Non-Mydriatic Retinal Cameras and Telemedicine
Timothy J. Bennett, CRA, OCT-C, FOPS
Penn State Hershey Eye Center
Non-mydriatic fundus cameras with digital capture capabilities are often used as screening devices for diabetic retinopathy and glaucoma. Diabetes is a significant worldwide health problem affecting an estimated 18 million people in the United States alone. One of the most devastating complications of diabetes is blindness from diabetic retinopathy. Early detection and treatment can significantly reduce the incidence of blindness from retinopathy. It is estimated however, that only about half the known patients with diabetes receive recommended annual eye examinations. The reasons for the low rate of patient compliance are complex, and include poor access to ophthalmologists in rural or other underserved areas. Digital fundus photography is an effective method of retinopathy screening that is capable of detecting macular edema and proliferative diabetic retinopathy, the most common causes of vision loss in diabetics.
Non-mydriatic digital fundus cameras are designed with an infrared focusing system that promotes physiologic dilation in a darkened room, making them simple to operate. They can be placed at remote primary care sites and operated by available clinical personnel such as nurses and medical assistants. In a telemedicine environment, images are electronically transferred to a centralized reading center for image review and treatment recommendations. Image quality can be quite good, but doesn't match the quality produced with a mydriatic camera through pharmacologically dilated pupils.
Although professional ophthalmic photographers generally don't perform imaging in digital screening programs they often oversee network design, training and sometimes serve as primary image graders in screening programs. Digital retinopathy screening programs have been implemented in many locations around the world and are most successful in countries with centralized health care, such as the government sponsored screening program in the United Kingdom.