I’ve been sent a D-Eye to review which is great as I love smart phone gadgets especially medical ones. I just love what people can do with a processor and camera and a few sensors and a UI.
The D-Eye is a clever lens that attaches to your smart phone via a custom bumper case (you have to get the right case for your phone) and allows you to view and capture images of the retina. Fundoscopy as its called is something we do in general practice though to be fair its perhaps less important than it once was.
Historically the most common reason for doing fundoscopy in general practice is screening for damage done by diabetes. I remember as a junior doing clinics that went on for hours staring into peoples eyes looking for damage. We now have diabetic retinopathy screening services that see all these patients so GPs have been deskilled a little – also opticians (who in my opinion are seriously under rated by the public) are very good at examining fundi and often have a retinal camera that take amazing photos and a lot of GPs tend to direct a lot of acute eye problems that might need fundoscopy such as retinal hemorrhages or detachments to them. Some GPs still examine their own and most rooms have an opthalmosope in them. Partly as we often look at the front of the eye as well as the back and also we often check the fundi in patients with hypertension as it can show damage that the BP alone wont tell you has happened.
So most GPs have an opthalmoscope on their desk but I strongly suspect some arent that good at using it and because its a live view the image isnt recorded so you cant do anything with it or show it anyone. Also people dont tend to take their big bulky scopes on home visits.
This is where D-eye comes in. You attach it to your iPhone – having installed and activated their app – and it allows you to use your phone like an opthalmoscope. Its small and portable.
The good news: You can see what you are doing on the screen and its relatively easy to use from an app point of view. Even better a medical student or other person can watch what you are doing and you can show them and explain to them what you are seeing as they see it too. This has always been an issue for teaching opthalmoscopy as there arent any dual view ones available. You can also take video or images of what you are seeing to show others at a later date and there is a built in editor to zoom in and make the image better.
The bad news: its not some super easy replacement that automatically takes an amazing image. You still have to know how to position a patient and how to hold the scope and the image would still benefit from dilating the pupils. The price – its not that cheap – I don’t see it replacing the one on my wall at the surgery and I’m not convinced its cheap enough that everyone will get one for their bags as a spare/second when much cheaper ones old style ones exist. The app also doesn’t connect to my EPR directly though there are work arounds to save the images in it.
My initial conclusions are – its forte may be in teaching others how to do opthalmoscopy. You can see the red reflex and you can show someone how to follow it in and find the optic disc you can take an image of an abnormality and then look at it at leisure.
There may be a role for each practice having one and being able to take an image of a retina and emailing it to a consultant or other for advice. However I wonder if you were to do this properly whether you would invest in a full retinal camera system though as the image quality improvement might be worth it.