AOP Council meeting

AOP Council: spotlight on AI

The implications of artificial intelligence technology for eye care and the future regulation of optical businesses were up for discussion at AOP Council

A wooden gavel decorated with the AOP logo of a blue circle rests on a table

The difficulties in translating artificial intelligence (AI) technology from code to clinic was among topics discussed during the latest meeting of the AOP Council (7 June, London).

The meeting was the first attended by new AOP councillors, following an appointments process that ran between February and March.

The first presentation was delivered by Lloyd & Whyte director of strategic partnerships, Daniel James, and chief executive officer, Matthew Pyke, who outlined the services that the company offers to AOP members as well as its charitable contributions as a member of the Benefact Group.

James shared that in the nine years Lloyd & Whyte has worked with the AOP, 240 members have received support with their personal finances while 500 members have been assisted with commercial insurance needs.

Pyke highlighted that in 2019, Lloyd & Whyte became a 20% shareholder in the Benefact Group – which is the third largest corporate donor in the UK. He added that the group has donated £100 million to charity since 2016.

A key role

AOP chief executive, Adam Sampson, spoke about the important role that AOP Council plays within the governance structure of the AOP.

“Our Council is the beating heart of the organisation,” he said.

“When we want to know what members are thinking and feeling this is where we come,” Sampson shared.

He stressed the importance of the Council reflecting the membership of the AOP.

“One of the skills that we want is not for you to come and speak only for yourselves, but to network and share the views of other members,” Sampson said.

Artificial intelligence technology in eye care

Professor Pearse Keane, of Moorfields Eye Hospital and the UCL Institute of Ophthalmology, gave a presentation to Council on the potential of AI technology within eye care.

As part of a discussion about the increasing use of optical coherence tomography (OCT) scans within eye care, Keane noted that between 2008 and 2016 there was a 14-fold increase in the number of OCT scans performed at Moorfields Eye Hospital.

By 2017, Moorfields Eye Hospital was performing 1000 OCT scans per day, and by 2022, it held a repository of 20 million ophthalmic images.

Person holding one trainer. On the front of the trainer is a customised image of Professor Pearse Keane
Pearse Keane
Professor Pearse Keane shared a photograph of a pair of Vans customised with his own OCT scan that his wife gave him as a birthday gift.

Keane noted that the number of scans being performed each day does present challenges for clinicians.

“How do you ensure that you have enough people with the right skills to look at them?” he said.

There were also concerns about the number of false positive referrals following increasing use of OCT scans within community optometry practices.

Keane added that he thinks the use of OCT within primary care is “hugely beneficial.”

However, he noted the pressure that secondary care is currently under, with delays in treatment leading to sight loss.

“I believe that technology can help us to address these issues,” he said.

Keane shared that in the past year progress in AI has been accelerating, including innovations in generative AI, large language models and ChatGPT.

In 2016, IDx became the first US Food and Drug Administration-approved device powered by AI for the screening of diabetic retinopathy.

“That is now being used in the US in primary care settings,” Keane shared.

IDx is not in use within the UK, he added, partly because the country already has a well-established screening programme for diabetic retinopathy.

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Discussing the collaboration between Moorfields Eye Hospital and DeepMind, Keane noted that research published in 2018 revealed an AI algorithm could identify more than 50 retinal conditions with the accuracy of experienced clinicians. 

He displayed a series of newspaper headlines that heralded the sight-saving potential of the discovery.

“In 2023, how many people’s sight has been saved by this? The answer is zero,” he said.

Keane detailed the hurdles that must be overcome before AI technology can be translated into a clinical application.

These include clinical validation and regulatory approval, developing a business model and overseeing its implementation and adoption.

Keane shared that in taking steps to commercialise the technology, his team was focused on maximising patient benefit.

“We really want to make sure that we give the appropriate value back to the NHS,” he said.

He added that AI brings with it an opportunity to bring world-class expertise out of the hospital into the community.

Keane briefly discussed the AlzEye study, which links retinal imaging data held by Moorfields Eye Hospital with national hospital admission data.

The study links into the field of oculomics – gaining insight into systemic disease by examining the eye.

Business regulation

Director of regulatory strategy for the General Optical Council (GOC), Steve Brooker, updated AOP Council about the optical regulator’s work on business regulation.

Brooker noted that changes to the regulation of optical businesses is a substantial element of the legislative reform agenda.

He shared that the GOC will outline a framework for business regulation over the next two years.

“We are no clearer on the timetable for legislative reform but what we are planning to do is to make ourselves ready for when the Government moves forward,” he said.

Brooker highlighted that currently only practices that use the protected title ‘opticians’ are required to register with the GOC.

Companies that do not use this title can voluntarily register with the optical regulator but they are not required to.

In response to a consultation by the GOC, stakeholders supported a registration requirement for all businesses that carry out restricted functions.

“At the moment, the fact that some businesses are registered and others are not creates a regulatory gap,” Brooker highlighted.

Because there is not a requirement for all businesses to register with the GOC, it creates difficulties in determining how many optical businesses there are, he shared.

Brooker added that the best estimate is 5500, with approximately half registered with the GOC in November 2022.

Brooker shared that GOC Council has agreed that businesses carrying out restricted functions should be registered.

The GOC will now work out the detail of what this would involve – including inspection powers, individuals responsible for compliance within a business, and registration fees.

Following a nomination process and vote, AOP Councillor Nizz Sabir was elected to the AOP Board. The next AOP Council meeting will be held on 1 November.

A welcoming environment

Several newly-appointed AOP Councillors commented on the positive atmosphere during the meeting.

Speaking afterwards, AOP Councillor for Scotland, Erica Campbell-Walker, shared: “Joining the AOP Council and attending my first meeting was really good. Everyone was so lovely and welcoming. The actions and direction of the AOP are genuinely guided by the Councillors who represent AOP members in their region or field.”