Medical Forum / General / Vision / July 2007
Fundus imaging
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Helpful person - 26 Jun 2007 16:48 GMT I have a project to design a special purpose fundus camera. Although an experianced optical engineer and lens designer I have never examined the field of opthalmology.
I am looking for on line references, books and technical papers that describe such cameras from an optical viewpoint. So far I have found an excellent article at http://www.emedicine.com/oph/topic756.htm
All help will be apreciated.
Please visit my web site at www.richardfisher.com
Barry Cense - 26 Jun 2007 17:09 GMT Does it really have to be a fundus camera? Is it possible to use a scanning laser ophthalmoscope (SLO) instead?
Although it is easier to build a fundus camera, the SLO gives a much better contrast and it is easier to combine with other imaging modalities, such as polarimetry. A couple of years ago, I built a fundus camera in my OCT (optical coherence tomography) system for retinal imaging, but if I would have to do it again, I would use an SLO instead, because of the earlier mentioned advantages. However, there are applications where a fundus camera gives better results.
> I have a project to design a special purpose fundus camera. Although > an experianced optical engineer and lens designer I have never [quoted text clipped - 7 lines] > > Please visit my web site atwww.richardfisher.com Helpful person - 27 Jun 2007 20:29 GMT > Does it really have to be a fundus camera? Is it possible to use a > scanning laser ophthalmoscope (SLO) instead? [quoted text clipped - 20 lines] > > - Show quoted text - When you built the fundus camera did you use an aspheric objective lens? If so, can you recommend any supliers?
www.richardfisher.com
Barry Cense - 27 Jun 2007 21:55 GMT > > Does it really have to be a fundus camera? Is it possible to use a > > scanning laser ophthalmoscope (SLO) instead? [quoted text clipped - 27 lines] > > - Show quoted text - Yes, the double aspheric lenses we used were made by Volk (http:// www.volk.com/promenu-main.aspx). We also tried achromats, but the double asphere gave much better results.
Helpful person - 27 Jun 2007 21:58 GMT > > > Does it really have to be a fundus camera? Is it possible to use a > > > scanning laser ophthalmoscope (SLO) instead? [quoted text clipped - 32 lines] > > - Show quoted text - Thanks very much.
www.richardfisher.com
Dr Judy - 26 Jun 2007 17:14 GMT > I have a project to design a special purpose fundus camera. Although > an experianced optical engineer and lens designer I have never [quoted text clipped - 7 lines] > > Please visit my web site atwww.richardfisher.com Have you investigated the fundus cameras already on the market to see if one could be adapted to your special need? There are a number of digital cameras using light available as well as scanning laser imaging systems. You may not need to re invent the wheel.
http://www.retinalcameras.net/
Dr Judy
Don W - 26 Jun 2007 19:31 GMT > I have a project to design a special purpose fundus camera. You may not want to or can't, but you might get more feedback if you define (explain better?) the why of "special purpose".
Don W.
Helpful person - 26 Jun 2007 20:11 GMT > I have a project to design a special purpose fundus camera. Although > an experianced optical engineer and lens designer I have never [quoted text clipped - 7 lines] > > Please visit my web site atwww.richardfisher.com Please people, I really do know what I need. Can anyone help with literature suggestions?
www.richardfisher.com
William Stacy - 27 Jun 2007 01:47 GMT Can't help with any references, but I'm experienced with a fundus camera (now about 6000 images taken). Am curious as to what your "special purpose" would be. I mean do you need better resolution than now available or what? I'd say they have pretty much leveled off in improvements, rarely needing dilation for excellent single pics and pretty decent stereo pairs. I think what would be a real welcome thing would be an inexpensive version. My Canon was over 20K, and I imagine they have some patent apps. floating around that would detail the optics nicely.
You can view my first attempt at http://www.obase.net/MillerLeft.jpg (undilated, "normal" fundus, taken in 2004)
w.stacy, o.d.
> > [quoted text clipped - 17 lines] > > Helpful person - 27 Jun 2007 14:26 GMT > Can't help with any references, but I'm experienced with a fundus camera > (now about 6000 images taken). Am curious as to what your "special [quoted text clipped - 29 lines] > > - Show quoted text - Nice picture.
www.richardfisher.com
Marc Reinig - 27 Jun 2007 02:44 GMT Is this of any help?
http://www.optics.ru/info/AO-system-small.pdf
I work primarily with astronomical optical systems, but pretty much identical systems are used by our vision optics brethren. They image the retina at micron level resolution using adaptive optics to correct for the distortions and motions of the of the eye.
