A Remote Operating Slit Lamp Microscope System

N. Tanabe; K. Go; Y. Sakurada; M. Imasawa; F. Mabuchi; T. Chiba; K. Abe; K. Kashiwagi

doi:10.3414/ME10-01-0064

Methods of Information in Medicine, Table of Contents

Methods Inf Med 2011; 50(05): 427-434
DOI: 10.3414/ME10-01-0064

Original Articles

Schattauer GmbH

A Remote Operating Slit Lamp Microscope System

Development and its Utility in Ophthalmologic Examinations

N. Tanabe

¹Department of Ophthalmology, University of Yamanashi School of Medicine, Chuo, Yamanashi, Japan

,

K. Go

³Department of Computer Media Engineering, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Kofu, Yamanashi, Japan

,

Y. Sakurada

¹Department of Ophthalmology, University of Yamanashi School of Medicine, Chuo, Yamanashi, Japan

,

M. Imasawa

¹Department of Ophthalmology, University of Yamanashi School of Medicine, Chuo, Yamanashi, Japan

,

F. Mabuchi

¹Department of Ophthalmology, University of Yamanashi School of Medicine, Chuo, Yamanashi, Japan

,

T. Chiba

¹Department of Ophthalmology, University of Yamanashi School of Medicine, Chuo, Yamanashi, Japan

,

K. Abe

⁴Department of Ophthalmology, Yamanashi Prefectural Central Hospital, Kofu, Yamanashi, Japan

,

K. Kashiwagi

¹Department of Ophthalmology, University of Yamanashi School of Medicine, Chuo, Yamanashi, Japan

²Department of Community and Family Medicine Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan

› Author Affiliations

Abstract

Summary

Objectives: To develop a remote-operating slit lamp microscope system (the remote slit lamp) as the core for highly specialized ophthalmology diagnoses, and to compare the utility of this system with the conventional slit lamp microscope system (the conventional slit lamp) in making a diagnosis.

Methods: The remote slit lamp system was developed. Three factors were evaluated in comparison to the conventional slit lamp. The ability to acquire skills was investigated using a task loading system among specialists and residents in ophthalmology. Participants repeated a task up to ten times and the time required for each task was analyzed. The consistency of the two systems in making a diagnosis was investigated using eyes of patients with ocular diseases as well as healthy volunteers.

Results: The remote slit lamp is composed of a patient’s unit and ophthalmologist’s unit connected by high-speed internet. The two units share images acquired by the slit lamp in addition to the images and voices of patients and ophthalmologists. Both ophthalmology specialists and residents could minimize the completion times after several trials. The remote slit lamp took more time than the conventional slit lamp. Both systems showed a high consistency in evaluations among eyes with healthy eyes or those with ocular diseases.

Conclusions: The remote slit lamp has a similar diagnostic ability, but required more examination time in comparison to the conventional slit lamp. The currently developed remote slit lamp has the potential to be employed for telemedicine purposes in the field of ophthalmology.

Keywords

Telemedicine - slit-lamp microscope - ophthalmology

Full Text

References

References
1 Bai VT, Murali V, Kim R, Srivatsa SK. Teleophthalmology-based rural eye care in India. Telemed J E Health 2007; 13: 313-321.
2 Viviers S, Lachance L, Maranda MF, Menard C. Burnout, psychological distress, and overwork: the case of Quebec’s ophthalmologists. Can J Ophthalmol 2008; 43: 535-546.
3 Pick ZS, Stewart J, Elder MJ. The New Zealand ophthalmology workforce 2008. Clin Experiment Ophthalmol 2008; 36: 762-766.
4 Kumar S, Yogesan K, Constable IJ. Telemedical diagnosis of anterior segment eye diseases: validation of digital slit-lamp still images. Eye (Lond) 2009; 23: 652-660.
5 Bar-Sela SM, Glovinsky Y. A feasibility study of an Internet-based telemedicine system for consultation in an ophthalmic emergency room. J Telemed Telecare 2007; 13: 119-124.
6 Tang RA, Morales M, Ricur G, Schiffman JS. Telemedicine for eye care. J Telemed Telecare 2005; 11: 391-396.
7 Kumar S, Yogesan K, Hudson B, Tay-Kearney ML, Constable IJ. Emergency eye care in rural Australia: role of internet. Eye (Lond) 2006; 20: 1342-1344.
8 Taleb AC, Bohm GM, Avila M, Wen CL. The efficacy of telemedicine for ophthalmology triage by a general practitioner. J Telemed Telecare 2005; 11 (01) 83-85.
9 Sicotte C, Lehoux P. Teleconsultation: Rejected and Emerging Uses. Methods Inf Med 2003; 42: 451-457.
10 Go K, Ito Y, Kashiwagi K. Interaction design of a remote clinical robot for ophthalmology. LNCS 2007; 4557: 840-849.
11 Go K, Kashiwagi K, Ito Y, Nakazawa Y, Arata J. Eye, Robot: A Network Control System for Ophthalmologic Examination. LNCS 2008; 5068: 48-57.
12 Labiris G, Fanariotis M, Christoulakis C. et al. Teleophthalmology and conventional ophthalmology using a mobile medical unit in remote Greece. J Telemed Telecare 2003; 9: 296-299.
13 Saari JM, Kerola MT, Broas M, Saari KM. Hand-held digital video-camera for eye examination and follow-up. J Telemed Telecare 2002; 8: 237-240.
14 Ulrich JN, Poudyal G, Marks SJ. et al. Ocular telemedicine between Nepal and the USA: prevalence of vitreoretinal disease in rural Nepal. Br J Ophthalmol 2009; 93: 698-699.
15 Taylor CR, Merin LM, Salunga AM. et al. Improving diabetic retinopathy screening ratios using telemedicine-based digital retinal imaging technology: the Vine Hill study. Diabetes Care 2007; 30: 574-578.
16 Wei JC, Valentino DJ, Bell DS, Baker RS. A Web-based telemedicine system for diabetic retinopathy screening using digital fundus photography. Telemed J E Health 2006; 12: 50-57.
17 Boucher MC, Desroches G, Garcia-Salinas R. et al. Teleophthalmology screening for diabetic retinopathy through mobile imaging units within Canada. Can J Ophthalmol 2008; 43: 658-668.
18 Deb N, Thuret G, Estour B, Massin P, Gain P. Screening for diabetic retinopathy in France. Diabetes Metab 2004; 30: 140-145.
19 Takeshi Y. Regional Difference in the Number of Ophthalmologists. Nippon Ganka Gakkai Zasshi 2008; 112: 941-942.
20 Quigley HA. Number of people with glaucoma worldwide. Br J Ophthalmol 1996; 80: 389-993.