Abstract
Purpose of Review
With the introduction of portable fundus photography, the possibility of providing adequate eye care and reducing its cost globally became attainable. Smartphone photography currently plays a vital role in outreach programs where there is a lack of providers and limited availability of traditional fundus cameras.
Recent Findings
Smartphones are an attractive option in portable ophthalmoscopy due to their widespread availability. Newer techniques have allowed the acquisition of high-quality images that compare to images obtained with the more expensive conventional fundus cameras. Available options include slit lamp attachments, adapters for direct ophthalmoscopy, and the use of smartphones with handheld or mounted lenses as an indirect ophthalmoscope.
Summary
Telemedicine has a substantial ability to reach underserved populations without compromising the quality of care. The continuous improvement in smartphone technology establishes its integral role in tele-ophthalmology. Further validation studies are needed to prove its advantages and shape its implementation strategies.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Chan JB, Ho HC, Hussein NFE. DIY—smartphone slit-lamp adaptor. Journal MTM. 2014;3(1):16–22. https://doi.org/10.7309/jmtm.3.1.4.
EyeWiki. Smart phoneography—how to take slit lamp photographs with an iPhone. Available at: http://eyewiki.aao.org/Smart_Phoneography_How_to_ take_slit_lamp_photographs_with_an_iPhone. Last Accessed 1 Oct 2017.
Barsam A, Bhogal M, Morris S, Little B. Anterior segment slitlamp photography using the iPhone. J Cataract Refract Surg. 2010;36(7):1240–1. https://doi.org/10.1016/j.jcrs.2010.04.001.
Lee WW. Slit lamp adapters turn smartphones into clinical cameras. Ophthalmology Web. Available at: http://www.ophthalmologyweb.com/Featured- Articles/136817-Slit-Lamp-Adapters-turn-Smartphones-into-Clinical-Cameras/. Last Accessed 1 Oct 2017.
Gurram MM. Ophthalmic cell-phone imaging system: a costless imaging system. Can J Ophthalmol. 2013;48(5):135–9. https://doi.org/10.1016/j.jcjo.2013.06.007.
WelchAllyn. iExaminer eye imaging for your iPhone. Available at: http://www.welchallyn.com/en/microsites/iexaminer.html. Last Accessed 1 Oct 2017.
Russo A, Civili PS. A novel device to exploit the smartphone camera for fundus photography. J Ophthalmology. 2015;2015:1–5. https://doi.org/10.1155/2015/823139.
Russo A, Morescalchi F, Costagliola C, Delcassi L, Semeraro F. Comparison of smartphone ophthalmoscopy with slit-lamp biomicroscopy for grading diabetic retinopathy. Am J Ophthalmol. 2015;159(2):360–4. https://doi.org/10.1016/j.ajo.2014.11.008.
Navitsky C. The portable eye examination kit. Retina Today. 2013. Available at http://retinatoday.com/2013/12/the-portable-eye-examination-kit. Last Accessed 20 Sept 2017.
Bastawrous A, Mathenge W, Peto T, Weiss HA, Rono H, Foster A, et al. The Nakuru eye disease cohort study: methodology & rationale. BMC Ophthalmol. 2014;14(1):60. https://doi.org/10.1186/1471-2415-14-60.
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.
Maamari R, Keenan J, Fletcher D, Margolis T. A mobile phone-based retinal camera for portable wide field imaging. Br J Ophthalmol. 2014;98(4):438–41. https://doi.org/10.1136/bjophthalmol-2013-303797.
Solanki K, Ramachandra C, Bhat S, Bhaskaranand M, Nittala MG, et al. EyeArt. Automated, high-throughput, image analysis for diabetic retinopathy screening. Invest Ophthalmol Vis Sci. 2015;56:1429.
Rajalakshmi R, Arulmalar S, Usha M, Prathiba V, Kareemuddin KS, Anjana RM, et al. Validation of smartphone based retinal photography for diabetic retinopathy screening. PLoS One. 2015;10(9):e0138285. https://doi.org/10.1371/journal.pone.0138285.
• Lord RK, Shah VA, San-Filippo AN, Krishna R. Novel uses of smartphones in ophthalmology. Ophthalmology. 2010;117(6):1274–1274.e3. https://doi.org/10.1016/j.ophtha.2010.01.001. This letter was the first to report about the various use of smartphones as an educational tool in ophthalmology as well as its ability to capture images of the eye that can be shared digitally.
