Multidisciplinary Ophthalmic Imaging
Construction of an Inexpensive, Hand-Held Fundus
Camera through Modification of a Consumer ‘‘Point-and-
Kenneth Tran,1Thomas A. Mendel,2,3Kristina L. Holbrook,2and Paul A. Yates1,2
PURPOSE. To construct a low-cost, easy-to-use, high-image-
quality mydriatic fundus camera with ‘‘point-and-shoot’’
operation, and to evaluate the efficacy of this camera to
accurately document retinal disease.
METHODS. A prototype portable fundus camera was designed by
interfacing a novel optical module with a Panasonic Lumix G2
consumer camera. Low-cost, commercially available optics
were used to create even illumination of the fundus, providing
a 508 retinal field of view. A comparative study assessing the
image quality of the prototype camera against a traditional
tabletop fundus camera was conducted under an Institutional
Review Board (IRB)-approved study.
RESULTS. A stand-alone, mydriatic camera prototype was
successfully developed at a parts cost of less than $1000.
The prototype camera was capable of operating in a point-and-
shoot manner with automated image focusing and exposure,
and the image quality of fundus photos was comparable to that
of existing commercial cameras. Pathology related to both
nonproliferative and proliferative diabetic retinopathy and age-
related macular degeneration was easily identified from fundus
images obtained from the low-cost camera.
CONCLUSIONS. Early prototype development and clinical testing
have shown that a consumer digital camera can be inexpen-
sively modified to image the fundus with professional
diagnostic quality. The combination of low cost, portability,
point-and-shoot operation, and high image quality provides a
foundational platform on which one can design an accessible
fundus camera to screen for eye disease. (Invest Ophthalmol
Vis Sci. 2012;53:7600–7607) DOI:10.1167/iovs.12-10449
field and required manual exposure using flash powder and
color film.1,2Since then, the capabilities of fundus cameras
have improved dramatically to include nonmydriatic imaging,
electronic illumination control, automated eye alignment, and
high-resolution digital image capture. These improvements
n 1926, Carl Zeiss Company introduced the first commer-
cially available fundus camera, which offered a 108 retinal
have helped make modern fundus photography a standard
ophthalmic practice for detecting and documenting retinal
Although current fundus cameras have advanced signifi-
cantly since their introduction, the traditional tabletop optical
design has remained largely unchanged.4,5Complex optical
assemblies in current devices provide high-resolution imaging
of the fundus but also require dedicated clinical space and high
manufacturing costs. Portable cameras have recently become
commercially available, but most remain difficult to use in a
hand-held manner and often have substandard image quality,
compared to their tabletop counterparts.6,7
The commercial field of fundus camera equipment stands in
unique contrast to consumer digital camera technology, where
to use. Although other ophthalmic equipment manufacturers
have recently incorporated consumer digital single-lens reflex
(DSLR) cameras into their fundus camera designs, they do not
make full use of the consumer camera’s built-in functions or
space-saving design. Traditional fundus camera designs are thus
ill suited to leverage the significant cost reductions and
technologic advancements of consumer camera technology.
Within the past decade, retinal screening programs for
macular degeneration, have experienced rapid growth.7–10The
expansion of these screening programs into rural, nurse-
operated, highly distributed primary care facilities highlights
to-operate, and high-image-quality fundus camera.11–13
Our goal was to create a device capable of imaging the
human fundus and documenting retinal pathology with
components that cost less than $1000. We also aimed to
improve dramatically the ease of use of the device by
incorporating common ‘‘point-and-shoot’’ consumer camera
technology. A secondary objective was to reduce the design to
a portable form factor that would enable remote use of the
device in settings such as hospital bed consultations and
nursing home facilities. This design would provide a means of
acquiring fundus photographs in clinical settings previously
inaccessible to tabletop cameras.
In this article, we present the technical modifications needed
to transform a consumer digital camera into a mydriatic fundus
camera. We also demonstrate the functional feasibility of using
such a camera in a variety of clinical settings to produce images
of the posterior pole of the eye with pathology detail resolution
comparable to that of existing fundus cameras.
