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The storage of facial images in medical records poses privacy risks due to the sensitive nature of the personal biometric information that can be extracted from such images. To minimize these risks, we developed a new technology, called the digital mask (DM), which is based on three-dimensional reconstruction and deep-learning algorithms to irreversibly erase identifiable features, while retaining disease-relevant features needed for diagnosis. In a prospective clinical study to evaluate the technology for diagnosis of ocular conditions, we found very high diagnostic consistency between the use of original and reconstructed facial videos (κ ≥ 0.845 for strabismus, ptosis and nystagmus, and κ = 0.801 for thyroid-associated orbitopathy) and comparable diagnostic accuracy (P ≥ 0.131 for all ocular conditions tested) was observed. Identity removal validation using multiple-choice questions showed that compared to image cropping, the DM could much more effectively remove identity attributes from facial images. We further confirmed the ability of the DM to evade recognition systems using artificial intelligence-powered re-identification algorithms. Moreover, use of the DM increased the willingness of patients with ocular conditions to provide their facial images as health information during medical treatment. These results indicate the potential of the DM algorithm to protect the privacy of patients’ facial images in an era of rapid adoption of digital health technologies.

Teleophthalmology, a subfield of telemedicine, has recently been widely applied in ophthalmic disease management, accelerated by ubiquitous connectivity via mobile computing and communication applications. Teleophthalmology has strengths in overcoming geographic barriers and broadening access to medical resources, as a supplement to face-to-face clinical settings. Eyes, especially the anterior segment, are one of the most researched superficial parts of the human body. Therefore, ophthalmic images, easily captured by portable devices, have been widely applied in teleophthalmology, boosted by advancements in software and hardware in recent years. This review aims to revise current teleophthalmology applications in the anterior segment and other diseases from a temporal and spatial perspective, and summarize common scenarios in teleophthalmology, including screening, diagnosis, treatment, monitoring, postoperative follow-up, and tele-education of patients and clinical practitioners. Further, challenges in the current application of teleophthalmology and the future development of teleophthalmology are discussed.

Purpose To investigate environmental factors associated with corneal morphologic changes. Methods A cross-sectional study was conducted, which enrolled adults of the Han ethnicity aged 18 to 44 years from 20 cities. The cornea-related morphology was measured using an ocular anterior segment analysis system. The geographic indexes of each city and meteorological indexes of daily city-level data from the past 40 years (1980–2019) were obtained. Correlation analyses at the city level and multilevel model analyses at the eye level were performed. Results In total, 114,067 eyes were used for analysis. In the correlation analyses at the city level, the corneal thickness was positively correlated with the mean values of precipitation (highest r [correlation coefficient]: >0.700), temperature, and relative humidity (RH), as well as the amount of annual variation in precipitation ( r : 0.548 to 0.721), and negatively correlated with the mean daily difference in the temperature (DIF T), duration of sunshine, and variance in RH ( r : −0.694 to 0.495). In contrast, the anterior chamber (AC) volume was negatively correlated with the mean values of precipitation, temperature, RH, and the amount of annual variation in precipitation ( r : −0.672 to −0.448), and positively associated with the mean DIF T ( r = 0.570) and variance in temperature ( r = 0.507). In total 19,988 eyes were analyzed at the eye level. After adjusting for age, precipitation was the major explanatory factor among the environmental factors for the variability in corneal thickness and AC volume. Conclusions Individuals who were raised in warm and wet environments had thicker corneas and smaller AC volumes than those from cold and dry ambient environments. Our findings demonstrate the role of local environmental factors in corneal-related morphology.