There is much talk, both in optometry circles and generally, about the role artificial intelligence (AI) will play in our lives as we move forward. I am a keen supporter of use of AI in optometry and especially in the field of retinal image analysis.
There are companies currently supplying some excellent AI software for clinicians to use in their consulting rooms or offices. I don’t intend to advertise these companies here, but I would say I have experienced the software of one of them and find the prospect of using it in the consulting room very exciting.
I would certainly encourage everyone who uses optical coherence tomography technology to consider this type of development very carefully as AI is such a powerful partner to clinicians and will only get better over time.
It was with this in mind that I read with interest of a new system using AI that has been developed in Oxford to handle post-operative follow up of cataract surgery patients. A recent report in The Lancet’s eClinicalMedicine journal stated that this new system strongly agreed with the outcomes of the supervising ophthalmologist, and it is currently being used by nine hospital trusts, mainly in the South of England.
This system, known as Dora, follows up patients who have undergone cataract surgery three weeks after the operation by way of a telephone conversation. This has been shown to be highly effective at clearing follow up backlogs within hospital clinics, is generally liked by patients who are particularly pleased with the lack of impact upon their life and shows significant cost savings to the trusts.
This would appear, therefore, to be an excellent use of AI, with wins all around the system. The question that must be asked is, where does that leave the role of the optometrist?
There are currently many highly successful pre and post-cataract surgery schemes in operation around the country with an excellent pathway developed by Locsu, the Integrated Cataract Pathway, for use at a local level. Many of these schemes have run brilliantly for many years with some being born out of the original Action on Cataracts document of the late 1990s. But time moves on, so will optometrists still be delivering post-cataract care in the years to come?
There will be those who, because of events such as these, will say AI presents a threat to professions like optometry and that we will soon all be out of a job thanks to it.
However, such a view is, dare I say, highly myopic. AI throws up many opportunities for our profession. We need to know how to embrace those opportunities. To be able to do this we all need to have a clear idea of which direction we want optometry to go in the future.
I still talk to a lot of optometrists who cling to the belief that they have a divine right to be the one place to go for refraction and that the prime role, and indeed the prime source of income, should remain refraction and the selling of spectacles and other vision correcting products. I am not here to argue the rights and wrongs of those views.
It is clear however that, as circumstances change, the need to evolve becomes ever more paramount. Using the example already shown, we can all see how, with the introduction of AI, our role in post-cataract care may well very soon be usurped. Certainly, from what is reported in The Lancet, and the views of patients, this seems inevitable.
Therefore, we need, with a degree of urgency, a noticeably clear consensus of what modern optometry is aspiring to deliver. This consensus is something I have sought to find but, to date, have failed to do so. The professional bodies all have future plans, but I cannot discern what they really see optometry and optometrists doing 10 years from now.
It is clear functions will change radically for many professionals, especially those in the medical world as AI plays a greater role in patient care. Have we really embraced that change and developed a vision for our future role?
It seems inconceivable that in the future optometrists will spend their time asking people if the circles are clearer on the red or the green or in position one or two, but what then will we be doing? How are we preparing ourselves for this new world? What are we teaching the next generation? Do we know what we see ourselves doing and are we, as practising clinicians, preparing our practices for our new role?
I think the role of the optometrist in the future is a very exciting one, but it is going to be very different from today. If we try to hold on to the old work roles, we risk being left behind. We must create the vision for our future role now before evolution overtakes us and we, as a collective profession, all need to buy into that vision and make it happen.
