The retinoscope defines the prescription, but in modern eye care, correlating functional data with high-quality fundus photo-documentation is what truly elevates patient care.
The retinoscope remains one of the most iconic tools for objective refraction. For any eye care professional (ECP), mastering the play of light and shadow in retinoscopy is an art form that ensures refractive precision. It gives us the “how much”—the refractive power.
For decades, that information was enough. Today, however, a patient is more than just a “refractive error”; they are a clinical history in motion. Rapidly progressing astigmatism isn’t just a shift in power—and a standard retinoscopy is a fleeting assessment that leaves no permanent record. How, then, do we track and correlate a precise refraction with the structural health of the eye over time?
Correlating Function and Structure: The New Frontier
In a high-volume practice, efficiency demands that functional evaluation (refraction) and structural assessment (documentation) happen seamlessly. Specialists need to know: Does the patient’s complaint or the retinoscope’s finding match the actual ocular structure?
Retinoscopy may be flawless, but if there is a subtle macular change or suspicious optic nerve cupping, refraction alone doesn’t tell the whole story. Bridging this gap requires a tool that harmonizes functional refraction with structural records, integrating everything into a single, streamlined patient workflow.
This is the core philosophy behind platforms like the Eyer2. As a portable fundus camera and imaging system, it delivers an immediate connection between refractive data and retinal health.
Color fundus photography captured by the Eyer2 portable fundus camera.
Imagine this workflow: The patient undergoes a refractive assessment via retinoscopy. Then, right there in the exam chair, the Eyer2 captures high-definition images of the fundus or ocular surface. What was once just a static data point on a chart is now paired with visual documentation of the retina, macula, and optic nerve.
Instead of juggling two isolated tests—retinoscopy (functional) and fundoscopy (structural)—the specialist now operates within a unified workflow. The precision of the retinoscope gains the context of high-definition documentation. The prescription found through retinoscopy is validated and enhanced by the image captured by the Eyer2.
Meet the Eyer2
The Eyer2 handheld fundus camera supports the diagnosis of over 50 conditions, including glaucoma, cataracts, diabetic retinopathy, age-related macular degeneration (AMD), retinoblastoma, hypertensive retinopathy, retinopathy of prematurity (ROP), and ocular toxoplasmosis.
The device also enables the detection of various ocular surface diseases and conditions, such as blepharitis, eyelash abnormalities, Meibomian Gland Dysfunction (MGD), hordeola, conjunctival and eyelid tumors, advanced cataracts, foreign bodies, burns, corneal lesions, and various types of keratitis (resulting from dry eye, contact lens wear, infections, or ulcers).
Meibography scan captured via the Eyer2 portable retinal camera, evaluating meibomian gland structure for evaporative dry eye.
Key Features & Benefits:
All-in-One Portable Platform: A handheld ocular imaging system capable of performing six different types of exams in a single, non-mydriatic device.
High-Quality Color Fundus Photography: Features a 55° field of view in a single image, making it easy to detect peripheral retinal lesions.
Instant Green-Channel Imaging: Automatically generated immediately following color capture.
Infrared Posterior Segment Imaging: Allows for deeper retinal evaluation with enhanced patient comfort; essential for diagnosing choroidal nevi and assessing evaporative dry eye.
Stereo Disc Photography: Provides 3D visualization of the optic nerve head and cupping.
Panoramic Fundus Imaging: Captures wide-field views up to 120°.
Advanced Analytics: Built-in editing tools and graphics for precise Cup-to-Disc ratio (CDR) analysis.
HD Ocular Surface Documentation: High-definition photo-documentation to track and monitor disease progression.
Cobalt Blue Light: Optimized for the evaluation and documentation of corneal lesions and staining patterns.
Unmatched Mobility: Perfect for multi-clinic practices, remote primary care, and examinations of bedridden or neonatal patients.
Cloud Ecosystem (EyerCloud): Seamless integration with an online platform for comprehensive exam management and secure data storage.
About Phelcom
Phelcom Technologies is an American-Brazilian company combining physics, electronics, and computing to make vision care simpler, more connected, and intelligent.
The company was founded in 2016 by three young researchers: José Augusto Stuchi (computer engineer), Flavio Pascoal Vieira (electronics engineer), and Diego Lencione (physicist). Inspired by Diego’s brother, who struggled with a severe vision condition from childhood, the trio set out to develop a portable retinal camera integrated with a smartphone.