I just quickly grabbed the above link. I could give more, I'm just not sure if this is even relevant to your problem.
Marco ________________________ Marc Reinig UCO/Lick Observatory Laboratory for Adaptive Optics
>> I have a project to design a special purpose fundus camera. Although >> an experianced optical engineer and lens designer I have never [quoted text clipped - 12 lines] > > www.richardfisher.com Helpful person - 27 Jun 2007 12:41 GMT > Is this of any help? > [quoted text clipped - 32 lines] > > - Show quoted text - Thanks for the reference. I will check it out, although I'm looking for something more low tech.
www.richardfisher.com
Helpful person - 27 Jun 2007 12:52 GMT > > I have a project to design a special purpose fundus camera. Although > > an experianced optical engineer and lens designer I have never [quoted text clipped - 12 lines] > > www.richardfisher.com Thanks for the quick responses, expecially William and Marc.
I'm afraid I can't write about my special purpose except to say it consists mainly of repackaging and producing an inexpensive product for a specific application. My main area of concern is the instrument pupils, illumination and imaging. My present assumptions are:
There has to be spatial separation between the illumination and imaging pupils. This seems to be usually achieved by illimination through an annulus at the eye pupil and imaging through the center of this pupil. My present quandry is that I do not have a good feel as to the size and required separation of the these two pupils.
It seems that the illumination pupil needs to be small enough to avoid scattering from a dilated eye. A guess (and at present that's all it is) is that it's maximum size needs to be less than 6mm with it''s inner radius at maybe 4mm. To limit glare I would guess that the imaging pupil should have a diameter of 2mm.
Any comments?
www.richardfisher.com
Mike Tyner - 27 Jun 2007 13:46 GMT > It seems that the illumination pupil needs to be small enough to avoid > scattering from a dilated eye. A guess (and at present that's all it [quoted text clipped - 3 lines] > > Any comments? Could you experiment with a 15-mm glass sphere to mimic the curvature of the cornea?
-MT
Marc Reinig - 27 Jun 2007 16:25 GMT Things like the pupil separation are usually determined by experience rather than modeling. I'll see if I can find some references later today.
BTW, while the more extreme adaptive optics are expensive, there are lower cost (even low cost) approaches that provide significant improvement. It's only when you are trying to push to the higher levels of improvement that you hit the exponential part of the price curve.
Marco ________________________ Marc Reinig UCO/Lick Observatory Laboratory for Adaptive Optics
>> > I have a project to design a special purpose fundus camera. Although >> > an experianced optical engineer and lens designer I have never [quoted text clipped - 35 lines] > > www.richardfisher.com Helpful person - 27 Jun 2007 19:03 GMT > Things like the pupil separation are usually determined by experience rather > than modeling. I'll see if I can find some references later today. [quoted text clipped - 51 lines] > > - Show quoted text - Marco,
Thanks for your response. My present plan is to design the prototype with interchangeable apertures so that I can perform some experiments.
www.richardfisher.com
Richard J Kinch - 27 Jun 2007 19:02 GMT > It seems that the illumination pupil needs to be small enough to avoid > scattering from a dilated eye. A guess (and at present that's all it > is) is that it's maximum size needs to be less than 6mm with it''s > inner radius at maybe 4mm. To limit glare I would guess that the > imaging pupil should have a diameter of 2mm. That is all easily observed holding a ruler to a conventional mydriatic instrument. On my Topcon instrument the annulus is 9mm outside and 3mm inside. The angle of convergence also matters.
Scattering is not a problem. The annulus of light is often bigger than the dilated pupil, depending on the dose and age of the patient.
Phil Hobbs - 28 Jun 2007 17:32 GMT >>> I have a project to design a special purpose fundus camera. Although >>> an experianced optical engineer and lens designer I have never [quoted text clipped - 31 lines] > > www.richardfisher.com Sounds like a project I managed to wiggle out of, about a dozen years ago...a contact lens company wanted to put automated eye exam kiosks in malls, so that they could get past the dominant position of optometrists and sell disposable contact lenses by mail, direct to consumers. Not a truly terrible idea, but the development cost would have been fairly staggering--mostly in the interpretation rather than the optics. We managed to help them with an improved business model rather than a kiosk, so everybody went away happy. So far, optometrists still drive Mercedes.
