The missing dimension in retinal care

Optical coherence tomography (OCT) has changed retina care by providing us with the third dimension. It allowed us to see beneath the retinal surface and made structural monitoring central to the management of many retinal diseases. For retina specialists, this story is familiar. OCT became part of how we think.

Home OCT now gives us the next dimension: time.

In the clinic, we see the retina at selected points in time. We make management decisions from those visits, but we also know how much can happen between them. Fluid can recur quietly. A patient may be doing well at one visit and have meaningful disease activity before the next. Recurrence intervals can seem stable until they are not.

Home OCT changes that perspective. It allows us to see retinal disease as a process unfolding in real time. That temporal view may be especially important in diseases with acute dynamics.

Other areas of medicine have already shown us the value of this shift. Continuous glucose monitoring has changed how patients and clinicians understand diabetes. Heart rate and rhythm monitoring have made cardiovascular patterns visible in daily life.

Retina is ready for the same transition.

I remember when the first OCT systems came out, the data analysis was done on large computers sitting in laboratories. Today, every patient carries more computing power in a pocket than those systems once had. Home OCT with artificial intelligence–based biomarker tracking brings that same digital revolution to retinal care. It moves imaging from a place patients visit to a capability that can live with them.

The most meaningful part is not technological. It is personal. Vision-threatening diseases create uncertainty and fear. Home OCT can give patients a way to participate and feel that their disease is being closely monitored.

That may be the true missing dimension in retinal care.

Anat Loewenstein, MD, MHA

Professor of Ophthalmology, Vice President at the Tel Aviv Medical Center, Sidney Fox Chair of Ophthalmology at the Grey Faculty of Medicine at Tel Aviv University. Tel Aviv, Israel.