Over half of the visits to an ophthalmologist are routine eye checkups or post-operation follow-ups. Such in-person visits are necessary to monitor the condition of the patient’s eyes, so the physician can provide appropriate on-time treatment to mitigate damage to a patient’s vision. At each visit, the patient receives a set of routine eye examinations using standard ophthalmic instruments. These large machines are expensive, need to be stored in a controlled environment, and require a trained technician to operate them to conduct the exam. Because of these factors, a visit to an eye clinic can be expensive and time-consuming for a patient. In the case where the patient cannot physically visit the office, the ophthalmologist may call the patient and receive a verbal description of the patient’s eye condition, which often leads to misdiagnosis and costly late treatment. The problems associated with patients being unable to receive appropriate eye examination is made worse by the present COVID-19 pandemic, where everyone must stay at home and comply with the so-called social distancing policy to minimize the spread of the virus. Patients are unable to visit the eye clinic to receive their eye checkups, forcing ophthalmologists to rely on the patient’s verbal description for medical treatment.
To address the growing need for at-home eye monitoring, portable internet-enabled patient point-of-care ophthalmic instruments need to be designed to enable patients to self-examine their eyes in the comfort of their homes. The results from such screening are then forwarded to an ophthalmologist for off-site evaluation. Also, with these internet-enabled ophthalmic devices, patients can remotely connect with the physician to discuss their screening results via the internet. These devices aim to be low-cost, easy-to-use, reliable, and portable. They will replace the complicated to operate and costly to maintain conventional ophthalmic instruments such as the slit lamp, the visual acuity screener, the funduscope, and the tonometer.
The main objective of this master’s thesis is to develop portable internet-enabled ophthalmic instruments that enable users to perform self-monitoring of their eyes. These instruments are a self-imaging slit lamp, a self-screening visual acuity screener, and a compact 2-in-1 goggle tester, capable of performing slit lamp examination and visual acuity screening. The self-imaging slit lamp instrument can automate the slit lamp screening process of the anterior segment of the eye. Slit images are captured and stored via an attached smartphone. Unlike the traditional visual acuity exam, the self-screening visual acuity screener enables the user to perform the test on himself or herself without the need for a test operator to facilitate the screening process.
Moreover, the 2-in-1 goggle allows the user to perform a self-imaging slit lamp exam and receive self-screening visual acuity results from a single compact device. Ophthalmologists are given access to the examination results through secure cloud storage, and they can communicate with patients via the attached smartphone in these devices. Preliminary prototyping of these portable self-examining ophthalmic instruments has demonstrated promising results.