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Robert P. Werner, Thomas H. Mader, David G. Chamberlain, James T. Chapman; Adaptation of the iphone 4 to Slit Lamp Telemedicine. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1346.
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The initial evaluation of an emergency eye patient primarily distinguishes benign conditions from potentially blinding ones. Quick and accurate consultation with remotely located specialists is a useful goal of telemedicine. We have designed and tested a quick and inexpensive adaptive device that gives practitioners the capacity for remote video viewing using an iphone 4 and a standard slit lamp.
The oculars for the Haag-Striet BQ 900 were chosen because of their common usage. A 40 mm seatpost quick-release clamp, easily available from most bicycle shops, is attached to a spacer of 10 mm and mounted to a slightly modified rigid iphone 4 case. The quick release clamp is gently pinched onto the ocular and the iphone is slid into the mount suspended from the ocular. The resultant HD video after in-camera editing is transmitted with standard email from the phone. A series of common ER cases requiring high resolution for interpretation was evaluated by consulting ophthalmologists through email.
The attachment system was found to be easy to use for even novice practitioners. HD video acquisition with the iphone 4 is easy, since independent focus and exposure control are manipulated on the touch screen while filming. A series of ten representative cases were correctly interpreted by all of the reviewing ophthalmologists. These included even subtle cases of corneal guttata, sterile corneal melts and mild iritis.
The iphone 4 with HD video is easily adapted to slit lamp use and affords an inexpensive and practical portal for telemedicine diagnoses.
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