Harvey Richman, OD

Artificial Intelligence in Cataract Surgery and Optometry at Large with Harvey Richman, OD, and Rebecca Wartman, OD

2025 American Optometric Association Conference

 in Minneapolis, MN, Harvey Richman, OD, Shore Family Eyecare, and Rebecca Wartman, OD, optometrist chair of AOA Coding and Reimbursement Committee, presented their lecture on the implementation of artificial intelligence (AI) devices in cataract surgery and 

AI has been implemented in a variety of ophthalmology fields already, from analyzing and interpreting ocular imaging to determining the presence of diseases or disorders of the retina or macula. Recent studies have tested AI algorithms in analyzing fundus fluorescein angiography, finding the programs extremely effective at enhancing clinical efficiency.

However, there are concerns as to the efficacy and reliability of AI programs, given their propensity for hallucination and misinterpretation. To that end, Drs. Richman and Wartman presented a study highlighting the present and future possibilities of AI in cataract surgery, extrapolating its usability to optometry as a whole.

Richman spoke to the importance of research in navigating the learning curve of AI technology. With the rapid advancements and breakneck pace of implementation, Richman points out the relative ease with which an individual can fall behind on the latest developments and technologies available to them.

“The problem is that the technology is advancing much quicker than the people are able to adapt to it,” Richman told 

. “There’s been research done on AI for years and years; unfortunately, the implementation just hasn’t been as effective.”

Wartman warned against the potential for AI to take too much control in a clinical setting. She cautioned that clinicians should be wary of letting algorithms make all of the treatment decisions, as well as having a method of undoing those decisions.

“I think they need to be very well aware of what algorithms the AI is using to get to its interpretations and be a little cautious when the AI does all of the decision making,” Wartman said. “Make sure you know how to override that decision making.”

Richman went on to discuss the 3 major levels of AI: assistive technology, augmented technology, and autonomous intelligence.

“Some of those are just bringing out data, some of them bring data and make recommendations for treatment protocol, and the third one can actually make the diagnosis and treatment protocol and implement it without a physician even involved,” Richman said. “In fact, the first artificial intelligence code that was approved by CPT had to do with diabetic retina screening, and it is autonomous. There is no physician work involved in that.”

 that a significant amount of surgical technology is already using artificial intelligence, mainly in the form of pattern recognition software and predictive devices.

“A lot of our equipment is already using some form of artificial intelligence, or at least algorithms to give you patterns and tell you whether it’s inside or outside the norm,” Wartman said.

Richman H, Wartman R. A.I. in Cataract Surgery. Presented at the 2025 American Optometric Association in Minneapolis, MN, June 25-28, 2025.

Shao A, Liu X, Shen W, et al. Generative artificial intelligence for fundus fluorescein angiography interpretation and human expert evaluation. NPJ Digit Med. 2025;8(1):396. Published 2025 Jul 2. doi:10.1038/s41746-025-01759-z

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Drs. Richman and Wartman discuss the benefits of using predictive and diagnostic AI, while cautioning about the implicit risks of overreliance on early, imperfect technology.

Harvey Richman, OD

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