ESCRS - EYE PHONES ;
ESCRS - EYE PHONES ;

EYE PHONES

EYE PHONES

New smartphone tools for ophthalmologists are proving increasingly useful everywhere from the suburban office to the most remote areas of the developing world. Some of the more advanced products feature software and lens attachments that could serve as viable and very portable replacements for much more bulky and expensive equipment. For example, Peek, the Portable eye examination kit, includes a special lens attachment and a suite of diagnostic software that provides an affordable and portable means for comprehensive eye examinations anywhere.

In addition to providing visual acuity testing through the screen display, the Peek system has a clip-on lens adapter that enables it to serve as an ophthalmoscope capable of taking high-resolution fundus photographs. Moreover, the Internet connectivity now common in mobile phones means that the measurements and photographs taken can be uploaded to dedicated facilities for assessment. Andrew Bastawrous, Stewart Jordan, Iain Livingstone and Mario Giardini, developers of the Peek instrumentation and software, therefore, hope that their device will help bring modern eye care to people in low-income countries, where 90 per cent of the world’s 39 million blind people live and among whom 80 per cent of blindness is avoidable, and in many cases curable. The geo-tagging ability of smartphones means that once a patient has been examined at their home using Peek, it will record and upload the patient’s data and geographic position for future reference. It could, therefore, enhance the follow-up of such patients and also enable health workers to target their efforts more efficiently, said Andrew Bastawrous MRCOphth, International Centre for Eye Health (ICEH) | London School of Hygiene & Tropical Medicine who is co-founder of Peek.

“Currently eye care follows the inverse care law. That is, most human and technological resources are in the areas of least need. With Peek, patients can be examined in their homes and we can have coordinated efforts to deliver appropriate care to the point of need, or transport to the nearest facility,” he told EuroTimes in an email he sent from his mobile phone as he travelled on a bus on a poorly paved road in a remote area of Kenya.

Dr Bastawrous and his associates are currently testing the Peek device in conjunction with a large cohort study involving 5,000 people in Kenya to determine its efficacy as compared with the much bulkier equipment that is generally used for eye examinations. The team of investigators are examining the patients with the usual equipment and a healthcare worker who is part of the team separately examines the same study patients with the Peek Smartphone based system – the two sets of findings will be compared. As part of the study, Dr Bastawrous and his associates are currently analysing the results of over 1,000 retinal images obtained by a healthcare worker using the Peek system against images of the same eyes obtained with a top-of-the-range desktop fundus camera. Both sets of anonymised images are being graded at the Moorfield's Reading Centre in London. Dr Bastawrous noted that the system’s lens adapter enables retinal imaging with a resolution and a field of view that is superior to that of a conventional ophthalmoscope. Moreover, the software provides greater ease-of-use and enhances image acquisition and quality.

“We developed a functioning ophthalmoscope adapter for the phone but when we put it in the hands of our team in Kenya it proved to be too challenging to use without a significant amount of training. Thus, I turned to Dr Mario Giardini at University of Strathclyde who has a wealth of knowledge in optics and rapid prototyping with 3D printers. He was able to miniaturise and improve our set-up to use an adapter which modifies the phone's own optics and uses the native flash as a light source to image the retina. We are currently developing software algorithms for image stitching to further increase the field of view through our partnership with Dr Iain Livingstone at the Glasgow Centre for Ophthalmic Research,” he explained. Additional applications the Peek team are developing for the Peek system include visual field testing, for which they are assessing different approaches designed to be more user friendly than current techniques, and a prototype slit-lamp camera for imaging the anterior segment. Dr Bastawrous noted that Peek may also find a place in general practice in high- income countries.

“Although it is designed for low-resource settings, there is huge scope for this to be used in primary care by GPs, optometrists on ambulatory visits and non-ophthalmic doctors. It is much easier to use than an ophthalmoscope. Most people are able to obtain a non-mydriatic view of the optic disc with their first attempt of using it. We hope that it might increase routine retinal examination and be cost-saving within the NHS in the UK,” he said.

Further information or requests for collaboration through the Peek website: www.peekvision.org.

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