Cheers,
Phil Hobbs
Helpful person - 29 Jun 2007 13:50 GMT On Jun 28, 12:32 pm, Phil Hobbs <p...@SpamMeSenseless.pergamos.net> wrote:
> >>> I have a project to design a special purpose fundus camera. Although > >>> an experianced optical engineer and lens designer I have never [quoted text clipped - 47 lines] > > - Show quoted text - I don't know about wriggle out. Sounds like a really fun project, although as you stated, extremely difficult (and expensive on NRE) to achieve. Maybe a better business plan would have been to develop an instrument for ophthalmologists (you try spelling this word!) and then try to fully automate for consumer use. Still sounds like reinventing the wheel.
However, this project is actually fairly simple. The only dificult problem is my lack of experience in ophthalmic instruments.
www.richardfisher.com
Rex Stomponato - 02 Jul 2007 16:48 GMT > Sounds like a project I managed to wiggle out of, about a dozen years > ago...a contact lens company wanted to put automated eye exam kiosks in [quoted text clipped - 4 lines] > managed to help them with an improved business model rather than a kiosk, > so everybody went away happy. So far, optometrists still drive Mercedes. You blew it big time.
Once the optics would have been designed (perhaps not as easy a task as you imply), the data should have been sent immediately to a real optometrist in India for interpretation and prescription.
Et voila! :-)
Just as certain hospitals (allegedly) send their X-rays to India for interpretation by qualified radiologists.
As an optical engineer and having worked with optometrists and ophthalmologists (*) I have found out that optometrists know their optics while ophthalmologists are for the most quite hazy about it.
Let me say that's not their forte while they may well be medically speaking truly outstanding.
Therefore while optometrists (allegedly) enjoy their "dominant position" and as you put it "drive Mercedes" they still perform a useful function.
(*) One of the project I was working on before was refractive surgery (on the cornea): radial keratotomy, keratomileusis and (excimer laser) ablation.
Now and as far as I am aware the ophthalmologists who perform this type of surgery rely on optometrists for the initial optical diagnostic and follow up.
Or at least they should!
Phil Hobbs - 02 Jul 2007 17:29 GMT > > Sounds like a project I managed to wiggle out of, about a dozen years >> ago...a contact lens company wanted to put automated eye exam kiosks in [quoted text clipped - 12 lines] > > Et voila! :-) That's more or less what they were intending to do--make the optometrists function more like pharmacists at the big mail-order places, i.e. much lower on the food chain. The same thing happened to the weavers in the 18th Century--the spinning jenny made thread very cheap, so they made out like bandits until the flying shuttle turned weaving from a craft into a factory operation.
The reason I wanted to duck it was that I was a consultant to the consultant...i.e. downstairs tenant in the outhouse. They weren't bad people--I really quite liked them all, and one of them turned out to be a long-lost cousin--but the production pressures in that job were not going to be fun, and the available rewards would be small, since none of my management cared much about it.
Besides, they weren't going to be able to make any money at it for some years, and that wasn't on their agenda. As I said, the consultant and I managed to fix them up with an improved business model instead, which they adopted most of.
> As an optical engineer and having worked with optometrists and > ophthalmologists (*) I have found out that optometrists know their > optics while ophthalmologists are for the most quite hazy about it.
> Therefore while optometrists (allegedly) enjoy their "dominant position" and > as you put it "drive Mercedes" they still perform a useful function. But the correlation between usefulness and high incomes is very imperfect at best. It's okay with me for people to drive Mercedes if they like...but if I were a kid starting a career now, and even if I wanted money more than fun, I still wouldn't become an optometrist or a stockbroker. Those weavers would be in the back of my mind.
Cheers,
Phil Hobbs
Rex Stomponato - 03 Jul 2007 16:35 GMT > That's more or less what they were intending to do--make the optometrists > function more like pharmacists at the big mail-order places, i.e. much > lower on the food chain. Very successful approach as far as programmers or engineers are concerned, optometrists I don't know yet.
Sad for the pharmacists but they have little need to interact directly with the patients
> The same thing happened to the weavers in the 18th Century--the spinning > jenny made thread very cheap, so they made out like bandits until the > flying shuttle turned weaving from a craft into a factory operation. An oft repeated tale of the early industrial age. Actually from what I understand the flying shuttle predated the spinning jenny. But I am not a specialist of the history of weaving. :-(
> But the correlation between usefulness and high incomes is very imperfect > at best. Who says there is one?
Optometry is a medico-scientific field like several others. A para medical profession I you prefer.
> It's okay with me for people to drive Mercedes if they like...but if I > were a kid starting a career now, and even if I wanted money more than > fun, I still wouldn't become an optometrist or a stockbroker. Those > weavers would be in the back of my mind. Mentioning optometrists and stockbrokers in the same sentence seems to me a little strange.
