Smartphone new tool for emergency department diagnosis
If you already love your smartphone, here's yet another reason to love it even more — it may help your ophthalmologist.
Eye Center investigators have found that smartphone displays are as good, and may be better, for reading fundus photographs of the back of the eye than desktop computer monitors. The new technology application has been an additional finding in a multi-year study examining the use of non-dilated photography of the back of the eye within the emergency department. Emory researchers published this more recent finding in the "Research Letters," Archives of Ophthalmology, July 2012.
The findings follow up on the study: "Quality of non-mydriatic digital fundus photography obtained by nurse practitioners in the emergency department" (Ophthalmology, March 2012). The method studied allows specialized consultations within the emergency department that would not have otherwise been obtainable. Emergency rooms, of course, do not have "in-house" ophthalmologists, so having the ability to send readily-obtained photographs of the back of the eye, taken by nurse practitioners, to an ophthalmologist outside the hospital setting can be a critical tool that expedites patient care. It helps emergency room practitioners assess the severity of their patients' medical conditions almost immediately and allows them information to decide when further ophthalmological consultation is necessary.
"We expected equal- or lower-quality images displayed on the iPhone compared with the desktop computer, but instead found that the iPhone images seem to be superior despite their small size and lower resolution," says Beau Bruce, a neuro-ophthalmologist at Emory Eye Center. "We believe that the phone's higher resolution and brightness helped. This finding warrants further investigation, and should enable smartphones of all types to be used in a telemedicine network."
Because of the prevalence of smartphone technology, the ready access of obvious high-quality images joins the many other applications of smartphones within medicine, such as electronic medical records, books, guidelines and other diagnostic tools. Their portability can provide access to any ophthalmologist with a smartphone.
The study conducted by Emory titled, "Fundus Photography vs. Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED)," has shown that non-mydriatic digital fundus photography cameras in the emergency department are helpful in triaging patients who come in with headaches, neurological disturbances, visual changes or severe high blood pressure. Emergency room practitioners need a timely and accurate assessment of the patient's condition. Certain conditions can be overlooked when an eye exam is not a part of the overall evaluation. Most patients would not guess that a look inside the eye is what they need for a complete diagnosis.
"The eye is a strong indicator of whole-body health," says Bruce. "Patients who come to us with hypertensive retinopathy, for example, show us how their hypertension is by the condition of their retina.
"Regarding use of the smartphone technology in more subtle conditions such as diabetic retinopathy, we are not suggesting the iPhone or any smartphone be used to screen for these conditions or as a replacement for a patient and doctor consultation," explains Bruce. "Nothing will take the place of a one-on-one exam, particularly for certain conditions."