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Foldscope: A smartphone based diagnostic tool for fungal keratitis
Dipali P Parmar1, Jay S Rathod1, Minhaz M Karkhanawala2
1M and J Institute of Ophthalmology, (Government Eye Hospital), B.J. Medical College, Ahmedabad, Gujarat, India.
Indian Journal of Ophthalmology
|September 28, 2021
Summary
Smartphone-based Foldscope (FS) shows excellent specificity for diagnosing fungal keratitis (FK) on direct smears, though sensitivity is limited compared to compound light microscopes (CLM). This portable tool offers a low-cost diagnostic option for resource-constrained settings.
Area of Science:
- Ophthalmology
- Medical Diagnostics
- Microbiology
Background:
- Compound light microscopes (CLM) are standard for diagnosing fungal keratitis (FK).
- Resource-limited settings often lack access to advanced diagnostic equipment.
- Smartphone-based microscopy offers a potential low-cost alternative.
Purpose of the Study:
- To detect fungal pathogens causing keratitis using a smartphone-mounted Foldscope (FS) on direct smears.
- To evaluate the diagnostic efficacy of FS compared to routine CLM for fungal keratitis.
Main Methods:
- A prospective study involving 60 smear examinations (Gram stain and Lactophenol Cotton Blue) from clinically suspected FK cases.
- Comparison of diagnostic utility between smartphone-mounted FS and CLM.
- Quantification of agreement using Cohen's kappa.
Main Results:
- Forty-six out of 60 samples were positive for fungi by CLM.
- Moderate agreement (kappa = 0.49) was found between CLM and FS.
- FS demonstrated high specificity (1.00 for LCB, 0.87 for GM) in detecting fungal keratitis.
Conclusions:
- Direct smear microscopy is a sensitive method for early FK diagnosis.
- Smartphone-mounted FS offers excellent specificity for FK detection, making it a valuable tool in resource-limited areas.
- FS is a simple, portable, and inexpensive diagnostic option where CLM is unavailable.
