Published November 4, 2014
University at Buffalo researchers — including an ophthalmology resident — have successfully used a smartphone app to image the back of the eye, or fundus, in patients who can be particularly challenging to examine: newborns and children.
“Our group aimed to investigate an alternate method of fundus imaging to better serve patients who may be too young or too ill to hold a position for the traditional cameras,” says lead author Jiaxi Ding, MD, a resident in the Department of Ophthalmology and UB’s Ross Eye Institute.
The iExaminer adapter, developed and marketed by WelchAllyn, allows the UB researchers to instantly take photos and videos of the fundus by combining iPhone technology with the PanOptic ophthalmoscope — a portable lighted instrument used to look inside the eye.
The system can capture key structures at the back of the eye in a single view without necessarily needing drops to dilate the eye.
“That makes it an attractive option for non-specialized eye care by physicians in the emergency department and primary care doctors,” says Matthew S. Pihlblad, MD, clinical assistant professor of ophthalmology.
The iPhone technology also would allow medical professionals to instantly transmit electronic images — aiding telemedicine consults with other care providers — and easily capture, store and transfer data.
Conventional fundus cameras, which typically accommodate adult patients, are expensive and generally only available in specialized eye clinics.
Ding and Pihlblad evaluated 28 pediatric patients in their clinic and at Women and Children’s Hospital of Buffalo.
“As you can imagine, children are often the most challenging subjects to image,” says Ding.
“The children we studied ranged from healthy, hyper-energetic kids to medically fragile infants in intensive care units. We were able to capture a diverse range of retinal and optic nerve findings.”
One example is retinopathy of prematurity, or ROP. “ROP is an eye disease that can lead to vision loss in premature babies for which laser treatment may be appropriate,” Ding explains.
“The iExaminer is extremely useful for educating patients, parents, residents and students, as well as for providing medical documentation that helps with follow-up on these patients,” says Pihlblad, who works with ophthalmology residents as well as medical students and family medicine residents.
“The old saying of a picture is worth a thousand words rings true in this situation,” he says.
Ding agrees: “Imagine trying to explain to a newborn’s nervous parents that urgent, sight-saving laser treatment is needed. In that moment, it would be so powerful to show them a photo taken at the bedside of what we as doctors see,” she notes.
“That’s what we can do with the iExaminer system.”
The researchers presented their findings during the annual meeting of the American Academy of Ophthalmology (AAO) in Chicago.
International attendees were especially interested in the UB findings.
“Our poster received significant interest from colleagues in India, Korea and other countries where they may not have as much access as we do to the most sophisticated ophthalmic equipment,” says Ding.
“The iExaminer system provides an alternative measure for them to obtain inexpensive and good-quality imaging at the bedside.”
The UB research was funded by an unrestricted grant from Research to Prevent Blindness to the UB Department of Ophthalmology.