Commercial Slit Lamp Anterior Segment Photography versus Digital Compact Camera Mounted on a Standard Slit Lamp with an Adapter

Oliphant, Huw; Kennedy, Alasdair; Comyn, Oliver; Spalton, David J.; Nanavaty, Mayank A.

doi:10.1080/02713683.2018.1490435

Cited by 12 publications

(5 citation statements)

References 9 publications

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“…By shining a thin sheet of light into the eye, an in vivo stereoscopic evaluation of the pathological changes of the cornea, conjunctiva and other anterior segment tissues can be performed by SLB [9]. However, the limited magnification and poor spatial resolution of traditional SLB make it difficult to visualize more detailed pathological structures and perform accurate biometric measurements [10][11][12]. Fluorescein stain could stain stroma while leaving the intact epithelium with a specific fluorescein dye, thereby demarcating the location and area of the epithelial loss in ocular surface diseases, on a relative macro scale as well [13].…”

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confidence: 99%

Multi-modal Anterior Eye Imager Combining Ultra-High Resolution OCT and Microvascular Imaging for Structural and Functional Evaluation of the Human Eye

et al. 2020

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To establish complementary information for the diagnosis and evaluation of ocular surface diseases, we developed a multi-modal, non-invasive optical imaging platform by combining ultra-high resolution optical coherence tomography (UHR-OCT) with a microvascular imaging system based on slit-lamp biomicroscopy. Our customized UHR-OCT module achieves an axial resolution of ≈2.9 µm in corneal tissue with a broadband light source and an A-line acquisition rate of 24 kHz with a line array CCD camera. The microvascular imaging module has a lateral resolution of 3.5 µm under maximum magnification of ≈187.5× with an imaging rate of 60 frames/s, which is sufficient to image the conjunctival vessel network and record the movement trajectory of clusters of red blood cells. By combining the imaging optical paths of different modules, our customized multi-modal anterior eye imaging platform is capable of performing real-time cross-sectional UHR-OCT imaging of the anterior eye, conjunctival vessel network imaging, high-resolution conjunctival blood flow videography, fluorescein staining and traditional slit-lamp imaging on a single device. With self-developed software, a conjunctival vessel network image and blood flow videography were further analyzed to acquire quantitative morphological and hemodynamics parameters, including vessel fractal dimensions, blood flow velocity and vessel diameters. The ability of our multi-modal anterior eye imager to provide both structural and functional information for ophthalmic clinical applications was demonstrated on a healthy human subject and a keratitis patient. evaluation of ocular surface diseases, different imaging modalities are usually applied in ophthalmic clinics to provide multi-modal and multi-dimensional images [7,8].Slit-lamp biomicroscopy (SLB) is the gold standard for routine ophthalmic examinations. By shining a thin sheet of light into the eye, an in vivo stereoscopic evaluation of the pathological changes of the cornea, conjunctiva and other anterior segment tissues can be performed by SLB [9]. However, the limited magnification and poor spatial resolution of traditional SLB make it difficult to visualize more detailed pathological structures and perform accurate biometric measurements [10][11][12]. Fluorescein stain could stain stroma while leaving the intact epithelium with a specific fluorescein dye, thereby demarcating the location and area of the epithelial loss in ocular surface diseases, on a relative macro scale as well [13]. Developed in the 1990s, optical coherence tomography (OCT) has revolutionized the field of ophthalmology and vision science with its non-contact, non-invasive and high-resolution nature and become one of the prominent diagnostic tools in offering cross-sectional tissue imaging [14][15][16]. Applications of OCT for in vivo human eye imaging have been widely demonstrated in the literature [17][18][19][20][21][22][23][24][25][26][27][28]. With ever-improving techniques in broadband light sources, ultra-high resolution OCT (UHR-OCT) has achieved m...

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Multi-modal Anterior Eye Imager Combining Ultra-High Resolution OCT and Microvascular Imaging for Structural and Functional Evaluation of the Human Eye

et al. 2020

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“…Slit-lamp photography is classically performed by a permanently mounted camera, which often requires a computer system for data storage and network connectivity [ 1 ]. In addition, such mounted slit-lamp cameras require a significant amount of clinic space, are stationery that limits their use to a single examination lane, and require operation by trained technicians or physicians [ 2 ].…”

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Medical Students’ Perspectives Regarding the Use of a Slit-Lamp Smartphone Adapter for Clinical Slit-Lamp Photography

