Smartphone co-aided cobalt blue anterior segment with intraocular lens photography

Abstract

In this report, we have utilized a smartphone-based innovative tool named anterior segment photography with an intraocular lens (ASPI) with a cobalt blue filter on the smartphone flash for photographing fluorescein-stained corneas. An intraocular lens along with a cobalt blue filter was attached to the smartphone camera to achieve this purpose. The filter could block out all wavelengths of light except the blue wavelength (450-490 nm) emerging from the smartphone camera. A pilot study was conducted on 27 eyes of 25 patients where images of various corneal pathologies were obtained using ASPI blue light imaging. The images were clear and highly magnified and could be used for documentation, teleconsultation for expert opinion, education, and monitoring of disease progression. ASPI-aided blue light imaging could be easily fabricated and is a frugal inexpensive device, which is used by different ophthalmic personnel to obtain fluorescein-stained corneal images.

Keywords: Anterior segment smartphone photography; cobalt blue filter; intraocular lens; ocular surface disease.

Figure 1

Materials required for the preparation of ASPI blue light imaging i. Black chart paper, ii. Double-sided tape, iii. Acrylic blue filter (450–490 nm) iv. Paper puncher, v. Measuring scale, vi. Scalpel, vii. PMMA rigid intraocular lens (15D), viii. Micropore, ix. Smartphone with the peripheral camera (iPhone 5s) and center camera (One Plus 6T)

Figure 2

(a) Black chart paper of 1 cm × 8 cm with dotted line blue (guide-lines) and red (fold line); (b) Double-sided tape stuck to the chart paper; (c) Measuring the distance between the center of the camera and the center of the flashlight to calculate the distance of the hole on the chart paper to be created; (d) Holes created with paper puncher; (e) Double-sided tape peeled and IOL placed; (f) Chart paper folded at the red fold line and acrylic blue filter placed on chart paper; (g) Attachment of micropore on the chart paper; (h) Attachment of the chart paper to the smartphone

Figure 3

(a-d) Series of screenshots from a video demonstrating positive Seidel’s test; (e) ASPI-blue light imaging device on a peripheral camera; (f) ASPI-blue light imaging device on a central camera; (g and h) Demonstration of ASPI-blue light imaging on a patient

Figure 4

Photographs of various corneal pathologies captured using ASPI blue light imaging (a). Diffuse punctate epithelial erosions due to the dry eye; (b) Inferior punctate epithelial erosion due to lid-related pathology; (c) Bulbar conjunctival staining in Steven–Johnson syndrome; (d) Large epithelial defect; (e) The epithelial component of graft rejection; (f) Recurrent dendritic viral keratitis with surrounding scars; (g) Filamentary keratitis; (h) Total epithelial defect with suture on postoperative day 1 - status post penetrating keratoplasty