AI tool spots early glaucoma in 71-year

At Saswad tehsil in Pune district, 71-year-old Shiva, who was recently diagnosed with diabetes, decided to drop in at a mobile eye-screening camp.

His images, along with those of 30 others, were sent to Dr Parikshit Gogate, consulting ophthalmologist at his clinic in Pune.

That’s where retina specialist Dr Supriya Phadke ran them through an AI tool that uses machine learning and deep learning algorithms to analyse retinal images and eye data, often achieving over 90% accuracy in identifying early structural damage.

That’s how she found that Shiva had early signs of glaucoma.

“Such mobile eye-screening initiatives are particularly valuable in areas where ophthalmologists are scarce and access to fundus imaging — a diagnostic technique to capture detailed, high-resolution photographs of the retina — and specialist care is limited,” says Dr Gogate.

A new study published in the Lancet Primary Care journal suggests that recent advances in AI may provide a more viable option in such cases.

For low- and middle-income countries, where glaucoma is frequently diagnosed only at an advanced, vision-threatening stage, these findings are particularly significant.

“The AI operates on relatively low-cost fundus cameras (which photograph the interior of the eye).

These can be run by trained non-physician staff and dramatically reduce the burden on scarce specialist services.

Where diabetic eye screening infrastructure already exists, glaucoma screening can be added at minimal incremental cost.

In our view, AI-enabled glaucoma triage offers a realistic path to earlier detection at population scale, including in settings where specialist access is limited or unavailable,” Afonso Lima-Cabrita, Department of Ophthalmology, Unidade Local de Saúde Santa Maria, Lisbon, Portugal and lead author of the study, told TheIndian Express.

What’s glaucoma and why should you get tested for it?Glaucoma is a condition when fluid builds up in the front part of your eye, increasing the pressure on it and damaging the optic nerve.

It is the leading cause of irreversible blindness worldwide and often goes undiagnosed until vision loss is advanced.

However, it can be prevented with early diagnosis and treatment.

Glaucoma poses a substantial public health challenge with India accounting for 20 per cent of global glaucoma cases, making it the second-most affected country worldwide.

It is responsible for vision loss in approximately 1.2 million people, accounting for 5.5 per cent of the nation’s total blindness.

A major concern is that nearly 90 per cent of glaucoma in India remains undiagnosed, as per the report.

Why is glaucoma underdiagnosed?Dr Gogate recommends routine screening as traditionally glaucoma is under-diagnosed.

“For example, one of the forms of glaucoma, called normal-tension glaucoma, can result in optic nerve damage and vision loss despite eye pressure remaining within the normal range (10-21 mmHg).

It is believed to be caused by factors like poor blood flow to the optic nerve, low blood pressure or a weak nerve structure.

Some may have a condition where the pressure inside the eye is higher than normal — above 21 mmHg — but without damaging the optic nerve or vision loss.

It is primarily caused by an imbalance in the fluid production and drainage in the eye.

It is because of this variability that glaucoma has traditionally been both under-diagnosed and over-treated,” says Dr Gogate.

What the study says about efficacy of AI tool
The study was carried out at a single screening centre in Lisbon, Portugal in 2023, where 671 adults, aged between 55 and 65 were screened via the AI tool.

The images were also independently graded by six glaucoma experts.

The AI-based tool correctly identified 78 per cent  of people who truly had glaucoma (compared to 75 per cent identified by ophthalmologists) and correctly ruled out the disease in 95 per cent of people  (compared to 91 per cent by ophthalmologists).

The authors say that the high accuracy is the key takeaway as false alarms can lead to unnecessary hospital visits, patient anxiety and added strain on healthcare services.

AI-enabled screening can be cost-effective“Our results suggest that AI-enabled screening in primary care can be cost-effective and can reduce unnecessary expert referrals, even though a one-off screening round might not capture every case.

AI could enhance efficiency and detection, enable earlier treatment and prevent avoidable blindness,” says Lima-Cabrita.

Anuradha Mascarenhas is a Senior Editor at The Indian Express, based in Pune.

With a career spanning three decades, she is one of the most respected voices in Indian journalism regarding healthcare, science and environment and research developments.

She also takes a keen interest in covering women's issues .

Professional Background
Education: A gold medalist in Communication and Journalism from Savitribai Phule Pune University and a Master’s degree in Literature.

Author: She authored the biography At The Wheel Of Research, which chronicles the life and work of Dr.

Soumya Swaminathan, the former Chief Scientist at the WHO.

Key Focus: She combines scientific accuracy with storytelling, translating complex medical research into compelling public and human-interest narratives.

Awards and Recognition
Anuradha has won several awards including the Press Council of India's national award for excellence in journalism under the gender based reporting category in 2019 and the Laadli Media award (gender sensitivity -2024).

A recipient of the Lokmat journalism award (gender category-2022), she was also shortlisted for the RedInk awards for excellence in journalism-2021.

Her debut book At The Wheel Of Research, an exclusive biography of Dr Soumya Swaminathan the inaugural chief scientist of World Health Organisation was also nominated in the Popular Choice Category of JK Paper AUTHER awards.

She has also secured competitive fellowships including the Laadli Media Fellowship (2022), the Survivors Against TB – New Research in TB Media Fellowship (2023) and is part of the prestigious 2025 India Cohort of the WomenLift Health Leadership Journey.”
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Anuradha is known for her COVID-19 reportage, where she was one of the first journalists to provide detailed insights into the Covishield and Covaxin trials.

She has a dedicated interest in gender diversity in health and science, often profiling women researchers who are breaking the "leaky pipeline" in STEM fields.

Her writing style is scrupulous, often featuring interviews with top-tier scientists and health experts from various institutions....

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