Comparative Functional Evaluation of A Stereoscopic Robotized Teleophthalmic Drone Slit Lamp With Conventional Slit Lamp

Abstract

 

Purpose

 

To make a comparative evaluation of the functional capability of a remotely operated stereoscopic robotized teleophthalmic slit lamp with a conventional slit lamp by simulating anterior segment corneal lesions on model eyes.

 

Methods

 

A Zeiss model 100 Slit lamp was robotized with precision stepper and servo motors to motorize all the slit lamp functions. (Figure 1) The slit lamp’s ocular lenses were replaced with two CCD video cameras. The robotized slit-lamp can be operated from any remote location with an internet connected computing device. On-screen virtual controls give access to all the slit-lamp features such as magnification, X-Y-Z movement, slit controls and digital calipers. Real-time, 3-D stereoscopic viewing on any monitor is achieved with simple prismatic spectacles. Two sets of model eyes were designed to simulate corneal lesions. Penetrating Keratoplasty with asymmetric suturing was simulated on one eye model using 9-0 black colored nylon and 10-0 blue colored prolene sutures with few sutures deliberately broken. The second model eye simulated a corneal ulcer and phlyctenular nodule. Three experienced ophthalmologists, masked to the protocol, were asked to identify, localize and/or measure the lesions on the robotized slit lamp from a remote location using virtual controls on a computer (Figure 2) and then on a conventional slit lamp (Haag Streit Model BQ 900).

 

Results

 

The three ophthalmologists correctly localized and identified the number of different colored intact and broken sutures with 100% accuracy in the first model eye on both the teleophthlamic and conventional slit lamp. In the second model eye the accuracy of measurement of lesions was 97.2%, 84.28% and 96.17% for observer 1, 2 and 3 respectively on teleophthalmic slit lamp compared to 97.48%, 67.02% and 87.41% for observer 1, 2 and 3 respectively on conventional slit lamp.

 

Conclusions

 

The robotized teleophthalmic slit lamp provides good stereoscopic capability for examinations of anterior segment lesions which compares favorably with conventional slit lamp. The robotic slit lamp can be used to conduct standard ophthalmic exams for patients from inaccessible remote locations.

 

 

Figure 1. Teleophthalmic Slit Lamp. Inset shows the screen shot of the captured image from model eye (arrow) simulating corneal transplant.

 

 

Figure 2. Observer operating the teleophthalmic slit lamp from a remote location

 

Keywords: 550 imaging/image analysis: clinical