Purpose
Dry Eye Disease (DED) and ocular surface disorders diagnosis, scoring and follow up apply vital stainings. However, interpretation is influenced by observer experience and subjectivity. The aim of the present work is to describe a web-based application (app) which runs an algorithm to analyzes images of fluorescein ocular surface staining obtained with the digital camera of a smartphone to quantify, register and provide a follow up tool.
Methods
Support Vector Machine (SVM) was applied to score the intensity and pattern of fluorescein staining in images of ocular surface obtained from healthy individuals and ocular surface diseases patients using the camera of the smartphone connected to a slit lamp. We are trying an automated approach to reduce the noise and to crop the unwanted background, using a sequence of algorithms from the Open Computer Vision (OpenCV) programming library. The goal is to obtain an image that can be analysed by a standard method which produces a numerical coefficient tha can be compared to clinical results.
Results
The software determines the optimal hyperplane to provide the most accurate maximum margin to separate the staining area from not one, as seen in punctate keratitis in DED, corneal ulcers and epithelial defects. Gauss filters are being applied to improve the final results. Preliminary results have showed necessity to improve the techniques in order to reduce the noise and crop the image properly and, then, improve the statistical and clinical relevance of the numeric coefficient.
Conclusions
The present work describes a new tool capable to register and score corneal fluorescein staining. It will be useful for clinical standardization and follow up measurements of DED severity and ocular surface disorders. Regarding practical aspect this tool can run in devices present in the daily clinical practice, the slit lamp and the smartphone, providing a feasible and more precise method to analyse ocular surface staining.