In 2019, Phelcom launched its first product, the Eyer portable retinal camera. Five years later, the company introduced the Eyer2, a comprehensive photo-documentation platform capable of capturing high-quality images of both the posterior and ocular surface segments.
Today, with a 10-year track record, Phelcom’s technology has benefited over two million people across multiple countries, including the United States, Japan, Chile, Colombia, the United Arab Emirates, and Brazil, and has been deployed in more than 200 social outreach initiatives worldwide.
In a modern clinical setting, speed and mobility are vital, but seamless communication is everything. A medical device shouldn’t act like an isolated island. When diagnostic images are trapped on standalone equipment or require a complicated, manual export process, clinical workflows stall and patient care suffers.
The Eyer2 solves this bottleneck through native multi-protocol integration. While highly regarded for its portability and ability to capture stunning, 55° wide-field color retinal images without pupil dilation, the Eyer2’s true superpower is its ability to communicate directly with the eye care industry’s leading software ecosystems.
The EHR & PACS Ecosystem: True Compatibility
Operating on an intuitive, smartphone-integrated Android platform, the Eyer2 utilizes standard Wi-Fi to transmit files instantly. Rather than forcing your practice to adapt to proprietary software, the Eyer2 adapts to you, boasting native compatibility with the most trusted Electronic Health Records (EHR) and Picture Archiving and Communication Systems (PACS) in eye care today.
Supported Platforms At-A-Glance
Table references EHR and PACS systems/ platforms supported with Eyer as well as their purpose.
Flexible Formats and IT-Friendly Protocols
The Eyer2 bridges the gap between patient care and IT requirements by supporting multiple data communication protocols, including DICOM, DICOMWeb, SMB, and FTP. Depending on your department’s specific imaging needs, the Eyer2 allows you to save and download high-resolution exams in two primary formats:
DICOM Images: Ideal for full integration into PACS networks like Harmony or Forum. The Eyer2 embeds rich patient metadata directly into the image file, making tracking and compliance completely hands-free.
JPEG Images: Perfect for a quick snapshot, a patient education handout, a research slide, or a fast upload to a local, non-DICOM desktop directory.
Note for Network Administrators & IT Teams
The Eyer2 is engineered specifically to interact with advanced image management software and standard file-sharing architectures. Because our platform prioritizes rich, high-resolution visual data, the system handles data transport via robust DICOM/DICOMWeb protocols and secure network folder syncing (SMB/FTP). This ensures complex image files and metadata are attached accurately to the patient’s medical chart, bypassing the limitations of text-only messaging protocols.
The EyerCloud Platform
Engineered for high-volume clinical workflows, Phelcom Technologies’ EyerCloud platform combines unparalleled convenience, security, and stability by leveraging the trusted data infrastructure of Amazon Web Services (AWS). Every Eyer fundus camera purchase includes immediate access to the platform with an expanded free capacity of 10,000 images per clinic, allowing providers to securely access, sync, and share exams in real-time across any device.
To support growing practices while maintaining rigorous global standards, including full HIPAA and LGPD compliance, EyerCloud is introducing flexible premium subscription plans. These cost-effective paid tiers directly fuel enterprise-grade server performance, continuous workflow feature updates, and advanced encryption for a fraction of the cost of in-house IT, averaging less than one cent per image. Whether clinics choose to remain on the generous free tier or upgrade to a premium plan as their data needs expand, EyerCloud delivers a transparent, ready-to-use solution that ensures clinical workflows remain efficient, protected, and entirely uninterrupted.
The EyerCloud database
Ironclad Security: FDA Clearance and HIPAA Compliance
Introducing a connected device to a medical network requires absolute confidence in data security. The Eyer2 platform was built from the ground up to respect strict data privacy regulations.
FDA 510(k) Cleared: The Eyer2 is officially FDA cleared, solidifying its status as a trusted, professional-grade diagnostic tool.
HIPAA-Compliant Infrastructure: When syncing data to our cloud management system, EyerCloud, your information is securely backed up via Amazon Web Services (AWS)—the global benchmark for secure healthcare data infrastructure. End-to-end encryption keeps Protected Health Information (PHI) secure whether at rest or in transit.
