ME 'n' EYE

The mysterious case of Baum's loop

2024-09-16T04:29:00.000-07:00

The Mysterious Case of Baum’s Loop

Do you take scientific information from Wikipedia as a reference? Do you check the authenticity of such online references? If you don’t, then this Blog is for you.

Hi I am Dr. Biju Raju and I am a vitreoretinal surgeon practicing at Dr. NSD Raju’s Eye Hospital, in Kochi, India. A few months ago, when I was going through the visual pathway, as a part of refreshing my understanding, I stumbled upon the mysterious “BAUM’s Loop.” This eponym was new to me and I was very sure I hadn’t come across this either during my Masters in Ophthalmology or during my vitreoretinal fellowship. An eponym is one for whom or which something is or is believed to be named. So who is Baum and what is the mystery?
In the visual pathway, the axons of the retinal ganglion cells, traveling through the optic nerve reach the Chiasma. In the optic chiasma, the temporal fibers pass directly to the optic tract while the nasal fibers cross over or decussate to the opposite optic tract. Then these fibers in the optic tract travel to the first relay station in the thalamus - the Lateral Geniculate Body. Few fibers travel towards the supraoptic nucleus, concerned with circadian rhythm, and few fibers, through the brachium of superior colliculus - the afferent fibers for the pupillary reflex.

The Fibers from the LGB, the axons of the 3rd order neurons (Photoreceptors being receptors, Bipolar cells, the first and RGCs, the second order neurons) in the visual pathway travel to the Calcarine sulcus as the optic radiation. The optic radiation has 3 bundles - the anterior inferior bundle, the central bundle, and the posterior bundle. The anterior bundle is eponymously known as Meyers loop, after Adolf Meyer whose meticulous dissections of the temporal lobe paved the way for the discovery of these fibers. According to his studies as well as recent studies, the anterior inferior or the ventral bundle, from the LGB, travels anteriorly into the temporal lobe before forming a loop and running posteriorly to the occipital cortex. The central bundle goes directly from the LGB to the Calcarine sulcus. The posterior bundle or the dorsal travels superiorly and posteriorly traversing the parietal lobe to reach the visual cortex. However literature doesn’t point to the fact that the posterior bundle was eponymously named after Baum.

Letter to the editor: the origin of "Baum's Loop"

I searched online, and then I found an article and video that cleared the mystery. It all started when 3 radiologists got an “email in regards to a potential error on the eponymous naming of the dorsal bundle of the optic radiation, which has also been given the name Baum’s loop.” These doctors, Dr Knipe, Dr. Bell & Dr Gaillard, then launched an all-out effort to get the bottom of the mysterious Baum’s loop. Their first step was to look at all the available databases for both Baum’s loop as well as Meyer’s loop. There were enough scientific materials in literature right from the early 1900s on Meyer’s loop. But to their surprise, the references to Baum's’ loop started appearing in literature after 2011 in textbooks and after 2012 in scientific journals. Since then, 10 scientific articles mentioned Baum’s loop and also in six textbooks, including the text we consider as the bible of surgical anatomy - the Grey’s Surgical Anatomy!

So now they then turned their investigation to Wikipedia - where all of us look up anything and everything under the sun. The article on Optic Radiation on Wikipedia was started in 2004. The text “also called Baum’s Loop” was added on 18th October 2009 by an anonymous user. Following the IP address, from where this edit was made, they zeroed in on a University, and from the list of Medical Students in that era found a name - A. Baum or Andrew Baum. When contacted via email, he confirmed it was indeed them who inserted “Baum’s loop” as an eponym into the Wikipedia article. The authors conclude their letter to the editor in the Surgical and Radiologic Anatomy Journal by adding “Though this addition was against Wikipedia’s verifiability policy the term persisted in the article and from there, propagated into the wider medical literature. Although this is perhaps a trivial footnote in the naming of anatomical structures, which we note are often not named after the original discoverer or inventor, given its origin and in line with the discouragement of eponyms in anatomy, we believe the use of “Baum’s loop” as an eponym for the dorsal bundle of the optic radiation should also be discouraged.”

