Robert Boston, Washington University School of Medicine
With a shortage of readily available medical care worldwide, the inability to screen patients for diseases leaves many untreated. To combat the problem, Todd Margolis, new head of the Washington University School of Medicine's ophthalmology and visual sciences department, is pioneering a phone app that uses image-recognition software to screen patients for eye diseases.
“I thought if we could take pictures of the back of the eye with a cellphone camera, we could send the images to an expert who could read them from a distance,” he explained. “Ultimately, I borrowed someone’s iPhone and literally stuck it right in front of an eye. I illuminated the eye with a light, and I could see the optic nerve.”
Since cellular networks are generally better developed than computer networks, using cellphone cameras to screen patients inexpensively, without a doctor, was a better solution than trying to send doctors images of patients over the Internet.
“We have some amazing tools for managing patients with diabetic retinopathy that decrease their visual problems tremendously, but first you have to identify the patients who need to be treated,” he said. “In the United States, only 50 percent of people with diabetes who are supposed to get eye exams actually get them. But if we set up a camera at the corner pharmacy or local health clinic right next to the blood pressure machine, we could screen a lot more patients for diabetic eye disease when they come to pick up their oral medicines or insulin.”
Outside the U.S., Margolis also saw the need for more accessible screenings on a trip to Thailand. “The big problem was that only about six ophthalmologists in the whole country were willing to see patients with HIV, and there were about 1 million HIV patients who needed to be screened for CMV retinitis and other eye infections.”
Margolis created prototypes of a fundus camera, which is used to photograph the interior surface of the eye, to connect with an iPhone. He has been collaborating with Daniel Fletcher, a biomedical engineer at the University of California Berkeley, who was using cellphone imaging to look at blood smears for malaria.
