Smartphone-Based Slit-Lamp Photodocumentation in Microbial Keratitis: a Prospective Study

To evaluate the utility of smartphone-assisted slit-lamp photo documentation as an adjunct to routine clinical care for documenting disease progression and supporting patient counselling and treatment follow-up in patients with microbial keratitis.

This prospective observational study included 38 patients diagnosed with microbial keratitis who presented to a tertiary eye care centre between January 2023 and June 2024. Serial slit-lamp photographs were obtained using a handheld smartphone camera under standardised settings at presentation, day 3, week 1, week 2, week 3 and one month. Clinical findings, visual acuity, disease progression, patient compliance were evaluated. Data were analysed using SPSS version 26, with statistical significance set at p < 0.05.

The mean age of the study population was 40.5 years, with fungal keratitis accounting for 65.8% of cases. At one month, 71% of patients achieved complete clinical healing, while 28 out of 38 patients (73.7%) demonstrated good treatment compliance. An improvement in visual acuity was observed during follow-up. Smartphone-based slit-lamp imaging provided reproducible, high-quality clinical documentation and facilitated serial assessment of disease progression during follow-up.

Smartphone-assisted slit-lamp photo documentation is an inexpensive, practical, and reliable technique for documenting microbial keratitis. It may facilitate patient counselling and treatment follow-up and was associated with good observed treatment compliance in this prospective observational study. Further controlled studies are required to determine whether photographic counselling directly improves treatment adherence.