Abstract

Purpose: Retinal imaging is an essential component in the practice of ophthalmology; its use is limited to the availability of necessary imaging equipment. We reviewed fundus photos taken using a recently described technique of fundus photography using a smartphone, and its utility in a large hospital with a busy ophthalmology training program. This study describes and evaluates the use of this technique in a setting when fundus cameras are not available.

Methods: We performed a retrospective review of all fundus photographs of retinal pathology taken using smart phone cameras in the inpatient or emergency room settings. Fundus images were captured with an iPhone 4, 5 or 6 and a 20D lens. Using the coaxial light source from the phone and its included video software,the phone functions as an indirect ophthalmoscope, high-definition videos of the fundus can be recorded for subsequent still image extraction. The pictures were evaluated by ophthalmologists to asses its quality and clinical utility.

Results: We obtained fundus photos of patients with retinal pathology incluiding retinal detachment, pre-retinal membranes, proliferative diabetic retinopathy with pre-retinal and vitreous hemorrhage, macular pucker, commotio and retinal hemorrhages of shaken baby syndrome . Retina specialists the residents easily identified the pathology that was photographed using this technique. Pictures were of very good quality even when taken by ophthalmology residents that were inexperienced with the technique. The resolution and details observed in the photos was sufficient to recognize important retinal details and to establish a diagnosis. The pictures were also noted to be an excellent resource to compare disease progression and changes of retinal anatomy in subsequent examinations.

Conclusions: In our review, we noted that the technique to obtain retinal pictures with smartphones is an excellent resource, especially in the emergency room and inpatient setting. With this technique eye doctors can assess and follow up retinal pathology effectively, high quality fundus photos can be obtained by relatively inexperienced personnel. This technique should be introduced to all eye care specialists in order to effectively document retinal findings when there are no retinal cameras available; this technique could also be introduced to emergency room personnel in order to evaluate a patient’s retina with minimal equipment cost.