• Bastawrous A. Smartphone fundoscopy. Ophthalmology. 2012;119(2):433–433.e2. https://doi.org/10.1016/j.ophtha.2011.11.014. This article was the first to describe using the camera’s flash as a coaxial light source and the smartphone as an indirect ophthalmoscope to capture retinal images.
Ryan ME, Rajalakshmi R, Prathiba V, Anjana RM, Ranjani H, Narayan KMV, et al. Comparison Among Methods of Retinopathy Assessment (CAMRA) study: smartphone, nonmydriatic, and mydriatic photography. Ophthalmology. 2015;122(10):2038–43. https://doi.org/10.1016/j.ophtha.2015.06.011.
Kim DY, Delori F, Mukai S. Smartphone photography safety. Ophthalmology. 2012;119(10):2200–1. https://doi.org/10.1016/j.ophtha.2012.05.005.
Haddock LJ, Kim DY, Muka S. Simple, inexpensive technique for high-quality smartphone fundus photography in human and animal eyes. J Ophthalmol. 2013;2013:518479–5. https://doi.org/10.1155/2013/518479.
Myung D, Jais A, He L, Blumenkranz MS, Chang RT. 3D printed smartphone indirect lens adapter for rapid, high quality retinal imaging. J Mobile Tech Med. 2014;3(1):9–15. https://doi.org/10.7309/jmtm.3.1.3.
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.
Volk iNview fundus imaging: Available at: https://volk.com/index.php/volk-products/ophthalmic-cameras/volk-inview/inview.html. Last Accessed 20 Oct 2017.
Ludwig CA, Murthy SI, Pappuru RR, Jais A, Myung DJ, Chang RT. A novel smartphone ophthalmic imaging adapter: user feasibility studies in Hyderabad, India. Indian J Ophthalmol. 2016;64(3):191–200. https://doi.org/10.4103/0301-4738.181742.
Toy BC, Myung DJ, He L, Pan CK, Chang RT, Polkinhorne A, et al. Smartphone-based dilated fundus photography and near visual acuity testing as inexpensive screening tools to detect referral warranted diabetic eye disease. Retina. 2016;36(5):1000–8. https://doi.org/10.1097/IAE.0000000000000955.
Sharma A, Subramaniam SD, Ramachandran KI, Lakshmikanthan C, Krishna S, Sundaramoorthy SK. Smartphone-based fundus camera device (MII Ret Cam) and technique with ability to image peripheral retina. Eur J Ophthalmol. 2016;26(2):142–4. https://doi.org/10.5301/ejo.5000663.
Suto S, Hiraoka T, Oshika T. Fluorescein fundus angiography with smartphone. Retina. 2014;34(1):203–5. https://doi.org/10.1097/IAE.0000000000000041.
Wang A, Avallone J, Guyton DL. Head mounted digital camera for indirect ophthalmoscopy. Invest Ophthalmol Vis Sci. 2014;55:1606.
Welch RJ, Nguyen QD. A novel approach to ophthalmic photography using a portable and versatile camera device. Invest Ophthalmol Vis Sci. 2015;56:4102.
Hansen MB, Abràmoff MD, Folk JC, Mathenge W, Bastawrous A, Peto T. Results of automated retinal image analysis for detection of diabetic retinopathy from the Nakuru study. Kenya PLoS One. 2015;10(10):e0139148. https://doi.org/10.1371/journal.pone.0139148.
Maker MP, Noble J, Silva PS, Cavallerano JD, Murtha TJ, Sun JK, et al. Automated Retinal Imaging System (ARIS) compared with ETDRS protocol color stereoscopic retinal photography to assess level of diabetic retinopathy. Diabetes Technol Ther. 2012;14(6):515–22. https://doi.org/10.1089/dia.2011.0270.
Tran K, Yates PA. Constructing a non-mydriatic point and shoot fundus camera for retinal screening. Invest Ophthalmol Vis Sci. 2012;53:3105.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
Anita Barikian and Luis Haddock declare that there is no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
This article is part of the Topical Collection on Retina
Rights and permissions
About this article
Cite this article
Barikian, A., Haddock, L.J. Smartphone Assisted Fundus Fundoscopy/Photography. Curr Ophthalmol Rep 6, 46–52 (2018). https://doi.org/10.1007/s40135-018-0162-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40135-018-0162-7