Emam,

Alharbi,

Alammar

et al. 2024

Cureus

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Background This study aimed to investigate medical students’ perspectives regarding the ease and utility of smartphone slit-lamp photography. Methodology In this prospective experimental study, fourth and fifth-year medical students who were in or had finished ophthalmology rotation were included to attempt slit-lamp smartphone anterior segment photography on adult patients after a brief hands-on instruction course. Each medical student attempted to record five supervised slit-lamp videos of the anterior segment of five patients using the described adapter and their own smartphone. The time taken until photography was calculated for each attempt. After the fifth attempt, each medical student rated the ease of the use of this method of slit-lamp photography as well as their perspective regarding its utility as a potential means of medical education and telemedical consultations on a five-point Likert scale. Results A total of 33 medical students participated, with each successfully recording five slit-lamp examinations using their smartphones. The time used for the application of the adapter until the image capture ranged from 6 to 278 seconds (average = 39.51 ± 34.7 seconds) and markedly improved by the fifth attempt (30.5 ± 25.7 seconds) compared to the first attempt (67.3 ± 49.3 seconds). Learning this skill was perceived to be relatively easy (2.2 ± 1), with high potential in clinical education (4.6 ± 0.75) and teleconsultations (4.7 ± 0.65). Conclusions Smartphone slit-lamp photography is a relatively easy process. It can be quickly acquired by medical students and has the potential to enhance their medical education and telemedical consultation capabilities.

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“…The cost is prohibitive, and as a result many ophthalmology departments do not have photography access. Studies have shown that image quality from digital cameras mounted to the slit-lamp eye piece are comparable to formal slit-lamp cameras [ 10 ] and recent developments of slide-on magnification lenses with LED lights, have meant that high-resolution anterior segment photographs can be taken with smartphones without a slit-lamp. With 99% of doctors and 95% of nurses in the UK owning a smartphone [ 11 ], this is technology that can be harnessed over a wide range of clinical scenarios and has the potential to significantly aid ophthalmic care.…”

Section: Introductionmentioning

confidence: 99%

Creating a secure clinical ‘Bring Your Own Device’ BYOD photography service to document and monitor suspicious lesions in the lid oncology clinic

Kilduff

Deshmukh

Guevara

et al. 2022

Eye

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Background Ophthalmic examinations are mostly documented using sketches and written descriptions. Improvements in app security and IT infrastructure mean that high-quality anterior segment photographs can be routinely collected with smartphones alone. The lid oncology team relied on pre-operative formal slit-lamp imaging in the one-stop biopsy clinic, a lengthy process with capacity limitations, that risked delays to care. Methods A Bring Your Own Device (BYOD) photography service was developed through a series of iterations and collaborations. Healthcare Assistants took photographs on iPhone SE with Quikvue lens attachments in Pando app. Lesions requiring a slit lamp were photographed by the doctor. Images were uploaded to the patient record twice weekly. The service was evaluated using time–motion studies, imaging quality and utility grading, and patient feedback. Results BYOD photography saved lid oncology patients 41 min (one-third of total appointment time) and reduced delays to treatment to zero. A patient survey reflected the acceptability of the service, with 100% feeling photography was important at every visit. In terms of utility, 97.5% of smartphone images were suitable for monitoring lesions and making management decisions. The management plan based on the smartphone photographs was consistent with the management plan formulated face-to-face in clinic in 92.5% images. Conclusion BYOD photography has replaced formal slit-lamp imaging in the lid oncology service. This sustainable, cost-effective BYOD solution requires little training and can be adapted, reproduced, and scaled globally. BYOD photography can offer detailed records to monitor progress, contribute to remote care models, improve patient experience, and reducing medical error.

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Commercial Slit Lamp Anterior Segment Photography versus Digital Compact Camera Mounted on a Standard Slit Lamp with an Adapter

Abstract: DCC on slit lamp with an adaptor is comparable to a SLC. There is an initial learning curve, which is similar for both for an inexperienced person. This opens up the possibility for low cost anterior segment imaging in the clinical, research, and teaching settings.

Cited by 12 publications

References 9 publications

Multi-modal Anterior Eye Imager Combining Ultra-High Resolution OCT and Microvascular Imaging for Structural and Functional Evaluation of the Human Eye

Multi-modal Anterior Eye Imager Combining Ultra-High Resolution OCT and Microvascular Imaging for Structural and Functional Evaluation of the Human Eye

Medical Students’ Perspectives Regarding the Use of a Slit-Lamp Smartphone Adapter for Clinical Slit-Lamp Photography

Creating a secure clinical ‘Bring Your Own Device’ BYOD photography service to document and monitor suspicious lesions in the lid oncology clinic

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