Eye Care For You: Mobile retinal AIs enable faster diagnosis

‚The eyes are the window to the soul’ – so a famous proverb says. Scientifically more correct would probably be ‘the eyes are the window to the health of a person’. Because the retina not only allows us to determine general parameters such as high blood pressure. It can also provide important clues to diseases that may not yet have been detected.

Eye2you wants to open this ‘window to health’: With a mobile, easy-to-use smartphone app, photos of the eye retina are to be evaluated quickly, cheaply and effectively in the future. And all this without the patient having to wait for a long time and go to a specialist. In an interview with 5-HT, Dr. Jörn-Philipp Lies, CEO and co-founder of eye2you, explains how the idea for eye2you traveled from Ethiopia and Korea to Germany to open up completely new possibilities in diagnostics.

Dr. Jörn-Philipp Lies, CEO and Co-founder of eye2you
Dr. Jörn-Philipp Lies, CEO and Co-founder of eye2you

The window to combined mobility and AI

“On the one hand, there are already companies that have specialized in telemedicine. They use smartphones to take mobile pictures. But the resulting data is forwarded to medical specialists instead of being evaluated directly on site. On the other hand, there are also companies that specialize in artificial intelligence and evaluate the data immediately. However, they only work with stationary devices and AI services in the cloud. The patient still has to see a doctor who has these devices on site. So there is no combination of mobile devices and artificial intelligence for the creation and evaluation of medical images live on site. This is exactly what we want to bring together with eye2you”.

The window to the retina

“As a patient over 35, you usually have a check-up appointment with your family doctor every two to three years. This check-up usually includes a blood count, perhaps an ECG of the heart and some other standard tests. We at eye2you would like to achieve that a patient at this check-up has an examination of the back of the eye, i.e. the retina, in addition to these standard examinations, which only takes a few minutes.

This actually works quite simply: The family doctor or the medical staff use a hand-held funduscope, a kind of magnifying glass the size of a hair dryer, to assess the retina. A smartphone is inserted behind the funduscope. The smartphone then takes a photo of the retina and evaluates it directly with our app. In this way it can be quickly detected whether there are retinal diseases or changes in the retina.

Hand-held funduscope with software from eye2you
Hand-held funduscope with software from eye2you

So the idea behind it is that our examination is just as simple as any other check-up. The examination should not only be possible in doctor’s surgeries, but also by nursing services who drive to the patient’s home and examine not only blood pressure and blood sugar but also the retina. Of course, this should not replace the ophthalmologist, but it should offer another possibility for the examination”.

The window to the patient

“In our opinion, medical care should be oriented towards the patient. That means it should also be possible to provide it comfortably and easily at the patient’s home. This is particularly essential for older people, but mobile medical care is also important for companies and their company doctors. And last but not least, it is our goal that in the future family doctors will also be able to perform our diagnostic procedures. This will save patients the long waiting time for an appointment with a specialist and the journey there, but also relieve the burden on the few specialists. In addition, it will be possible to recognize in good time whether a disease is present before permanent damage or more serious changes occur”.

The window to a whole world of diseases

“What exactly can be seen on the retina is currently a major research topic. The retina is a part of the body’s vascular structure that is visible from the outside because it is located behind a transparent shield. This has the advantage that one can detect even the smallest changes in the vascular structure that would otherwise not be visible. Diseases such as high blood pressure, diabetes, but also dementia, Alzheimer’s disease and certain infectious diseases can be detected very well via the retina because one can look directly at the vessels – without these vessels being disturbed by the examination. And, of course, eye diseases can also be detected via the retina.

The retina is thus an additional indication of disease, although the changes in the retina in hypertension and diabetes are already well established. Studies have even shown that the consequences of a severe COVID19 infection on the retina can also be proven. This shows that viruses can also lead to changes in the retina.

The retina and its changes are an interesting field that has not yet been sufficiently researched. It will therefore remain exciting to see what can be diagnosed in two, three or five years with an examination of the retina. At the moment, however, the retina already indicates some diseases and thus facilitates the diagnosis. For example, instead of just measuring blood pressure for 24 hours, the retina can also be examined to make more reliable diagnoses.

