Phase-Informed Tool Segmentation for Manual Small-Incision Cataract Surgery

Cataract surgery is the most common surgical procedure globally, with a disproportionately higher burden in developing countries. While automated surgical video analysis has been explored in general surgery, its application to ophthalmic procedures remains limited. Existing works primarily focus on Phaco cataract surgery, an expensive technique not accessible in regions where cataract treatment is most needed. In contrast, Manual Small-Incision Cataract Surgery (MSICS) is the preferred low-cost, faster alternative in high-volume settings and for challenging cases. However, no dataset exists for MSICS. To address this gap, we introduce Cataract-MSICS, the first comprehensive dataset containing 53 surgical videos annotated for 18 surgical phases and 3,527 frames with 13 surgical tools at the pixel level. We benchmark this dataset on state-of-the-art models and present ToolSeg, a novel framework that enhances tool segmentation by introducing a phase-conditional decoder and a simple yet effective semi-supervised setup leveraging pseudo-labels from foundation models. Our approach significantly improves segmentation performance, achieving a $23.77\%$ to $38.10\%$ increase in mean Dice scores, with a notable boost for tools that are less prevalent and small. Furthermore, we demonstrate that ToolSeg generalizes to other surgical settings, showcasing its effectiveness on the CaDIS dataset.

A Comparative Study of CNN, ResNet, and Vision Transformers for Multi-Classification of Chest Diseases

Large language models, notably utilizing Transformer architectures, have emerged as powerful tools due to their scalability and ability to process large amounts of data. Dosovitskiy et al. expanded this architecture to introduce Vision Transformers (ViT), extending its applicability to image processing tasks. Motivated by this advancement, we fine-tuned two variants of ViT models, one pre-trained on ImageNet and another trained from scratch, using the NIH Chest X-ray dataset containing over 100,000 frontal-view X-ray images. Our study evaluates the performance of these models in the multi-label classification of 14 distinct diseases, while using Convolutional Neural Networks (CNNs) and ResNet architectures as baseline models for comparison. Through rigorous assessment based on accuracy metrics, we identify that the pre-trained ViT model surpasses CNNs and ResNet in this multilabel classification task, highlighting its potential for accurate diagnosis of various lung conditions from chest X-ray images.

CataractBot: An LLM-Powered Expert-in-the-Loop Chatbot for Cataract Patients

The healthcare landscape is evolving, with patients seeking more reliable information about their health conditions, treatment options, and potential risks. Despite the abundance of information sources, the digital age overwhelms individuals with excess, often inaccurate information. Patients primarily trust doctors and hospital staff, highlighting the need for expert-endorsed health information. However, the pressure on experts has led to reduced communication time, impacting information sharing. To address this gap, we propose CataractBot, an experts-in-the-loop chatbot powered by large language models (LLMs). Developed in collaboration with a tertiary eye hospital in India, CataractBot answers cataract surgery related questions instantly by querying a curated knowledge base, and provides expert-verified responses asynchronously. CataractBot features multimodal support and multilingual capabilities. In an in-the-wild deployment study with 49 participants, CataractBot proved valuable, providing anytime accessibility, saving time, and accommodating diverse literacy levels. Trust was established through expert verification. Broadly, our results could inform future work on designing expert-mediated LLM bots.

Towards Automating Retinoscopy for Refractive Error Diagnosis

Refractive error is the most common eye disorder and is the key cause behind correctable visual impairment, responsible for nearly 80% of the visual impairment in the US. Refractive error can be diagnosed using multiple methods, including subjective refraction, retinoscopy, and autorefractors. Although subjective refraction is the gold standard, it requires cooperation from the patient and hence is not suitable for infants, young children, and developmentally delayed adults. Retinoscopy is an objective refraction method that does not require any input from the patient. However, retinoscopy requires a lens kit and a trained examiner, which limits its use for mass screening. In this work, we automate retinoscopy by attaching a smartphone to a retinoscope and recording retinoscopic videos with the patient wearing a custom pair of paper frames. We develop a video processing pipeline that takes retinoscopic videos as input and estimates the net refractive error based on our proposed extension of the retinoscopy mathematical model. Our system alleviates the need for a lens kit and can be performed by an untrained examiner. In a clinical trial with 185 eyes, we achieved a sensitivity of 91.0% and specificity of 74.0% on refractive error diagnosis. Moreover, the mean absolute error of our approach was 0.75$\pm$0.67D on net refractive error estimation compared to subjective refraction measurements. Our results indicate that our approach has the potential to be used as a retinoscopy-based refractive error screening tool in real-world medical settings.

Keratoconus Classifier for Smartphone-based Corneal Topographer

Keratoconus is a severe eye disease that leads to deformation of the cornea. It impacts people aged 10-25 years and is the leading cause of blindness in that demography. Corneal topography is the gold standard for keratoconus diagnosis. It is a non-invasive process performed using expensive and bulky medical devices called corneal topographers. This makes it inaccessible to large populations, especially in the Global South. Low-cost smartphone-based corneal topographers, such as SmartKC, have been proposed to make keratoconus diagnosis accessible. Similar to medical-grade topographers, SmartKC outputs curvature heatmaps and quantitative metrics that need to be evaluated by doctors for keratoconus diagnosis. An automatic scheme for evaluation of these heatmaps and quantitative values can play a crucial role in screening keratoconus in areas where doctors are not available. In this work, we propose a dual-head convolutional neural network (CNN) for classifying keratoconus on the heatmaps generated by SmartKC. Since SmartKC is a new device and only had a small dataset (114 samples), we developed a 2-stage transfer learning strategy -- using historical data collected from a medical-grade topographer and a subset of SmartKC data -- to satisfactorily train our network. This, combined with our domain-specific data augmentations, achieved a sensitivity of 91.3% and a specificity of 94.2%.