Digital health · Retinal screening

Spect

A smartphone retinal camera, a coach on the line guiding the shot, an ophthalmologist grading the picture afterward. Spect sold diabetic eye exams into primary care for seven years without an FDA marketing authorization. As of September 2026 its website no longer loads.

Fewer than one in ten

Justin Chin, DO, a family medicine physician at LifeLong Medical Care’s William Jenkins Health Center in Richmond, California, had a number he could not explain. Fewer than 10% of his patients with diabetes were getting screened for diabetic retinopathy, the slow damage to the small blood vessels of the retina that is the leading cause of blindness in working age adults.

The pandemic explained the first year. It did not explain the second. “But after the restrictions settled down, we never really saw the rates of diabetes eye exams increase,” Chin told the California Health Care Foundation.

His clinic had no eye equipment. Every screening went out as a referral to an ophthalmologist outside Richmond, and his patients, many of them Spanish speaking, underinsured or undocumented, could not take the time off work and had no reliable way to get there. So he brought the camera to them. Within a year, exams rose from roughly 10% of the patients whose doctors recommended one to 40%, according to the foundation, which had also put $475,000 into the company that supplied the device.

The gap Spect aimed at

The arithmetic of diabetic eye screening is unforgiving. There is roughly one eye specialist for every 17,000 Americans, and the exam has to happen every year, for life, for tens of millions of people. Health plans are scored on whether it happens: the NCQA measure counts the share of people aged 18 to 75 with diabetes who had a retinal eye exam. James Powell, who runs DocGo’s Clinical Practice Group, called it “one of the hardest HEDIS quality measures for health plans to close.”

The payment plumbing already existed. By May 2019 the American Academy of Ophthalmology was publishing coding advice for precisely this setup: a primary care group with a fundus camera, an ophthalmologist writing the interpretation. Code 92227 covers remote imaging for detection of retinal disease under physician supervision, average allowable $15.24. Code 92228 covers monitoring of known disease and splits between the office that takes the picture and the doctor who reads it.

That is the business Spect built. Put a camera in the primary care office, let the office bill the code and lift its quality score, and do the reading somewhere else.

A grandfather’s camera

Ankur Gupta spent childhood summers in India watching his grandfather, a local physician, work through an endless stream of patients. Many arrived with vision loss and there was no eye specialist to refer them to, so the grandfather rigged a makeshift eye camera out of a cell phone.

Years later Gupta was at Stanford, where he met Michael Leung, an electrical engineering doctoral student, and Theodore Leng, a Stanford ophthalmologist who was seeing the same failure from the other end: patients who did not book a screening until something already hurt. “That got us brainstorming around how we can catch these patients earlier, before complications arise,” Leung said. They rebuilt the grandfather’s idea on top of an iPhone, and Leung dropped out of his PhD program to work on it full time.

Spect Inc. was incorporated in Delaware in 2017 and went through Y Combinator’s Summer 2017 batch. Michael Ricci, a serial digital health operator, came in as a consultant and then became CEO. The company’s only SEC filing, lodged that September, names a fourth person the later coverage drops: Rishab Gargeya, listed as an executive officer and a director. That summer Gargeya was eighteen, had just won a $50,000 Davidson Fellows Scholarship for a smartphone vision disease detector, and had published a deep learning classifier for diabetic retinopathy in Ophthalmology with Leng.

Who actually read the picture

This is where the record matters most. Autonomous AI for diabetic retinopathy is real and regulated. IDx-DR was granted a De Novo authorization in April 2018 and cleared twice more under Digital Diagnostics. Eyenuk’s EyeArt cleared in August 2020 and again in 2023. Those companies hold their own marketing authorizations and carry the regulatory burden that comes with software that diagnoses without a physician.

Spect held none. No 510(k), no PMA and no De Novo appears under the company name in FDA databases, and no establishment registration or device listing appears under Spect Inc. in openFDA, though the company website advertised “FDA Registration (Class 2 Exempt).”

The press releases were loose about the difference. The November 2021 launch and the January 2022 MedArrive announcement both listed a “Spect Retinal Image Grader” and said the AI-enabled platform analyzed results within minutes. Fierce Healthcare, covering the same partnership, described what the workflow actually did: images graded asynchronously by ophthalmologists and optometrists in Spect’s network. The company website, in its last archived version, said the same without hedging.

What is proven, and what is still claimed

Read plainly: Spect was a services business wearing device language. The camera was a smartphone accessory, the intelligence in the loop was a trained human navigator coaching the shot, and the diagnosis came from a licensed eye doctor reading asynchronously. That is a useful model, and it is also the model that needs no FDA authorization, which is likely why none was sought. The cost of the framing is a record holding claims about AI grading and FDA registration that the company’s own final website and the public databases do not support.

What to watch

• Whether the company is operating at all. The website has not resolved as of September 2026 and Y Combinator lists it as Inactive.
• Whether DocGo, which named Spect its preferred diabetic eye exam solution in July 2024, has replaced it.
• Whether any successor ships the AI grading step Spect described as near term from 2021 through 2025.

In their words

Related companies

• Breathe Well-being: Also in Consumer Health and Wellness. A New Delhi area program that coaches people with Type 2 diabetes off medication by phone and through a mobile app
• Empirical Health: Also in Consumer Health and Wellness. A virtual primary care practice built on wearable data and an extended lipid panel, pointed at one disease
• Instalab: Also in Consumer Health and Wellness. A New York concierge service that lets people order their own blood work, imaging and screenings, with a network of physicians authorizing the orders behind the scenes
• Veera Health: Also in Consumer Health and Wellness. An online clinic for polycystic ovary syndrome, built in Mumbai in 2020 and funded by Y Combinator and Sequoia Surge

Sources

1. Public recordForm D, Spect Inc., CIK 0001716651SEC EDGAR · Sep 13, 2017
2. Public recordFDA 510(k), De Novo and device registration searches for SpectopenFDA · Sep 2026
3. Public recordTelehealth Retinal Codes, CPT 92227 and 92228American Academy of Ophthalmology · May 6, 2019
4. Public recordADA Names Winners of Diabetes Innovation ChallengeAmerican Diabetes Association · Jun 22, 2024
5. Public recordSpect company and jobs listings, batch S17, status InactiveY Combinator · Sep 23, 2026
6. Public recordAutomated Identification of Diabetic Retinopathy Using Deep LearningOphthalmology, Gargeya and Leng · July 2017
7. IndependentStart-Up Spect Advances Health Equity with Diabetes Eye ExamsCalifornia Health Care Foundation · Nov 20, 2023
8. IndependentMedArrive teams up with tele-ophthalmology startup SpectFierce Healthcare, Heather Landi · Jan 31, 2022
9. IndependentSpect Is Fighting Blindness With a New Portable Eye CameraMedTech Innovator · Jan 20, 2022
10. IndependentTelemedicine Startup Spect Raises $3.5 MillionMedTech Innovator · Jan 2, 2022
11. IndependentSpect receives series seed fundingOphthalmology Times · Nov 30, 2021
12. IndependentSaratoga teen wins $50,000 for creation of medical appThe Mercury News · Aug 31, 2017
13. CompanySpect Launches to Build Largest Retinal Data Set in the WorldPR Newswire · Nov 30, 2021
14. PartnerDocGo and Spect Partner to Reduce Care GapsBusiness Wire · Jul 9, 2024
15. CompanySpect website home, about, value and newsroom pagesgetspect.com, archived through Dec 12, 2025