Advanced Access Controls: Secure logins and customizable user access levels ensure that your clinic stays fully compliant with medical privacy standards.
Team Spotlight: Jeff from Technical Support
Jeff is our technical support analyst and brings an extensive background in healthcare IT and medical device network integration. He specializes in helping clinics onboard their new Eyer2 systems, configuring local DICOM networks, mapping FTP/SMB servers, and ensuring that your image pipeline flows smoothly into systems like ModMed, Forum, or Harmony.
“Joining Phelcom at a time when portable eye care is expanding so rapidly is incredibly exciting,” says Jeff. “Because the Eyer2 natively supports DICOM and standard file sharing, mapping it to systems like NextGen is incredibly clean. I’m here to handle the background technical setup so clinicians can focus purely on what they do best: patient care.”
Whether you need assistance establishing a server link or training your clinical staff on the EyerCloud interface, Jeff and our dedicated support team have you covered.
About Phelcom
Phelcom Technologies is an American-Brazilian company that employs Physics, Electronics, and Computing to make visual health simpler, more connected, and smart.
Founded in 2016 by three young researchers: José Augusto Stuchi, a computer engineer; Flavio Pascoal Vieira, an electronic engineer; and Diego Lencione, a physicist. Inspired by co-founder Diego’s brother, who had struggled with a severe vision condition since childhood, the three founders set out to develop a portable retinal camera with an integrated smartphone.
In 2019, Phelcom launched its first product, the Eyer, a portable retinal camera. Five years later, the company introduced the Eyer2, a photo documentation platform capable of capturing high-quality images of both the posterior and anterior segments.
Today, with 10 years of history, Phelcom’s technology has benefited over two million people across multiple countries, including the United States, Japan, Chile, Colombia, the United Arab Emirates and Brazil. It has also been used in over 200 social outreach initiatives.
Beyond its role in daily clinical workflows, the Eyer handheld fundus camera and EyerMaps Artificial Intelligence have become instrumental in advancing global ophthalmic research. Recently, two landmark studies were selected for presentation at the world’s most prestigious vision research conference: The Association for Research in Vision and Ophthalmology (ARVO). Notably, one of these studies also received the “Best Paper” award at the Association of University Professors of Ophthalmology (AUPO) annual meeting.
Eyer’s Artificial Intelligence in the Real World
The paper “Real-world performance of an offline, automatic algorithm for diabetic retinopathy detection embedded in a handheld smartphone-based retinal camera on two ethnically diverse populations,” led by Dr. Fernando Malerbi, evaluated Eyer’s offline AI for Diabetic Retinopathy (DR) screening in challenging, real-world environments. The study will be presented on May 3, 2026.
Overcoming Algorithmic Bias
For AI to be truly effective, it must perform reliably across all demographics, not just in a controlled lab setting. “In addition to the initial tests we perform to verify if the algorithm provides correct answers, it is crucial to reproduce them in populations with different characteristics—for example, in our study, with diverse ethnic backgrounds. This ensures representativeness in the database, optimizes the tool’s performance, and mitigates the risk of it succeeding in one scenario but failing in another,” explains Dr. Malerbi.
To prove this robustness, the study analyzed retinal images from 1,257 diabetic patients across two demographically distinct Brazilian regions:
Itabuna (Bahia): A population predominantly of African descent, characterized by a higher prevalence of DR and shorter diabetes duration.
Blumenau (Santa Catarina): A population predominantly of European descent.
Map highlighting Itabuna and Blumenau, the cities where patient samples were collected.
Professional Results in the Hands of Volunteers
A key differentiator of this study was that image acquisition was performed largely by non-medical volunteers with varying experience levels during high-volume screening events.
Even without specialized medical training, the results were impressive. “The relevance of this study also lies in its excellent accuracy metrics and image quality. In more than 90% of the cases, it was possible to acquire adequate, high-quality images,” notes Dr. Malerbi. He attributes this success to Eyer’s intuitive design, which simplifies framing, lighting, and focus.
The study confirmed that Eyer’s AI is accurate, consistent, and free of geographic or ethnic bias, demonstratimg that low-cost, user-friendly devices can play a massive role in preventing global blindness.
