OSN Europe: Easy-to-use modular system turns smartphone into versatile recording device

Maninder Bhogal, FRCOphth, explains how he devised and created the EyeCamHD.

Despite rapid advances in portable video technology, it remains difficult to record what we see down the slit lamp or through the operating microscope. A further challenge is to then process any recorded material into a format useful for learning and sharing. This month, I interviewed Maninder Bhogal, FRCOphth, who shares his story of developing the EyeCamHD from scratch and gives his advice to young ophthalmologists with their own innovative ideas.

Anthony P. Khawaja, MB BS, MA(Cantab), MPhil, FRCOphth, Chair of the SOE Young Ophthalmologists committee

Khawaja: What is the EyeCamHD?

Bhogal: The EyeCamHD is a purpose-built case and set of adapters that allow ophthalmologists to couple their smartphone or iPad to the slit lamp and surgical microscope. It has specifically been designed with ease of use in mind, so setup is easy and you can start recording instantly.

Khawaja: What can we expect from the output? Are videos and photos of publication and presentation quality?

Bhogal: The video output from modern phones continues to improve at a rapid pace. All of the devices I have built adapters for record in 1080p HD or better, and this currently surpasses the requirements for most international conferences.

Khawaja: How does the output compare with other specialized equipment?

Bhogal: I recently conducted a formal evaluation comparing the video quality from the EyeCamHD setup to the best medical camera systems currently available. The same case was recorded with each of the devices in 1080p HD. In masked evaluations, the majority of surgeons thought the videos from the EyeCamHD were better quality and more than clear enough to be able to evaluate and critique surgical practice.

Khawaja: Do you think the EyeCamHD has any big advantages over current theater systems?

Bhogal: There are three main advantages. Firstly, the videos can be directly viewed and edited on the device itself. They can be anonymized and stored in encrypted folders straight from recording. This keeps data safe and means you do not need to invest in further expensive storage media.

Secondly, the internal optics of the newest phone cameras allow for continuous autofocus. This is especially useful for younger surgeons who will often find that images are perfectly in focus at the start of a case but get blurred as they accommodate. As we accommodate more under stress, it is often the trickiest parts of the surgery that come out the blurriest, making them hard to evaluate.

Finally, the ability to record sound is incredibly useful. I can hear technical things such as when the phaco is on, but more importantly, I hear how I interact with patients and theater staff in straightforward and stressful situations.

Khawaja: What inspired you to develop the device?

Bhogal: As a trainee, I soon realized the importance of being able to record and review each case I performed. I would watch the cases I had done and those done by my consultants to see how I could improve. It was amazing to see how much I spent doing nothing at the start. Before my next list I would watch what I had done the week before and would decide what was good and how I would try and improve this time. I found this type of analysis and mental rehearsal allowed me to make constant small improvements, and it is something I do to this day.

The problem was that each theater I worked in often had a different camera setup, most only recorded grainy standard definition images, and the format of the videos made them difficult to review and edit. By the time I was in my fourth year of training, I had spent more than £2,000 on equipment and needed a small backpack to carry it all in. At that point, I thought there had to be a better way, so I started working on one.

Khawaja: How did you develop your idea into a reality?

Bhogal: I have always been interested in engineering, product design and 3-D animation. I knew I wanted to make something practical and easily accessible to all, and having seen how smartphones were changing every other facet of daily life, I decided that a recording device using my smartphone was the way forward.

I started taking some measurements of the microscope and did some simple optical calculations. Once I had an idea of what I wanted, I started making prototypes. When I saw the images for the first time, I knew this was something worth pursuing. Twenty prototypes later, I was happy with what I had achieved. Since then, I have tweaked the design slightly based on feedback from my customers and expanded the number of devices EyeCamHD supports.

Khawaja: How long did the development take?

Bhogal: It took 6 months to go from first prototype to final product for the original case I made for my iPhone 4. Because the system is designed to be modular, each time I upgraded my phone I simply designed a new case that would work with the existing slit lamp and microscope adapters. When people asked if I had a case for their phone model, I would design one. The whole process has been enjoyable and has allowed me to learn many useful skills that I can apply to my practice as a corneal specialist.

Khawaja: How else do you think modern manufacturing techniques can assist modern-day ophthalmology?

Bhogal: Manufacturing is going through a renaissance at the moment. CAD software is easier than ever to use, and most universities now have “making” centers where you can prototype things on a 3-D printer, laser cutter or CNC machine. The limit is your imagination. Smartphones have changed the world and, for many people, replaced the personal computer. They will undoubtedly change the way we examine and interact with patients throughout the rest of our careers and give us the opportunity to disseminate care and education to places where it is currently unavailable.

Khawaja: What advice do you have for YOs with a good idea?

Bhogal: If you have a good idea, run with it. It is easy to access tutorials on 3-D design and CAD on YouTube or your local library. The feeling you get when you unbox your first product fresh from the manufacturer is as good as completing your first phaco, and the new skills you learn along the way will give you a fresh perspective on your work as an eye surgeon. People will forever tell you why you cannot do something, but if you believe in what you are doing and have a thick skin, you can achieve something great. Just look at Charlie Kelman.

For more information:

Maninder Bhogal, FRCOphth, can be reached at Department of Cornea and External Disease, Moorfields Eye Hospital, City Road, London, EC1V 2PD, England; email: info@eyecamhd.com.

SOE Young Ophthalmologists website: http://soevision.org/yo.

Disclosure: Bhogal reports he is the inventor of the EyeCamHD and the director of EyeCamHD Ltd.

Click here to read the full publication exclusive, The Young Ophthalmologist, published in Ocular Surgery News Europe Edition, April 2015.