Eyeworld

85 EW IN OTHER NEWS July 2015 by Hong Sheng Chiong, MB, BCh, BAO for diagnostic, screening, and tele- consultation purposes. Our team came up with a development plan with 3 main objectives: affordability, accessibility, and accuracy. Affordability is easily achieved by using low cost material and plas- tic optical lenses. For accuracy, we are running a pilot trial comparing retinal images taken with the device to those of a standard fundus camera. Initial re- sults are promising; common retinal diseases such as diabetic retinopathy, retinal detachment, and macular degeneration can be detected with the device. However, accessibility remains a challenge. We wanted to create a device that could potentially reach thousands, if not millions, of health- care providers around the world, especially those living in developing countries where financial constraints limit access to conventional oph- thalmic diagnostic equipment. We had been looking for a medical project that could do that with minimal cost. There was none. So we started looking at projects out of the medical field as part of our lateral thinking sessions. We found Google Cardboard. Google Card- board is a project backed by Google (Mountain View, Calif.) with the aim of making virtual reality some- thing that everyone can enjoy and experience. The blueprint is avail- able online, and anyone can make First open source smartphone retinal imaging device released "W iki" describes online open collaboration. It is a concept almost always associated with software and online encyclopedia, such as Wikipedia. Never did I imagine that my team would apply the same principle in the field of ophthalmology. On May 8, the first open source smartphone retinal imaging device, known as OphthalmicDocs Fundus, was released online. Ophthalmic- Docs Fundus is a 3D printable adapt- er designed to convert a smartphone into a retinal camera capable of achieving up to a 40-degree view of field. It is an online open source ini- tiative designed by our team to fight preventable blindness by providing free and affordable ophthalmic equipment in developing countries. Because it is an open source project, files are freely available to anyone. Within the first 4 weeks of launch, the device was downloaded 3,000 times, with 80,000 people flocking to the site. How it started It all started more than a year ago. We wanted to create an affordable fundus camera that could be used The Wiki of ophthalmology? The first open source smartphone retinal imaging device, the OphthalmicDocs Fundus continued on page 86 The OphthalmicDocs Fundus shown attached to a smartphone one. The specifications and drawings are freely available so manufacturers can mass produce them. If you don't have the time to make one, all you have to do is buy one online; Google Cardboard is sold between $3 and $8 each. We loved the concept. We applied the same principle to our first project, the OphthalmicDocs Fundus. The device requires a smart- phone and a 20 D lens. We have chosen the 20 D lens as it is one of the most widely available lenses in any eye clinic in the world. The soft- copy of the blueprint is made freely available online. We wanted to take it a step further, making it an open- source project. Anyone with knowl- edge in 3D designs can download the blueprint for modification and improvement and resubmit it back to the community. The final designs are stream- lined for 3D printing. Anyone could download the files and 3D print a fundus camera locally. The problem with access to a 3D printer is solved by an online 3D printing communi- ty known as 3D Hubs, where more than 18,000 3D printers are connect- ed worldwide. A healthcare provider could choose a 3D printer nearest to his or her location and have it printed locally. Mobile app Seeing the success of the first device, we applied the same principle to a mobile app. OphthDocs Eye App was born. It is an open source mul- tifunction app that offers electronic patient medical records, a large variety of vision tests, and ocular image acquisition modes. With an app and a couple of external adapt- ers, a healthcare provider will have the entire eye clinic in the palm of his hand. It may not mean much to an ophthalmologist who is already well equipped, but for a primary care physician, this means a lot. Being able to perform all the basic eye examinations accurately in a non- eye clinic setting gives the physician a huge advantage. The ability to photo-document the ocular disease makes it even easier when seeking consultation. This may well be a disruptive innovation in the field of ophthal- mology applied not just to software but to hardware and equipment. The next wave of open source innova- tion is coming, and that includes other diagnostic eye tools such as the perimeter, slit lamp microscope, OCT scan, and corneal topographer. Because the system is used in conjunction with a smartphone, it also shares access to the camera, telecommunication, and wireless transmission capabilities, making it an ideal tool for telemedicine. This proven concept may well be a

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