A New Technique of iPhone 11 Pro Max Smartphone-aided Angle Video and Standstill Image Documentation

Abstract

In this report, the authors highlight 2 effective and simple techniques of video documentation of the anterior chamber angle using the newer generation iPhone, iPhone 11 Pro Max. In these techniques, we also used a commercially available macro lens with the phone. The patient positions his/her chin on a slit-lamp biomicroscope as done during a routine slit-lamp examination. The first observer places the gonioscope over the patient’s eye and projects a thin slit beam of light of the slit-lamp biomicroscope along the superior or inferior Gonio mirror. A second observer records the anterior chamber angle findings using the macro lens clipped smartphone after bringing it closer to the eye of the patient. In the phone, the video mode is selected after opening the phone’s camera application. In the subcategory of video mode, 1× or the wide-angle mode is chosen. Under 1× mode, the magnification is further increased to 3× to document high-quality imaging findings of angle. Similarly, in the second technique, the slit (streak) light beam of the direct ophthalmoscope was used that completely circumvented the need for a slit lamp as a source of light.

A Study Validating the Estimation of Anterior Chamber Depth and Iridocorneal Angle with Portable and Non-Portable Slit-Lamp Microscopy

“…They used an external light source and the camera function of the smartphone to record intricately detailed images of the mydriasis cataract [25]. Moreover, Pujari A, et al demonstrated a method for photographing the iridocorneal angle using the latest smartphone and external slit-lamp biomicroscope [26]. Finally, Chiong et al invented the three-dimensionally (3D) printed smartphone attachment, which uses the smartphone's light source and camera function [27].…”

The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques

“…The current capability of SI in the observation of anterior segment features is promising. Refined techniques using either gonio or macro lens combinations make it possible to capture high-quality videos and standstill images of the iridocorneal angle ( 422 , 423 ). A trial conducted by Pujari et al found that inferior angle measurements acquired using the iPhone-macro lens combination demonstrate excellent correlation with measurements acquired using AS-OCT ( 424 ).…”

Smartphone Gonioscopy With a Magnifying Intraocular Lens: A Cost-effective Angle Imaging Device

“…Previously anterior chamber angle could be imaged only with slit-lampbased gonio-photography, however, recently smartphone-based anterior chamber angle imaging techniques have been described. 5,6 These techniques utilized independent smartphone imaging or placement of an adapter on a smartphone camera which is then used to image the anterior chamber angle via a goniolens devoid of a slit lamp. We have previously reported anterior segment imaging using an intraocular lens (IOL) attached to a smartphone camera called anterior segment photography with an intraocular lens (ASPI), 7 and in this report we extend as well as describe its use to photograph the anterior chamber angle aided with a goniolens which can be used as a cost-effective screening tool.…”

“…They also performed corneal wedge examination and documentation using the slit beam of a slit lamp as well as that of a direct ophthalmoscope. 6 Their technique, however, required the use of a relatively expensive smartphone. We have utilized an IOL as a magnifying lens attached to a smartphone camera and obtained high resolution, clear, and magnified images of the anterior chamber angle, thereby expanding the use of ASPI for gonio-imaging.…”

“…Imaging the anterior chamber angle via gonioscopy forms an integral part of glaucoma screening, diagnosis, and management. Previously anterior chamber angle could be imaged only with slit-lamp–based gonio-photography, however, recently smartphone-based anterior chamber angle imaging techniques have been described 5,6. These techniques utilized independent smartphone imaging or placement of an adapter on a smartphone camera which is then used to image the anterior chamber angle via a goniolens devoid of a slit lamp.…”