AI, VR and DTx: Advances in optics and ophthalmology worldwide | Part 1

This article examines the transformative impact of artificial intelligence (AI), virtual reality (VR), and digital therapeutics (DTx) in ophthalmology and optics. By evaluating advancements across the United States and Canada, Europe and UK, the Middle East, Asia-Pacific including Australia and Africa, it provides an in-depth analysis of how these technologies revolutionize diagnostics, treatment, patient outcomes, and the design of lenses adjusted to individual gaze dynamics. Additionally, the role of DTx in enhancing patient engagement and treatment efficacy in eye care is explored. The article series integrates technological advancements and their implications for the global improvement of eye care. Here you will find Part 1 of the article. Part 2 will be published in MAFO issue 01/2025.

Ophthalmology and optics are experiencing a paradigm shift driven by technological innovations such as new approaches for surgical training, lens design, and patient rehabilitation.

Digital therapeutics (DTx) are clinically validated software solutions designed to treat or manage diseases, often targeting ophthalmic and chronic conditions including specific applications for ophthalmology like those targeting diabetic retinopathy and age-related macular degeneration, mental health, and neurological disorders.

Delivered via digital platforms like smartphones, they offer personalized, evidence-based interventions and are increasingly integrated into traditional healthcare. With growing demand, advancements in AI, and improving regulatory frameworks, the future of DTx points toward broader adoption, enhanced personalization, and the potential to complement or replace traditional treatments, particularly as healthcare continues to shift toward remote and patient-centric care models.

This article explores the global impact of these advancements, highlighting how they are being implemented across different regions and their potential to shape the future of eye care. The global digital therapeutics market is projected to reach approximately $32.52 billion by 2030, growing at a compound annual growth rate (CAGR) of 27.2% from 2024 to 2030[1,2]. This growth is driven by factors such as the increasing adoption of digital health technologies, rising smartphone penetration, and the demand for patient-centric care[1,2,3]. In the map opposite, you can see all the countries and regions analyzed.

Integration of artificial intelligence, virtual reality, and digital therapeutics in ophthalmology

Europe (EU)

In Europe, artificial intelligence (AI), virtual reality (VR), and digital therapeutics (DTx) are being integrated into ophthalmology and optics to enhance diagnostic accuracy, treatment planning, and patient engagement.

AI is extensively utilized for image analysis and disease prediction, facilitating the early detection of conditions such as myopia, diabetic retinopathy, age-related macular degeneration (AMD), and glaucoma[1]. Additionally, VR enhances training and rehabilitation by providing immersive environments for surgical practice and patient adaptation[2]. Notably, recent advancements, such as Google’s DeepMind AI for retinal screening, have demonstrated capabilities that surpass those of human specialists in 2024.

DTx is gaining traction in Europe as a complementary approach to traditional therapies. Recent studies indicate that DTx applications can effectively manage conditions like amblyopia and strabismus through interactive software designed to promote visual acuity improvement[3]. These digital interventions offer personalized therapy plans, thereby increasing patient adherence and engagement.

However, challenges remain in the integration of these technologies, including the need for standardized regulations, ensuring data privacy, and addressing the high costs associated with implementation[4]. Finally, in 2024, the European Medicines Agency is expected to introduce regulatory frameworks aimed at streamlining the approval process for DTx and other digital health technologies.

Middle East (ME)

The Middle East is increasingly adopting artificial intelligence (AI), virtual reality (VR), and digital therapeutics (DTx) to advance eye care. AI is enhancing diagnostic precision and facilitating large-scale screening programs, particularly in countries such as the UAE and Saudi Arabia[5]. VR is being utilized for advanced surgical training and patient education, while DTx applications are emerging as valuable tools for patient engagement and therapy management.

For example, DTx platforms are supporting patients with visual impairments by offering interactive tools designed to improve visual function and help them adapt to daily activities[6]. These digital interventions have the potential to address gaps in care, especially in remote or underserved areas. However, challenges remain, including limited healthcare infrastructure in conflict-affected regions and the need for regulatory frameworks to govern the implementation of DTx[7].

Recent advances highlight the emergence of cloud-based telemedicine platforms in Saudi Arabia and the UAE, which enhance real-time diagnostics, particularly for underserved populations. Additionally, drone-assisted delivery of ophthalmic medications is being piloted in conflict zones such as Yemen.

Africa

In Africa, the integration of artificial intelligence (AI), virtual reality (VR), and digital therapeutics (DTx) is still in its early stages but shows considerable promise, particularly in addressing the shortage of ophthalmologists and improving access to eye care.
AI tools are facilitating the screening and diagnosis of conditions such as cataracts and glaucoma in areas with limited access to specialists[8]. VR is primarily utilized for training healthcare professionals, providing an innovative approach to skill development in regions where traditional training resources are scarce[9].

DTx presents a novel strategy for delivering therapeutic interventions in regions with limited healthcare resources. Mobile-based DTx applications are being explored to provide visual training exercises for children with amblyopia, capitalizing on the widespread use of mobile technology in Africa[10]. These applications offer an accessible, low-cost solution for managing visual disorders; however, challenges such as inadequate infrastructure and funding persis[11].

Recent advancements indicate that Google AI’s 2023 program for mobile-based cataract screening has demonstrated excellent results in rural Kenya and Nigeria. Furthermore, cross-continental partnerships between African health systems and Asian tech companies are increasingly focused on providing VR-assisted ophthalmic training.

Asia-Pacific

The Asia-Pacific region is at the forefront of integrating artificial intelligence (AI), virtual reality (VR), and digital therapeutics (DTx) in ophthalmology. AI is widely employed for the early detection and treatment planning of conditions such as glaucoma and cataracts[12]. VR enhances training and rehabilitation by providing immersive environments for both practitioners and patients.

