High street opticians could use AI to help diagnose dementia with an eye scan

Opticians could play a key role in identifying people at risk of dementia by spotting distinctive patterns in the back of the eye linked to early signs of the condition, according to new research funded by Alzheimer’s Research UK.

An artificial intelligence (AI) tool has identified differences in the shape and size of blood vessels at the back of the eye that correspond to cognitive health, according to research led by scientists at City St George’s, University of London.

The study, funded by Alzheimer’s Research UK, could open the door to a new diagnostic tool that experts say could complement existing tests, like brain scans, to help ensure people get the full picture of their dementia, and the support they deserve, more quickly.

The AI tool, called Quartz, can analyse eye scans in seconds, identifying key differences in the shape and size of tiny blood vessels in the retina – known as arterioles and venules. These blood vessels in the eye serve as an extension of those in the brain, providing a unique, non-invasive window into brain health.

Using Quartz, researchers at City St George’s scanned the eyes of more than 63,000 people aged 40 to 69. They then compared the images with cognitive test scores measuring memory, reaction time, and intelligence.

The researchers found that those with retinal blood vessels that had reduced width and had particular patterns of twisting were linked to lower scores in tests for memory, reaction time and intelligence.

Scientists believe changes in retinal blood vessels may be due to reduced blood supply in the brain, which in turn may be an early cause or consequence of diseases such as Alzheimer’s.

Prof Chris Owen, lead author of the study, said the technique could one day be “seamlessly embedded” into the daily routines of high street opticians and eye clinics.

“It would provide an easily accessible, low cost and quick way to flag people who are at risk of developing neurodegenerative conditions in the future without the need of invasive tests.”

Prof Owen now plans to use Quartz in other studies and populations to see how it could be used more widely in the healthcare sector.

Currently, a dementia diagnosis involves a series of tests which assess memory, thinking and overall wellbeing. Sadly, many people with dementia don’t ever receive a formal diagnosis. In fact, around one in three people over 65 with dementia in England remain undiagnosed.

David Thomas, Head of Policy and Public Affairs at Alzheimer’s Research UK said this must change.

“People are waiting too long for a dementia diagnosis, often struggling to even get through the NHS front door. Detecting early signs of dementia, for example through a routine eye test at your local optician, would be a gamechanger. Integrating these scans with existing tests, like brain scans, would ensure people get the full picture of their condition, and the support they deserve, more quickly.”

Thomas also highlighted that this innovation aligns with government ambitions to shift more healthcare services into community settings.

“The upcoming 10-year health plan must ensure the NHS is able to rapidly pilot and adopt new innovations such as eye scans into routine healthcare settings,” he added.

Experts estimate that this type of scan won’t be available in high street opticians for at least five years due to lengthy approval processes and the time needed to integrate them into healthcare settings. Crucially, scans will only be offered to people who specifically request them.

By then, effective dementia treatments that can slow down or stop the condition progressing could be available in the NHS, making early detection even more critical.

“When these treatments arrive, we’ll need ways to pinpoint those in the early stages of dementia” says Thomas. “Eye scan tests could prove invaluable in helping people get diagnosed and treated sooner.”

Forgetting things such as being unable to remember where you put your car keys happens to all of us. But if memory problems start interfering with daily life, it might be time to seek advice. It can be hard to know when to speak to a GP, and many people wait until symptoms worsen. If you have questions about getting a dementia diagnosis you can contact the Dementia Research Infoline on 0300 111 5111 or email infoline@alzheimersresearchuk.org.