Handheld Retinal Camera As An Eye For Innovation – D-EYE Review

Sure, if something’s portable, easy to use and helps patients and doctors alike, it definitely ticks all our boxes. Does that mean we are going to test it though? Who are we kidding, of course it does! Join us on our journey to learn about the present and future of ophthalmology – and to get to know D-EYE, a new handheld digital retinal camera.

Ophthalmology can really profit from telemedicine. Recognising its potential, tech companies started targeting this medical sector, producing more and more interesting apps and devices. So, naturally, we’ve kept our eyes on ophthalmology for the past couple of years.

Source: unsplash.com

Visionary devices

Retinal implants and bionic eyes? CRISPR technology and brain implants to restore vision? DeepMind detecting early the most common cause of blindness? Sounds futuristic, but these are all projects of the present. Eye-care is full of awesome technologies. Even if Google and Novartis halted their glucose-sensing contact lens project, there’s no need to worry – researchers have worked out a method for simultaneous glucose measurement and controlled drug delivery in a contact lens. This medical specialty is already bringing science fiction technologies to patients right now.

We love inexpensive, smartphone-connected sensors and apps that use the phone’s camera. These can also help in diagnosing eye conditions in under-developed regions. Devices like Personal Vision Tracker for measuring an individual’s refractive status, or EyeQue Insight to determine visual acuity fit exactly into this category. And so does D-EYE. The device has a brand-new take on the traditional ophthalmoscope. Let’s see their creative solution!

Eye candy for smartphones

D-EYE S.r.l. is an Italian developer of retinal screening systems for smartphones. They won numerous awards for their ideas and implementation of the project. So we were quite excited to test it.

Source: fondazioneveronesi.it

In recent studies, this fundoscopic smartphone lens lived up to the standards of researchers. It was found useful in the ER to quickly evaluate hypertensive retinopathy or other pathological fundus abnormalities.

D-EYE also proved to be just as practical in measuring vertical cup-to-disc ratio as slit-lamp biomicroscopy. Moreover, it showed great promise in pediatric settings and medical students and patients found it to be more comfortable and educational than the usual fundoscopic exam.

The test

We tested this device with Zoltán Cserháti, MD, our ophthalmologist expert to truly assess its usefulness in different fields, situations, or used by different people. After reading the papers mentioned above, both Dr. Cserháti and our team were keen to see how this little gadget performs in real life.

Putting the eye in iPhone

We always love a clean design and the D-EYE team is definitely great at the visuals. Both the box and the device are modern, elegant and minimalistic, which gives D-EYE a professional look. Opening the box we find a bumper case, the D-EYE lens, a quick set-up guide and a user guide.

The bumper is fragile, made from a low-quality material and the installation process seems to put too much stress on some weaker spots. At the moment, the bumper only fits certain iPhone models, so make sure to check compatibility before the purchase. Since the design is actually quite simple, we hoped the device would be available to other brands – but it just isn't.

Setting up our digital ophthalmoscope is quick and easy; the lens part attaches smoothly to the frame magnetically. And since the device itself is just an extension of the phone and not an electronic gadget, it truly seems durable and well-made. No battery, no buttons, no hardware issues. It’s fairly easy to use even without much technological literacy.

After downloading the app and creating an account, we’re ready to go. The app is exactly what you would expect from a new medical device. It has a nice layout, it’s user-friendly and easy to navigate.

Starting the app, we have the option to start a new examination or access previously recorded files and patient info. Before the examination begins, we can either choose a previous patient or add a new one to the list. We can enter their basic information, diabetic status, diagnoses and refractive errors for each eye.

Images and comfort

There’s a video or a multi-shot examination option. Multi-shot just shoots pictures at set intervals. Although it’ll create a bigger file, we still preferred the video option. Autofocus didn’t work well, but manually setting the camera performs just fine.

The file’s resolution is naturally lower than what you can achieve with the traditional ophthalmoscope. It depends on the phone’s camera. In most cases, ophthalmologists would still stick with a slit lamp or a traditional ophthalmoscope.

Traditionally, fundus exams are uncomfortable for the patients: the light of the device is strong, the doctor is just a few centimetres away from their face while they’re required to stay still for the duration of the procedure.

The D-EYE smartly resolved these issues. The light they use is not that blinding, but it’s not as customisation either. There’s no need to be so close to anyone, we only need to move the phone near the eye. And this means it’s easier to follow or correct patients’ movements.

It worked perfectly on normal, not dilated pupils in the dark, but not in a lighter room. It’s a quick and comfortable solution for a retina test. And it works even better on dilated pupils! Using dilation drops and a dark room –the standard examination setup – offers a wider field of view.

Another aspect we loved is how we can show the results as soon as the recording stops. Educating patients and showing them therapeutic results just became super simple. After the recording stops, you can save, delete, or edit these files in the app.

To summar-eyes:

Who do we recommend D-EYE to? Do we recommend it at all? After discussing our experience with Dr. Cserháti, we decided to say we loved the product!

However, as an ophthalmologist working at a public hospital, Dr. Cserháti wouldn't replace traditional tools with D-EYE just yet. Instead, he would use it in specific situations where traditional options fail: be it bedridden patients and children, a quick consultation in another ward or teaching patients more about their conditions. Dr. Cserháti can see how new digital health technologies, like D-EYE, could replace the instruments currently used in the near future.

"In the future, tools like this may replace those currently in use..."

Dr. Zoltan Cserhati

A useful tool for challenging situations

It’s a winner when it comes to examining fidgety children and disabled patients. Furthermore, in the time of a pandemic, not being right up another person’s face is a huge advantage as well. And not just this time, really.

The device also comes in handy when teaching students and educating patients. Let’s just say, it is great for pupils! Pun intended. It’s cheap, compared to any device currently used to take videos, yet its files are good enough quality for papers, conferences and teaching.

It’s a great option for GPs, ER doctors, paediatricians and neurologists, too. Oh, and let’s not forget vets – they’ll love this device. D-EYE is sci-fi and fun to use. Sure, we cannot turn a blind eye on the not-so-strong bumper, lower resolution images and the limited compatibility. But at the end of the day, we were pleased with how it performed.

Eyes are our most important sensory organ. 80-85 percent of our perception, learning, cognition, and activities are mediated through vision. These disruptive technologies give a huge boost to the creative minds of ophthalmology and we just can't wait to see them.

Dr. Bertalan Mesko, PhD is The Medical Futurist and Director of The Medical Futurist Institute analyzing how science fiction technologies can become reality in medicine and healthcare. As a geek physician with a PhD in genomics, he is a keynote speaker and an Amazon Top 100 author.

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