For one of the most renowned Ophthalmologists in Brazil, technology is fundamental in primary care because it allows the detection of eye diseases in a faster, simpler and cost-effective way.
For 20 years, Ophthalmologist Rubens Belfort Jr. has been looking for efficient ways to use telemedicine to diagnose ocular diseases. “Initially, the devices were very expensive and heavy, which made it very difficult, especially in Brazil, to use teleophthalmology,” recalls Belfort.
However, in the last few years, more modern, practical and cheaper models have appeared on the market. One of them is the smartdevice Phelcom Eyer, which is attached to a smartphone, performs fundus exams in a few minutes and without the need for pupil dilation. In addition, it allows the photograph to be sent and stored on an online platform for remote evaluation.
Through the scientific community, Belfort found out about the equipment still in the development phase. “I accompanied the whole process and helped in the improvement of this technology that revolutionizes the possibility of expanding the diagnosis of ophthalmological diseases. And not only in Brazil, but in all countries, since the lack of financial resources is widespread,” he says.
However, the doctor has never had any commercial relationship with the company that created the device, the startup Phelcom Technologies.
Belfort believes that the device has significant advantages over traditional retinal cameras, such as portability, easy handling, high image quality and extremely affordable price. “This type of technology is very important not only in Ophthalmology, but also for other specialties such as Endocrinology, Geriatrics, and Rheumatology. In addition, medical students need to learn how to use this model of device and retire the old one, which has existed for more than 150 years and is totally outdated”, he points out.
Since 2019, the Eyer is used daily by Belfort’s team in primary care of SUS patients at the Paulista Institute for Studies and Research in Ophthalmology (IPEPO), popularly known as the Vision Institute, in São Paulo. The entity is a non-profit, philanthropic organization linked to the Ophthalmology Department of the Paulista School of Medicine, Federal University of São Paulo (Unifesp). Belfort has been a full professor in the Department of Ophthalmology since 1991.
The Vision Institute provides medical services through diagnosis, clinical and surgical treatments in assistance and didactic projects. Currently, it assists approximately 80 thousand SUS patients with the help of teleophthalmology. With quick training, the professionals of the area, such as technicians, nurses and students, under the supervision of doctors, perform the exams. So far, more than 80 thousand exams have been done to detect diseases such as glaucoma, cataract, diabetic retinopathy, maculopathies, toxoplasmosis, and others.
“Our experience shows that for every 1,000 patients, 850 do not have a disease that requires referral and treatment. In fact, 85% need glasses or have symptoms of dry eye or less dangerous problems. Therefore, through this technology, we are able to diagnose and already refer these 15% for the correct treatment. This provides significant savings in time and resources for the medical system and for the patient as well. Everybody wins,” points out Belfort.
In this sense, the Ophthalmologist believes that the use of Eyer in primary care is fundamental, because it empowers professionals to detect, in a faster and simpler way, ocular diseases. “That is the future. Even more: in a few years, the patient will be able to examine himself. This is the path that this technology is allowing”, he reflects.
Social actions and research
Belfort also uses Eyer in medical actions and research at Unifesp. “We use it in the Amazon Eye Oncology Center, in Manaus, and as of this year, we will also use it in our advanced campus in Rondônia, in partnership with the University of São Paulo,” he says.
In relation to research, the most recent one counted on Eyer in the detection of the new coronavirus (SARS-CoV-2) in retinal lesions. The discovery is unprecedented. The work was carried out in partnership with the Federal University of Rio de Janeiro (UFRJ) by scientist Wanderley de Souza and published in the journal JAMA Ophthalmology.
The researchers, led by Belfort, photographed the fundus of a patient’s eye with Eyer. “The image quality is very good. It’s certainly not inferior to other much more expensive models. It’s probably even better than these. The quality is so good that the photographs taken in the research are accepted in the best ophthalmology journals in the world,” says Belfort.