I am not sure that the optometrists employed by Lens Crafters or Walmart (the well known philanthropic organization) are actually receiving princely salaries.
Maybe they do but the parallel with 18th century weavers is misplaced.
Optometrists are not going the way of the weavers any time soon, especially with all the ongoing progress in diagnostic instrumentation and analytical techniques.
And of course the current advances in treatment, not someting done so well by remote control.
Except for strictly medical acts such as actual surgery, there is a great overlap between ophthalmology and optometry at least in the US.
In fact these fields are now more and more complementary.
There is more to optometry than prescribing lenses/glasses/contacts and checking how they fit on your nose or on your cornea.
In our corner of the woods the State University of NY has a College of Optometry, in Manhattan, facing Bryant Park and next to the New York Public Library.
You might take a few minutes to look over their site and its various pages.
http://www.sunyopt.edu/
http://www.sunyopt.edu/uoc/
and particularly this one:
http://www.sunyopt.edu/uoc/services/
Have a great day.
Rex Stomponato - 03 Jul 2007 17:14 GMT Sorry for the possible dual post...
Previous post was sent in error.
> That's more or less what they were intending to do--make the optometrists > function more like pharmacists at the big mail-order places, i.e. much > lower on the food chain. Very successful approach as far as programmers or engineers are concerned, optometrists I don't know yet.
Sad for the pharmacists but they have little need to interact directly with the patients
> The same thing happened to the weavers in the 18th Century--the spinning > jenny made thread very cheap, so they made out like bandits until the > flying shuttle turned weaving from a craft into a factory operation. An oft repeated sad tale of the early industrial age. Actually from what I understand the flying shuttle predated the spinning jenny. But I am not a specialist of the history of weaving. :-(
> But the correlation between usefulness and high incomes is very imperfect > at best. Who says there is one?
Optometry is a medico-scientific field like several others. A para medical profession I you prefer.
> It's okay with me for people to drive Mercedes if they like...but if I > were a kid starting a career now, and even if I wanted money more than > fun, I still wouldn't become an optometrist or a stockbroker. Those > weavers would be in the back of my mind. Mentioning optometrists and stockbrokers in the same sentence seems to me a little strange.
I am not sure that the optometrists employed by Lens Crafters or Walmart (the well known philanthropic organization) are actually receiving princely salaries.
Maybe they do but the parallel with 18th century weavers is misplaced.
Optometrists are not going the way of the weavers any time soon, especially with all the ongoing progress in diagnostic instrumentation and analytical techniques.
And of course the current advances in treatment, not someting done so well by remote control.
Except for strictly medical acts such as actual surgery, there is a great overlap between ophthalmology and optometry at least in the US.
In fact these fields are now more and more complementary.
There is more to optometry than prescribing lenses/glasses/contacts and checking how they fit on your nose or on your cornea.
In our corner of the woods the State University of NY has a College of Optometry, in Manhattan, facing Bryant Park and next to the New York Public Library.
You might take a few minutes to look over their site and its various pages.
http://www.sunyopt.edu/
http://www.sunyopt.edu/uoc/
and particularly this one:
http://www.sunyopt.edu/uoc/services/
Have a great day.
PS. Thanks for the stimulating exchange!
Dan Abel - 03 Jul 2007 20:04 GMT > > That's more or less what they were intending to do--make the optometrists > > function more like pharmacists at the big mail-order places, i.e. much > > lower on the food chain.
> Sad for the pharmacists but they have little need to interact directly with > the patients In the US? My BIL (a very unreliable source) said that they eliminated the middleman in Thailand, where he lived for a few years. If you need pills, you see the pharmacist, not a doctor. He will listen to your symptoms, and give you the medicine.
I think that there are pluses and minuses. I get my prescription drugs by mail. There is no waiting, and I'm not charged for mailing. My doctor prescribed three new drugs a couple of weeks ago, when I last saw him. There was no written prescription. I could either pick them up downstairs, or have them mailed. If I picked them up downstairs, I would have to wait. I chose mail, and they arrived at my house in a week. There is always a phone number on the pharmacy receipt to call for a pharmacist consultation, but I've never called.
Dr Judy - 27 Jun 2007 14:09 GMT > > I have a project to design a special purpose fundus camera. Although > > an experianced optical engineer and lens designer I have never [quoted text clipped - 12 lines] > > www.richardfisher.com This group (sci.med.vision) is primarily populated with people who are curious about the health of their eyes and a few eye professionals who may use retinal cameras at work but have limited understanding of how they work and no understanding of how to build one. I think you need to be talking to bio medical and optical engineers if you want useful answers.
