Diabetic retinopathy checkup

I have an eye check every year
My previous check lacked the usual eyedrops to make my pupils small but I was checked with what looked like a very expensive Sony machine
and the check only took just a few seconds.

Now I’ve just read about a new company:
“Eyetelligence Eyetelligence
utilises AI as well as retinal imaging to check for eye and other systematic diseases. “The three most common eye diseases — diabetic retinopathy, age-related macular degeneration and glaucoma — can be detected far earlier with algorithmic retinal image analysis.”

The algorithm has FDA approval but that’s it.
I would think that after Theranos
where a medical test was allowed to be used at a department store
that the FDA would tighten their regulations around medical checks

There’s a world of difference between a trained medical professional doing the test on a FDA approved machine followed by a trained medical professional analyzing the results and buying an App to check your eyes then taking a selfie of your own eye and waiting for the results.

Or am I just being old fashioned and I should embrace new and unregulated technology?

Those eye drops dilate the pupils. Which means they make the pupils large enough for the optometrist or ophalmologist to see inside your eyes. Apparently, the machine can see your retina without dilation of your eyes. I would not worry about the accuracy. What they are looking for in a retinopathy exam is whether your retina has developed extra blood supply and any leakage of blood. The machine allows the doctor to see that without applying the dilating drops, waiting for them to work, then sending you home with dilated eyes, which makes it risky to drive.


As I wrote expensive Sony machine
and the check only took just a few seconds.

and it was done by medical professionals

Those machines like the Sony are newish to the market, maybe 5-8 years. As Willow4 said, they don’t require the ophthalmologist to dilate the eye for the pictures. My ophthalmologist still dilates for manual checking of the retina. The technology that has gone into taking the various images has improved greatly in the 40 years I’ve been Type 1. The various manufacturers and industry has made great strides in making the imaging process easier and more accurate for the patient and the provider. The average cost of the machine you used is above $50k,

Digital images are wonderful, I remember in my younger years the doctors used 35mm film cameras and hoped that the picture was done correctly without the eyelids blinking in on it!


That is something I appreciate from my retinologist. We go over all the pictures that the cameras have done. Those are great, but I want to have the manual check by the doc as well. It gives me confidence that I am having a proper exam, not just done by machines.


My retinal center does a cross hatch type of photos, then dilates and has the tech refract my eyes, then does an exam before you can go home. I hate having them dilated for the whole rest of the day, but it is very thorough so…


I’ve asked my eye doc about all the cameras and machines he has vs him peering into my dilated eyeballs with the slit lamp.

He tells me that the slit lamp exam is far superior to any of the machines and cameras for detecting the earliest stages of retinopathy.

The camera is most useful after there is known retinopathy to track progression, he says.

Some of the machines aren’t checks for retinopathy but do make maps of the back of my eyeball.

I see a completely different doc for the front of my eyeball - have had cataract surgery and cornea transplant because of Fuch’s dystrophy.


I don’t want to hijack this thread, but I, too, have T1 for 61 years and have Fuchs Dystrophy. No cornea transplant yet.
It’s sort of comforting hearing I’m not the only T1 that has Fuchs.


Machine designed for use by nonprofessionals are useful for screening and identification of possible problems for people who may not go to doctors or who know that they have a problem and want to check its progress.

Their biggest potential problems are mis-calibration and false negatives. An optical system shouldn’t need calibration. If not today, then within a few years image interpretation “limited AI” should be as capable as - if not better than - an optometrist at doing screening and identification of known abnormalities of the eye.

Today I’d trust machines to do most test basic analyses- because they already do. Where I don’t yet trust them is where they would need to touch or manipulate me.

All of my eye tests and checking of my glasses Rx this past year were conducted by assistants. The doctor repeated one test that can’t be measured in the standard way because of calcification and recommended a procedure The procedure involved was a SLT -laser burning drainage holes around the periphery of my eye. They later did an eye chart test that could have been automated.

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Like another person here, my HMO does a scan & dilated exam. The scan is at several horizontal levels, in each eye, and they use it to compare over time. I have edema in one eye and mild non-proliferative retinopathy in both (T1D for 36+ years). The scans are at shorter intervals (between 1 & 4 months), and the dilated exams are between 6 mos and a year apart. When I have an ophthalmology appointment, they do a scan, then I see the ophthalmologist 15-30 minutes later, so the ophthalmologist has time to assess the scan and decide what her next move should be.


I asked about optometrist reading a photo vs in person exam after photo showed no retinopathy and in person exam showed both eyes. This about 5 years after first diagnosed with retinopathy. The optometrist said he could see more than what the camera can capture. So now I have in person every year, instead for alternating between a in person and a photo.


Seconded, well, thirded; dilation for these devices is irrelevant. Here’s the WebMD link:

As of this moment my eye care specialist has been selling this, or similar, stuff for years but my insurance didn’t cover it. My retinologist however does a “3D” scan of one, or sometimes both (seems to depend on the phase of the moon) of my eyes and gets that covered.

I rather suspect Eye-marketing will drop the “AI” term from their marketing in a few months, but that is off-topic. Remember; fake it until you make it, bait’n’switch, $1 plus $20,000 in taxes and remunerations etc.

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Absolutely correct. In the slit-lamp exam the ophthalmologist places the lamp at multiple angles and has me look in multiple directions. This he tells me is much more sensitive than the single camera photo.

There are also more specialized scans and photos. For example the camera where they inject me with fluorescent dye (aka “carrot juice”) which might be … every 3 or 5 years? There’s also a laser scanner (which I call the “Battle Zone game” based on the arcade game of my youth) that makes like a topographic map of back of the eye.

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I think there’s an actual value to the new digital cameras for screening in communities without good access to an ophthalmologist. Not everyone has good insurance (historically I went basically uninsured for almost 20 years due to preexisting condition clauses… even though I was actually paying for insurance) and not everyone can justify taking a day off work to travel to the nearest ophthalmologist (maybe 100+ miles away outside of cities).


Yup, my ophthalmologist says that a dilated exam with the slit-lamp is more sensitive, but she can compare changes in my edema (and other features) over time with the pictures. They each have their uses.

And I agree that scans are better than nothing … mostly.

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