clinical and professional director, Dr Peter Hampson, shared that optometry and ophthalmology are data-rich professions.

“Both professions capture huge volumes of data every single year. For example, we know there are around eight million outpatient attendances in ophthalmology each year and around 20 million sight tests are conducted within optometry annually,” he said.

Hampson observed that a range of tests and information is captured during eye examinations, but currently most of this data sits within the practice.

There are around two million episodes of retinal imaging within secondary care each year, Hampson said.

He highlighted that attending hospital for an eye clinic appointment can be challenging for some patients. This has been referred to in the Age UK report Painful journeys.

“That sets out how hard it can be for some of these patients to get to the care that they need,” Hampson said.

“This creates a barrier to care that does not need to exist,” he said.

Hampson shared that improving connectivity between primary and secondary eye care presents an opportunity to tackle the outpatient backlog, streamline care, and free up capacity for those who do need to attend hospital.

“We believe that by utilising the skills and technology in primary care, we could gather visual field data, OCT data and ocular pressures then feed that into the hospital system. This will enable consultants to have oversight,” he said.

He shared that the AOP is ambitious but realistic in its approach to IT connectivity – calling for access to NHS mail “as a bare minimum.”

“It isn’t a fix but it would allow us to start sharing images, visual fields and basic data backwards and forwards securely,” Hampson said.

He shared that the cost of rolling out NHS mail across England is estimated to be around £250,000.

“The true win would be rolling out an electronic referral system which would allow synchronous communication in real time,” Hampson highlighted.

He emphasised the need for an overarching national eye health strategy in England in order to coordinate care.

“A piecemeal approach has existed for so long and it cannot continue. With a national, joined-up approach to how we deliver care and connectivity, we can make use of the potential of primary care optometry and more importantly provide a better and safer environment for our patients,” Hampson concluded.

Paul Cox, of the Industry Vision Group, also highlighted the importance of connectivity between the High Street and secondary care.

“We believe prioritising the roll out of electronic records will go a long way to supporting better integration,” he said.

“We need to allow information sharing between different parts of the system so they can work together properly,” Cox emphasised.

Cox highlighted that the strategic direction of eye care is also a priority for the Industry Vision Group.

He shared that a national eye health strategy for England could help to address unwarranted variation in eye health outcomes.

The third area of focus for the Industry Vision Group is assisting people with rare eye conditions.

“There are thousands of people living with inherited eye conditions that are individually rare,” Cox said.

He highlighted that while there have been developments in genetic therapy, action needs to be taken to ensure that the UK can realise the potential of this innovation.

Dr Matteo Rizzi, of the UCL Institute of Ophthalmology, spoke about developments in ocular gene therapy.

“It has been an exciting time in gene therapy – in the last few years, there has been a surge in gene therapy trials,” he shared.

He highlighted that gene editing can be used to correct small mistakes within the genetic code. Rizzi added that developments in AI are assisting the field.

He shared that previously scientists could only compare “a handful” of vectors at one time when developing a genetic therapy, but AI has enabled the comparison of millions of vectors.