Artificial intelligence (AI) isn’t the future of optometry—it’s the present. The continent’s second largest grocery chain, Albertsons (which also operates under the banners Acme, Safeway, Shaw’s and Vons, among others), has installed autonomous AI diagnostic systems designed to spot diabetic retinopathy (DR), and they are ready for customers to use. The IDx-DR system scans the eye and detects DR and macular edema without any clinicians ever reviewing the images. The non-invasive exams take five to 10 minutes and are now available in the chain’s retail health clinics CarePortMD.1,2

“It is important to understand CarePortMD is a primary care visit hosted within a retail setting," said Michael D. Abramoff, MD, PhD, founder and president of IDx. “Positive patients are routed to an eye care provider.” In other words, the idea is for the technology to issue patients a precise metric and, hopefully, encourage them to seek medical care earlier rather than later. Unlike blood pressure cuff self-tests, the IDx-DR system requires a prescription (only those at risk are screened) and is performed by a registered nurse.1

According to Brad Sutton, OD, a past president of the Optometric Retina Society and professor at Indiana University’s School of Optometry, this technology might not be so welcomed by optometrists. “It is very important that people not be told that they are free of retinopathy when they indeed have it. Obviously, that could have significant consequences,” he warns. Even worse, he fears, patients may be confused and believe that the IDx—which only analyzes patients for DR and macular edema—constitutes a comprehensive eye exam. What if, Dr. Sutton asks, “the patient continues to not get eye exams, as they feel that they do not need to after the screening was passed? Unfortunately for them, they have undetected glaucoma, or an undetected tumor, or undetected macular degeneration that does not get addressed and causes them irreversible damage.”

On the other hand, if it works as intended, “a diabetic patient who has not been to an eye doctor in years [could] take the screening, which detects clinically significant retinopathy. This prompts the patient to schedule an examination, where the findings are confirmed and the patient ends up getting treatment before serious vision loss develops,” Dr. Sutton says.

Experts recommend annual eye exams to catch disease in its early stages, but as few as 15% of Medicare patients actually do, IDx explains in a press release.2

 “The reality is, AI in the realm of health care is here to stay, and it will continue to become more prevalent. We need to do everything in our power to harness the potential good, while minimizing the potential harm. A daunting task for certain,” says Dr. Sutton.

1. Nelson R. AI screening for diabetic retinopathy moves to retinal clinics. Medscape. November 26, 2019. Accessed December 17, 2019.

2. IDx. Autonomous AI diagnostic launch in retail health clinics. Ciston PR Newswire. November 19, 2019. Accessed December 17, 2019.