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NEI joins call for standardization of ophthalmic imaging devices

Statement from Michael F. Chiang, director of the National Eye Institute
April 8, 2021
Dr. Michael Chiang

NEI Director Michael F. Chiang, M.D.

Not all health care providers speak the same language, but the software in their clinical imaging devices can and should.

The National Eye Institute, part of the National Institutes of Health, is joining the American Academy of Ophthalmology (AAO) and others in calling for imaging device makers to standardize their data formatting. Such standardization is expected to enable communication across health care providers, improve quality of care, and enhance the creation of datasets for research.

Failing to standardize ophthalmic imaging devices risks leaving the eye care field behind as the health care industry increasingly relies on artificial intelligence to analyze diagnostic imaging. Falling behind is bad for research, and bad for quality of care.

Vision care providers use a variety of imaging devices to diagnose, monitor, and treat eye disease. Examples include basic photography and optical coherence tomography, a noninvasive imaging technique used to evaluate the retina and other structures inside the eye. Often, such imaging is used to detect subtle anatomic changes that help evaluate disease progression and guide treatment.

A doctor uses optical coherence tomography to evaluate a patient’s eyes. Credit National Eye Institute.

The AAO has for many years supported adoption of the Digital Imaging and Communications in Medicine (DICOM) standard. DICOM includes a system of globally agreed-upon ophthalmological definitions. It promotes the seamless sharing of medical images by detailing how to format and exchange images and the information with which they are associated, such as the text describing the image and patient demographic information. Currently, meeting these standards is optional and DICOM compliance is low for ophthalmic imaging technologies. Even so-called DICOM compliant devices fail to fully meet DICOM standards; there is no easy way to exchange digital imaging data from one manufacturer’s equipment to another’s without creating a custom interface.

For more information, see “Recommendations for Standardization of Images in Ophthalmology,” published March 5, 2021, in Ophthalmology. DOI:

Michael F. Chiang, M.D., is director of the National Eye Institute at the National Institutes of Health in Bethesda, Maryland. His clinical practice focuses on pediatric ophthalmology and strabismus. He is board certified in clinical informatics. His research develops and applies biomedical informatics methods to clinical ophthalmology in areas such as retinopathy of prematurity, telehealth, artificial intelligence, clinical information systems, genotype-phenotype correlation, and data analytics. His group has published over 200 peer-reviewed papers and has developed an assistive artificial intelligence system for ROP that received breakthrough designation from the U.S. Food and Drug Administration.



NEI leads the federal government’s research on the visual system and eye diseases. NEI supports basic and clinical science programs to develop sight-saving treatments and address special needs of people with vision loss. For more information, visit

About the National Institutes of Health (NIH): NIH, the nation’s medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit

About the American Academy of Ophthalmology: The AAO is the world’s largest association of eye physicians and surgeons. For more information, visit

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