Dr. Abhishek Mandal, Ph.D.
Founder, Vision Science Academy, London, U.K.
Vision Science Academy Exclusive
The field of optometry has been modernised with the advent of advanced technological innovations. Today, a plethora of diagnostic modalities are available which have rendered the ophthalmological examination far more precise and convenient than it was a few decades ago.
What is Robot-assisted Examination?
Millions of people around the world encounter visual impairment at some stage during their lifetime. For several individuals, accessing an ophthalmologist from a remote region could prove to be cumbersome. This issue, however, can be resolved with the aid of robot-assisted ophthalmic examination. This technology can help a person seek quality eye care without ever actually visiting an ophthalmologist’s clinic. It can be expected that such advanced diagnostic tools will soon transform optometry and ophthalmology into vital components of telemedicine (Keane & Topol, 2019).
Robotic Slit Lamp Eye Examination
A slit lamp device uses a high intensity light source to perform a focused examination of the internal structures belonging to the anterior chamber of eye. Successful attempts have been carried out to transform the existing slit lamp systems into robot-assisted devices. By means of internet connectivity, this has enabled clinicians to view the internal layers of their patient’s eyes while being hundreds of miles apart from one another (Larsson et al., 2017).
How does it work?
Robotic slit lamp examination consists of two major components (Charukamnoetkanok et al., 2009):
1) An experienced ophthalmologist, who serves as the client
2) Server (a technician and a patient) which is present in a remote area
Server Control Mode
Once both the ends of communication have been secured, a technician at the server side of the network will position the patient’s face on the slit lamp correctly, and then record the eye imaging data by using a high-resolution camera. After that, the imaging results are sent to the ophthalmologist. Since the ophthalmologist is not in direct control of the eye position, the patient’s orientation can be readjusted by the technician at the server end so as to assist the eye specialist in confirming their diagnosis (Charukamnoetkanok et al., 2009).
Client Control Mode
In the client control mode however, the ophthalmologist can themself undertake the readjustment process remotely. Moreover, the client control mode can also enable the clinician to command the slit lamp directly to perform various focusing maneuvers. In addition, the ophthalmologist can directly communicate with the technician at the server end which allows the former to store all the useful information for keeping patient’s visual records up-to-date (Charukamnoetkanok et al., 2009).
Efficacy of the Robotic System
Limited results are available for evaluating the exact role of robotic slip lamp in eye examination. It has been estimated that in the examination of the anterior chamber abnormalities, it possess a sensitivity > 40% and specificity > 90% (Charukamnoetkanok et al., 2009). Satisfactory results have also been obtained for other ocular structures such as eye lids, conjunctiva, cornea and sclera, iris, and intraocular lens. Undoubtedly, further improvement can render this clinical apparatus much more consequential in the screening of various eye diseases.
References
Charukamnoetkanok, P., Ekkachai, K., Klanarongran, N., Leelasawassuk, T., Komeswarakul, P., Suramethakul, P., . . . Tungpimolrut, K. (2009). Robotic slit-lamp for tele-ophthalmology. Paper presented at the 2009 ICCAS-SICE.
Keane, P., & Topol, E. (2019). Reinventing the eye exam. The Lancet, 394(10215), 2141.
Larsson, D., Irving, D., Effendi, S., Dubin, J., Bach, A., Morris, M., & Tosunoglu, S. (2017). Ophthalmic robot. Paper presented at the Proceedings of the 30th Florida Conference on Recent Advances in Robotics.
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