SPOTLIGHT ON TECHNOLOGY & TECHNIQUE

Tiny camera, big results

DigiSight offers a pocket-sized camera for ophthalmologists on the go.

By Robert Stoneback, Associate Editor

Attach the Paxos Scope to a smartphone to take ophthalmic photos.

In the blink of an eye, Raj Rathod, MD, can take and upload retinal photos from anywhere using the DigiSight Paxos Scope.

This past April, while on call at a hospital, an oncology team asked him to document the retinopathy of a 14-year-old boy with leukemia. Before he started using the Paxos Scope in November 2015, that request would not have happened, as there was no easy way of taking pictures while out of his clinic. But the Paxos Scope, an ophthalmic camera that can attach to a smartphone to capture anterior and posterior segment images, has made it much simpler for Dr. Rathod to not only document patient conditions but to share that information with his colleagues and students.

The Paxos Scope app lets physicians take images, then share and store them online.

“I use it almost every day,” says Dr. Rathod, of Orange County Retina, in Santa Ana, Calif.

Dr. Rathod’s clinic regularly takes hospital calls. In these situations, having an easy-to-use, pocket-sized ophthalmic camera has been a significant time-saver for him. These pictures can be uploaded to the Internet using the Paxos Scope’s phone app, where they can be shared with other ophthalmologists.

POCKET-SIZED CAMERA

Before Dr. Rathod began using the Paxos Scope, he did not have a good way of obtaining retinal images at a remote location, since most hospitals lack retinal imaging systems. The only other option, he discovered in a Journal of Ophthalmology article from 2013, was to hold a condensing lens in front of the smartphone camera.¹

“That’s much harder to do because it requires lining things up perfectly to obtain an image,” he says.

With the Paxos Scope, he just needs to attach it to his smartphone, open the camera’s app and take the picture. The Paxos Scope will automatically line up with the eye’s axis and lens, and then focus on the image of the eye. The camera’s static field of view for fundus images can reach 56 degrees, and can switch between taking images of the eye’s anterior segment and retina.

While there are other smartphone ophthalmic cameras on the market, DigiSight states that the Paxos Scope currently markets the largest field of view and is the only one that can capture both anterior and posterior images.

According to DigiSight’s website, the Paxos Scope is compatible with any iPhone or iPod that runs operating system iOS 7 or above.

After the image is taken, it can be labeled as the left or right eye and as an anterior or fundus image. While managing the interface takes a little bit of practice, it’s easier to use than a full ophthalmic camera system, says Dr. Rathod.

Like a more traditional ophthalmic camera, a patient must sit still so the Paxos Scope can obtain the highest-quality images. While the smartphone camera does not have a headrest or chinrest to keep a patient stable, it can take pictures while the subject is upright or lying flat.

And patients with arthritis or who have issues with their neck or spine find posing for the Paxos Scope more comfortable than using the chinrests found on the larger cameras, Dr. Rathod says.

While the image quality is very good on the Paxos Scope, Dr. Rathod doesn’t believe it’s a replacement for a full ophthalmic camera system. The Paxos Scope, for example, does not have as wide an angle lens as those cameras, nor can it conduct certain types of images and tests, such as a fluorescein angiogram.

EASE OF SHARING

Images are sorted based on a patient’s name, which can be selected once the app is started. New patients can also be entered directly into the app. The images assigned to each patient’s file are then saved on DigiSight’s online portal, where they can be transferred to JPEGs to easily share with other professionals.

Dr. Rathod regularly attends talks and seminars where “a picture is worth a thousand words, as they say.” Showing these images of his patients is far more powerful than describing them. “Being able to obtain that quickly and easily is a great benefit,” he adds.

The Paxos Scope would be ideal for outreach programs in rural or poor parts of the United States, and third-world countries, Dr. Rathod says. “That portability is very useful.” OM

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