The Revolution of Handheld Imaging Devices in Eye Care

Introduction

In the field of ophthalmology, handheld imaging devices for the eyes have been a significant innovation. These portable devices can be used to screen various diseases, be it cataract retinal diseases, infections of the anterior segment of the eye, refractive error, or visual field loss. With these devices, ophthalmic screenings could become decentralized, bringing them closer to the patient’s context, such as public health centers and primary care clinics, and even at the convenience of one’s home. Due to their compact nature, these devices offer portability, enabling easy screening and examination of eyes in diverse settings. This approach allows for the early detection of eye conditions and enhances accessibility. This would ensure that eye care remains affordable in this era of financial strain.

How Do Handheld Imaging Devices Benefit Eye Care?

Several benefits can be charted when the two get compared; handheld devices are:

• Portable: Can be easily carried even in remote and unreserved areas.

• Accessible: People who might face geographical barriers could be accessed easily.

• Efficient: Rapid and efficient examination can be done.

• Timelessness: As timely intervention is necessary in preventing and treating various diseases of the eyes, it remains valuable that way.

• Non-invasive: Ensures the patient's comfort.

• Real-time Imaging: The conditions could be diagnosed and observed on the spot.

• Diagnostics.

• Remote Monitoring: It could be used in any pandemic situation.

• Telemedicine: For remote consultations.

• Integration of AI: Complex data can be easily interpreted as AI algorithms could help in better image analysis.

• Cost-effectiveness.

• Patient engagement.

• Patient education.

Why Is There a Need for Handheld Imaging Devices in Eye Care?

It is estimated that about 2.2 billion people are affected worldwide due to visual impairment, as estimated by the WHO. It is well known that at least half of it could be treated and prevented if an earlier diagnosis is made. An increase in visual impairment has been seen with a rise in age, change in lifestyle, and the challenges faced by the healthcare specialist. The most challenging part is the shortage of trained eye care specialists who screen, diagnose, and treat the disease. This remains a critical problem for those conditions that remain asymptomatic in the early disease stage and, without treatment, would lead to permanent loss of eyesight. These portable devices come with low cost, portability, and ease of use relative to conventional instruments.

What Are the Types of Handheld Imaging Devices in Eye Care?

• Remidio Fop NM10 Portable Fundus Camera: These devices have become very sophisticated and can capture retina images with a 45-degree field of view. These could also be used in slit lamps and provide images equivalent to a retina desktop. It is infrared enabled. Within 10 seconds, it can screen for the presence of diabetic retinopathy using an offline AI algorithm.

• Remidio Vistaro: It is smartphone-based, a mydriatic, and a wide-field imaging device. It can help screen diseases beyond the posterior pole in a single shot. It can provide the equivalent of the traditional seven-field ETDRS image. It also gives a view that would extend beyond 60 degrees.

• MAESTRO2 Automated Oct/Fundus Camera With Octa: A fully automatic OCT system that can capture a color fundus image OCTA and OCT in a single button in an undilated eye. During subsequent visits, it allows for follow-up feature scans offering high precision and exact location. It further decreases the dependency on highly skilled technicians and shows clinic efficacy. An inter and intra-photographer viability is delivered between follow-up visits.

• Ophthalmoscopes: To directly visualize the retina and other structures at the back of the eyes, to mainly examine and screen the eye initially.

• Handheld Retinal Scanners: These are portable and use lasers to scan the retina. One such device is the ZEISS VISUSCOUT 100, a hand-held retinal fundus camera, allowing retinal imaging and wireless flexibility wherever needed. Retinal conditions like diabetic retinopathy, glaucoma, and macular degeneration can be documented and checked. Another such device, Optomed Aurora, is a handheld and mobile camera that could be easily used in a primary care setting to screen retinal problems.

• Handheld Optical Coherence Tomography (OCT) Devices: Based on photonic integrated circuit technology, the handheld OCT offers a system in the wavelength of about 1060 nm wavelength, offering optimum tissue penetration and step changes in imaging performance, with size and cost beyond state of the art. It is expected to contribute significantly to point-of-care diagnostics- for newborns, the elderly, and home remote diagnosis. It comes to reduce patient outcomes and healthcare costs.

• Handheld Tonometers: Used for measuring the intraocular pressure (IOP) and is an important indicator of glaucoma. These are portable devices and are handheld. One such device is the Tono Pen AVIA, a hand-held tonometer, which is readily usable and accessible for calibration.

• Handheld Autorefractors: Refractors determine how the light gets reflected through the eyeball. The handheld ones are portable, lightweight, and very easy to use. Two examples are plenOptika Quicksee Free and Quicksee Free Pro, which provide painless and accurate measurements.

• Handheld Pachymeter: Used to measure corneal thickness to plan surgeries and treat glaucoma. The Reichert iPac is a one-button navigator, the most feature-rich handheld pachymeter.

• Handheld Slit Lamps: For a detailed examination of the anterior eye segment. Used to access corneal abnormalities, cataracts, and anterior eye segments, for example, Remido PSLD20.

What Are The Safety Concerns of Handheld Imaging Devices?

Although these handheld devices are safe and well-tolerated, some safety concerns remain.

• Exposure to Light: Light lasers and bright lights may pose a risk of eye exposure.

• Patient Concern and Cooperation: The proximity to the patient is there, and it might make them feel uncomfortable.

• Infection Control: If not cleaned properly, the handheld devices may be a source of cross-contamination.

• Electrical Safety: The electrical components may be risky if mishandled or improperly maintained.

• Patient-Specific Consideration: An alternative adjuvant may be required in case of pregnancy.

• Data Security and Privacy: This may threaten data security and privacy.

• Device Calibration and Maintenance: The accuracy of results may be affected if the calibration is affected.

Conclusions:

Handheld imaging devices play an important role in advancing eye care by being portable, efficient, and accurate. It enables healthcare professionals to go for timely diagnosis and intervention for various eyes. With the evolution of technology, one can expect greater improvement in outcomes for patients in terms of ophthalmic diagnosis.