Just a few years ago the optometrist will take pictures of the anterior segment using a simple “point and shoot” camera and focusing through the slit lamp eyepiece.
Today we have a slit lamp camera adapter that will plug in directly over the eyepiece or will replace it. These compact cameras will also allow you to take videos, which are useful for fundus photography.
We might think that due to the growing popularity and quality improvements on cameras in smartphones, that they are the best option for slit lamp examination , but most of the time it will be faster and more convenient to dedicate a compact camera.
How about Quality?
As this shots taken by Dr Chan Jan Bond show, there is no loss of quality when using an anterior segment camera to document his patients findings. In facet as technology improves and we get closer to the 20 mpx compact digital camera, the quality of the pictures will improve too considerably.
The three pictures at the top are from a smartphone camera and the ones on the bottom from a conventional anterior segment camera.
The picture shows the removal process of a foreign body on a 20 years old patient. The sequence is A) initial presentation, B) post removal or corneal foreign body and C) post removal of rust ring.
You can find a deeper explanation in Dr. Bond’s article
Top 3 advantages of using an anterior segment camera instead of a smartphone
It is advisable to keep the pictures of your patients and family separate.
Would you like to have pictures of your patients’ eyes mixed with the ones of your last family’s vacation? By default the iPhone and Android smartphones will mix all of your pictures in one big folder, unless you take the time to organize them different folders.
The same situation could happen when you are showing pictures to the patient’s family or a colleague and by accident they browse through your personal pictures.
By using a dedicated camera adapter in your slit-lamp eye examination you avoid this unfortunate situation.
One of the issues I’ve found is that in order to transfer the pictures from the camera to the PC, you have to either take out the camera from the adapter to take the memory out, or connect a USB cable from the camera to the PC.
Both of these methods will take time and can be an inconvenience for a doctor with more than just a few patients.
However, a few years ago a new company launched a new technology: WiFi SD Cards http://www.eyefi.com/ .
These memory cards follow the SD cards standards of the market with one main difference: after you take the picture the card will automatic transfer the picture to your PC using your WiFi network.
And even if you don’t have a WiFi network in place it can become a hotspot and your PC will be able to communicate with your camera and still transfer the pictures or video.
This means you will not need to take the memory card out of your camera..ever! Just take the picture and it will show up in your PC.
Once you setup your slit lamp camera adapter and Wifi memory card, you will not need to take the camera out of the adapter. You will only have to slide in the adapter and camera on the slit lamp and take it out after taking the picture.
Compare this with using your smartphone: First you need to take out the protective cover, which is often difficult , attach the phone to the adapter, take the picture or video, take it out of the adapter and place your original cover. It might seem like no big deal, but I’ve seen doctors get frustrated just by taking the cover out of their phones once.
3. Sharing With a Slit Lamp Camera Adapter
The main purpose of these slit lamp camera adapter is to be able to share easily. The camera and smartphone each are able to do this, however for an Optometrist a camera can have the most advantages.
Let’s think about this for a minute; the main purpose of a slit lamp camera is to show and explain the pictures to the patients and/or family, also to further analyze the pictures on a big screen.
The pictures might end in an EMR (Electronic Medical Records) system connected to the PC on the doctor’s office too. So basically we would like both a big Screen to show the pictures and also on the computer.
Both goals can be achieved much more easily with an anterior segment camera than with a smartphone (we are not talking about tablets with large screens). You will need a Eyefi card to do this without taking the camera off the adapter.
As soon as you take the picture, it will be transferred through the wireless network into your PC, then you can show it in high-resolution and will be shared with your EMR simultaneously, to obtain this result you did nothing; you just took the picture.
Any other sharing capabilities can be done through the PC by emailing pictures or uploading to back up servers.
If you want to use a bigger screen you can by connecting the camera to an external monitor, end result you don’t even need a computer to show the pictures.
There are other advantages of using a slit lamp camera adapter instead of a smartphone for your slit lamp pictures. I’ll cover them in future posts.