Vision problems in newborns are easily detected — and easily explained to parents — with smartphone app

BUFFALO, N.Y. — Researchers at the University at Buffalo School of Medicine and Biomedical Sciences have successfully used a smartphone app to image the back of the eye, or fundus, in patients who can be particularly challenging to examine: newborn babies and children.  

The iExaminer adapter, developed and marketed by WelchAllyn, allows the UB researchers to combine the PanOptic ophthalmoscope, a portable lighted instrument used to look inside the eye, with iPhone technology to instantly take photos and videos of the fundus.

The findings were presented earlier this week by the UB researchers in a poster session and at a news conference at the annual meeting of the American Academy of Ophthalmology in Chicago.  

Conventional fundus cameras, which typically accommodate adult patients, are expensive and generally only available in specialized eye clinics.  

“Our group aimed to investigate an alternate method of fundus imaging to better serve patients who may be too young or too ill to hold a position for the traditional cameras,” explains Jiaxi Ding, MD, a UB medical resident in the Department of Ophthalmology and UB’s Ross Eye Institute. She and fellow researcher Matthew S. Pihlblad, MD, clinical assistant professor, Department of Ophthalmology, focused their project on 28 pediatric patients in their clinic and at Women and Children’s Hospital of Buffalo.

“As you can imagine, children are often the most challenging subjects to image,” says Ding. “The children we studied ranged from healthy, hyper-energetic kids to medically fragile infants in intensive care units. We were able to capture a diverse range of retinal and optic nerve findings.”

One example is retinopathy of prematurity, or ROP. “ROP is an eye disease that can lead to vision loss in premature babies for which laser treatment may be appropriate,” says Ding.

“Imagine trying to explain to a tiny newborn’s nervous parents that urgent, sight-saving laser treatment is needed,” she says. “In that moment, it would be so powerful to show them a photo taken at the bedside to show them what we as doctors see. That’s what we can do with the iExaminer system.”

Pihlblad agrees: “The old saying of a picture is worth a thousand words rings true in this situation. I work with my ophthalmology residents on a daily basis, along with rotating medical students and family medicine residents.  The iExaminer is extremely useful for educating patients, parents, residents and students, as well as for providing medical documentation that helps with follow-up on these patients.”

International attendees at the AAO meeting were especially interested in the UB findings. “Our poster received significant interest from colleagues in India, Korea and other countries where they may not have as much access as we do to the most sophisticated ophthalmic equipment,” says Ding. “The iExaminer system provides an alternative measure for them to obtain inexpensive and good-quality imaging at the bedside.”

The system can capture key structures at the back of the eye in a single view without necessarily needing drops to dilate the eye.

“That makes it an attractive option for non-specialized eye care by physicians in the emergency department and primary care doctors,” Pihlblad explains.   

The iPhone technology also enables instant electronic transmission of images and consultation between physicians via telemedicine, and facilitates capturing, storing and transferring collected data.

The UB researchers were funded by an unrestricted grant from Research to Prevent Blindness to the UB Department of Ophthalmology.