The Technical Challenge: AI at the Edge
For Paulo Prado, Phelcom’s AI and Mobile Software Coordinator, the project was a masterclass in engineering with a purpose. “Participating in this project was a very meaningful experience, connecting my background directly to people’s health. One of the most important aspects was developing an algorithm capable of running offline and embedded in the device without compromising accuracy, which posed a massive technical challenge,” Prado reports.
Prado reinforces that sample diversity was crucial to validate the engineering team’s work. “Validating the system across two such distinct populations demonstrates its robustness in real-world scenarios and helps ensure the technology is truly useful in clinical practice. For me, it was incredibly rewarding to contribute to a solution that aids in the early detection of diabetic retinopathy, expanding access to disease screening, especially in areas with less medical infrastructure.”
Paulo Prado taking a retinal image with Eyer during the Diabetic Retinopathy Screening Event in Itabuna, 2022.
Eyer at the Bedside: Top Honors at AUPO
A second study, “Handheld Non-Mydriatic Fundus Camera for Bedside Inpatient Ophthalmology and Neurology Consultations,” led by neuro-ophthalmology specialist Dr. Valerie Biousse and researchers at Emory University, highlighted Eyer’s utility in hospital settings.
In scenarios where transporting patients to traditional tabletop devices is impossible, Eyer’s portability allowed for rapid, accurate bedside diagnoses. The clinical impact was so profound that the study was named Best Paper at the AUPO conference.
Shaping the Future of Precision Ophthalmology
The 2026 ARVO Annual Meeting centers on the theme: “Achieving precision ophthalmology through innovative vision research,” a topic thoroughly aligned with the studies conducted using Eyer. The meeting will take place from May 3 to May 7, 2026.
“This event is considered the largest and most important scientific meeting for ophthalmology and visual science research in the world,” Dr. Malerbi summarizes. “It is where the main ideas are presented and validated. Solutions that will enter the market or become available as treatments in the future are presented at ARVO. It inherently carries this pioneering character.”
For Phelcom, having Eyer validated in these studies proves the company’s alignment with the future of global “precision ophthalmology.” As Dr. Malerbi concludes: “It is truly important to be present at this event, both from the perspective of a scientific author and that of a company with such robust research and development.”
Diego Lencione, Co-founder and CTO of Phelcom, sees these accolades as a sign of the company’s maturity. “It is incredible to witness the evolution of Phelcom’s products and our growing relevance on the international stage. In recent years, we have achieved FDA regulatory clearance for our products, and year after year, we see our presence expanding in the global market. Undoubtedly, part of this success stems from our efforts and investments in Research and Development, which culminate in this highly relevant work to be presented at ARVO 2026, combining our expertise in the design and manufacturing of ophthalmic devices and artificial intelligence solutions that truly add value for doctors, patients, and society as a whole.”
About Phelcom
Phelcom Technologies is an American-Brazilian company that employs Physics, Electronics, and Computing to make visual health simpler, more connected, and smart.
Founded in 2016 by three young researchers: José Augusto Stuchi, a computer engineer; Flavio Pascoal Vieira, an electronic engineer; and Diego Lencione, a physicist. Inspired by co-founder Diego’s brother, who had struggled with a severe vision condition since childhood, the three founders set out to develop a portable retinal camera with an integrated smartphone.
In 2019, Phelcom launched its first product, the Eyer, a portable retinal camera. Five years later, the company introduced the Eyer2, a photo documentation platform capable of capturing high-quality images of both the posterior and anterior segments.
Today, with 10 years of history, Phelcom’s technology has benefited over two million people across multiple countries, including the United States, Japan, Chile, Colombia, the United Arab Emirates and Brazil. It has also been used in over 200 social outreach initiatives.
Fundus imaging plays a crucial role in diagnosing and monitoring various eye diseases, including diabetic retinopathy. However, in many low- and middle-income countries, access to conventional retinal imaging equipment remains limited due to high costs and infrastructure requirements. Additionally, publicly available image datasets for doctors, researchers, and clinicians remain scarce, particularly for images captured with portable fundus cameras.
In this context, portable fundus cameras like the Eyer have emerged as a more accessible and cost-effective solution for eye screening and disease management. Mounted onto a smartphone, the Eyer captures high-quality retinal images in minutes—without requiring pupil dilation.
These devices can be used in a variety of settings beyond hospitals, such as community health screenings and remote telemedicine consultations. Additionally, they record detailed metadata typically unavailable in other datasets, including patient age, sex, diabetes duration, treatments, and comorbidities.
