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Jean-Marie A Parel, Cornelis Rowaan, Alex Gonzalez, Juan Silgado, Mariela C Aguilar, Karam AlRahman Alawa, Carolina De Freitas, Victor M Hernandez, Nidhi Relhan, Sonia H Yoo, Mukesh Taneja; Second Generation Robotic Remote Controlled Stereo Slit-Lamp. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1721.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the feasibility of building a 2nd GEN roboticized remote controlled stereo slit-lamp with an improved feature set to transmit live ophthalmic stereoscopic views along with bi-directional audio communication in real time, over a network connection between the LV Prasad Eye Institute in Hyderabad, India the Bascom Palmer Eye Institute in Florida, USA and their respective satellites.
A slit-lamp (Model AIA 11 5SL-LED, Appasamy Associates, India) was modified to accept a motorized X-Y-Z stepper based motion mechanism. Servo actuation of slit-angle, width, height, intensity, fixation light, filter and magnification are controlled with a computer system via an on-screen virtual interface. Clinician-patient audio communication and an overview video of the patient allows the clinician to deliver exam instructions. The 2nd GEN instrument utilizes miniaturized components and has, an improved user interface with selectable shortcuts for choosing preset functions while still allowing for micro adjustments via a slider, on-screen point and click measuring function measures length and angle, user controlled fixation light, overview camera view with zoom feature for precision operation of the instrument in close proximity to the patient, image capture and store, 200x digital magnification, and OS and OD position selectable via button press.
The 2nd GEN weight was reduced to >1/3 and its bulk to >1/2 that of the 1st GEN instrument; ergonomics were improved. Testing of the 2nd GEN and its new feature set, was successfully conducted prior to deploying to India, and consisted of remote operation by LVPEI clinicians specialized in anterior segment. High resolution, real-time stereo video and audio was acquired during testing and each function of the instrument was tested for range, precision and speed. Transcontinental network connectivity between both institutes was suitable and sufficient to maintain stable control of the device with minimal latency.
Successful testing of the 2nd GEN robotized slit-lamp between Hyderbad, India and Miami, Florida, demonstrate that it is feasible to use this instrument to provide rapid and accurate tridimensional examination of the anterior segment of the eye, in patients with visual problems throughout rural regions of India, USA and elsewhere.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
2nd generation robotic remote controlled slit-lamp
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