Abstract
Purpose: :
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.
Methods: :
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.
Results: :
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.
Conclusions: :
The iphone 4 with HD video is easily adapted to slit lamp use and affords an inexpensive and practical portal for telemedicine diagnoses.
Keywords: imaging/image analysis: clinical • clinical (human) or epidemiologic studies: systems/equipment/techniques • anterior segment