Recently, Scientific Data, a journal from the Nature portfolio, published the article “A portable retina fundus photos dataset for clinical, demographic, and diabetic retinopathy prediction,” introducing mBRSET: the first publicly available diabetic retinopathy dataset captured using handheld fundus cameras in real-world, high-burden environments. Among the authors of the study are ophthalmologist Fernando Korn Malerbi and Phelcom’s CEO, José Augusto Stuchi.
Fundus images captured with Eyer during the Itabuna Diabetes Campaign, held in 2022, highlighting the attention map generated by EyerMaps, indicating possible anomalies.
mBRSET: A Groundbreaking Dataset
mBRSET consists of 5,164 from 1,291 patients of diverse backgrounds, all captured with the Eyer device during the 2022 Itabuna Diabetes Campaign in Bahia. Recognized as one of the world’s largest diabetes prevention and treatment initiatives, this campaign provides hundreds of patients with vital screenings—such as fundus examinations—and referrals for specialized treatment.
Exam performed with Eyer during the Itabuna Diabetes Campaign, held in 2022.
To validate the utility of mBRSET, state-of-the-art deep learning models were trained for benchmarking, demonstrating high accuracy in diagnosing diabetic retinopathy and macular edema, as well as predicting demographic data.
An analysis of 4,885 assessed images revealed that 3,759 images (76.79%) showed no signs of diabetic retinopathy (DR), 272 images (5.56%) indicated mild non-proliferative DR, 570 images (11.64%) exhibited moderate non-proliferative DR, 82 images (1.67%) showed severe non-proliferative DR, 427 images (8.69%) displayed signs of macular edema.
A Milestone for Ocular Health and Scientific Research
The significance of the mBRSET dataset can be outlined in 5 key aspects:
Representing Brazil’s Diverse Population
mBRSET helps reduce the underrepresentation of low- and middle-income country (LMIC) populations in ophthalmological datasets by including individuals from various ethnic and socioeconomic backgrounds in Brazil.
The First Public Dataset with Portable Camera Images
This is the first publicly available dataset featuring images captured with portable fundus cameras, reflecting the increasing adoption of this technology in resource-limited settings.
Data Collection in Real-World, High-Demand Environments
Images were captured in high-volume clinical settings, ensuring the dataset accurately represents real-world challenges in eye disease screening and management.
Inclusion of Detailed Demographic Data
mBRSET goes beyond retinal images, incorporating information such as gender, education level, and health insurance status. This enables researchers to evaluate AI algorithm performance across different subpopulations.
A Foundation for AI Development in Ophthalmology
This dataset serves as a critical resource for training and validating AI algorithms, fostering advancements in automated screening, diagnosis, and monitoring of diabetic retinopathy and other eye conditions.
Phelcom CEO José Augusto Stuchi emphasizes the dataset’s impact on the scientific and medical communities:
“The creation of this mBRSET marks a significant milestone in ocular health, particularly for regions with limited resources. By providing high-quality images captured with portable devices, we expand research opportunities and accelerate the development of AI-driven solutions that can revolutionize the diagnosis and treatment of eye diseases.”
Diego Lencione, co-founder and CTO of Phelcom, Flavio Pascoal Vieira, co-founder and COO of Phelcom, Paulo Prado, coordinator of Mobile Software and AI at Phelcom, and José Augusto Stuchi, co-founder and CEO of Phelcom, during the Itabuna Diabetes Campaign, held in 2022.
Eyer
The Eyer is a portable fundus camera that attaches to a smartphone, enabling high-quality retina exams in just minutes—without the need for pupil dilation.
The technology supports the diagnosis of more than 50 diseases, including: glaucoma, cataracts, diabectic retinopathy, retinoblastoma, hypertensive retinopathy, retinopathy of prematurity, ocular toxoplasmosis.
Recently, Phelcom launched Eyer2, an enhanced version of the device featuring new built-in tools for expanded diagnostic capabilities. In addition to posterior eye imaging, Eyer2 enables the detection of anterior segment conditions such as: blepharitis and other eyelash abnormalities, meibomian gland dysfunction, styes, conjunctival and eyelid tumors, advanced cataracts, foreign bodies and burns, corneal injuries, keratitis caused by dry eye, contact lenses, infections and ulcers.
