Smartphone displays may possibly now be good enough to enable ophthalmologists to diagnose patients even when they are away from their base hospital. But there does look to be a key limitation in the analysis that indicates some conclusions offered by third parties might not be very as they seem.
There have been suggestions in response to the research that it could be feasible for emergency area staff to take a photo of a patient’s eye on a smartphone, transmit it to a remote specialist, and await a diagnosis. That could be beneficial for ER departments that don’t constantly have an ophthalmologist on hand.
The issue is that in impact the study, carried out at Emory University in Atlanta, merely examined the high quality of the display on the iPhone, not the phone camera itself. (Sadly it was the 3G model, which means no room for gags about the retina display.)
Dr Valerie Biousse and colleagues utilised ocular cameras to take photographs of the interior of the eyes of 350 patients who had reported troubles potentially associated to the eye. They then asked two ophthalmologists to examine the photos on a “typical” desktop laptop or computer, rating the high quality from a single to five. They had been then asked to do the very same job six weeks later with a random choice of 100 of the pictures, this time displayed on an iPhone 3G.
One particular ophthalmologist stated the desktop photo was better top quality in one situation, the two were equally good in 53 instances, and the iPhone photo superior in 46 cases. The other ophthalmologist favored the desktop image twice, rated them equally 56 times and preferred the iPhone picture 42 instances.
The researchers concluded that they believed this was “because the rewards of the iPhone’s display (eg, greater dot pitch and brightness) outweighed its disadvantages (eg, lower resolution and smaller screen spot).
There are some clear limitations here, and not just the restricted scope of what was being examined. We don’t know the quality of the display on the desktop monitor — an opthalmologist who expects to get a lot of images sent for remote diagnosis would certainly invest in a high-resolution screen.
We also only know which photos the opthalmologist preferred. Even though the answer may effectively be the same in most situations, the study didn’t attempt to locate out which photographs allowed the most precise diagnosis.
But the biggest limitation is that this only covers one particular side of the story. The study was in no way attempting to look at the high quality of photographs taken on a smartphone camera rather than specialist healthcare equipment. It also didn’t examine the practicalities of transferring an image from an ocular camera to a smartphone or laptop or computer for transmission to the opthalmologist’s phone.
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