Smartphone Applications as Cost-Effective Solutions for Retinal Imaging in Low Resource Settings

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Mbarara University & Referral Hospital Eye Centre (MURHEC) was made possible by support from the EU and Sightsavers International

During a recent visit with the Ophthalmology Faculty at Mbarara University & Referral Eye Centre (MURHEC), Dr. Shizuo Mukai and retina fellow Dr. Cynthia Qian (Mass Eye and Ear) demonstrated how smartphone applications can be used as clinical diagnostic tools, instantly accessible educational resources, and cost-effective substitutions for obtaining diagnostic quality retinal images.

Retina image taken by Dr. Cynthia Qian during clinic in Mbarara

Retina image taken by Dr. Cynthia Qian during clinic in Mbarara

While retinal/fundus photography is an essential element of any ophthalmology practice, the high cost of fundus cameras (tens to hundreds of thousand dollars US) make them out of the reach for many programs.  For the past several years, Dr. Shizuo Mukai and a contingent of other ophthalmologists and MIT engineers have explored techniques to duplicate fundus photography without the use of a fundus camera.  Fortunately, the proximity of camera lens and light source in smartphones are similar to the combination of optics and illumination required for high-quality image acquisition and have been shown to produce consistently high-quality fundus photographs in patients when .  Dr. Mukai’s solution is aimed at simplicity and accessibility, preferring the use of a 20D lens common to the majority of opthalmic practices (Mbarara’s program has 1) rather than an additional hardware device.

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MEEI Fellow Cynthia Qian working with MURHEC residents and faculty (Dr. Simon Arunga) on using smartphones as tools in ophthalmic clinical practice.

MURHEC Faculty and Residents as well as ophthalmologists from the private not-for-profit Ruharo Eye Centre attended Drs. Mukai and Qian’s hands-on demonstration of how to use the before-mentioned smartphone application and lens to take retina images and additional lectures on retina topics.  Ruharo Eye Centre has been an educational partner to MURHEC, providing additional support to its residency program through its current greater clinical and surgical load and trained staff (several of which are graduates of the MUST MMed program).  Before departing, Dr. Mukai presented Dr. Amos Twinamasiko, Head of the Department of Ophthalmology at Mbarara University of Science and Technology and Director of MURHEC, with a donated smartphone to support continued clinical imaging.

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Dr. Amos Twinamasiko receives a smartphone on behalf of MURHEC from Dr. Shizuo Mukai (Mass Eye and Ear)

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Retinal image taken by MURHEC ophthalmologists using a smartphone and 20D lens

Since their departure, Dr. Shizuo Mukai and Dr. Cynthia Qian have continued to received retina images taken by Dr. Simon Arunga and his colleagues and discussions are ongoing as to a potential research collaboration.

For reference, please see 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. doi: 10.1155/2013/518479. Epub 2013 Sep 19.

 

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