Official ESCRS | European Society of Cataract & Refractive Surgeons


Using a novel portable smartphone slit lamp prototype to assess anterior chamber depth

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Session Details

Session Title: Anterior Segment Imaging

Session Date/Time: Monday 16/09/2019 | 14:00-16:00

Paper Time: 14:18

Venue: Free Paper Forum: Podium 4

First Author: : D.Chen SINGAPORE

Co Author(s): :    Y. Yu   D. Tolley   Y. Ho   J. Lee   C. Yen   C. Tan              

Abstract Details


Primary angle closure glaucoma is a cause of major visual impairment in Asia. There is currently no good screening modality for narrow angles and angle closure disease. Smartphones have been demonstrated to have clinical utility and application potential in ophthalmology. In this study, we used a smartphone mounted on a novel portable slit lamp prototype to assess anterior chamber depth of phakic patients with an undilated pupil.


Single-centre, single-blind, randomized image-validation non-inferiority study


This is a prospective, single-centre, single-blind, image validation study. Patients above 60 years of age with no history of laser or intraocular surgery were recruited from the outpatient clinic. Slit lamp images of undilated eyes were taken with the anterior segment camera (ASC) and the smartphone slit lamp (SSL), followed by anterior segment imaging using anterior segment optical coherence tomography (AS-OCT, Casia SS-1000, Tomey). Computation algorithm was applied to calculate a proprietary anterior chamber parameter ("Calculated AC Parameter") based on images taken with the smartphone slit lamp. These values were then compared with anterior chamber parameters acquired from the AS-OCT.


51 eyes of 51 patients were recruited from June 2018 to February 2019. After excluding 2 eyes due to poor image quality, a total of 49 eyes (right = 30, 61.2%) were included. Mean temporal trabecular-iris space area (TISA-500) was 0.11±0.05mm^2^, mean temporal angle opening distance (AOD-500) was 276.6±140.2µm, mean central anterior chamber depth (ACD) was 2637±364µm, and mean anterior chamber area (ACA) was 19.5±3.6mm^2^. Calculated AC Parameter has a strong positive correlation with both ACD (Pearson = 0.67, Spearman = 0.71, both p<0.001) and ACA (Pearson = 0.66, Spearman = 0.72, both p<0.001).


The portable smartphone slit lamp prototype provides strong positive correlation with selected anterior chamber measurements taken from the AS-OCT. Further studies would be required to evaluate the feasibility of this novel device as a low-cost screening tool for angle closure disease in the primary care setting.

Financial Disclosure:


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