Dr Judy
Richard J Kinch - 26 Jun 2007 23:08 GMT > I have a project to design a special purpose fundus camera. Although > an experianced optical engineer and lens designer I have never > examined the field of opthalmology. I have been working with the Topcon instruments for a while, designing digital camera upgrades to the film cameras originally used on them.
I think I have come to understand their essential optical principles. To my knowledge none of the many textbooks on optics and instrument design treats this particular type of instrumentation, since it is so specialized. You must also have a theoretical model of the eye's optics in mind when analyzing fundus imaging, although this is only lightly treated in a very few textbooks.
The key element is a very high-powered, aspheric lens which more or less matches the eye's focal system of about 80D. The eye's focusing system and the instrument's thus combine to make a 1X telescope, providing a "window" into the eye for low-power microscopy with further optics. The asphericity is critical to compensate for at least two factors, one that the eye's system is quite aberrant, and second the retina is a sharply curved target.
Another aspect of the instrument is that it must retro-illuminate the retina yet not through the center of the pupil where it would reflect off the corneal surface and wash out the view. So a hollow cone of light converges onto the pupil, at a very steep angle that the eye optics invert and spread broadly across the retina. There is a fundamental conflict between this retro-illumination and its strong corneal reflection, versus the need to simultaneously image a naturally non-reflective subject further on. This is further complicated by the eye's pupil being difficult to adequately dilate in many patients.
Practicalities intrude, such as the need to collimate in several dimensions a large and heavy apparatus to the patient's jumpy eye.
You may also want to consider making a model eye. I've used 80D aspheric condenser lenses in front of an eye-sized shell coated inside with a retinal photo.
Rex Stomponato - 27 Jun 2007 19:22 GMT >I have a project to design a special purpose fundus camera. Although > an experianced optical engineer and lens designer I have never [quoted text clipped - 7 lines] > > Please visit my web site at www.richardfisher.com Fundus examination is nothing new.
Have you looked at patents?
Colleges of Optometry (the state variety) have libraries which may be open to the public.
This is true at least in NYC.
Also Medical Schools with an Ophthalmology Department should have libraries.
Tthere is surely one in Ann Arbor .
Even if not open to the public on a regular basis they should allow you to sneak in once in a while if you explain your purpose.
Google Scholar with "fundus camera" yields 4000 answers mostly to ophthalmology magazines which should accessible in the above libraries at least the paper version of available.
Google Books with the same yields 400 answers.
Good Luck.
Helpful person - 27 Jun 2007 19:45 GMT > >I have a project to design a special purpose fundus camera. Although > > an experianced optical engineer and lens designer I have never [quoted text clipped - 31 lines] > > Good Luck. The problem with searches and most books and articles is that they do not go into detail but just talk in generalities. There is plenty published on using fundus cameras but not much on their design.
There are good libraries in Ann Arbor. I just got back from the Ophthalmic library at the University. I was looking at a good publication:
Opthalmic Photography Tyler, Saine, Bennett 2002 ISBN 0-7506-7372-9
However, this still spoke largely in generalities. I probably have enough information to design a fundus camera. However, I do not wish to redesign the wheel more than necessary. In addition the more information I can glean, the lower the risk that I will miss something important.
www.richardfisher.com
Don W - 28 Jun 2007 01:41 GMT To my knowledge, in analyzing retinal problems presently, the OCT and the Fourier Domain OCT (which hopefully will get to be more common) are presently equipments of choice. But these give the pictures in the z direction. As far as plan view pictures, one thing I would like to see is the ability to cross correlate pictures from two different time periods, and then take the difference to show how treatments and/or symptoms are progressing (regressing?) But that doesn't sound like the approach you are contemplating. Just musing.
Don W.
Barry Cense - 28 Jun 2007 14:56 GMT I realize it is a bit off topic, but spectral-domain / Fourier-domain OCT systems just came to the market. One great thing about this new technology is that it acquires data so quickly that you can actually make plan view pictures (reduced from a 3D volume).
> To my knowledge, in analyzing retinal problems presently, the OCT > and the Fourier Domain OCT (which hopefully will get to be more [quoted text clipped - 6 lines] > > Don W. Don W - 28 Jun 2007 15:22 GMT Not quite sure what exactly what "on topic' is, but it is nice to see, with the new resolution of the FD-OCT, the improvement over the old OCT's "coarseness". One could get spoiled quickly.
Don W.
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