A mobile retinal camera with fully integrated artificial intelligence (AI) is being deployed in remote Western Australia in an effort to prevent rural and Indigenous Australians going blind from Diabetic Retinopathy (DR), a sight-threatening condition that disproportionately affects Australians in outback regions, and is the leading cause of blindness globally in working-age people.
Pioneered by Australian non-profit organisation Lions Outback Vision, the breakthrough medical AI service was developed in collaboration with technology partners Google and Topcon, with support from UCL Institute of Ophthalmology (IoO) and the INSIGHT Health Data Research Hub at Moorfields Eye Hospital NHS Foundation Trust.
Following a one-year pilot, the mobile AI service won a grant of A$5 million (£2.5 million) from the West Australian government in October to fund implementation in the Pilbara, a sparsely populated region in the north of the state where access to health services is extremely limited. The Pilbara has approximately 45,000 residents, spread over an area of 507,896 km2 (193,826 mi2), almost twice the area of the UK.
Currently, patients are screened, their photos sent to a specialist for diagnosis, and then reviewed by a consultant if needed. The new AI-enabled model provides instant point-of-care diagnosis and an on-the-spot telehealth appointment with an ophthalmologist for anyone flagged as high risk. The mobile system has the capacity to reach people living in areas where screening services are not currently accessible.
From left: A patient in the remote Pilbara region of Australia has a telehealth video call from the van. An OCT machine in the van is enabled with AI for 'instant' diagnosis. Professor Angus Turner (left) with a patient.
The next phase of the initiative will use the world’s first AI foundation model for eye health, RETfound, to finetune the DR algorithm for Indigenous people, using locally gathered data to enhance accuracy. Developed in 2023 by researchers at the IoO and Moorfields utilising 1.6 million anonymised eye images from Moorfields’ patients alongside other smaller data sources, RETFound will enable expansion of the AI system to detect of cardiovascular disease.
This technology is expected to have a significant impact on remote West Australian communities. The rate of blindness among Indigenous Australians is almost three times higher than that for non-Indigenous Australians, and cardiovascular disease is the leading cause of the gap in death rates between Indigenous and non-Indigenous Australians, according to the Australian Government.
Australian ophthalmologist Dr Mark Chia, part of the Lions Outback Vision team led by Professor Angus Turner, facilitated the project during his PhD in London with Pearse Keane, Professor of Artificial Medical Intelligence at the IoO, consultant ophthalmologist at Moorfields Eye Hospital, and director of INSIGHT.
Pearse Keane said: “There is immense potential for medical AI to reduce health inequalities in low-resource settings, and this is an exciting use case. By providing a novel AI solution to the problem of geographic isolation and limited access to health services, care providers in the remote Pilbara region now have the power to help close the gap in eye health between outback and urban populations.”
Mark Chia said: “Working with our collaborators in the UK, we have been able to bring together world-leading data science and medical AI expertise with the experience and ingenuity of eyecare professionals in Australia to develop an original approach to saving sight, and saving lives, in remote parts of the country.
Professor Angus Turner said: “The deployment of this mobile retinal camera with 'on-the-spot' diagnosis across the Pilbara has already begun to make a significant impact. By improving access to eye screening, we’re ensuring that people living in remote places have access to diagnosis that can prevent blindness with early treatment. This innovation is a game-changer for healthcare delivery in the region.”
For more information please contact us: enquiries@insight.hdrhub.org
All photos courtesy of Lions Outback Vision.
UCL Institute of Ophthalmology is one of the foremost eye and vision research institutes in the world. It operates at the cutting edge of translational research, delivering new therapies, diagnostic tools and preventive measures to patients suffering from visual impairment or blinding conditions. The combination of the Institute’s research resource with Moorfields Eye Hospital, which has the largest ophthalmic patient population in the western world, opens the way for further advances in vision research. Close collaboration with other academic partners and with industry extends its impact. The Institute has been named as the best place to study ophthalmology in the 2017 Centre for World University Rankings (CWUR). For further information, please visit www.ucl.ac.uk/ioo.
About Moorfields Eye Hospital NHS Foundation Trust
Moorfields Eye Hospital NHS Foundation Trust is one of the leading providers of eye health services in the UK and a world class centre of excellence for ophthalmic research and education. Moorfields main focus is the treatment and care of NHS patients with a wide range of eye problems, from common complaints to rare conditions that require treatment not available elsewhere in the UK. Moorfields unique patient case-mix in serving 23 locations across Greater London combined with the number of people treated means that the hospitals clinicians have expertise in discrete ophthalmic sub-specialties. The Trust also operates commercial divisions that provide care to private patients in both London and the Middle East. Together with the UCL Institute of Ophthalmology, Moorfields is recognised as a leading centre of excellence in eye and vision research.
About INSIGHT
INSIGHT is the Health Data Research Hub for eye health, based at Moorfields Eye Hospital NHS Foundation Trust, working in partnership with University Hospitals Birmingham NHS Foundation Trust. It is an NHS-led initiative serving to improve healthcare for the benefit of patients and wider society by enabling safe and trusted research access to anonymised data.
The origin for INSIGHT is a research collaboration that began in 2016 between Moorfields Eye Hospital with UCL and DeepMind Technologies, now part of Google. INSIGHT is widely considered the world’s largest ophthalmic bioresource with over 35 million retinal images linked to clinical data.
About Lions Outback Vision
Lions Outback Vision was established in 2010 with the support of the Lions Eye Institute and the University of Western Australia. Collaborative care has proven to be a transformative approach for our team over the last decade. Partnering with optometrists and ophthalmic nurses and the integration of Aboriginal eye health workers has allowed us to bridge the gaps in care and ensure culturally sensitive, integrated care and patient outcomes.