Portal de Periódicos da CAPES

From iPhone to eyePhone: A technique for photodocumentation

2011; Elsevier BV; Volume: 46; Issue: 3 Linguagem: Inglês

10.1016/j.jcjo.2011.05.016

1715-3360

Joshua C. Teichman, Jeffrey H. Sher, Iqbal Ike K. Ahmed,

Retinal and Optic Conditions

Ophthalmology residents frequently encounter new, challenging, and untreated pathology while on-call. This encounter can be after hours and may not be in the clinic setting. As such, the most valuable time to document findings in these treatment naïve patients is often missed as there is no photography service available or we are geographically isolated. In 2005, at the University of Iowa, Doan et al.1Doan A. Boland M. Oetting T. Digital photography for ophthalmologists—an economical alternative.http://webeye.ophth.uiowa.edu/eyeforum/photography.htmDate: 2005Google Scholar published on the web site EYERounds a technique of holding a digital camera up to the slit-lamp ocular to take anterior segment images. Work by Dr. Yan from the University of Toronto has also revealed the usefulness of adapters that attach a standard digital camera to a slit-lamp ocular. (Yan DB, A primer on optic nerve photography using consumer digital cameras, unpublished data, 2002) This technique works very well, however, these adapters can be expensive. In 2006, McLean et al.2McLean C.J. Tossounis C.M. Saleh G.M. Camera adapter for anterior segment slitlamp photography.J Cataract Refract Surg. 2006; 32: 1889-1891Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar described a method of fashioning a slit-lamp adapter as a more affordable alternative. Unlike the University of Iowa, many residency programs do not equip their residents with a digital camera at the beginning of their residency and many staff physicians do not carry a digital camera around with them. Or do they? A recent survey by the American Society of Cataract and Refractive Surgery found that 83% of members polled currently use a smartphone or Web-enabled device.3Davis E.A. Hovanesian J.A. Katz J.A. Kraff M.C. Trattler W.B. Professional life and the smartphone.Cataract & Refractive Surgery Today. 2010; Sept: 21-22Google Scholar We present a technique for digital slit-lamp photography requiring nothing more than the camera-enabled cell phone that the resident or staff physician would already have on them. This technique has been used at McMaster University since April 2010 with good results. To begin, the slit-lamp is focused on the area of interest, as one would normally do during evaluation of the anterior segment. Next, the cell phone's camera aperture is held adjacent to one of the slit-lamp oculars and a picture is obtained (Fig. 1). Barsam et al.4Barsam A. Bhogal M. Morris S. Little B. Anterior segment slitlamp photography using the iPhone.J Cataract Refract Surg. 2010; 36: 1240-1241Abstract Full Text Full Text PDF PubMed Scopus (27) Google Scholar have recently described their methods for using a cell phone for anterior segment photography as well, and in their report they describe what settings they have found to work well for the various slit-lamp illumination techniques. Images taken using a cell phone (iPhone 3G, Apple Inc, Cupertino, CA) are shown in Figure 2. This technique has also been used for gonioscopic and fundus photography.Fig. 2Recurrent corneal erosion syndrome (A). Anterior chamber intraocular lenses (B). Open iridocorneal angle by gonioscopy (C).View Large Image Figure ViewerDownload (PPT) Images obtained with the above technique have been used at our departmental rounds and are of sufficient quality to be projected for an audience. Moreover, recent improvements in the iPhone have increased the resolution of the digital camera from 2 megapixels, as was used here, to 5 megapixels. It is predicted that cell phones with cameras of 12 megapixels may exist in the near future using nanotechnology.5Dotty but dashing: nanotechnology could improve the quality of mobile-phone cameras.The Economist. 2010; April 8: 82Google Scholar The technique used here may be an easy way of capturing ocular pathology without any change to what we already bring with us while on-call. These images may aid in the teaching of medical students, residents, and other physicians. Last, the images obtained may be incorporated into an electronic medical record as the patient's initial visit when they are later seen in clinic.