MATERIALS AND METHODS
General Design Description
Human fundus photography is based upon the principle of indirect
ophthalmoscopy. A front objective lens is positioned at a working
distance of 5 to 50 mm from the front of the eye. This lens is used to
From the1Departments of Biomedical Engineering,2Ophthal-
3Pathology, University of Virginia, Charlottesville,
Supported by the UVa-Coulter Translational Partnership Grant
(GF11938), Ivy Foundation of Charlottesville Research Grant (DR-
02314), and National Institutes of Health (NIH) Grants T32
GM08715 (TAM) and K08 GC11897 (PAY).
Submitted for publication June 22, 2012; revised September 2,
2012; accepted October 2, 2012.
Disclosure: K. Tran, RetiVue, LLC (I, E, S), P; T.A. Mendel,
None; K.L. Holbrook, None; P.A. Yates, RetiVue, LLC (I, E, S), P
Corresponding author: Paul A. Yates, Department of Ophthal-
mology, PO Box 801375, Charlottesville, VA
Investigative Ophthalmology & Visual Science, November 2012, Vol. 53, No. 12
Copyright 2012 The Association for Research in Vision and Ophthalmology, Inc.
8. Cheung N, Mitchell P, Wong TY. Diabetic retinopathy. Lancet.
9. Mohamed Q, Gillies MC, Wong TY. Management of diabetic
retinopathy: a systematic review. JAMA. 2007;298:902–916.
10. Saligan LN. Preventing diabetic retinopathy in primary care.
Nurse Pract. 2008;33:46–47.
11. Klein R, Meuer SM, Moss SE, Klein BE, Neider MW, Reinke J.
Detection of age-related macular degeneration using a non-
mydriatic digital camera and a standard film fundus camera.
Arch Ophthalmol. 2004;122:1642–1646.
12. Taylor CR, Merin LM, Salunga AM, et al. Improving diabetic
retinopathy screening ratios using telemedicine-based digital
retinal imaging technology: the Vine Hill study. Diabetes Care.
13. Askew D, Schluter PJ, Spurling G, et al. Diabetic retinopathy
screening in general practice: a pilot study. Aust Fam
14. Bradley JC, Bentley KC, Mughal AL, Bodhireddy H, Brown SM.
Dark-adapted pupil diameter as a function of age measured
with the NeurOptics pupillometer. J Refract Surg. 2011;27:
15. Fariza E, Jalkh AE, Thomas JV, O’Day T, Peli E, Acosta J. Use of
circularly polarized light in fundus and optic disc photography.
Arch Ophthalmol. 1988;106:1001–1004.
16. Fariza E, O’Day T, Jalkh AE, Medina A. Use of cross-polarized
light in anterior segment photography. Arch Ophthalmol.
17. Sommer A, Kues HA, D’Anna SA, Arkell S, Robin A, Quigley
HA. Cross-polarization photography of the nerve fiber layer.
Arch Ophthalmol. 1984;102:864–869.
18. Peli E. Circular polarizers enhance visibility of endothelium in
specular reflection biomicroscopy. Arch Ophthalmol. 1985;
19. Evans JN. Polarized light attachment for ophthalmoscopy.
Trans Am Ophthalmol Soc. 1936;34:113–117.
20. Delori FC, Webb RH, Sliney DH; American National Standards
Institute. Maximum permissible exposures for ocular safety
(ANSI 2000), with emphasis on ophthalmic devices. J Opt Soc
Am A Opt Image Sci Vis. 2007;24:1250–1265.
21. Sliney DH. Ocular injury due to light toxicity. Int Ophthalmol
22. Sliney DH. Optical radiation safety of medical light sources.
Phys Med Biol. 1997;42:981–996.
23. Sliney DH. Radiometry and laser safety standards. Health Phys.
24. National Health Service. Essential elements to developing a
diabetic eye screening programme. Available at: http://
diabeticeye.screening.nhs.uk/workbook. Published January
19, 2012. Accessed May 5, 2012.
IOVS, November 2012, Vol. 53, No. 12
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