Introduction

Use of smart phone for imaging the fundus has been a technique which has taken the world by storm. Initially only the expensive iPhones¹ could be used but since the advent of good quality android phones with high resolution camera, fundus imaging is now literally at everybody’s finger tips. These smart phones have been used for indirect ophthalmoscopy, direct ophthalmoscopy and anterior segment imaging   For Indirect ophthalmoscopy, only a condensing lens is required apart from the mobile phone. For direct ophthalmoscopy an LED light source is attached to the mobile phone close to the camera².

In the technique described by Nazari et al ³the smart phone fundus imaging was done with a condensing lens in one hand and a smart phone in other hand. This was similar to the technique described by Shanmugham et al and Lord et al^1,2. In all these techniques high amount of precision and hand coordination was required so it was a challenge for many. To maintain alignment between the smart phone and the condensing lens the need for a structural support was recognized.⁴ These were provided either by PVC pipes, plastic bottles or plastic arm made using 3D printing technology in the later innovations. These were glued to a mobile cover on one side and a condensing lens fixed to the other end.^4-6

This article is about a fundus camera built indigenously by the students and house surgeons posted in department of Ophthalmology of Government Medical College, Kozhikode, Kerala.

The traditional hand held fundus camera which have been described innumerable times in various journals and during conferences was modified to suit the multifarious requirements in a teaching hospital.^3-5This camera could be made and used by ophthalmologists, post graduate students, house surgeons and even undergraduate students with some amount of training.

1. Lord RK, Shah VA, Filippo ANS, Krishna R. Novel Uses of Smartphones in Ophthalmology. Ophthalmology [Internet]. 2010 Jun 1 [cited 2020 May 17];117(6):1274-1274.e3. Available from: https://www.aaojournal.org/article/S0161-6420(10)00002-3/abstract
2. Shanmugam M, Mishra D, Madhukumar R, Ramanjulu R, Reddy S, Rodrigues G. Fundus imaging with a mobile phone: A review of techniques. Indian J Ophthalmol. 2014 Sep 1;62:960–2.
3. Nazari Khanamiri H, Nakatsuka A, El-Annan J. Smartphone Fundus Photography. J Vis Exp JoVE [Internet]. 2017 Jul 6 [cited 2020 May 5];(125). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5609317/
4. Chandrakanth P, Ravichandran R, Nischal NG, Subhashini M. Trash to treasure Retcam. Indian J Ophthalmol [Internet]. 2019 Apr [cited 2020 May 5];67(4):541–4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446627/
5. Raju B, Raju NSD, Akkara JD, Pathengay A. Do it yourself smartphone fundus camera – DIYretCAM. Indian J Ophthalmol [Internet]. 2016 Sep 1 [cited 2020 May 5];64(9):663. Available from: http://www.ijo.in/article.asp?issn=0301-4738;year=2016;volume=64;issue=9;spage=663;epage=667;aulast=Raju;type=0
6. 3D Printed Smartphone Indirect Lens Adapter for Rapid, High Quality Retinal Imaging | Journal of Mobile Technology in Medicine [Internet]. [cited 2020 May 17]. Available from: https://www.journalmtm.com/2014/3d-printed-smartphone-indirect-lens-adapter-for-rapid-high-quality-retinal-imaging/
7. Adam MK, Brady CJ, Flowers AM, Juhn AT, Hsu J, Garg SJ, et al. Quality and Diagnostic Utility of Mydriatic Smartphone Photography: The Smartphone Ophthalmoscopy Reliability Trial. Ophthalmic Surg Lasers Imaging Retina. 2015 Jun;46(6):631–7.
8. Bolster NM, Giardini ME, Bastawrous A. The Diabetic Retinopathy Screening Workflow. J Diabetes Sci Technol [Internet]. 2015 Nov 23 [cited 2020 May 17];10(2):318–24. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4773975/
9. Raju B, Raju NSD, Akkara JD, Pathengay A. Smartphone-based fundus documentation in retinopathy of prematurity. Indian J Ophthalmol. 2019;67(11):1909.

Dr Silni Chandra

Assistant Professor, Department of Ophthalmology, Government Medical College, Kozhikode, 673008