Eye health technology

As more consumer technology focuses on or requires the use of vision, and as many world populations continue to age, the eye healthcare industry has increased attention. This technology includes a variety of developments in ophthalmologic and optometric diagnostics and care. As the technology continues to evolve, new companies have emerged to offer new treatments for common eye diseases and for reimaging existing eye technologies.

Technologies developed by common conditions, such as glaucoma, dry-eye, cataracts, and retinal diseases, explore many of the different technologies being developed to combat the diseases or reverse the diseases in cases when possible.

Glaucoma is a condition in which the optic nerve is damaged; it is a leading cause of blindness. As the disease progresses, the patient loses peripheral vision and develops tunnel vision. Multiple technologies have been developed to treat glaucoma. One of these technologies is a simple, safe, and pain-free laser treatment that works better than eye drops for preventing deterioration with glaucoma; it could also save hospitals and patients millions of dollars a year, according to Moorfields Eye Hospital and UCL Institute of Ophthalmology.

A three-year trial, reported in The Lancet, studied 718 patients newly diagnosed with glaucoma or ocular hypertension who received this laser therapy, and found that they regularly achieved the target intraocular pressure compared with those being treated with standard eye drops. Laser patients were also less likely to need treatment for glaucoma and cataracts.

Similarly, artificial intelligence has been used for triaging glaucoma. These AI systems are designed to screen for the early detection and treatment of glaucomatous optic neuropathy. The CDC has reported that approximately three million Americans are affected by glaucoma, and it is a leading cause of blindness. An AI system could detect cases early and allow those with glaucoma to receive treatment before it reaches a certain risk level.

Similarly, there are companies developing contact lenses to supplement glaucoma. These contact lenses monitor the intraocular pressure (IOP) of the eye, which is essential to diagnosing and managing glaucoma. The IOP readings are a part of the glaucoma workup and are used to determine whether the patient's current treatment regimen is sufficient in achieving a target IOP for healthier eyes.

Dry eye is a chronic condition in which a person's eye cannot sufficiently lubricate itself. This can be because of insufficient tear production, increased tear evaporation, or an imbalance in tear composition. The technologies being developed for dry eye have included artificial tears, eye drops, and eye inserts to help a person sufficiently lubricate their eye.

Further, there are companies using intense pulsed light (IPL), which is a newer technology used to treat dry eye. The non-invasive procedure uses sequenced light pulses to stimulate and unblock the meibomian glands, which produce the oils that eyes need to stay lubricated.

Cataracts are another common cause of vision loss in people over forty and a leading cause of blindness. The main treatment for cataracts is surgery, in which an ophthalmologist removes the clouded lens and replaces it with a plastic intraocular lens. Several startups have been working on optimizations of cataract surgery. One such example of this has been the use of robot-assisted surgical tools, which can expedite conventional surgeries, increase the precision of those surgeries, and offer better manipulations for surgery to help ophthalmologists perform more surgeries than would be possible manually.

The retina is a light-sensitive tissue at the back of an eye. Two of the most prevalent diseases of the retina are diabetic retinopathy and age-related macular degeneration; treatments for these include injections, laser surgery, and other innovations.

This includes tools used to image, monitor, and track eyes for a wide range of diseases. Developments in this category include using infrared technology to look inside an eye for an ultra-wide retinal scan to produce images of the eye and any damage. This can make it possible to analyze the delicate lining at the back of the eye and detect and monitor retinal changes that can be associated with diabetes or macular degeneration.

A non-invasive diagnostic imaging option for the cornea is corneal topography, which maps the surface and shape of the cornea and analyzes the curvature, thickness, and other details of the corneal surface. Ophthalmologists are capable of diagnosing conditions such as keratoconus and can fit contact lenses to the unique characteristics of an individual. Corneal topography is an essential diagnostic technology capable of creating a colored map of the cornea curvature with a specialized camera and digital analysis that highlights any abnormalities and guides treatment. Specific imaging methods include placido disk, Scheimpflug, and scanning-slit topography.

Through the combination of multiple diagnostic images in a computerized analysis, optical coherence tomography (OCT) can create images of the structure and blood flow of the retina. This non-invasive equipment eliminates the need for injected fluorescent dyes to create detailed images for review. The details with 3D scans produced by an OCT machine can help ophthalmologists diagnose and treat diseases of the retina, including vessel occlusions, macular degeneration, and diabetic retinopathy. These images provide a picture of what is causing issues with vision and can be used to track improvements and progression of retinal diseases.

