Once only found in uber-expensive fighter jets, heads-up displays (HUDs) are finding their way into mainstream automobiles. My car has a mesmerizing HUD that functions to the level of distraction. There is so much information in the display: speed, speed limit, direction of travel, arrows that move to show me where to go during navigation, and highlights of animals and people along the road to prevent accidents. The augmented reality of highlighting obstacles, streets I should be turning on, and other information is a first in a production car.

The forerunner to HUDs appeared in World War 2 fighter aircraft with simple gun sights that displayed speed and turn rates to increase the probability of gunners hitting their targets. More recent HUDs allowed pilots to see their key instruments while looking out of the cockpit window without having to look down or refocus on different instruments scattered at different focal lengths from their eyes. The latest evolution is found in the F-35 Lightning fighter jets, in which augmented reality helmets allow pilots to “see” through the bottom of their planes at enemy jets or even bombing targets. This technology is being explored in retina for 3D surgical capabilities.

The idea of using artificial intelligence (AI) to place cues onto our standard imaging displays is starting to gain hold. We have first seen this in surgical technologies where we can place an OCT or fluorescein image onto a surgical display. Future iterations may allow us to have simultaneous live intraoperative OCT images displayed over the surgical video. In this issue, we explore the use of augmented reality for retinal imaging in the clinic. Much like using AI to highlight areas of concern on, say, a mammogram, future imaging technologies will assist us by highlighting areas of concern. For example, small areas of intraretinal fluid can be highlighted on an OCT image. This blending of AI and our own knowledge will hopefully enable us to make better diagnosis and management decisions.

Of course, not everyone likes HUD or would want this technology in clinic. My wife absolutely hates driving my car because the HUD is so distracting. She always turns it off, which goes to show that not all technology helps everyone. RP