Assessing the Impact of AI-Assisted Portable Slit Lamps on Rural Primary Ophthalmic Medical Service.

Purpose: To investigate the effect of an AI-assisted portable slit lamp (iSpector) and basic ophthalmology training on cataract detection, referral, and surgery rate in rural areas.

Methods: This randomized control trial randomly assigned 63 village doctors to either the AI-assisted group (providing iSpector and training) or the control group (providing training). Doctors were followed for 1 year before intervention as a baseline and 1 year after to make the comparison. Multivariable Poisson regression was applied to compare the difference in cataract detection, referral, and surgery rate between the two groups, adjusted for primary doctors' baseline characteristics. We further conducted subgroup analysis to estimate the change after the intervention.

Results: Compared to the control group, the detection, referral, and surgery rate of cataracts among the AI-assisted group was comparable, 1.7 times higher, and 4.9 times higher, respectively. Providing iSpector and training increased the detection, referral, and surgery rate of cataracts. However, only based on training to elevate the detection rate of cataracts did not change the referral and surgery rate.

Conclusions: iSpector helps village doctors detect and refer cataract patients appropriately, thus increasing the probability that patients receive cataract surgery.