Especially for diagnostics, artificial intelligence has been shown to make correct referral decisions for more than fifty eye diseases, with a 94 percent accuracy, which represents an equivalent rate with world-leading experts. For example, Google's DeepMind system could increase the capabilities to revolutionize the management of eye tests and enable healthcare professionals to spot conditions earlier and prioritize patients with the most serious diseases before irreversible damage sets in. This could allow ophthalmologists and optometrists to perform eye scans at a faster pace and can reduce the delays in diagnosis and treatment of sight-threatening diseases, further allowing specialists to respond to urgent situations.

The uses of, and use cases for, telemedicine have continued to extend over the vision disease spectrum. This has included the ability to detect types of refractive error, including myopia, hyperopia, astigmatism, and presbyopia through telerefraction techniques. Many of these advances in the direct treatment of eyes has been accelerated by COVID-19 and related lockdowns. This has also accelerated the use of tele-optometry services, in which optometrists and ophthalmologists have been able to talk to patients with digital tools rather than holding in-person appointments. While this does not yet provide the same level of care as in-person appointments, they do allow patients who need to speak to an optometrist in an urgent situation as soon as possible.

As mobile devices have become an indispensable technology in today's world, innovators are looking for ways to use this technology to enhance eye care services. Eye care professionals are aided with mobile health tools that offer more efficient and accurate examinations. They have been used to assist doctors in eye therapy and to help both patients and eye care professionals monitor eye health and prevent diseases. Doctors have already tried carrying head-mounted displays with ophthalmic technologies that could replace other examination devices used in eye clinics. Mobile technologies also hold the possibility for eye care professionals to provide health assistance to patients in remote areas.

Similar to mobile eye health technologies, wearable technologies have been increasing in popularity and have proved a vital tool in managing eye health, capable of doing more than just tracking vitals. Wearable devices have been used to assist both patients and optometrists and ophthalmologists in correcting eye issues. Smart contact lenses, as one example, are a clinical trial development shown to be capable of correcting eye problems, with an artificial iris helping patients in cure eye injuries and congenital diseases. Smart lenses have also shown increased possibilities of enhanced eye health management.

As explored above, robotic surgical systems have begun to be used in ophthalmic surgeries. These systems have offered improved surgical precision and amplified scale of motion over manual surgical techniques. And ophthalmic surgeries are usually performed with high magnification and a three-dimensional view through a surgical microscope. The precise manipulations performed by robotic surgeries have been specifically capable for ophthalmic surgery and have been proven to reduce accidental damage.

For example, through a clinical phase trial of using robot-assisted surgery in ophthalmology, a team used a robot to insert a fine needle under the retina to dissolve blood in three patients who had age-related macular degeneration. All experienced an improvement in their vision as a result. These trials were conducted by the University of Oxford, supported by the National Institute for Health Research Oxford Biomedical Research Center.

With millions of people suffering from visual impairment, it is no surprise that innovators and technology companies have been working on developing new ways to restore sight, including bionic eyes and artificial retinas. A possible solution for visual disabilities, the bionic eye is intended to work inside the existing eye structures and is designed to attain functional vision goals, as opposed to physical cosmetic ones. Commercially available artificial retinas have included a small camera mounted on a pair of eyeglasses and a tiny array of electrodes that is implanted on the retina. The camera captures are transformed into signals, which are transmitted to the retinal implant. In response, electrodes stimulate the retinal cells, causing them to send information to the optic nerve that can be processed by the brain.

A five-year study into a bionic eye in patients with little or no sight has marked a big step forward in eye health research. But the researchers stress they are a long way from achieving full vision for their research subjects. For example, a patient may be able to see an object without knowing if it is a mug or a baseball.

Gene therapy has been suggested to help with genetic therapies, such as inherited blindness. The therapy has, as tested, generated controversy; some of these therapies have initial costs of USD $850,000, making it one of the most expensive treatments in the world. The therapy has proven to be capable to restore vision in people with a rare RPE65 genetic mutation that causes progressive vision loss that begins in childhood. The RPE65 gene provides instructions for making a protein that is essential for normal vision. Most patients are blind by the time they become adults, as so far there are no other treatments for the disease.

Eye tracking technology has been proposed as a possible technology for developing applications to enhance workflow, facilitate skills transfer, provide additional security, promote safety and wellness, and is possible to improve as computing and resource efficiency increase. Eye tracking has been suggested for use in surgical robots for improving their efficiency, including for eye tracking that can decode human attention by transforming head-and-eye biometrics and movements into real-time data streams. This is as eye tracking technologies have also found increased use in diagnostics. For example, eye tracking technology has been used to diagnose autism spectrum disorders with promising results and has been shown to be easy use for patients of any age. As well, this technology has been used for diagnosing patients with glaucoma and strabismus.