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David Myung, John Welling, Matthew Oliva, David Chang, Geoffrey Tabin; Smartphone-based Ophthalmic Imaging with Paxos Scope™ to Expand and Improve Eye Care in Rural Nepal. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1684.
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© 2017 Association for Research in Vision and Ophthalmology.
Approximately 81% of people in Nepal live in rural villages and have limited access to eye care. Paxos Scope™ (DigiSight Technologies) is an FDA-registered Class II 510(k) exempt device for both anterior and mydriatic posterior segment photography that enables low-cost teleophthalmology through a proprietary, secure, cloud-based platform. The goal was to assess the usability and value of the device on clinical work flow and patient care in rural satellite clinics outside of Kathmandu as well as at the Tilganga Institute of Ophthalmology (TIO).
Health care practitioners trained on the use of the platform by the Himalayan Cataract Project International Fellow obtained anterior and posterior images of patients using Paxos Scope™ during regularly scheduled eye clinics and outreaches. The quality of the photos was measured using a five-point scale as described in the FOTO-ED study. Ease and comfort of using the device was evaluated using a five-point Likert scale. Diagnoses from photos taken were correlated to those achieved by in-person clinical exam.
Paxos Scope™ provided high quality images and users were able to comfortably acquire both anterior and posterior images with minimal training. In many settings, the device was the only available or functional ophthalmic imaging modality available. A wide variety of anterior and posterior segment pathology was photodocumented at both TIO and at outlying satellite hospitals, including both pre- and post-op photos of patients that underwent cataract surgery.
Paxos Scope™ provided an easy-to-use, low-cost, and high quality anterior and posterior segment imaging solution where conventional ophthalmic cameras were not available. The device provides a cost-effective solution for teleophthalmology in under-resourced settings with difficult access to subspecialty ophthalmologic care.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Paxos ScopeTM by DigiSight Technologies is an ophthalmic imaging system for smartphones that includes a camera adapter developed at Stanford and a HIPAA-compliant mobile imaging application.
Figure 2: Photos taken by Dr. John Welling (center), a Fellow with the Himalayan Cataract Project, using Paxos Scope in Kathmandu, Nepal. Upper left: Severe infection after corneal transplant. Bottom left: Perforated cornea in infant with severe Vitamin A deficiency. Upper right: Cataract, pre-operatively. Bottom right: POD#1 s/p small incision CE/IOL
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