Mobiles for eye care are welcome, but caution needed: RANZCO

However, the use of smartphone apps and adaptors to perform common eye-examination functions such as retinal imaging is both a welcomed innovation but caution is needed.
Their high-resolution photographic capabilities may be of great use in developing countries or rote areas where transporting, or finding, traditional ophthalmic equipment could be a challenge when images taken by such devices are then sent to ophthalmologists for diagnosis, RANZCO said on 4 May.
The devices are as simple as a clip-on camera adaptor that gives high-quality images of the posterior chamber and the retina, combining a traditional ophthalmoscope and a retinal camera in a mobile phone.
The 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 those devices challenge our traditional thinking.
“Many of RANZCO’s ophthalmologists have worked in rural or rote 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 thselves. 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,” Dr Horsburgh said.
“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?” Dr Horsburgh questioned.
RANZCO has a position statent 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 examination, the ophthalmology industry is ready to respond to changing times”, Dr Horsburgh said.