The smartphone is entering nearly every field of medicine, and ophthalmology is no exception. Given how many eye emergencies we handle, it's surprising we haven't incorporated detailed eye exam images into our daily practice, though I believe this is more because of HIPAA than a lack of available tools. Not only would it be good practice and valuable to a medical and legal record, but a good retinal image could motivate patients, like diabetics, to change dangerous habits.
One tool fresh on the market is the D-EYE portable retinal imaging system ($450), a smartphone clip-on device that turns it into a powerful and easy-to-use fundus camera. D-EYE has a 20-degree field of view and blocks corneal glare. D-EYE's HIPAA-compliant ImageVault, available later this year, will offer cloud-based storage and the ability to share images, but what would be more useful is an easy way to send images into an EMR.
Welch Allyn offers a similar product called the iExaminer system ($750), which is comprised of a PanOptic, an iPhone case adapter (iPhone 4/4s), and an app. The PanOptic does have a wider field of view (25 degrees) and other benefits relative to the D-EYE system, like a cobalt blue filter for diagnosing corneal injuries.
Yet another (and cheaper) alternative is to hold your smartphone in one hand and a 20D lens ($300 online) in the other, and use an app such as Filmic Pro, which allows you to control focus, exposure, and light intensity, to perform high-quality fundus photography. The technique is well described in a Journal of Ophthalmology article. (2013;2013:518479; http://goo.gl/fn5PFa.)
The missing link, as I mentioned, is an easy and HIPAA-compliant mechanism to send images from your smartphone to an EMR, and connect the image directly to a specific ED chart. Direct message me on Twitter @amohseni if you know of such a system!
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