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The contribution of computers in our lives is Gigantic. There is hardly any field that is not influenced by computer contribution. We live in a world where Alexa plays the music in the living room, and Siri sets the alarm on the phone. Not far is the day when most of us will have robots in our homes, loading the dishwasher and assembling our furniture. We already have drones, and experiments on driverless cars are going on. In the present era, which is also known as the Martian Era, computers made it possible for one to reach the Mars.
COMPUTERS
When humans started civilizing, they needed to count things. Therefore, they discovered the numbers and number system. Even before that they needed to calculate, therefore, they invented the abacus. This was a most important invention, not less than invention of a wheel. Abacus was the foundation stone of modern-day computers which was laid down in millenniums Before Christ.
From the historic era, we credit Charles Babbage (1822) as the father of computers. The 17th century gave us analog calculator, which was followed by analog computers during the 19th century.
The digital era started with the following 5 generations of computers:
The first generation (1940-56) started with the invention of vacuum tubes, the 2nd generation (1957-63) with transistors, the 3rd generation (1964 – 70) with the ICs, the 4th generation (1971- present) gave us the microprocessors leading to fast calculations and small computer sizes which enabled the Artificial Intelligence to work, and finally the 5th generation computer (present and counting) boosted the AI.
Until the 4th generation, there was gradual advancement predominantly in the hardware whereas the 5th generation marked the advancement in the software so much so that computers have started trying to mimic the human brains.
AI IN MEDICINE
Artificial Intelligence plays an important role in the field of medical sciences such as cardiology, neurology, etc. Computers have contributed enormously to the field of diagnosis and management of eye diseases also.
Although computers have been playing a pivotal role in the diagnosis and management of diseases, from 2016 onwards, a big chunk of investments is seen in AI in biomedical research and development. AI helps medicine in two ways, ‘virtually’ such as in the form of electronic health record systems to neural-network based guidance in treatment-based decisions, whereas robotics, intelligent prosthesis, etc., come under ‘physical’ aspects. Ophthalmology is not untouched with the favourable impact of AI, be it from retina imaging and its processing, corneal topography, visual analysis to many more indications in the ocular surgeries.
ARTIFICIAL INTELLIGENCE (AI)
An intelligence is the ability to acquire and apply knowledge and skills possessed by the humans and other animals’ brains.
An artificial intelligence (AI) is the intelligence demonstrated by the machines. Technologies like Artificial Intelligence, Machine Learning, and IoT (Internet of Things) could bring a sea of changes in our daily lives. A range of industries right from agriculture, textiles to our Defense field is highly dependent on computer technology. There does not exist a sector, which is untouched by the magic of computers. These machines mimic and display the human cognitive skills that were previously associated only with the human mind. This is the learning and problem-solving ability. Contrary to popular belief, AI is not a new modality, it was there since early 1940s.
The applications of AI include, advanced web search engines (such as, Google), recommendation systems (such as, YouTube), understanding human speech (such as, Alexa), self-driving (such as, Tesla cars), automated decision-making, and competing the highest level of strategic gaming (such as, Ludo), etc.
The traditional goals of AI include research, knowledge representation, planning, natural language processing, perception, etc.
Whereas the human mind works by the neural connections and release of neuro-transmitting chemicals AI works based on mathematical calculations known as algorithms. Although, engineers and scientists are trying to make artificial neural networks which are solely based upon the statistics, probability, and economics, etc. AI is applicable in the fields of computer science, psychology, linguistics, philosophy, and so on.
It is said to err is human, but machines do not err. Thus, we want to supplement human intelligence with AI to eliminate human errors.
AI shows great promise in the detection, diagnosis, grading and follow-up of disease processes.
MACHINE LEARNING (ML)
Machine learning is a subset of an AI which is devoted towards understanding and building methods of learning by the machines to make predictions and take decisions. Machine learning algorithms build models based upon training data processing as programmed.
Once machine learning programs are developed, they can perform their designated instructions without active involvement of the human mind by means of continuously developing its own algorithms.
