Devising a Coaching Method for a Smartphone-Based Slit-Lamp Microscope and Its Learning Effects: A Pilot Study

Objectives: To develop an effective learning method for using a smartphone-based slit-lamp microscope (SBSL) and to identify key points to emphasize when coaching individuals with no prior SBSL experience. Methods: This study included 60 orthoptic students: 40 second-year students (control group: 20, training group 1: 20) and 20 first-year students (training group 2). Subjects were instructed to record the anterior eye segment of a patient-role subject using the Smart Eye Camera. The control group was given paper instruction and was shown the demonstration of the SBSL beforehand. In addition, training groups 1 and 2 watched a tutorial video, practiced using the SBSL for 30 min, and received guidance from an expert. Four ophthalmologists evaluated the recordings based on the eyelid, conjunctiva, cornea, pupil including iris, lens, and anterior chamber depth. Results: ANOVAs showed significant differences among groups for all items. The control group had significantly lower scores than both training groups, while no significant differences were found between training groups 1 and 2. Principal component analysis of training groups 1 and 2 showed that the first principal component accounted for 74.36% of the variance. The second principal component accounted for 10.71%, with a wide range of loadings (anterior chamber depth of 0.7780 to conjunctiva of -0.5585), implying the existence of different favorite focusing depths within subjects. Conclusions: A coaching program consisting of tutorial video learning, a 30 min hands-on trial, and feedback is effective in helping individuals without an ophthalmological background acquire anterior segment imaging skills using SBSL. Comprehensive focusing across the entire anterior segment should also be emphasized.