DTx is rapidly gaining acceptance in countries like Japan and China, where digital health solutions are increasingly incorporated into standard care practices. Studies have demonstrated the effectiveness of DTx applications in managing myopia progression in children through personalized visual exercises and behavior modification programs[13].

Furthermore, DTx platforms are being utilized to provide post-operative care and rehabilitation for patients undergoing cataract surgery, leading to improved recovery outcomes and higher patient satisfaction[14].

However, challenges remain, including ensuring data security, integrating DTx into existing healthcare systems, and navigating complex regulatory environments[15].

Notably, in 2024, the launch of AI-driven myopia control lenses in Japan and China, which incorporate gaze-tracking DTx platforms to dynamically adjust lens configurations, represents a significant advancement. Additionally, regulatory reforms by the Pharmaceuticals and Medical Devices Agency (PMDA) in Japan in 2023 have expedited the approval process for AI-driven ophthalmic diagnostics.

United States (USA)

In the United States, artificial intelligence (AI), virtual reality (VR), and digital therapeutics (DTx) are leading advancements in ophthalmological research and clinical practice. AI-based diagnostic tools, such as IDx-DR for diabetic retinopathy, have received FDA approval, enhancing early detection and treatment planning[16]. VR is utilized for advanced training simulations and patient rehabilitation, contributing to improved surgical outcomes and enhanced quality of life for patients[17].

Significant advancements in DTx have been observed in the U.S., with numerous applications developed to support various aspects of eye care. A notable example is the use of DTx for managing amblyopia in children, where gamified applications have demonstrated effectiveness in improving visual acuity and increasing patient engagement[18].

Additionally, DTx platforms are being integrated into telemedicine services, allowing for remote therapy and monitoring of patients with chronic eye conditions[19].

Despite the potential of these technologies, challenges such as high implementation costs, regulatory hurdles, and ensuring equitable access remain significant obstacles.

Recent developments in the U.S. include the expansion of IDx-DR to encompass IDx-AMD, an FDA-approved tool for age-related macular degeneration (AMD). Additionally, a 2023 study published in JAMA Ophthalmology highlighted that VR-assisted cataract surgery simulations reduced the error rate in training by 30%.

Latam & Brazil

In Latin America and Brazil, the integration of artificial intelligence (AI), virtual reality (VR), and digital therapeutics (DTx) is emerging as a promising solution to address healthcare disparities, particularly in ophthalmology.

AI-driven tools are aiding in the diagnosis of common conditions such as glaucoma and cataracts, thereby enhancing early detection and treatment[20]. While VR is being utilized for training and patient education, its adoption is still in the early stages compared to more developed regions.

DTx presents new opportunities for patient care in Latin America and Brazil. Applications focusing on visual therapy for conditions like amblyopia are being developed in collaboration with local universities and international tech companies. These digital interventions offer cost-effective and accessible solutions for patients who may not have regular access to traditional therapies[21].

The potential for growth is significant, especially as DTx becomes more integrated into the healthcare system. However, challenges such as regulatory approval and the need for broader improvements in healthcare infrastructure remain persistent obstacles[22].

Recent developments in Latin America and Brazil highlight the success of VR-enhanced patient rehabilitation programs launched in Chile in 2023, which have shown positive outcomes. Additionally, AI-driven diabetic eye care programs in Brazil have been implemented in collaboration with telemedicine companies and public health agencies.

Summary and outlook

This article is divided into two parts. Part 1 offered a detailed comparison of how different countries have integrated AI, VR, and digital therapeutics (DTx) into eye healthcare, covering aspects such as in-store sales experiences and lens design. The depth of analysis provides valuable insights into the current state of these technologies across various regions.

Part 2, set to be published in MAFO issue 01/2025, promises to expand on this foundation by discussing the general role of AI, VR, and DTx, their growing potential, and the regulatory framework surrounding digital therapeutics. This continuation is anticipated to enrich the reader’s understanding of the evolving landscape of eye care technology. The well-structured and informative article, should make it a significant resource for professionals and stakeholders in the eye care industry.

David Benet Ferrus is a C-suite executive serving as the Chief Commercial Officer (CCO) at Horizons Optical. He brings a wealth of experience from the pharmaceutical sector, along with a strong management background characterized by his strategic vision and tactical acumen. David is adept at fostering high-performance teams and driving innovation, with a particular focus on emerging technologies such as Artificial Intelligence (AI), Machine Learning (ML) and Digital Therapeutics (DTx). As a thought leader, David has contributed extensively to international publications and holds numerous certifications. His academic background includes a bachelor’s degree in Telecommunications Engineering and Information, and master’s degrees in business administration and marketing management.

References: [1] Global Health Intelligence & Grandviewresearch, 2024. [2] EuroHealthNet, 2023. [3] Morris et al., 2024; Wen & Sun, 2024. [4] European Medicines Agency, 2024. [5] Baker McKenzie, 2024. [6] El-Mansour et al., 2024. [7] Ophthalmology Middle East, 2024; Al-Jubair et al., 2023. [8] Sambath et al., 2024. [9] Orbis International, 2024. [10] Kariuki & Otieno, 2024. [11] World Health Organization, 2024. [12] IQVIA Healthcare, 2024. [13] Li et al., 2024; Zhang et al., 2023. [14] Digital Health Asia, 2023. [15] Asia-Pacific Journal of Ophthalmology, 2024. [16] Health Systems Observatory, 2024. [17] Smith et al., 2024. [18] Brown & Anderson, 2024; Johnson et al., 2023. [19] American Academy of Ophthalmology, 2024. [20] Costa et al., 2024. [21] Mendes et al., 2024; Souza & Pereira, 2023. [22] Brazilian Journal of Telehealth, 2024