Ophthalmology Business

SEP 2015

Ophthalmology Business is focused on business topics relevant to the entrepreneurial ophthalmologist. It offers editorial, opinion, and practical tips for physicians running an ophthalmic practice. It is a companion publication of EyeWorld.

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September 2015 • Ophthalmology Business 7 detection In a second study, the device was used in single photo mode. Sensitivity was slightly decreased but specificity remained high limiting false positives. Finally, the two noted changing the flash to 90 degrees or an oblique angle from 180 degrees "may be more effective in detecting with-the-rule astigmatism." Both physicians agree more research is necessary. "Our study confirmed that a smartphone camera can give reliable images and has software capable of valid interpretation of the ARF factors in preschool children," Dr. Arnold said. OB Editors' note: Dr. Silbert has financial interests with Gobiquity. Dr. Arnold has no financial interests related to his comments. Contact information Arnold: pdimd@me.com Silbert: davidsilbertmd@gmail.com were determined 'unreadable,'" he continued. There were 55 eyes (30 patients) identified with the cycloplegic astig- matism component above the AAPOS guidelines. Of those, 16 had both cycloplegic cylinder and additional refractive comorbidities. There were 14 patients referred for cycloplegic cylinder only; 5 were correctly diagnosed with a single photo. In the older children, the initial automated interpretation of the acquired images was similar between the automated and manual readings in both sensitivity and specificity. "Photoscreening often will interpret a suprathreshold ARF child as 'pass' if the child can adequate- ly accommodate the hyperopia or astigmatism," Dr. Arnold said. Dr. Silbert noted that many of these children with good accommodation are unlikely to have actual amblyo- pia. In this analysis, the optimized overall ARF sensitivity/specificity for the automated mobile photoscreener compared to cycloplegic refraction: 60%/82% (manual grading SN/SP = 60%/89%). visible-light photoscreening." Gobiquity also has investigated results with other smartphones, including the iPhone. Study details There were 174 preschool-aged children (between 12 and 72 months old) who underwent photorefraction with the GoCheck Kids screener and a cycloplegic refraction (n=348 eyes). Two images were acquired, at 90 and 180 degrees; manual and automated grading were performed. Ages ranged from 12–30, 31–48, and 49–72 months (n=58, 44, and 72 respective- ly); only the 49–72 month group was considered for statistical purposes, the authors said. "Although children from all age groups were recruited, readable images were more numerous in the older group," Dr. Arnold said. "More children from the younger groups had unreadable images. "The smartphone has software capable of instant interpretation; in our validation study, the interpre- tation software was in its infancy and so more of the younger children

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