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Hong SC. 3D printable retinal imaging adapter for smartphones could go global. Graefes Arch Clin Exp Ophthalmol. 2015;253(10):1831–3. https://doi.org/10.1007/s00417-015-3017-z. The images obtained with smartphone fundoscopy are typically not as sharp as those obtained with traditional cameras; however, they are of sufficient quality to be interpreted, and recent studies have validated their potential for screening and telemedicine. For example, the recent reports by Giardini et al 8 and Russo et al 9 showed that smartphone funduscopy images could be successfully used to screen for glaucoma and diabetic retinopathy. The results were comparable to standard images or examinations, and they could largely expand its utility in the community setting and in isolated rural areas with poor resources. Figure 5: An innovative way to display anterior segment pictures through LCD projector, monitor or LED/LCD TV How to use the smartphone slit lamp camera
SteadyPix Telescope Photo Adapter for iPhone. The adapter fits Leica M840 operating microscopes and Haag-Streit 900 BM models. The adapter's adjustable eyepiece clamp has a diameter of 35 mm (1.38 in) and should fit a wide range of slit lamp oculars. Aligning the slit lamp ocular and the camera lens can take a little longer than the Keeler Adapter because the eyepiece clamp's arm is also adjustable. To achieve more rapid centration of the slit lamp ocular and the camera's lens, prealign the iPhone in the adapter so that only a small portion of the adapter’s clamp is symmetrically seen in the corners of the phone’s screen. Makes, D.J. Innovations in ophthalmic photography. J. Ophthalmic Nurs. Technol. 1984, 3, 116–117. [ Google Scholar] Measure the eyepiece’s diameter. The adapter’s ocular will replace the original ocular, so it must be the same size. Usually, the eyepieces are from 23 to 30 mm.
Conventional slit lamp camera is expensive costing at about USD 15,000.00. The commercially available smartphone slit lamp camera adaptor (eg. EyePhotoDoc, Zarf iPhone Adaptor, Magnifi iPhone adaptor, Steady iPix Telescope Photo adaptor for iPhone, Keeler portable slit lamp, iExaminer, Tiger Lens and Skylight) ranges from USD 75.00 to USD 520.00. The estimated cost for a DIY smartphone slit-lamp adaptor is USD 15.00 (Refer Table 1) which reduces the cost significantly. A conventional slit lamp camera needs to be serviced and maintenance needs to be done which incurs additional cost to the ophthalmologist. By using the smartphone slit lamp camera, there is virtually zero maintenance.
Dr. Korn says he still owns that Nikon D800 and also a Sony Alpha 7 III, but as far as his work as an ophthalmologist is concerned, they are “gathering dust” because he is able to provide frictionless care using the iPhone. The three pictures at the top are from a smartphone camera, and the ones on the bottom are from a conventional anterior segment camera.Lord RK, Shah VA, San-Filippo AN, Krishna R. Novel uses of smartphones in ophthalmology. Ophthalmology. 2010;117:1274. Elloumi, Y.; Akil, M.; Kehtarnavaz, N. A mobile computer aided system for optic nerve head detection. Comput. Methods Programs Biomed. 2018, 162, 139–148. [ Google Scholar] [ CrossRef] [ PubMed] Russo et al 9 recently reported on the use of the D-Eye adapter (Si14 S.p.A., Padua, Italy), which magnetically attaches to the smartphone and can capture fundus images of an approximately 200º of field of view ( Figure 5). Using images captured with this device they showed substantial agreement in the grading of diabetic retinopathy between the smartphone fundoscopy and slit-lamp fundus examination by masked examiners. Bastawrous A, Giardini ME, Bolster NM, Peto T, Shah N, Livingstone IA, et al. Clinical validation of a smartphone-based adapter for optic disc imaging in Kenya. JAMA Ophthalmol. 2016;134(2):151–8. https://doi.org/10.1001/jamaophthalmol.2015.4625.
The picture shows the removal process of a foreign body on a 20-year-old patient. The sequence is A) initial presentation, B) post removal of corneal foreign body, and C) post removal of rust ring. My consultants at the time seemed indifferent to this suggestion but one of my seniors agreed with me. So when the camera was not in use (the vast majority of the time), we used it in the clinic. It helped me to develop my clinical skills and I found it particularly useful for learning how to examine the cornea and recognize a huge variety of pathologies. In January 2013, the FDA approved the iExaminer (Welch Allyn, Skaneateles Falls, NY), which is a smartphone adaptor system that attaches and aligns an iPhone to Welch Allyn’s PanOptic Ophthalmoscope, to use the iPhone’s camera to capture images of the retina and optic nerve, in combination with the iExaminer App ( Figure 2). 5 This device can capture fundus images without dilation of the pupil with 25º field of view. Although good images can be acquired with this device, especially of the optic nerve, fundus imaging is limited by the narrow field of view.
Pinpoint illumination is used to demonstrate cell and flare in a patient with iritis (Fig. 17) and pigment dispersion syndrome (Fig. 18). Morales-Leon, J.-E.; Díaz-De-León, L.R. Smartphone stereoscopic imaging: Inexpensive 3d telemedicine. Pan-Am. J. Ophthalmol. 2020, 2, 35. [ Google Scholar] [ CrossRef] When I moved to my new rotation, I was disappointed to find that, rather unsurprisingly, there was no slit lamp camera. The overwhelmingly complex and high-effort process of applying for funding for a slit lamp camera system was too much to contemplate at that time. A conventional slit lamp camera is usually used for taking good quality pictures of the eye. The problem with slit lamp camera is that it is expensive and usually immobile. https://optimetrics.com/home/1265-smart-phone-digital-slit lamp-adapter.html (accessed on 20 October 2022)
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