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. 2020 Oct 20;10:17851. doi: 10.1038/s41598-020-75027-3

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Reasons for misclassification output from the algorithm in the prospective dataset. (a) A patient with central corneal lesions was diagnosed as cataracts by the algorithm. (b) A patient with corneal dystrophy was diagnosed as cataracts by the algorithm. The misclassification in these two images was primarily the result of the corneal lesion being limited to the pupil area (red arrow). (c) A patient with arcus senilis (red arrow), a common corneal degeneration in older subjects, was diagnosed as cataracts by the algorithm. (d) A patient with non-infectious keratitis was diagnosed as infectious keratitis by the algorithm and the junior ophthalmologist. (e) A patient with a complicated case of cataracts was diagnosed as infectious keratitis by the algorithm. (f) A normal subject was diagnosed as infectious keratitis by the algorithm. We postulate that multiple and irregular corneal reflecting light (red arrow) may manifest as a corneal lesion to the algorithm.