Fungal Hyphae With Iolscope Recognition Study - F I R S T

To compare hyphal morphology seen through simple microscope and an innovative device, IOLSCOPE

To compare the morphology and identity of 10 common fungus using IOLSCOPE and a compound microscope – a test of efficacy of IOLSCOPE by grading image quality

The study was done in the Cornea and Microbiology department of a tertiary eye hospital. It was a cross sectional, hospital based, comparative study. The sample size was calculated as 35 patients assuming 80% sensitivity, 5% allowable error, prevalence 15%. Study included samples of corneal scrapping sent to the microbiology department from cornea department for the identification of fungal hyphae.

IOLSCOPE IS A INNOVATIVE DO IT YOURSELF SMARTPHONE MICROSCOPE WHICH IS MADE OUT OF FOUR INTRAOCULAR LENS COMBINED TOGETHER TO HAVE A COLLECTIVE 120D POWER. this device was used to identify fungal hyphae. All corneal scrapping sample sent to the microbiology lab for suspected fungal growth over a period of 3 months were assessed. sample was divided into KOH mount for identification of fungal hyphae and the other for culture. Image taken from gold standard microscope and iolscope were compared to each other for fungal identificationa and species identficiation.

We included a total of 194 samples – out of which 83 were diagnosed as fungal keratitis. The IOLSCOPE when compared to the simple microscope had 94% sensitivity and 100% specificty in identifying koh sample for hyphae and 100% sensitivity (95% Confidence Interval (CI) : 89.2 – 100)  and 100% specificity in diagnosing KOH mounted and LPCB mounted hyphae identification from culture sample. 

IOLSCOPE is a innovative cost effective do it yourself instrument which can be used as a screening device for diagnosing fungal keratitis. IOLSCOPE is a good alternative to conventional microscope, as it provides good quality images for diagnostic purposes. It has wide applications for use in peripheral centers, fields and camps and for teleconsultation especially during COVID times to detect corneal fungal ulcer and to start prompt treatment.