During a recent checkup with his diabetes doctor in Iowa City, Kevin Sales rested his chin onto a machine that snapped some pictures of his eye. Using artificial intelligence, it analyzed his retina and, 20 seconds later later, made its diagnosis.
Diabetes is on the rise globally, and with it, diabetic retinopathy, a leading cause of blindness. About one-third of the estimated 285 million people with diabetes worldwide have signs of diabetic retinopathy. If you catch the warning signs of the disease, it’s fairly treatable. But often, the disease goes undetected for years. One reason is those afflicted typically don’t have noticeable symptoms in the early stages. That’s why doctors recommend all diabetics get an annual eye exam. Another issue is that, in many rural areas, eye doctors are scarce.
More than 50% of Americans with diabetes don’t have annual eye exams, which are undertaken by dedicated eye specialists, usually ophthalmologists. In rural areas in the US and elsewhere, the closest specialist might be several hours’ drive away. A 2015 study found that 24% of US counties had no ophthalmologists or optometrists. The situation is even more dire for people in sub-Saharan African: a 2012 study found countries in the area had fewer than three ophthalmologists per million people.
Sales is the kind of patient who might typically go unmonitored for the onset of diabetic retinopathy. A 50-year-old who’s had diabetes for 40 years, he lives about two hours outside of Iowa City. He makes the drive to Iowa City a few times a year to to make sure his condition is under control and to fill his prescription. But he usually doesn’t get an annual eye exam because his health insurance only covers one every two years (a fairly common limitation in the US).
This summer, however, he was able to get screened for diabetic retinopathy at one of his regular visits to the diabetes clinic—no need for an eye specialist. His clinic is using a new diagnostic system called IDx-Dr, which was able to accurately image and assess the state of his eyes. Afterwards, Sales’ doctor told him he had no more than a mild degree of diabetic retinopathy—nothing to be concerned about yet.