Abstract
Background/objectives
Limited resources and staffing hinders efforts to reduce preventable blindness, especially in low- to middle-income countries. The slit-lamp examination (SLE), which is essential for ophthalmology practices, is often unavailable in primary and secondary eye care facilities due to the high costs and lengthy training required for operation. We conducted a cross-sectional, multicentre study exploring the potential for a smart eye camera (SEC; a tele-ophthalmology handheld device developed by OUI Inc., Japan) to address the limitations of the SLE.
Subject/methods
Ocular diagnoses, visual acuity assessments and examinations of the eyes were performed independently using both a conventional SLE and a SEC. Four independent assessors (blind to the study) reviewed the images captured by the SEC and the SLE as administered by separate investigators. All analyses were performed using R version 4.2.2 for macOS at a 5% level of statistical significance.
Results
The results of the image quality analysis demonstrated that the number of higher-quality images was significantly higher (p < 0.05) for the images captured using the SEC device compared to the SLE machine. Remarkably, up to 96% accuracy of diagnosis was recorded with SEC. Evaluation of diagnostic accuracy rates derived from images obtained from both machines revealed a degree of divergence in assessments among evaluators, yielding a Fleiss’s Kappa value of 0.092. The sensitivity analysis for the SEC device revealed a reasonably strong capacity to correctly identify true positive cases, with an average sensitivity score of 90%.
Conclusion
The results of this study indicate that SEC can effectively evaluate anterior segment lesions in ophthalmology.
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Data availability
The data can be shared upon reasonable request to the corresponding authors.
Change history
03 February 2025
The original online version of this article was revised: Dr. Rohan Khemlani, Shintaro Nakayma, and Eisuke Shimizu’s affiliations and the order of the authors has been corrected. Mayor Orezime Atima has been replaced with Emmanuel Oluwadare Balogun.
03 March 2025
A Correction to this paper has been published: https://doi.org/10.1038/s41433-025-03654-z
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Acknowledgements
We thank the assessors for their time and insights in assessing the images obtained from the smart eye camera and the conventional slit-lamp microscope. Professor (Dr.) Emmanuel Abah of Ahmadu Bello University Teaching Hospital, Zaria, Dr. Peter Jiya of the National Eye Center, Kaduna, Dr. Ezeh Ernest of the University of Calabar Teaching Hospital, Calabar, and Dr. Itiyafa Njinaka of General Hospital, Lagos. Your expertise and perspectives are greatly appreciated.
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EOB, AJO, MOA, ES, NS and RK contributed to the concept and design of the study. AJO, EOB, MOA, EAA, KKO, EP, UI, OK, and HOA collected the data and participated in the data analysis. EJD wrote the manuscript. EOB, AJO, MOA, NS, RK, and EJD critically reviewed the manuscript. All authors read and approved the final manuscript.
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The original online version of this article was revised: Dr. Rohan Khemlani, Shintaro Nakayma, and Eisuke Shimizu’s affiliations and the order of the authors has been corrected. Mayor Orezime Atima has been replaced with Emmanuel Oluwadare Balogun.
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Orugun, A.J., Atima, M.O., Idakwo, U. et al. Validation and optimization of smart eye camera as teleophthalmology device for the reduction of preventable and treatable blindness in Nigeria. Eye 39, 925–930 (2025). https://doi.org/10.1038/s41433-024-03489-0
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DOI: https://doi.org/10.1038/s41433-024-03489-0
