title: Tele-ophthalmology screening for retinal and anterior segment diseases.
abstract: A digital indirect ophthalmoscope (DIO) was developed and tested for use in tele-ophthalmology screening for posterior and anterior segment diseases. Using custom software, images from the DIO were digitized, compressed, stored and transmitted to a centralized eye clinic for interpretation. A total of 43 subjects were primarily screened for glaucoma using the DIO, a hand-held fundus camera and a stereo fundus camera. The photographic slides from the stereo fundus camera used as gold standards. Images (390 x 300 pixels x 3 bits) were stored using a laptop computer together with patient information. Image quality received at the central eye clinic was good and showed adequate diagnostic information. An ophthalmologist estimated cup-disc ratios and graded the quality of the images. The sensitivity and specificity of each instrument was calculated. A high sensitivity and specificity was found when using the DIO, indicating that it could be used in tele-ophthalmic screenings. Further modifications are needed to make the instrument more user-friendly and to enable it to be used with undilated pupils, so that it can be easily operated by health-care personnel in remote areas. The camera can also be used to image gross external eye pathology.
authors.affiliation: Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Australia. yogesan@cyllene.uwa.edu.au
authors.forename: K
authors.initials: K
authors.lastname: Yogesan
authors.forename: M
authors.initials: M
authors.lastname: Cuypers
authors.forename: C J
authors.initials: CJ
authors.lastname: Barry
authors.forename: I J
authors.initials: IJ
authors.lastname: Constable
authors.forename: L
authors.initials: L
authors.lastname: Jitskaia
mesh_terms: D000869:Anterior Eye Segment; D001315:Australia; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation; D005128:Eye Diseases / Q000175:diagnosis*; D006801:Humans; D008875:Middle Aged; D019721:Ophthalmoscopes; D012164:Retinal Diseases / Q000175:diagnosis; D019035:Rural Health Services; D017216:Telemedicine / Q000295:instrumentation*