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Research Letter |

Novel Telemedicine Device for Diagnosis of Corneal Abrasions and Ulcers in Resource-Poor Settings

Robi N. Maamari, MD1; Somsanguan Ausayakhun, MD2; Todd P. Margolis, MD, PhD1; Daniel A. Fletcher, PhD3; Jeremy D. Keenan, MD, MPH1
[+] Author Affiliations
1Francis I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco
2Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
3Department of Bioengineering and Biophysics Program, University of California, Berkeley
JAMA Ophthalmol. 2014;132(7):894-895. doi:10.1001/jamaophthalmol.2014.335.
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Corneal ulcers are a significant cause of corneal blindness worldwide.1 Normally, traumatic corneal damage and secondary infections are diagnosed by an ophthalmologist via slitlamp examination. However, limited health care resources in developing regions may delay diagnosis and treatment, increasing the risk of vision loss.2 Mobile phones are widely available even in resource-limited settings and therefore could potentially be used to aid in diagnosis of corneal pathology.3 Herein, we describe and test a custom-made smartphone attachment that allows diagnosis of corneal epithelial defects with a smartphone.

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Figure 1.
Diagram and Photograph of the Corneal CellScope Device

A, Schematic illustration of the smartphone attachment for corneal imaging. Fluorescein photographs are taken with blue light-emitting diodes (LEDs) and a fluorescence filter that passes only light emitted from a fluorescein-stained defect. White-light photographs are taken with white LEDs without a filter. B, Photograph of the fluorescein smartphone attachment. To use, the device is positioned so that the ridge shown in the photograph rests on the orbital rim of the patient.

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Figure 2.
Corneal Photographs of Participants Diagnosed as Having an Epithelial Defect by the On-Site Ophthalmologist

Photographs of the 6 participants found to have epithelial defects (arrowheads), taken with the white-light smartphone attachment (left) and the fluorescein smartphone attachment (right). When viewed as a pair, all 3 graders correctly identified the epithelial defects in A through E and 1 grader correctly identified the epithelial defect in F.

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