Of machines and microbes

30 November 2018
Autumn 2018

AI is pushing the boundaries of diagnosis, but are we on the verge of an antimicrobial dark age?

Welcome back to Acuity, and another issue with lots of interesting clinical content. All supporting references to our articles are available online, so remember to look at these if there’s anything that really piques your interest. You can gain access to many journals through OpenAthens, using your College membership to open an account. Simply contact the College librarian if you haven’t opened an account already.

Speaking of piquing, we look here at the work of Andrew Bastawrous of Peek Vision, a charity and company helping people in developing countries to access eye care. Andrew has harnessed the power of the smartphone to help identify eye disease and ensure it is managed appropriately. His insight into the way technology can be used from step one, gathering clinical data, right through to mapping the patient pathway to secondary and tertiary care helps patients to access the care they need, as well as aiding officials in charge of public health. There might even be some lessons for us to learn here in the UK. 

Continuing the technology theme, George Winter details how artificial intelligence (AI) could revolutionise diagnosis of ocular disease. With an overview of what these terms actually mean, we learn how machine learning and artificial neural networks have been able to analyse optical coherence tomography (OCT) scans and retinal photographs to an unprecedented level of detail. AI is able to determine the urgency of referral from an OCT to the same level of accuracy or better when compared with expert retinal ophthalmologists and optometrists. 

The rate at which microbes are evolving is becoming too fast for modern science to keep up 

Furthermore, it can predict age, gender and blood pressure from fundus images. These are important risk factors for cardiovascular disease, and features that we do not currently understand how to detect from clinical fundus examination. In deep learning, the computers are teaching us what to look at, not the other way round. However, human verification and interpretation remains highly important for clinical applications.

Something that we have firm control over is our prescribing habits. In the past few years, the risk of ‘superbugs’ and untreatable pandemics has been highlighted in the media. The rate at which microbes are evolving is becoming too fast for modern science to keep up. 

In her article on antimicrobial resistance (AMR), Kathy Oxtoby finds out what optometrists can do to help. This is an urgent public health issue, and something all healthcare professionals should be aware of. The increase in IP optometrists means the profession is more involved than ever in the fight against AMR. Optometrists without IP should also be aware of these issues so they can advise patients appropriately, especially when considering the use of over-the-counter medicines. Read, take note and help protect us all…

Kieran Loft MCOptom, Clinical Editor 

Picture credit | Caroline Andrieu


Kieran RG Loft MSc BSc (Hons) MCOptom DipTp (IP)

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