Machine learning algorithms are used in the areas of speech recognition, computer vision, and so on to perform designated tasks. (See figure 1 & 2)
Although computers have been playing a pivotal role in the diagnosis and management of diseases, from 2016 onwards, a big chunk of investments is seen in AI in biomedical research and development
Data mining is somewhat like ML and sometimes overlap significantly. DM is used to dig unknown data from the past experiences whereas ML is used to predict based on the known data from the training dataset. DM uses various ML methods with different aims while, ML uses various DM methods under unsupervised learning and acts as a pre-processing step to improve the accuracy. (See figure 1 & 2)
DEEP LEARNING (DL)
Deep learning is somewhat like the human neural processing of the information done by the human brain. In DL, multiple layers of processing are used to extract progressively higher-level features from raw data. This could be explained by taking image processing as an example where, lower layers might identify edges, whereas the higher layers might identify human relevant concepts like digits, letters, or faces.
Artificial Neural Networks (ANNs) inspired from biological neural networks tend to be static and symbolic, whereas biological neural networks of most living organisms are dynamic and analogue.
For example, in an image recognition application, raw input data is in a matrix form of pixels, the first layer may abstract pixels and encode edges, the next layer may encode edge arrangements, the third layer may encode low frequency modulation, and the final output layer may correlate a diseased condition.
A DL process learns which feature to place optimally in which level by itself. But this does not eliminate the importance of hand-tuning. Thus, an ANN is not as efficient as a human brain. (See figure 1 & 2)
APPLICATIONS OF AI IN OPHTHALMOLOGY
AI makes a physicians’ job much easier in the diagnosis and, management of diseases. There are many ways in which AI is being successfully used in ophthalmology especially in the use of imaging and its further interpretative processing.
ANTERIOR SEGMENT DISEASES
We collect data in the form of images, videos, texts, etc., in order to evaluate the anterior segment of the eye. This is subjected to AI. Application of AI is useful in addressing anterior segment disorders such as keratoconus, infectious keratitis, refractive surgery, corneal transplantation cataracts, angle-closure glaucoma, contact lens practice and tele ophthalmology.
Cornea
Infectious Keratitis: The input data of AI in infectious keratitis are slit lamp photographs.
Keratoconus: Various corneal imaging modalities like corneal topography, corneal tomography, OCT, etc., generate a lot of data which is being processed using AI in detection and early diagnosis of keratoconus. AI can predict the outcome of keratoconus management efficiently.
Corneal Dystrophies and Degenerations: With the help of AI, we can detect corneal dystrophies and degenerations early with high level of sensitivity and specificity.
Corneal Grafts: The detection, delineation, counting of endothelial cells and prediction are done using AI.
Dry Eye
AI algorithms in dry eye diseases are used in the interpretation of ocular surface images.
Glaucoma
AI is useful in the screening, diagnosis, and monitoring of glaucoma. We can assess cup disk ratio, progression of visual fields, RNFL thickness, etc., using AI. The tools used are fundus photography, OCT, automated perimetry, etc. Interpretation of the combined tools of glaucoma detection using AI gives an opinion which is comparable to second opinion.
Cataract
AI is used in the screening and grading of cataract using slit lamp and fundus photograph. More accurate IOL calculation is possible nowadays only because of the application of AI. AI can also be used in the surgical skill training. AI is also being successfully used to predict the progression of ECU and eventual need of capsulotomy.
POSTERIOR SEGMENT DISORDERS
There is enormous role of AI in the diagnosis and treatment of Posterior Segment Disorders.
AI, ML, & DL
Whereas the human mind works by the neural connections and release of neuro-transmitting chemicals AI works based on mathematical calculations known as algorithms
Age-Related Macular Degeneration (AMD)
AI is useful in predicting the likelihood of developing wet AMD from the dry AMD. AI algorithms are utilised in the prediction of likelihood of need of giving intravitreal anti-VEGF injections.
