Using portable devices to carry out eye checks raises interesting questions around health diagnosis and service provision according to RANZCO, the leaders in eye care.
The use of smartphone apps and adaptors to perform common eye exam functions such as retinal imaging is both a welcomed innovation and a reminder for caution.
Their high-resolution photographic capabilities may be of great use in developing countries or remote areas where transporting, or finding, traditional ophthalmic equipment could be a challenge. Images taken by these devices are then sent to experts – ophthalmologists – for diagnosis.
These devices are as simple as a clip-on camera adaptor that give high quality images of the back of the eye and the retina, combining a traditional ophthalmoscope and a retinal camera in a mobile phone.
President of RANZCO, Dr Bradley Horsburgh, explains the implications. “The eye care industry are innovators and fast adopters of technology to improve the quality of eye diagnosis and treatment. We want our job to be more efficient, and these devices challenge our traditional thinking.
“Many of RANZCO’s ophthalmologists have worked in rural or remote areas, especially overseas. We don’t endorse one specific product over another, but help facilitate eye health awareness through local and affiliated partner organisations. Such devices could bridge the gap between health workers and enable stronger communication and collaboration – all for the patient’s benefit”.
RANZCO ophthalmologists have been heavily involved with the Lions Outback Vision Project in rural Western Australia, in which an app was developed that enables patient bookings and secure image transfer from a GP or eye health worker’s smartphone to the ophthalmologist.
The smartphone can be used to take screen shots, photos of printouts of a patient’s visual field or a printout of an OCT scan.
Dr Horsburgh however cautions against an easy-health-fix mentality if such devices become easily accessible to the public. “Product manufacturers should maintain responsibility in their marketing and distribution according to local laws and guidelines.
“We don’t want the public to be able to make eye health assumptions about images they have taken themselves. An ophthalmologist is best-qualified to make any diagnosis. They can interpret data and images at the most sophisticated level due to their extensive training,” he says.
“There are also issues around patient confidentiality with image sharing from phones. What happens if someone shares an image and then gets a wrong diagnosis? Is there informed consent to share the image? What sort of patient history comes with it?” questions Dr Horsburgh.
RANZCO has a position statement on the use of clinical photographs which covers consent, collection and disclosure, particularly if minors are involved, which adhere to Australian Privacy Principles. The Australian Medical Association has also developed a guideline for clinical images and the use of personal mobile devices.
“It’s an exciting time to see the uptake of new technologies. There are off-the-shelf free apps and customised solutions that you can use on mobile devices and tablets. While portable devices will never be a substitute for a full eye exam, the ophthalmology industry is ready to respond to changing times”, says Dr Horsburgh.
For more information or to arrange an interview contact Luke Vanem or Louise Treloar at RANZCO on 61 426 842 121 and firstname.lastname@example.org