Researchers at Stanford University have developed two new low-cost iPhone adapters for optical photography. In two papers recently published in the Journal of Mobile Technology in Medicine, first spotted by Medgadget, the researchers suggest that existing smartphone-connected ophthalmoscopes, like Welch Allyn's iExaminer are still larger and more complicated than necessary, especially for particular settings like rural areas or primary care clinics.
“A picture is truly worth a thousand words,” David Myung, an ophthalmology resident at Stanford and one of the authors said in a statement. “Imagine a car accident victim arriving in the emergency department with an eye injury resulting in a hyphema — blood inside the front of her eye. Normally the physician would have to describe this finding in her electronic record with words alone. Smartphones today not only have the camera resolution to supplement those words with a high-resolution photo, but also the data-transfer capability to upload that photo securely to the medical record in a matter of seconds."
Devices like iExaminer contain their own slit lamp and still require an ophthalmologist's training to use. The new devices, for viewing the front and back of the eye respectively, just use a small lens and an LED light, combined with the smartphone's built-in camera.
The two papers cover the front of eye, or anterior, adapter and the back of eye, or fundus, camera respectively. The main difference between the two is the anterior camera can simply be held up to the eye, whereas the fundus camera has to be mounted a set distance from the patient's eye. The team developed a mount for the fundus camera that can be 3D printed, which brings the per unit cost down to $90 for the fundus camera, according to the researchers, and they're hoping to drive it down even lower. For the anterior adapter, the cost is less than $15.
The two published papers were feasibility studies, in which researchers developed the tools and demonstrated their cost and general effectiveness. Images were transmitted via Epic's EHR app Haiku, medical image sending app Medigram, or secure email. The next step will be to test the cameras' performance against standard of care optical cameras.
"Our ultimate goal is for this system to be usable by healthcare staff with minimal specialized training to remotely capture and share high quality retinal images in order to enhance healthcare provider communication," the researchers wrote in one study. "An example would be enabling a triage nurse to text a secure, reliable image to an ophthalmologist on-call. In future work, we plan to deploy subsequent generations of the adapter to non-ophthalmologists to determine the efficacy of smartphone-based photography for remotely triaging patients when access to an ophthalmologist is limited."