If you spent time with an optometrist or ophthalmologist who started working in the 1970s or earlier, how they worked back in the day seemed so primitive. No computers or smart devices. Optometrists couldn’t prescribe medicine. Treatment options for many vision conditions were limited or nonexistent. Diagnostic equipment took up an entire room.
Thanks to technology, research and the lobbying efforts of optometrists, things changed for the better. That includes diagnostic equipment. What once took up an entire exam room now can be held in your hand. Case in point, there are ophthalmoscopes that attach themselves to smartphones and they allow for photos of the fundus without dilation.
The Welch Allyn iExaminer allows eye doctors to get high resolution photos of the fundus and retinal nerve. This is a suite of products, which includes an ophthalmoscope, a smartphone adaptor and the iExaminer app. It currently works only with iPhones. What makes this so great is that it provides the doctor with a view of the fundus that is five times larger than the standard Welch Allyn ophthalmoscope and provides a 25-degree field-of-view of the back of the eye, which includes the macula and the optic nerve, without having to dilate the pupil.
This device was used by an ophthalmologist Wyche Coleman III, MD on the top of Mount Kilimanjaro in Kenya. He was with a group of people who were climbing the mountain, he took a picture of the back of one of his fellow climbers eye’s and emailed the photo to Johns Hopkins University. Talk about telemedicine in a remote location.
Of course, Welch Allyn isn’t the only one in the smartphone ophthalmoscope business. D-EYE is another ophthalmoscope that utilizes a smartphone, currently only iPhones, that can record both photos and video of the fundus oculi.
The device is attached to a regular smartphone over the camera aperture and the LED light. The great thing about this is that it is an extension of the iPhone, it isn’t an electronic device that needs batteries, nor does it have problems with hardware. The camera connects to the D-EYE app to enter the patient information, focus the camera and record the images. Sounds pretty cool, doesn’t it? There’s more. The field view of this device is up to 20 degrees, it eliminates corneal glare, the patient file is built in and the doctor can review before and after images with the patient.
Other benefits to using these device as opposed to a traditional ophthalmoscope include:
Examining small children and infants without dilation drops
Evaluating emergency room patients
Assessing bed ridden patients
While the Welch Allyn iExaminer and the D-EYE aren’t currently replacements for the ophthalmoscope, they can do lot as far as examining the eye goes. As technology advances and is refined, they will become replacements for the ophthalmoscope and other diagnostic tools that are currently available. So, if you haven’t upgraded from a flip-phone to a smartphone, maybe now you should.