portable devices in ophthalmology

by Enrique Gambra, CTO at 2EyesVision

The most common image we have of an ophthalmology device is probably a relatively large desktop instrument with a chin and a front rest for patient stability and a joystick to align the patient with the system.

Example of an ophthalmology device

However, in the last years there has been a considerable development of new instruments enabled by new technologies and driven by two main market needs: telemedicine, which has been accelerated by COVID-19 pandemics, and access to rural areas or emergency situations. In both cases, there is a clear need in the clinical practice of new devices that are portable, low-cost and easy-to-use to evaluate vision. A basic set would contain a phoropter or autorefractor, a portable slit lamp, a fundus camera and a tonometer, but the current offer of portable instruments also include corneal topographers, OCTs, wavefront aberrometers or electroretinogram devices.

Clinician using a handheld slit lamp in the Vision Van, a mobile ophthalmic outpatient clinic, in the Great East Japan Earthquake (source)

​The benefits of portable devices can also be applied to regular office practice. This type of devices usually has a lower cost, require smaller space in the clinic, and many of them are handheld, what can facilitate use in patients with reduced mobility. Other approaches to portable devices include head-mounted devices and technologies based on mobile phones or tablets.

On the other hand, portability introduces a higher risk of damaging the unit, and alignment becomes an even more critical feature. Manufacturers must therefore concentrate in delivering a very robust product with special emphasis on algorithms that help the clinician in achieving the proper alignment.

Within IMCUSTOMEYE project, we are developing new technologies and devices for the Ophthalmic and Optometric practice. The first of the technologies is based on Optical Coherence Tomography (OCT) and will evaluate biomechanical properties of the cornea to diagnose corneal abnormalities. This technology is highly sophisticated, with stronger requirements on eye alignment stability, so the final product is expected to be a desktop device. The second technology attempts to detect the presence of corneal abnormalities and refer the patient to the ophthalmologist. This device is expected to be portable to facilitate its use in any environment for screening purposes.