A new approach to non-mydriatic portable fundus imaging.

INTRODUCTION: The present study proposes a new hand-held non-mydriatic fundus camera for retinal imaging. The goal is to design a fundus camera which is equally effective in both clinical and telemedicine scenarios. AREAS COVERED: A new retinal illumination approach is proposed to address the main dilemma of the optical design, i.e. balancing efficacy with structural simplicity. This is achieved by symmetrical and co-axial placement of multiple illumination sources along the optical pathway. Each illumination source includes a white and a Near Infra-Red (NIR) LED, which are placed adjacent to each other. Hence, the camera can produce a view-finder with NIR illumination without the need for additional beam-splitters and filters. EXPERT OPINION: The proposed design blends the structural simplicity of the 'off-axis illumination with the wide field of view and uniform illumination of the 'ring' illumination. Moreover, the camera is designed to work with Android-based smartphones, which can easily be mounted and interfaced. The efficacy of the proposed camera is determined by ocular safety analysis and comparative evaluation with a table-top fundus camera. The results convincingly demonstrate the ability of the proposed camera as a primary driver of a wide-scale screening program in both clinical and remote resource constraint environments.