Information for Patients

In Scotland, optometrists on the high-street are capturing millions of retinal images per year. The SCONe project aims to turn these images into a rich resource for eye healthcare and research.

What is SCONe?

The Scottish Collaborative Optometry-Ophthalmology Network eResearch (SCONe) project is a venture to build a world-leading nationwide resource for innovation in eye research, healthcare and education. 

SCONe's team of optometrists, ophthalmologists and researchers have been working together with IT experts. They have been securely transferring eye photographs captured in participating optometry practices to the National Safe Haven, a trusted research environment managed by Public Health Scotland. 

Working within the National Safe Haven, approved researchers can use the photographs to discover new information about eye diseases such as age-related macular degeneration (AMD), the leading cause of blindness in the UK. 

What is a retinal image?

During a routine eye examination your optometrist will take a photograph of the back of your eye. You may wonder "what are they looking for?"

The retina is a thin layer of tissue that lines the back of your eye that allows you to see. Because of the retina’s vital role for vision, your optometrist will capture a digital image to examine its health, called a fundus photograph.

A fundus photograph can be easily and comfortably captured. It works much like a normal photograph, but the specialist camera focuses through your eye's pupil to get a good view of the retina.

Your optometrist can use it to assess the health of your:

  • optic disc/nerve
  • macula
  • blood vessels
A photograph of the retina, with labels showing the location of the optic disc and the macula, as well as pointing out blood vessels.
The optic nerve is responsible for transferring light signals to the brain for visual processing. The macula is the most sensitive spot of the retina and is responsible for central vision. The blood vessels provides nutrients around the retina.

How can SCONe's retinal images help?

A Scotland-wide retinal image research resource allows: 

  • Better understanding of eye disease
  • Better understanding of how the eyes can be a window to our general health
  • Better outcomes for patients
  • Support for community optometrists
  • Provision of educational resources 

To use the example of AMD, it is vital to detect this as early as possible in order to give the patient the best chance of preserving their vision. There is a large reliance on optometrists to identify early features of AMD, called drusen. If the number and size of drusen increase, this indicates an increasing risk of developing late AMD. However, this is difficult for optometrists to monitor by manually comparing retinal images. 

SCONe aims to support optometrists in their clinical decision-making by discovering new methods to detect disease early and to predict the progression of AMD. 

What else can a retinal image tell us?

With the recent advances in retinal imaging and computing technology a retinal image can quickly, cheaply and non-invasively tell us more than just the health of the retina. Changes in how the retina looks may be the first sign of other diseases such as:

  • Cardiovascular disease;
  • Chronic kidney disease;
  • Diabetes;
  • Stroke;
  • Hypertension;
  • Parkinson's disease;
  • Dementia/Mild cognitive decline;
  • Alzheimer's disease;
  • Multiple Sclerosis.

Measurements obtained from retinal images could be used for:

  • Discovering biomarkers (i.e. a measurement that will show whether disease is present);
  • Early detection of disease;
  • More accurate referrals for specialist care;
  • Monitoring the progress of a disease;
  • Prioritising patients for treatment;
  • Increasing our understanding of the mechanisms of disease.

How are the images stored?

SCONe follows the strictest governance protocols. In October 2021, SCONe received approval from NHS Scotland's Public Benefit and Privacy Panel for Health and Social Care (HSC-PBPP) to collect retinal images from participating optometry practices and securely transfer these to the National Safe Haven.

The National Safe Haven is a secure storage facility run by Public Health Scotland. SCONe’s retinal image research resource is held within the National Safe Haven. Data will not be shared outwith this secure storage facility, and Public Health Scotland control who has access to the data. 

At no point will any personal identifiable data be shared with researchers.

All research conducted using the SCONe research resource is subject to stringent ethics approvals and we are committed to upholding the highest levels of data privacy. 

Read more about the PHS National Safe Haven  

Read more about HSC-PBPP

Where can I ask more questions?

If you have more questions, you can email us via the address below:

ask.scone@ed.ac.uk

SCONe has also produced a patient information leaflet, which you can find below.

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