Ophthalmology and eye care have captured the interest and financing of the Silicon Valley machine for many of the same reasons most of us picked ophthalmology: tremendous need, a large and growing market and the ability to make a dramatic difference in people’s lives. But to understand how Silicon Valley can affect change eye care, it’s first important to understand the culture’s motivations and ways of thinking.
Silicon Valley startups typically look not to enter a market, but to create one through large disruptions. They think big in terms of market, growth opportunity and returns (think 10-fold gains, rather than 10 percent growth). And they think big to have a better chance at funding, to create buzz and to make their mark on the world. This mindset pushes Silicon Valley toward the moonshots we’ve all heard about like flying cars and traveling to Mars.
In the health care market, new technologies like apps, wearables and software services are growing at an exponential rate. Here’s a look at 6 innovations that could change the face of ophthalmology.
1. Glucose-sensing lenses
Of the bigger eye-related efforts in Silicon Valley, the glucose-sensing contact lens by Google subsidiary Verily may be the best known . This idea has been in the works for years, but its complexity brought other labs to their knees. Currently, near-field radio frequency identification technology is being used for power and data transfer. Both accuracy and power issues make this technology exceedingly difficult to develop. Human trials are not yet underway, but Google has built its Verily subsidiary around this tech and the huge global need it represents. It’s clear this kind of monitoring technology will revolutionize treatment and not just result in a small, incremental step forward.
2. Machine-based screening and diagnosis
Google has made at least one other foray into eye care with its advanced artificial-intelligence technology. Using machine learning, the company is developing diagnostics for retinal pathologies. Its core technology, while still in development, has shown tremendous promise for basic retinal diagnosis and screening, as showcased in a recent JAMA paper.
Interestingly, the Google subsidiary Verily has also formed a strategic partnership with Nikon, which recently bought the Optos ultra wide-field image technology. Although Google is not the only player in AI-based ophthalmic diagnostics — nor the most seasoned — its resources and human capital may help the Silicon Valley giant become the early market leader in this new high-tech area. The Google team says it wants this device to increase access to care and lower its cost, two common themes in Silicon Valley health tech.
3. Smartphone-based imaging
A common focus of Silicon Valley is improving large, complicated and expensive technology to make simple and low-cost products. D-EYE is a very inexpensive, smartphone-based device for imaging the optic nerve and macula through an undilated pupil. Paxos Scope and several similar devices also allow basic images of the retina with low-cost devices as well, although they require dilation.
4. Contact lens renewal by app
A core concept in the Silicon Valley schema is “disruption” — or totally changing the way a market operates. This is distinctly different from the traditional model of joining or growing a market. And in health tech, several startups are indeed “disrupting” the consumer-facing vision care market.
Once such company is Simple Contacts, for which I serve as a consultant. A bi-coastal startup funded out of Silicon Valley, Simple Contacts is based in New York’s Silicon Alley. Its app-based technology works to simplify contact lens renewal via remote, physician-performed exams and vision testing, plus a renewal prescription and sales channel, all on your smartphone. After more than a year in operation, Simple Contacts’ medical director says the company has had no reported adverse events. Consumer reviews praise its ease of use and convenience.
5. Crowdsourced low vision support
Aira is another innovative solution that adheres to many of Silicon Valley’s ideals. This fledgling company connects a network of human volunteers with low vision patients through a Google Glass–type technology. The patient-mounted camera sends images to a network of sighted volunteers, who provide real-time audio feedback to the patient.
This technology demonstrates a popular meme: “Uber for …” In this case, Aira’s technology connects people with “extra sight and extra time” to those in need of these functionalities. Other companies are also working on AI solutions for this same issue.
6. Virtual- and augmented-reality treatment
Another promising area in which Silicon Valley is accessing the eye care market is virtual reality and augmented reality. Virtual reality presents a completely different input to your eyes via a headset (like immersive 3D gaming), whereas augmented reality provides video overlays on top of the real world (like the popular smartphone game Pokemon Go). Valley-based Vivid Vision is one of several efforts seeking to treat amblyopia with VR by projecting different images to each eye in a game setting.
Spectacles and contacts are also ripe for innovation in the virtual-/augmented-reality arena. iOptik is one company looking to offer a smart contact lens with an augmented-reality overlay, and several other companies are also developing augmented-reality technology in attractive, standard-looking spectacles. I expect to see this area explode as virtual- and augmented-reality technologies improve and gain more acceptance.
The Silicon Valley machine is well aware of the ophthalmology space. And as its focus on health care sharpens, I predict more disruption and innovation. As physicians, it’s incumbent upon us to help guide this innovative energy toward what’s best for our patients.
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About the author: Peter A. Karth, MD, MBA, is a member of the Academy’s YO Advocacy subcommittee. He is a vitreoretinal physician and surgeon with Oregon Eye Consultants. After several years in Silicon Valley, Dr. Karth continues to work with startups and mature tech companies to find and address unmet needs in ophthalmology. Financial disclosures: He is currently a physician consultant for Google and Simple Contacts. Contact Dr. Karth at peterkarth@gmail.com or www.PeterKarthMD.org or on social media at PeterKarthMD on Twitter, Facebook, LinkedIn and Instagram.