The window for the history of a startup

“Our foundation was more of a coincidental story. I come from the field of AI for Neuroscience. Before eye2you I worked for five years as an IT and strategy consultant and then I wanted to do something that would fill me out. I wanted to go back to technology. So I wrote to a befriended professor from Korea, Prof. Christian Wallraven, eye2yous scientific advisor, and asked him for advice. He told me about a doctoral student of his who is working on development aid in Ethiopia. He is an optometrist, specialist in taking retinal images. In Ethiopia very good retinal images are now available, but there are too few doctors who can evaluate the images. From this, the idea was born to build an AI to do just this job. So I flew to Korea two years ago and we built a first prototype to test our idea – and found that our prototype was already working well.

We quickly realized that we needed a mobile solution for developing countries that we could link to AI. But this was not available on the market until then. We brought Dr. Björn Browatzki, an expert in computer vision and AI, into the team and decided to establish a startup from our research project. Together with Prof. Dr. Philipp Berens from the Eye Clinic in Tübingen as our mentor, we received the EXIST Founders Grant from the German Federal Ministry of Economics and Technology at the end of 2019 and then officially founded eye2you at the beginning of 2020. We are based at the Eye Clinic Tübingen, so we have a very close exchange with the doctors and scientists there”.

The window to a vision

“Furthermore, every year 20 million people worldwide go blind from diseases that are actually very treatable. In Germany, there are still several thousand people each year who go blind or partially blind at working age because the diseases were diagnosed too late. That need not be the case. The only problem is that there is no established program for when the retina is regularly examined. We want to make this examination easier, faster and, through the use of AI, also cheaper available.

Our vision is to offer eye2yous solution first in Germany, then in Europe and then all over the world. We want to be able to help people worldwide in all countries. This applies to older people in Germany for whom the long waiting times for an appointment could be critical, or people in rural areas who cannot or do not want to take the long journeys, but especially also to people in developing countries for whom there are not enough medical professionals.

The window to networking – even in corona times

“As a startup we don’t have a lot of time, but nevertheless we participate in many networking events, because they have a great added value for us. This year, for example, we took part in 5-HTs Insuring Digital Health. What makes 5-HT especially good at their programs is the choice of partners – whether insurance companies, industry partners, health insurance companies and so on. As a start-up, this gave us easy access and allowed us to talk to the various partners on an equal footing. This makes the first contact much easier than via e-mail and phone calls. In addition, there was already trust on both sides, because when a startup – or a partner – was selected by 5-HT for a program, it was clear to everyone that 5-HT had already looked at it carefully.

What is currently – corona-related of course – very much missing are personal events. So far I have not seen a single online concept for a networking event that would have enabled an approximately comparable exchange. It would be very interesting to attend a program that would allow a relaxed, open contact to all participants and not just a meeting-driven exchange as I have observed so far.

The window to the future

“Next year in spring we plan to have our first prototype ready. However, the approval procedures in the medical field are very time-consuming. This was particularly difficult when working with investors who are not familiar with these approvals in the medical field. We are looking for investors from the field of business angels or family offices, who ideally already have experience in the medical sector. We also hope to cooperate with health insurance companies in order to be able to initiate the first pilot projects. At the same time, general practitioners who are open to new methods are also of interest to us”.

The window to the Bitkom Digital Health Conference

“The Digital Health Conference as part of the Bitkom Digital Transformation Week, where we pitched this week and which was moderated by Marco Majer from the 5-HT Digital Hub among others, was really well organized and was a lot of fun.

In the run-up to the event and in the backstage area there was a really great atmosphere among us startups. It was great to network and exchange ideas, almost like in physical pitches. The quality of the participating startups was also impressive and motivating us to become even better.

And also the event was worthwhile itself, so after the 3 minutes representatives of VCs and the press approached us directly because they had tasted blood and wanted to know more.”

The window for collaboration with 5-HT

“Over the last few months, 5-HT has become an incredibly valuable partner for us in networking with other startups, industry representatives, investors and health insurance companies. The health care system is a world of its own, as you can see time and again.

We hope that 5-HT can accompany us here for a long time to come and provide us with the right contacts and advice in the course of our company’s development from a small, visionary startup to a large, international AI medtech player.”

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