Diabetic Retinopathy (DR)
We take the fundus photographic images and subject them to AI to get the diagnosis and staging of diabetic retinopathy. AI is useful in the processing of OCT images, non-invasive fundus angiography.
Retinal Vein Occlusion (RVO)
Efforts have been made to utilise ML in RVO utilising CNN combined with patch-based and image-based vote methods to recognise the fundus VRVO automatically with higher degree of success.
Retinopathy of Prematurity (ROP)
AI has been tried to automatically identify the ROP stage from plus to not-plus disease with high accuracy.
NEURO-OHTHALMOLOGY AND STRABISMUS
Unlike other ophthalmic sub-disciplines, neuro-ophthalmology has not gained much from the latest investigative instruments. Still there are distinct applications of AI in neuro-ophthalmology. These include, classification of optic nerve appearance (Papilledema, Pseudo-papilledema, and other Optic nerve head abnormalities (ONH), ONH pallor, glaucomatous versus non-glaucomatous optic neuropathy, exploration of optic nerve function in neuro-ophthalmic diseases, detection of eye movement disorders (Strabismus and Conjugate Gaze Abnormalities, Nystagmus), classical machine learning in ocular myasthenia gravis.
LIMITATIONS OF AI
The computational cost and training experience is high due to the forming of an algorithm which indicates that AI might be useful for diseases with higher morbidity whereas it might be unavailable for rare diseases. AI could not wholly identify a disease separated from a human’s intervention as computers recognise structures and features mechanically. Thus, a small part of unusual features could be missed. Also, if the relation between the input and the expected output is complicated, the machine would not be able to build a model.
CONCLUSION
There are some algorithms formed in the field of Ophthalmology such as DR, ROP, AMD, RVO, glaucoma, cataract, etc. Not every image could be identified precisely or missed which not only depend on computer techniques but also on the quality of the input images. The analysts should be trained well because of the importance of the marking process as it is the foundation of computer learning. Thus, AI can proficiently conduct a task, but at some level, human intervention is crucial during the process.
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COOKIE POLICY
Cookies are alphanumeric identifiers that we transfer to your computer or device to enable our systems to recognize your browser and tell us how and when pages in our website are visited and by how many people.
Most browsers have an option for turning off the cookie feature, which will prevent or limit your browser from accepting new cookies, as well as (depending on the sophistication of your browser software) allowing you to decide on acceptance of each new cookie in a variety of ways. You may wish to leave the cookies activated because cookies enable you to take advantage of some of the Site’s most essential features.
SHARING OF YOUR PERSONAL INFORMATION
Personal Information will only be shared by Company to provide or improve our products, services, to contact you about our services; and with our advertisers to contact you about their new products etc; it will not be shared with third parties for their marketing purposes.
Others: We may access, read, preserve, disclose, or release Personal Information when we believe in good faith that release is necessary to comply with law and enforce or apply our Terms of Use; or protect the rights, property, or safety of Company, our employees, our users, or others.
SECURITY OF YOUR PERSONAL INFORMATION
We allow you to limit access to your account via a password for your privacy and security. If you access your account via a third party site or service, you may have additional or different sign-on protections via that third party site or service. You are responsible for ensuring against unauthorized access to your account and Personal Information by selecting and protecting your password and/or other sign-on mechanism appropriately and limiting access to your computer and browser by signing off after you have finished accessing your account.
We use industry-standard Secure Socket Layer (SSL) software to encrypt your Personal Information during transmission. However, because no data transmission over the Internet is completely secure, and no system of physical or electronic security is impenetrable, Company cannot guarantee the security of Personal Information in its possession or the security of its servers or databases. Unauthorized entry or use, hardware or software failure, and other factors, may compromise the security of user information at any time.
In the unlikely event that Company believes that the security of your Personal Information in its possession or control may have been compromised, Company may seek to notify you. If notification is appropriate, Company may notify you by email, messaging to your device, or other means within 72 hours of data compromise.
