Apps and ophthalmology

We look at the impact smartphones and apps have had on the world of ophthalmology

Aidan Hanratty

Posted: Tuesday, January 16, 2018

Photo by Adrianna Calvo

In 2017 the iPhone celebrated its 10th birthday. While it was not the first smartphone in existence, its innovations helped change the landscape of personal technology like no other. Its use of a touchscreen keyboard instead of a physical keyboard, like that used by Blackberry, followed by the opening of the App Store in 2008, were great leaps forward that would change the market – and the world – forever.

iPhones paved the way for the era of the smartphone, with Google’s Android following suit and taking a huge share of the market across a variety of different devices. We call them smartphones, but essentially, they are pocket computers – we depend on them more for the news or weather, for example, than for ever actually talking to someone. The same goes for doctors.

Clare Quigley, a third-year Resident at Mater Misericordiae University Hospital in Dublin, says that while she does use her Samsung smartphone for communication purposes, she also uses it for planning ahead, be it putting her on-call dates in her calendar or preparing for upcoming meetings. She has a specific folder designated for ophthalmology: “I have Crystal.Toric for verifying my pre-op limbal markings when I use toric IOLs. I have PDFs of books that I might need to reference, including The Wills Eye Manual and Kanski’s Clinical Ophthalmology. I also have the hospital antimicrobials guide, and also the EuroTimes app for browsing.”

Most interestingly, Dr Quigley uses apps to distract or settle young children when trying to catch a view of their fundi, be it the Kids Top Nursery Rhymes app or simply YouTube for the likes of Peppa Pig. She also uses an Ishihara app when dealing with bed-bound patients who are unable to attend clinics.

Rahil Chaudhary, Managing Director at the Eye7 Chaudhary Eye Centre in Delhi, India, uses the TorEye app on a daily dasis. “It is basically a toric axis marking app that eliminates the need of devices like bubble markers, and the accuracy of which is comparable to digital axis marking devices like the Verion.” Dr Chaudhary even presented a free paper at the XXXV Congress of the ESCRS in Lisbon on the accuracy of this app, so enamoured he is with the technology.

Arthur Cummings, Medical Director and owner of the Wellington Eye Clinic in Dublin, has incorporated smartphone technology into all aspects of his practice. He can play a patient’s choice of music on Spotify, as well as remotely changing the lighting in the laser suite to any colour of the rainbow. On the surgical side of things, he uses an app called Axis Assistant for marking the cornea for toric IOLs.

“This app allows exquisite accuracy as you don’t have to place the marks exactly at 180 degrees for a reference. Instead you mark the patient freehand at what you think 180 degrees is. You then check using the app while they are upright and measure the exact location. The axis alignment for the IOL is then measured from this reference point and marked with a toric marker to the desired axis.”

He also uses apps to track analytics for the Clinic’s website and as well the various social media channels to communicate with patients and anyone else following the Clinic.

While this technology helps Mr Cummings in his work, there is also a Wellington Patient Journey app, which breaks down the various procedures available as well as advising patients on postoperative behaviour and providing push notifications for medication and appointments. Such innovation shows a willingness to use technology not only to improve surgical outcomes but also to enhance the overall patient experience.

Despite these vast advancements, Mr Cummings says it’s something much more basic that impresses patients most often. As his slit-lamp camera is in a different room to where he regularly consults, he generally uses his smartphone to take a photo through the ocular of the slit-lamp in his consultation room. He then sends it to his computer and shows the patient and save it on their file, and this is what elicits a comment on the wonders of modern technology.

From this small selection of doctors it’s clear that the smartphone has had a massive impact on the day-to-day workings of ophthalmologists. We can only wonder what might be round the corner, let alone what may be available in 10 years’ time.

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