Interview with Kaushal Solanki

Founder of Eyenuk

August 2024

Adam Kaufman: Well, I'm very fortunate to be here with Kaushal Solanki, founder of Eynuk. Tell us a little bit about yourself and Eyenuk.

Kaushal Solanki: Thanks Adam, for having me. I founded Eyenuk way back in 2010, with the goal of bringing AI to the world of healthcare. I was trained as an AI scientist. Early in my career, I worked on completely different things with the Department of Defense and DARPA projects analyzing satellite and drone images. It was very cool cutting-edge work, but things that I couldn't talk about publicly.

Eyenuk was started based on my own healthcare; where I was identified as a glaucoma suspect by an optometrist who was just across the street. I tried to make an appointment with an ophthalmologist, and glaucoma specialist; this was in Santa Barbara. I had the best insurance money could buy, and I thought I'd get an appointment in the next week, but I was surprised that it was 4 and a half months out, and that gave me a lot of time to think about my health. 

So that prompted the idea that analyzing these images with AI can improve access.

I reached out to retina specialists in the Southern California area and they all confirmed that the early detection of these diseases, like diabetic retinopathy and glaucoma, can have a meaningful impact on the world. That's the Eyenuk response.

We got early funding from the National Institutes of Health. We beat the state-of-the-art solution within a few months. That led us to get more funding both from grants and also from investments. We secured a number of patents and that led to regulatory approvals in Europe followed by the US in 2020. We also got federal approval for reimbursement for the screenings. And fast forward…today we are in 27 countries with over 300,000 tests completed.

Adam Kaufman: Really exciting story. If we think about the use case you have the furthest development which is in diabetic retinopathy, a recent JAMA article from 2023, estimated that more than 26% of people with diabetes have diabetic retinopathy. But, at least according to the Office of Disease Prevention and Health Promotion of the Department of Health and Human Services, less than 65% of people with diabetes get the recommended annual screening.

Kaushal Solanki: In fact this 65% is an upper bound because that number comes from the percent of people who got screened in a particular year. The number of people who actually get annual screening regularly is much lower. There has been literature that puts it below 30%. 

There are a number of reasons for this. There is a lack of insurance, a lack of access. Patients need to take time off work and go see an ophthalmologist, and much like my experience, there are long wait times. 

And prior to Eyenuk, the standard of care was, you make an appointment with an eye care specialist. You go there. You get your eyes dilated and the doctor looks into your eyes. And that's a core reason why screening rates are low; the specialists are not always accessible.

Adam Kaufman: So as you make it more accessible through technology, are we seeing increased screening rates? 

Kaushal Solanki: Absolutely. I think we are. The technology addresses this problem by creating a fully autonomous AI that has been cleared by the FDA. Which means that there is no specialist oversight needed. And from a specialist perspective, they were previously screening mostly normal people without disease, which is not the best use of their time. Now, if you bring the screening to primary care, the specialists are happy because they are only referred patients who need treatment. And from a patient perspective, the screening can happen at the point of care and they can get it done during their routine doctor’s visit.

Adam Kaufman: Compelling. Certainly, the patient experience is much better. And I think you hit on two really interesting ways it increases access. One is, that it doesn't have to take the time of the busy specialist. And two, it actually doesn't require another appointment at all. The screening can be done in the context of another appointment. 

Do you think this is broadly applicable in screening and other categories or something unique about diseases of the eye?

Kaushal Solanki: Digital health AI technologies, the whole category of these technologies, I'm very bullish with respect to it improving access.

There are already applications in dermatology, for example, where skin lesions can be monitored, and they can be detected at a primary care office. Similar story - instead of doing a biopsy for every lesion or referring out to a dermatologist. There are similar parallels in primary care being able to do AI-guided ultrasounds. 

So I believe we already have many of these technologies and there are many more companies yet to be started.

Adam Kaufman: Thank you for your time and expertise, Kaushal! And for the groundbreaking work you're doing to improve access to sight-saving eye care.