J Korean Ophthalmol Soc.  2017 Aug;58(8):947-951. 10.3341/jkos.2017.58.8.947.

Fundus Photography with a Smartphone

• Choi SH
• Sun HJ
• Lee SJ

• KMID: 2388183
• DOI: http://doi.org/10.3341/jkos.2017.58.8.947

Abstract

PURPOSE
To evaluate the clinical usefulness, convenience, and possibility of using the medical records of fundus photography with a smartphone.
METHODS
We used an ophthalmoscope to examine the images using a smartphone (iphone 6, Apple Inc., Cupertino, CA, USA) and +20D and +28D condensing lenses. Twenty-four subjects were selected for comparison with the conventional funduscopic camera. The posterior pole of the 45° range of the right eye and the fundus photograph taken using the smartphone were analyzed. We measured the distances between specific points on three photographs taken of the patient and calculated the photographing range.
RESULTS
The +20 D lens was 0.80 ± 0.06 times smaller than that of the fundus camera and +1.12 ± 0.06 times bigger than that of the fundus photograph. When the area of the funduscope was converted to 45°, +20 D could visualize an area of 36.10 ± 2.82°, and +28 D could visualize a 50.56 ± 2.68° area.
CONCLUSIONS
Without expensive equipment, a smart phone and a condensing lens can be used to easily perform fundus examination without the need for a special technique. Therefore, this technique is not only useful clinically, but also is very convenient for keeping medical records as fundus photographs.

Keyword

Fundus examination; Ophthalmoscopy; Smartphone

MeSH Terms

Humans
Medical Records
Ophthalmoscopes
Ophthalmoscopy
Photography*
Smartphone*

Figure

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  Figure 1. Technique of smartphone indirect ophthalmoscopy. This picture shows approximate distance between the con-denser lens and the smartphone.

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  Figure 2. Examples of range measurement of retinal examination. The photographing range was compared with the b/a value of each photograph. a = total diameter of fundus photography; b = the point-to-point distance specified by patient (fundus photography); a', b' = same indication of +20 D indirect ophthalmoscopy; a", b" = same indication of +28 D indirect ophthalmoscopy.

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  Figure 3. Clinical application of smartphone indirect ophthalmoscopy. (A, B) Gestational age 26 + 5 weeks, 990 g, retinopathy of prematurity (36 weeks + 5 days, Stage 3, Zone II anterior, Plus sign [+], ridge with extraretinal fibrovascular proliferation [+], retinal hemorrhage [+]). (C) Barrier photocoagulation around horseshoe tear. This patients were admitted to intensive care unit and need bed rest.

Reference

References

1. Blanckenberg M, Worst C, Scheffer C. Development of a mobile phone based ophthalmoscope for telemedicine. Conf Proc IEEE Eng Med Biol Soc. 2011; 2011:5236–9.

2. Kumar S, Wang EH, Pokabla MJ, Noecker RJ. Teleophthalmology assessment of diabetic retinopathy fundus images: smartphone ver-sus standard office computer workstation. Telemed J E Health. 2012; 18:158–62.

3. Zvornicanin E, Zvornicanin J, Hadziefendic B. The use of smart phones in ophthalmology. Acta Inform Med. 2014; 22:206–9.

4. Maamari RN, Keenan JD, Fletcher DA, Margolis TP. A mobile phone-based retinal camera for portable wide field imaging. Br J Ophthalmol. 2014; 98:438–41.

5. Russo A, Morescalchi F, Costagliola C. . Comparison of smart-phone ophthalmoscopy with slit-lamp biomicroscopy for grading diabetic retinopathy. Am J Ophthalmol. 2015; 159:360–4.e1.

6. Shanmugam MP, Mishra DK, Madhukumar R. . Fundus imaging with a mobile phone: a review of techniques. Indian J Ophthalmol. 2014; 62:960–2.

7. Haddock LJ, Kim DY, Mukai S. Simple, inexpensive technique for high-quality smartphone fundus photography in human and animal eyes. J Ophthalmol. 2013; 2013:518479.