About Phelcom
Phelcom Technologies is a Brazilian medtech company based in São Carlos, São Paulo. Founded in 2016 by three young researches—a physicist, an electronics engineer, and a computer engineer—the company developed a portable retinal camera integrated with a smart phone.
The first prototype was inspired by co-founder Diego Lencione’s personal experience, as his brother struggled with a severe vision condition from childhood.
In 2019, Phelcom launched its first product, the Eyer portable retinal camera, in Brazil. Five years later, the company introduced the Eyer2, a platform capable of capturing high-quality images of both the posterior and anterior segments.
To date, Phelcom’s technology has benefited over two million people across Brazil and multiple countries, including the United States, Japan, Chile, Colombia and the United Arab Emirates. It has also been used in over 100 social outreach initiatives.
The doctor Gustavo Rosa Gameiro, a PhD student in ophthalmology at Unifesp, was selected by the Brazilian Academy of Sciences (ABC) and the Ministry of Science, Technology and Innovation (MCTI) to participate in the 8th BRICS Young Scientists Forum. The event occurred from July 31th to August 8th in Gqeberha, South Africa.
BRICS is a group of five developing countries focused on mutual economic cooperation: Brazil, Russia, India, China and South Africa.
Gameiro was one of the six Brazilian scientists nominated to take part in the panel “The future of education, skills and skill sets”. The PhD student points out that education entered the BRICS agenda with great force this year. “In my presentation, we discussed applications of basic models and the use of the Eyer portable fundus camera with artificial intelligence for teaching ophthalmology based on the results of our workshops,” says the doctor, the youngest member of the Brazilian delegation at the event at 27 years old.
Gustavo Gameiro used the Eyer portable fundus camera in his project presented at the 8th BRICS Young Scientists Forum. Photo: personal archive.
Gameiro explains that the first approach to diseases such as glaucoma, Age-Related Macular Degeneration (AMD) and diabetic retinopathy in primary care is often carried out by the newly qualified clinical doctor.
“However, studies reveal that they have a huge deficit in the teaching of ophthalmology during their degree, compromising the correct approach and prognosis of these cases. This can lead to insecurity in referring or treating patients with ophthalmic complaints,” he explains.
Workshops
The workshops took place with undergraduate students from Unifesp and the Albert Einstein Israelite Institute for Education and Research and were supported by the ophthalmologists Thiago Gonçalves Martins and Paulo Schor, Gameiro’s PhD advisor. The Eyer portable fundus camera and the EyerMaps AI system were provided free of charge by Phelcom Technologies for the project.
“With the EyerMaps AI resource, which uses a heat map to highlight areas of the retina with possible alterations caused by different pathologies, we were able to teach and correct the student’s interpretation findings at the same time as captured by the fundus of the eye,” says the doctor.
“The clarity of the images is absurdly incredible. We did exams on our colleagues and we were able to see every detail of the retina, optic nerve and vessels. Transforming large, heavy devices like a fundus camera into portable ones makes the doctor’s life much easier, because we can go to the patients and achieve better results,” says Unifesp medical student Suellyn Alves, who took part in the workshop.
Gameiro goes further: “Perhaps we need to change the paradigm of only teaching students how to acquire images using ophthalmic equipment. We need to focus on how to interpret them and manage these exams, organizing them in the cloud, for example. and with the Eyer, you can easily teach interpretation and management” he says.
With the satisfactory results of the workshops, the doctor reveals his desire to expand the project and turn it into support material for teaching ophthalmology throughout Brazil.
Brazilian delegation during the 8th BRICS Young Scientists Forum. Photo: personal archive.
“Eyes to the Future” contest
Gameiro is also working on a new project at the same time: evaluating the impact and follow-up of the projects presented in the “Eyes to the Future” contest, held by the Brazilian Association of Academic Ophthalmology Leagues (ABLAO), in partnership with Phelcom and with the support of the Brazilian Ophthalmology Council (CBO).
The competition seeks to teach students and encourage leagues to develop extension activities aimed at creating educational and/or assistance projects with the objective of reducing blindness due to posterior segment pathologies. To accomplish this.Phelcom provided 20 Eyer units with access to the EyerMaps feature and the EyerCloud cloud system.
