With technology evolving at a rapid pace, the field of ophthalmology is witnessing a transformative shift towards the integration of artificial intelligence (AI). AI algorithms offer the promise of enhancing diagnostic accuracy, improving patient outcomes, and streamlining clinical workflows. However, the adoption of such advanced technology into everyday clinical practice often brings with it a myriad of questions and concerns. A recent clinical letter published in Clinical & Experimental Ophthalmology addresses this conundrum through a practical checklist approach. Authored by Stephen S. Bacchi et al., the publication titled “Should this artificial intelligence algorithm be used in my practice now? A checklist approach” provides clinicians with a structured pathway to evaluate the readiness of AI applications for implementation in their practice.

Understanding the AI Revolution in Ophthalmology

Ophthalmology is a field that relies heavily on visual assessments in diagnosing and managing conditions. AI, especially machine learning and deep learning, has made significant strides in image recognition tasks, making it incredibly valuable for interpreting ophthalmic images such as retinal scans and visual fields. A study by Lee et al. (2023) highlights the current landscape in the assessment of visual fields in glaucoma, a key area where AI algorithms could play a transformative role in early detection and monitoring.

The Checklist Approach in Assessing AI Algorithm Suitability

Bacchi and colleagues propose a comprehensive checklist that touches upon various aspects including algorithm validation, ethical considerations, clinical effectiveness, interoperability, and user training. Their work emphasizes the need for a standardized framework that clinicians can use to appraise the plethora of emerging AI technologies. This is aligned with broader calls in the literature for more rigorous reporting guidelines, as stipulated by Liu et al. (2020) in their suggested CONSORT-AI extension for clinical trial reports involving AI interventions.

Key Considerations in Clinical AI Application

The utility of AI in clinical settings has been widely discussed, with studies such as Ramlakhan et al. (2022) elucidating the foundational concepts and potential applications in emergency medicine. These underline the importance of understanding not only the technical intricacies of AI but also its practical implications, including its integration into the existing healthcare system and its interpretability by clinicians.

In their guide for clinicians, Faes et al. (2020) discuss the critical aspects of evaluating machine learning studies, providing a lens through which clinicians can assess the quality and relevance of AI research. Such guides help demystify AI and reinforce the necessity of a cautious yet open-minded approach to its adoption in healthcare.

Scott et al. (2021) also contribute to this discussion with their checklist aimed at evaluating the suitability of machine learning applications in healthcare settings. Their work is a testament to the growing awareness that while AI offers incredible potential, it requires careful consideration and alignment with clinical needs and operational realities.

Implications of the Checklist for Ophthalmology Practice

The checklist proposed by Bacchi and team is expected to play a pivotal role in the decision-making process for ophthalmologists. The balance between embracing innovation and adhering to rigorous clinical standards is delicate. By providing a standardized approach, the checklist empowers ophthalmologists to make informed decisions regarding the integration of AI technologies into their practices, potentially changing the landscape of patient care within the speciality.


1. Ophthalmology AI Integration
2. AI in Eye Healthcare
3. Ophthalmic Artificial Intelligence
4. Clinical AI Adoption
5. Machine Learning in Ophthalmology


1. Lee, G. A., Kong, G. Y. X., & Liu, C. H. (2023). Visual fields in glaucoma: where are we now? Clinical & Experimental Ophthalmology, 51, 162-169. DOI: 10.1111/ceo.14307.
2. Liu, X., Cruz Rivera, S., Moher, D., Calvert, M. J., & Denniston, A. K. (2020). Reporting guidelines for clinical trial reports for interventions involving artificial intelligence: the CONSORT-AI extension. Nature Medicine, 26, 1364-1374. DOI: 10.1038/s41591-020-1034-x.
3. Ramlakhan, S., Saatchi, R., Sabir, L., & Thompson, J. (2022). Understanding and interpreting artificial intelligence, machine learning and deep learning in emergency medicine. Emergency Medicine Journal, 39, 380-385. DOI: 10.1136/emermed-2021-211673.
4. Faes, L., Liu, X., Wagner, S. K., Fu, D. J., Balaskas, K., Sim, D. A., Keane, P. A., & Denniston, A. K. (2020). A clinician’s guide to artificial intelligence: how to critically appraise machine learning studies. Translational Vision Science & Technology, 9(7), 7. DOI: 10.1167/tvst.9.2.7.
5. Scott, I. M., Carter, S., & Coiera, E. W. (2021). Clinician checklist for assessing suitability of machine learning applications in healthcare. BMJ Health & Care Informatics, 28. DOI: 10.1136/bmjhci-2020-100251.

As the ophthalmological community continues to grapple with the implications of integrating artificial intelligence into its practices, the checklist provided by Stephen S. Bacchi and his co-authors serves as an indispensable resource. The checklist approach could very well catalyze the responsible and effective adoption of AI in ophthalmology, ultimately leading to enhanced patient care, treatment outcomes, and a new era of tech-enhanced clinical practice. The future of ophthalmology may indeed be as bright and insightful as the AI algorithms poised to revolutionize this venerable field of medicine.