The Use of Innovative Digital Mobile Health Technology for Community Eye Care in Poor Resource Settings

Abstract

The practice of ophthalmology depends largely on ophthalmoscopy and photographic documentation of examination findings from patients. These images are used for patient education, monitoring, storage, expert reviews and treatment. In Africa, due to poor management and poor resources in some health systems, there is a dearth of infrastructure and equipment like fundus cameras. In such resource-poor settings, eye care personnel manage patients with available resources, or improvise with low-cost measures. Smartphone fundoscopy is one of such improvisations. This study describes a novel adapter for smartphone fundoscopy, used in conjunction with a tripod. It was built on existing research on smartphone fundoscopy. Fundus images were captured with a smartphone and a +20D lens, both coupled by an improvised adapter; the Chizaram-Condensing Lens Adapter for Smartphones (C-CLAS) on a tripod. This system works as an indirect ophthalmoscope. Videos of the fundus were recorded, and high-quality still-images were taken from segments of the videos. A total of 54 patients were used in the study, aged between 8 and 74 years. The C-CLAS captured high-quality fundus images from 39 patients (72%), in a variety of normal and pathological conditions. The use of a tripod rendered the procedure hands-free, introducing another dimension to smartphone fundoscopy.