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Medical Forum / General / Vision / July 2007

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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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