PERSONAL INFORMATION YOU CAN ACCESS
Company allows you to access the following information about you for the purpose of viewing, and in certain situations, updating that information: email address, name, location and marketing preferences. This list may change as the Service changes. The information you can view, update, and delete may change as the Website changes. If you have any questions about viewing or updating information, we have on file about you, please contact us at privacy@tionet.in or at The Indian Optician., A-99 Defence colony, New Delhi – 110024
You can add or update certain personal information on your account, such as name and email address. When you update information, however, we often maintain a copy of the unrevised information in our records.
Upon your written request to privacy@ tionet.in we will remove your Personal Information from our active user database provided that (a) you are current with all payment obligations, (b) we do not believe it reasonably necessary to keep such information for any pending legal action, and (c) we are under no obligation to retain such information. Please be aware that any unfulfilled subscriptions may be cancelled without refund and you will have to re-register in order to use the Service. It is your responsibility to request a refund from us.
TRADEMARKS
All names, images, logos identifying The Indian Optician are proprietary marks of The Indian Optician. All third-party brand, product, service and company names contained on this Website are the trademarks, service marks and trade names of their respective holders. TIO do not give permission for their use by any person other than the holders. Any such use may constitute an infringement of the holders’ rights.
EXTERNAL LINKS
The Indian Optician do not represent, warrant, endorse or hold responsibility over any external sites that may be linked to and from this Website. Any external site that you visit by clicking through a link on this Website is outside the control of TIO and you visit entirely at your own risk.
These Terms and Conditions and the other rules, guidelines, licenses and disclaimers posted on the Service (on the tionet website or tionet Apps constitute the entire agreement between tionet and you with respect to your use of the Service and supersede all previous written or oral agreements between us with respect to the subject matter hereof.
From time to time, tionet may revise these Terms and Conditions to keep them up to date with tionet products and services. Please refer to the tionet website and tionet Apps periodically for any changes. The update date first written above is used to alert you to recent modifications. Your access or use of the Service subsequent to such an update will signify your assent to be bound by such changes.
If you have any questions regarding our terms and conditions, please email us at infotiodel@gmail.com
JURISDICTION
These Terms & Conditions shall be governed by and construed in accordance with the laws of India. Disputes arising here from shall be exclusively subject to the jurisdiction of the courts of New Delhi to the exclusion of any other. If any of these Terms should be determined to be illegal, invalid or otherwise unenforceable by reason of the laws; it shall be severed and deleted from this clause. All other Terms of Use and Terms & Conditions shall remain in full force and continue to be binding and enforceable. The Indian Optician reserves the right to change any of its terms and conditions at any time by posting changes online.
LEGAL DISCLAIMERS
By registering on tionet.com and agreeing to its Terms of Use and Privacy Policy, you also agree and acknowledge the following Legal Disclaimer notice:
a. You agree that the use of tionet.in, the application and its services, are at solely at your own risk. Neither tionet.in nor its associates nor employees nor third party content providers guarantee that the service will be completely uninterrupted or error-free or fool proof against miscreant activities. Nor do they warranty that you will get the exact results as expected or promised by the website or product.
b. The website and the application are provided on an “AS IS” basis with no warranties expressly stated or promised regarding the results that would be obtained from the use of it.
c. In no event will TIONET.IN or any person or entity or third party involved in the creation, production and distribution of the content on the website and the application be liable in contract or legally for any damages, including and not limited to, direct, indirect, incidental, special, and consequential incurred to you while or on using tionet.com. By registering on the website or downloading the application, you agree that the provisions mentioned in this section shall apply to all use of and content on the website and the application.
d. The above disclaimer of liability applies to any damages or injury caused by any failure of performance, error, omission, inaccuracy, interruption, deletion, delay, defect in operation or transmission, computer virus attack, communication line failure, theft or destruction or unauthorised access to, alteration of or use of this website, on account of breach of contract or negligence or under any other cause of action.
e. You specifically acknowledge that tionet.com is not liable for any kind of defamatory or offensive or illegal conduct of other users or third parties or their content and that the risk of injury from the foregoing rests entirely with you.