The competition selected 10 projects and the top three will receive an Eyer. “It would be very interesting if we could permanently leave a portable fundus camera with each of the 10 leagues. We’re going to work on getting sponsorship to buy the seven remaining devices,” says the doctor.
“After the Academic Leagues were selected, we spoke to ABLAO’s president Luís Sabage and realized the need to evaluate and follow up on the projects submitted. Our future goal is to increase the number of ophthalmologic leagues, medical students and patients reached by the outreach projects developed,” he explains.
Furthermore, based on the results obtained in the “Eyes to the Future” contest and the points for improvement found, Gameiro intends to structure an online ophthalmology course for medical students and general practitioners, covering basic eye examination techniques, the use of artificial intelligence platforms and the interpretation of retinography images.
The doctor points out that traditional equipment for evaluating the fundus of the eye, such as fundoscopy performed with an indirect ophthalmoscope and condenser lens, is relatively difficult to handle, requires lengthy training, has a learning curve and depends on the examiner for evaluation. Besides, most of the time it doesn’t allow photographic recording of the retina for later discussion and review.
Alternatively, there is the conventional fundus camera. However, it is expensive to purchase. “Capturing images of the retina is extremely important for more accurate assessment and for monitoring the disease and treatment. It also plays a fundamental role in the training of new professionals through the presentation and discussion of findings in a group, allowing students and doctors to compare their exams and review the results,” he says.
The Eyer portable fundus camera is an extremely advantageous option in several aspects:
It makes it easy to capture high-quality images of the retina without much prior training;
Lightweight and small (it fits in the palm of your hand);
It does not require specialized labor;
Relatively more affordable than a traditional fundus camera;
It is non-mydriatic, shortening the examination time and avoiding possible adverse effects (visual discomfort, photophobia, keratitis and increased intraocular pressure);
Through telemedicine, it sends the images to the cloud, enabling remote diagnosis.
For Gameiro, the Eyer can have a significant impact on medical education. “The device can be used by medical students as a practical learning opportunity, demonstrating clinical cases and monitoring the progression of eye diseases over time, as well as stimulating interactive discussions between students and teachers, encouraging research projects and cases and facilitating access to and recording of a wide variety of cases,” he points out.
The equipment also has on-board artificial intelligence, which can be a reliable and cost-effective option for screening retinal and optic nerve pathologies using algorithms built on extensive databases.
“These algorithm models are able to predict the risk of alteration and thus notify the examiner of the need for follow-up with a more qualified specialist. In this way, the use of AI, together with deep learning and telemedicine, can represent an effective long-term solution for screening and monitoring patients in primary health care,” he concludes.
About the Eyer
Eyer Portable Fundus Camera
The Eyer is a portable fundus camera that works in conjunction with a smartphone and performs high-quality retinal examinations in a few minutes without the need for pupil dilation.
The technology supports the diagnosis of more than 50 diseases, including glaucoma, cataracts, diabetic retinopathy, AMD, retinoblastoma, hypertensive retinopathy and ocular toxoplasmosis. Currently, more than 10 million tests have been carried out in Brazil, the United States, Chile and Colombia.
The technology’s portability and affordability democratize access to retinal examinations. It costs approximately six times less than a conventional tabletop fundus camera, which still needs to be integrated with a computer.
About Phelcom
Phelcom Technologies is a Brazilian medtech company based in São Carlos, in the interior area of São Paulo. The company’s story began in 2016, when three young researchers – a physicist, an electronics engineer and a computer engineer (physics, electronics, computing) – created a portable fundus camera integrated with a smartphone.
The idea for the first prototype was realized by Diego Lencione’s interest in visual health, as his brother has had a condition that has severely compromised his retina and vision since childhood.
In 2019, Phelcom launched its first product on the Brazilian market: the Eyer portable fundus camera. Today, the technology has reached more than two million people across Brazil and worldwide.
In four years, the company has participated in more than 100 social actions and was recently named one of the 10 most innovative companies in Brazil by Forbes.
Augmented reality in health allows a real-time combination of images never before achieved, with new possibilities to diagnose diseases, which can increase accuracy in surgical procedures. That is, it can potentially improve patient quality of life.
In real time, the technology shows the material world overlayed with computer-made images, enabling greatly improved composite observations.
For this, smartphone cameras, tablets, smart glasses and even state-of-the-art helmets are used, so that the hands are unnecessary to command interfaces in systems and applications.
