DAWN TO DUSK NEWS: Smartphones become 'eye-phones' with low-cost devices Stanford University Medical Center

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Smartphones become 'eye-phones' with low-cost devices</h1>
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Date:</div>
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March 7, 2014</div>
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Source:</div>
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Stanford University Medical Center</div>
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Summary:</div>
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Researchers
 have developed two inexpensive adapters that enable a smartphone to 
capture high-quality images of the front and back of the eye. The 
adapters make it easy for anyone with minimal training to take a picture
 of the eye and share it securely with other health practitioners or 
store it in the patient's electronic record.</div>
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Stanford 
researchers have developed inexpensive adapters that enable a smartphone
 to capture high-quality images of the front and back of the eye.</div>
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<div id="text" style="font-size: 13px;">
 Researchers
 at the Stanford University School of Medicine have developed two 
inexpensive adapters that enable a smartphone to capture high-quality 
images of the front and back of the eye. The adapters make it easy for 
anyone with minimal training to take a picture of the eye and share it 
securely with other health practitioners or store it in the patient's 
electronic record.<br />
 "Think Instagram for the eye," said one of the developers, assistant professor of ophthalmology Robert Chang, MD.<br />
 The
 researchers see this technology as an opportunity to increase access to
 eye-care services as well as to improve the ability to advise on 
patient care remotely.<br />
 Ophthalmology resident David Myung, MD, 
PhD, lead author of two upcoming papers describing the development and 
clinical experience with the devices, began the project with Chang about
 two years ago, just before Myung began his residency at Stanford. The 
papers were published online March 7 in the <em>Journal of Mobile Technology in Medicine</em>.<br />
 The
 standard equipment used to photograph the eye is expensive -- costing 
up to tens of thousands of dollars -- and requires extensive training to
 use properly. Primary care physicians and emergency department staff 
often lack this equipment, and although it is readily available in 
ophthalmologists' offices, it is sparse in rural areas throughout the 
world.<br />
 <strong>Improved care</strong><br />
 "Adapting 
smartphones for the eye has the potential to revolutionize the delivery 
of eye care -- in particular, to provide it in places where it's less 
accessible," said Myung. "Whether it's in the emergency department, 
where patients often have to wait a long time for a specialist, or 
during a primary-care physician visit, this new workflow will improve 
the quality of care for our patients, especially in the developing world
 where ophthalmologists are few and far between.<br />
 "A picture is 
truly worth a thousand words," he added. "Imagine a car accident victim 
arriving in the emergency department with an eye injury resulting in a 
hyphema -- blood inside the front of her eye. Normally the physician 
would have to describe this finding in her electronic record with words 
alone. Smartphones today not only have the camera resolution to 
supplement those words with a high-resolution photo, but also the 
data-transfer capability to upload that photo securely to the medical 
record in a matter of seconds.<br />
 Chang, who is the senior author of
 the two papers, added that ophthalmology is a highly image-oriented 
field. "With smartphone cameras now everywhere, and a small, inexpensive
 attachment that helps the ancillary health-care staff to take a picture
 needed for an eye consultation, we should be able to lower the barrier 
to tele-ophthalmology," he said.<br />
 Adapters are available to attach
 a smartphone to a slit lamp -- a microscope with an adjustable, 
high-intensity light -- to capture images of the front of the eye. But 
Myung found this process time-consuming and inconvenient, even with 
commercially available adapters designed for this purpose. Given the 
fast pace of patient care, he wanted point-and-shoot ability in seconds,
 not minutes, with instant upload to a secure server. More importantly, 
the team envisioned the device to be readily usable by any health-care 
practitioner, not just eye doctors. So Myung decided to bypass the slit 
lamp, a complicated piece of equipment.<br />
 "I started entertaining 
the idea of a pocket-sized adapter that makes the phone do most of the 
heavy lifting," he said. After numerous iterations, he found a 
combination of magnification and lighting elements that worked.<br />
 <strong>Using 'Legos'</strong><br />
 "It
 took some time to figure out how to mount the lens and lighting 
elements to the phone in an efficient yet effective way," said Myung, 
who built the prototypes with inexpensive parts purchased almost 
exclusively online, including plastic caps, plastic spacers, LEDs, 
switches, universal mounts, macrolenses and even a handful of Legos.<br />
 After
 successfully imaging the front of the eye, he then focused on 
visualizing the inside lining of the back of the eye, called the retina.
 "Taking a photo of the retina is harder because you need to focus light
 through the pupil to reach inside the eye," said Myung.<br />
 To 
optimize the view through a dilated pupil, Myung used optics theory to 
determine the perfect working distance and lighting conditions for a 
simple adapter that connects a conventional examination lens to a phone.
 Myung and chief ophthalmology resident Lisa He, MD, shot hundreds of 
photos with various iterations of the adapter, consulting with Chang and
 Mark Blumenkranz, MD, retina specialist and chair of the ophthalmology 
department, until they got it right. Then Stanford mechanical 
engineering graduate student Alexandre Jais constructed computerized 
models of these "screwed-and-glued" prototypes to produce 3D-printed 
versions. Jais made the first of these prototypes on his own 3D printer 
before moving to the Stanford Product Realization Lab to manufacture 
higher-resolution adapters.<br />
 Chief resident He is leading a 
clinical study grading the quality of images taken using the adapters in
 the Stanford emergency department. A second study, spearheaded by 
resident Brian Toy, MD, will test the ability of the adapters to track 
eye disease in patients with diabetes.<br />
 Myung and Chang have 
recently been awarded seed grants from the School of Medicine and the 
Stanford Biodesign Program to fund the production of the initial batch 
of adapters, currently dubbed EyeGo, for distribution and continued 
evaluation. The initial adapters will be available for purchase for 
research purposes only while the team seeks guidance from the Food and 
Drug Administration. "We have gotten the production cost of each type of
 adapter to under $90 but the goal is to make it even lower in the 
future," Chang said. Recently, a team from the University of Melbourne 
in Australia used the two adapters on a medical mission trip to Ethiopia
 and told Chang they were excited about the results.<br />
 Myung, 
Chang, Jais and He co-authored both articles and Blumenkranz co-authored
 the article on the retinal-imaging adapter. Stanford's Office of 
Technology and Licensing is managing the intellectual property.<br />
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 <div id="story_source">
 <strong>Story Source:</strong><br />
 The above story is based on materials provided by <strong>Stanford University Medical Center</strong>. The original article was written by Rosanne Spector. <em>Note: Materials may be edited for content and length.</em><br />
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 :::::::::::::Sciencedaily.com::::::::::::::::::::</div>
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Smartphones become 'eye-phones' with low-cost devices

Smartphones become 'eye-phones' with low-cost devices Date: March 7, 2014 Source: Stanford University Medical Center Sum...