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Optometry has options in clinical apps for smartphones

May 30, 2012

By Dominick M. Maino, O.D., and Geoffrey G. Goodfellow, O.D.

It wasn’t looking very good. According to posters presented at a recent American Academy of Optometry meeting, most of the smartphone apps really did not do what they said they did. These apps seldom met the criteria expected by the researchers. But don’t dismay, if the color vision, visual field and visual acuity apps do not meet the necessary levels for appropriate examination criteria, there are other apps that are still very useful.

Medscape: This app has more than 7,000 drug references, 3,500 disease references, and 2,500 medical images, as well as procedure videos, a drug interaction tool checker, continuing education activities, and much more.

When you first log on, you are given a choice of tapping News, References or Education. Recently when we tapped the News section, we learned about adjustable sutures for strabismus surgery, Botox for strabismus, and about 45 dubious medical tests. (As noted in recent articles in Optometry & Vision Development and on the blog MainosMemos (Mainos Memos.blogspot.com) both adjustable sutures and Botox are not a very effective for strabismus.)

When we clicked on References, we had a choice of drugs, over-the-counters (OTCs) and herbals; diseases and conditions; procedures; drug interaction checker; a health director and Medline. The last offered choice was CE. All of these appear to do what they say they do and are easy to use. My Medscape app is something we frequently use to help us with patient care.

Skyscape: When you conduct vision information processing assessments, you must know the age of the patient you are testing. If your mathematical abilities are lacking, Skyscape, under the Archimedes button, has a miniapp “Age by DOB” that will calculate the age precisely for you.

Are you routinely taking vitals on all your patients as directed by most electronic health record programs and mandated by many health care plans? Do you know what’s considered normal for someone age 12-15 years? Skyscape will tell you (heart rate 60-115/min, respiratory rate 12-22/min. systolic blood pressure (BP) 92-136. diastolic BP 50-80). Are you an AOA InfantSEE® doctor? If you are and you choose to assess the child’s blood pressure, do you know the expected BP for an infant 6-11 months of age? Once again, Skyscape informs you that a systolic BP of 70-114 and diastolic BP of 40-75 are considered normal.

The Outlines in Clinical Medicine has articles from Down syndrome, to glaucoma, to age-related macular degeneration. It should be noted that when searching blindness, one of the statements that appears is that routine screening in a primary care health setting has not be shown to be beneficial. Skyscape also has an prescription drug listing as well. This app offers the option for paid access to several resources such as the journal Evidence Based Guidelines: Ophthalmology; Cochrane Reviews, and more.

Optometrists see many patients with strabismus and they frequently have a vertical anomaly present. Determining the affected muscle can be most challenging. That’s why after we use the Park’s 3-Step method to verify the affected muscle, we double-check it with the app, Automated Park’s 3 Step by Canadian optometrist Robert Burke, O.D.

This easy-to-use app instructs you to answer several questions, including “In primary gaze, which eye is the hyper eye? After you input the answer, it then asks you to rotate the smartphone right or left to simulate the patients head turn that makes the hypertropia worse and finally it asks you to rotate the phone clockwise or counter clockwise to simulate the direction that shows the greater vertical deviation. The affected muscle is then confirmed.

Finally, there is the EyeDoc app. This is a subscription-based smartphone app that has a great deal to offer. It has the ability to search for nearly 500 soft lenses and 1,000 gas-permeable contact lenses by name, company, or various parameters.

This app gives you additional information on 130 topical ophthalmic medications, ICD-9 diagnostic codes, and various clinical tools and calculators as well as patient education tools, simulators, images and drawings.

These apps are used by our colleagues every day. They provide the many tools we need to make our job a bit easier and our many patients a bit happier with the diagnoses and treatments we provide for them. Use them and then let us know what think.

Dr. Maino is a professor of pediatrics and binocluar vision at the Illinois College of Optometry (ICO). He can be contacted at dmaino@ico.edu. Dr. Goodfellow is an associate professor of optometry at ICO and the college’s assistant dean for curriculum and assessment. He can be contacted at ggoodfel@ico.edu.

One comment

  1. I’m flattered to see my app included here, but I wanted to correct a couple errors. Most importantly, the app (and the website) is called eyedock – don’t forget the “k” at the end! Also, the app does do soft CL searches, soft CL and GP calculations, and medication searches. The other features mentioned here are present on the website but I haven’t had a chance to get them on the app yet. Thanks again for the inclusion!
    – Todd



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