 The first presenter is Andrew Rodenberg. He's a visiting medical student fourth year from the University of North Dakota. And he'll be speaking about ophthalmology in the digital age. I'm sure you are all pretty excited by this topic. Curious, nonetheless. So we'll see if we can get it to come up here. I also wanted to reiterate that I don't have any commercial bias towards iPhones, even though it might seem like I'm really promoting them in this talk here. So dictionary.com defines a smartphone as a device that combines a cell phone with a handheld computer, typically offering internet access, data storage, email capabilities, et cetera. So by that definition, how many people here use a smartphone, maybe 50% while there's the mic? So a recent survey by the American Society of Cataract and Refractive Surgery found that E3% of people polled used a smartphone or web-enabled device. And so after observing some people in the clinic recently using their cell phone for different things in the clinical setting, I decided to do a little search on PubMed and see if I could find anything about smartphones and ophthalmology. And surprisingly, it came up with several articles that were published recently. And so today, I just want to discuss the usefulness of smartphones in the ophthalmology setting. And so there it is, OK. So succinctly, we're going to talk about, one, some clinical applications for smartphones, and then also how they might be useful in the research or laboratory setting. And then we'll just go over some final remarks. So I'm sure many of you have seen this application. This is a screenshot I took off of my iPhone. When you do a search on your phone for ophthalmology, you literally come up with hundreds of applications that are available for different aspects. And so iHandbook is one of the most comprehensive applications available. It is free. And if you haven't used it, there's probably something on here that everybody could use. They have testing tools, patient education tools, physician references, and patient education calculators. As you can see here, you can even look up codes and many different things. So if you haven't checked out that application, it might be worth your while. So if we go under this testing tab here, you see stuff like an Ampsler grade, color vision, your vision cards, fixation targets. You have different optotypes. You can use a pen light. They even have a blue light, I think, if you want to try to use it with fluorescein. And here in the corner, that's what the patient education application looks like. It has a little paragraph about each different disease. And then it gives links to different websites that patients might find useful to research the problem that they're dealing with. And that's just the testing. There's all kinds of neat features in that application. So one of the papers that I found was by Lamarill et al. And that was published this year. And they talked about fundus photography with the iPhone and or displaying photography on the iPhone. They didn't actually take these photos with the phone, but another study that I looked at did. Here they were looking at whether the image was displayed or crisply on a PC or a monitor desktop versus on the iPhone. And so you can see here, the study involved 100 randomly selected photographs that were taken via digital camera. And they graded the photographs one through five. And then they showed two different ophthalmologists, the images, both on the desktop computer here. It's an HP desktop and then also on the iPhone. And I guess these two ophthalmologists rated the image quality as superior on the iPhone versus the desktop. So that's just a small study, but interesting nonetheless. So fundus photography on the iPhone could be useful in different settings. ER, rural clinics, satellite clinics, where you might not have access to the various ophthalmic tools. Remote review of clinical photographs say if you want to consult somebody or send a photograph to a colleague, ask them a question about what might be going on with a certain patient. And so these photographs, I think I said the top one is an HP desktop. And then here's the on the iPhone. And this is just a cropped view of this iPhone image. And then you can also zoom in on the iPhone to look at the features more closely. You can also use them on the slit lamp. These images here, they may be useful in teaching medical students, residents, physicians. They might be incorporated into the patient's electronic medical record, say, like I was saying, if you're in a satellite clinic or if you're in a rural area, you don't have access to great photography capabilities. You can use your phone. And so there's been recent improvements in the iPhone. These images here, I think A, is representing a recurrent corneal ulcer, Bs, and anterior chamber IOL, and then Cs using the corneal lens. But these pictures were taken with a 2 megapixel camera. And this study was published in 2011. But I think these pictures were taken in 2010 with that version of the iPhone. And since then, they've advanced. They had a 5 megapixel version. And now the new iPhones come with 8 megapixel. And they also have 1080 PhD video. And it is more challenging than it looks to do this. I've attempted it on a couple occasions. So another study that I found is by Bass Rouse. And that was done this year, trying to figure out a good method to capture indirect fundus, capture an image using indirect fundus photography. And they described a method where instead of having the phone on picture mode, you put it on video mode. And then you set the flash to on. And so it's constantly illuminated. And that acts as a light source for the lens. And then you just hold the lens like you normally would and use the iPhone as your illumination source. And you record video. And then once you have a video recorded, you have more options of going through and finding the still image that has the best quality. And there were some other images that they had taken using this method. And it looked like it worked fairly well for them. I'm sure it's more difficult than it sounds. OK, so as I mentioned, this might be useful for documentation or consultation in different areas of practice. These are just a couple more examples of screenshots that were taken using the iPhone. And these capabilities are not limited to an iPhone. Android has great applications and good cameras. So any smartphone should be capable of doing this. But on the top, you have a photo that was taken using the slit lamp. And then one using the indirect lens. And then C down there in the corner is just a zoomed out version of that. And then they also used it in the surgical setting. I don't know how aseptic that is. They're sterile, but they used the iPhone to record video through an operating microscope. Looks like a vitrectomy or some sort of procedure there. So there's some of the ways you could use a smartphone in the clinical setting. And I'm just going to briefly go over some other applications that might be useful for researchers or in the laboratory setting. So there's multiple applications. If you type in ophthalmology and research or laboratory, come up with all kinds of things. So I'm just going to go over a couple that I found when I did a little search. But there are things like lab timers, molecular weight calculators, graphing calculators, fact sheets, product information, data analysis software, all kinds of things. One application I came across is called Lab Timer. And I guess this was used by some people for their gel electrophoresis and timing that. There's other, this is just one screenshot from that. There's other uses for that application as well. But now there is the lab cal. There's two versions. One is free and I think one is $1.99 or something. So the first one has malaria calculators, dilution calculators, and SI prefixes, et cetera. And the other one comes with some additional features that one might find useful. And another application, BioRat Real Time PCR. That this one is fairly interesting and has a lot of usefulness. There's information about different reagents, product information. It has a, what's called PCR doctor, in case you need a troubleshoot, can help design your assay. And if you go through this, it actually just explains the PCR in general and how it works. And so there's a lot of neat things under that application. So in summary, smartphones are rapidly being integrated into the practice of ophthalmology. There's a lot of applications that might be of benefit to all of us in this room. Teleophthalmology using smartphones might be the future. So using them as a consultation device. So there's all kinds of possibilities and there's a lot of information out there. And I just kind of skimmed the surface. So those are the resources that I found when I was doing the search. And are there any questions? Yeah, they did. And that's definitely something that needs to be thought about sending images or patient data over the cellular network. And yeah, definitely. There used to be documentation that the patient is okay with it. They, none of these papers talked about doing that directly but I know you can upload the photos onto the desktop and then from there, you can incorporate them into the EMR. It's just something, a technical thing that would have to be figured out but I'm sure it would be fairly simple. All right, thank you.