For instance, there is a strong trend to use Augmented Reality (AR) in this industry, according to the Journal of Med Internet Research (JMIR). Even with a still low use by doctors and institutions, there is an increasing number of applications of AR in medicine.
Learn about the advantages of using augmented reality in health and some cases of success.
Augmented reality X Virtual Reality
First, it’s important to understand the difference between augmented reality and Virtual Reality (VR).
AR, in its turn, integrates the physical and the virtual by overlaying computerized images in the real world, through software and devices. For example, the Google Glass app can be accessed from the user’s own mobile phone or tablet. There is also the famous game Pokémon Go, in which players searched for virtual Pokémon in real-world environments using the mobile phone camera.
Augmented reality in healthcare: advantages
Undoubtedly, there are numerous advantages of using AR in health. One of them is to ease access to the patient’s medical history in emergencies or on the surgery table, for example. Image overlaying may also more accurately ensure to locate an area of interest in surgical procedures, thus decreasing risk to the patient. In this case, it is possible to integrate imaging examinations and better see every detail of the organs in the preoperative care and, thus, have more success in surgery.
In fact, technology is a great ally of telemedicine. For example, specialists can instruct other doctors remotely in more complex operations. Another aspect is diagnostic medicine, because the patient can better understand the diagnosis and the recommended treatment.
AR has also been used in the digital screening of patients who have suffered accidents. In these cases, orthopedists help in the performance of arthroscopic surgeries on shoulders and in training interns and residents to carry out ultrasound examination at the care site.
Neurosurgery is one of the most advanced specialties in the use of AR, with reports of tumor resection, open neuro-vascular surgeries, spinal procedures, location of catheters or probes, cortical resection in epilepsy and aneurysms involving unusual trajectories or hidden ramifications.
In hospitals and clinics, the technology assists remote support by enabling on-site technicians and teams to receive specialized help needed for installation, setup, maintenance, troubleshooting, and repair of sensitive and specialized hospital equipment.
Teaching in medicine
Augmented Reality in healthcare allows seeing details of the human body and training procedures in a repetitive and precise way.
Student, imagine practicing surgery in a virtual environment? Stanford University has a simulator which allows the most complete training for the future surgeon.
For researchers, a three-dimensional virtual surgical environment can allow for enhanced preoperative planning and testing. It thus improves patient results, decreases complication rates and improves technical skills.
The Stanford Virtual Surgical Environment (VSE) is developed for rhinologic procedures. The technology allows the surgeon to interact with patient-specific three-dimensional reconstructions of nasal sinus CT data sets using a modified haptic interface device, triggering a virtual endoscope.
In Brazil, there are also options for simulators. For example, Eyesi is aimed at training intraocular cataract surgery and vitreo-retinal procedures. It presents performance score and evaluates tremor, movement accuracy and repetitiveness, among other analyzes. Thus, it is a good tool for resident practice to introduce new techniques in ophthalmic surgery.
There are also the da Vinci surgical systems for robotic surgery, already in the fourth generation. The technology carries out minimally invasive surgeries in different procedures. One of its tools is a console – inspired by flight simulators – in which doctors visualize the high-definition 3D images and make the operative movements with their own hands, which are transmitted to the robot.
Another application is training and retraining for students, residents and specialists in care or in the surgical center. Thus, it is possible to carry out an ethnographic analysis of the performance of the professional, who is alone during the procedure, through the capture of images by a camera installed on the site.
Augmented Reality solutions in healthcare
On the market, there are already quite interesting solutions of AR.
For example, the application EyeDecide allows you to see the eyeball from any angle just by directly touching the image generated on the tablet and rotating it with your finger. It is also possible to reduce, expand, move or make notes on the eye in almost any direction. All this assists to simulate various disorders and helps to diagnose more accurately.
The app Anatomy 4D makes it possible to explore more than two thousand anatomical structures. Undoubtedly, it helps students and medical colleges.
Even with all the advantages, augmented reality in health is still relatively new and is not heavily employed in the area. However, as it proves its value for the quality of patient care, soon AR technologies will be stronger in the medical industry.
Reviewed by Paulo Schor, ophthalmologist, associate professor and director of innovation of the Federal University of São Paulo (Unifesp) and collaborator of the Faculty of Medicine of the Albert Einstein Hospital.
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