The clinical significance of the bundles of the optic radiation are the peculiar visual field defects that arise when these bundles are damaged, especially the Anterior inferior and the Posterior superior bundles.

Meyer’s loop is of utmost importance when considering temporal lobectomy in cases of intractable epilepsy. The surgeon should be aware of the anatomic location of the Meyer’s loop in the temporal lobe, and plan a surgical approach using tractography imaging techniques to avoid damage to the anterior superior bundle or the ventral bundle of the geniculocalcarine tract or the optic radiation.

We should always be grateful to the amazing contributions of Stalwarts like Dr. Adolf Meyer, whose work in the early 1900s still baffles modern neuroscientists. Even now, with all the hi-tech imaging systems, scientists are awestruck at though these complex fibers of the optic radiation, hidden deep in the mysteries of the brain, were accurately marked and mapped at a time when both technology and techniques were primitive. But phony and misleading eponyms like “Baum’s Loop” undermine the efforts of Great men and therefore should be considered a serious offense.

An Experiment to Explore the Conoid of Sturm

2022-07-23T23:18:00.001-07:00

The Conoid of Sturm

Described by Johann Christoph Sturm (1635–1703), a German philosopher, one of the first experimental physicists, a mathematician, astronomer, calendariographer, and Lutheran priest.

Light that passes through a spherical lens is brought to a focus as a single point. Light that passes through a spherical/cylindrical lens, or a sperocylindrical lens or a toroidal lens system, will not be brought to a focus to a single point but to something that resembles a cone or a ‘CONOID’. The conoid that forms when light passes through an astigmatic system is called the Conoid of Sturm, in honour of Johann Sturm, who first described it.

Sturm’s Conoid Experiment

Materials required

Trial frame
+5D sph trial lens
+5D cyl trial lens
Torch / Light source
Screen
Scale to mark the focal points

Method

Prepare the spherocylinder on the trial frame with +5D cyl @ 180 (horizontal axis) in front of the +5D sph. The powers of this spherocylinder can be calculated as follows:

Along the axis of the cylinder = +5 D (where a cylinder axis is, there is no power; therefore, +5D sph + 0 = +5D)
Along the axis perpendicular to the cylinder (where all the cylinder power is; +5D sph + (+5D from cyl) = +10D)

Now that the powers are known, find the focal points from the formula m=1/d, focal length in meter is the inverse of dioptric power.

In the horizontal axis, where d = +5D, m = 1/5m or 100/5 cm = 20 cm
In the vertical axis where d = +10, m = 1/10m or 100/10 cm = 10 cm

Place the light source sufficiently far from a screen, say about 2 m, so that the light rays are almost parallel and the light is of sufficient intensity.
Measure and mark 10cm, 15 cm and 20 cm from the screen.
Place the trial frame with the astigmatic set up at the above markings in the path of the light and observe the image of the light source on the screen.
With this astigmatic setup, one can appreciate 2 focal points - one causing the light to be horizontal line and the other as a vertical line. When the lenses are held in path of light at 10 cm from the screen, a perfectly focussed horizontal line of light is seen. When the lenses are moved to 20 cm from screen, a perfectly focussed vertical line of light is seen. At 15 cm, a perfect circle of light is seen. Any distance less than 15 cm, a horizontal ellipse is obtained and any distance more than 15cm, a vertical ellipse is seen. The whole thing, the 2 perpendicular lines, the circle and all the infinite number of ellipses put together is called the Conoid of Sturm.
The Horizontal and Vertical lines are the Focal lines / Principle Foci.
The distance between the 2 foci is the Interval of Sturm
At the middle of the interval of sturm, between the 2 foci is that part of the beam of light that is more nearly perfect than the rest. This is circle that is formed at 15 cm in this experiment and is called the Circle of Least Confusion (CLC).

https://www.youtube.com/watch?v=ReKGh4_ZU5o

Donesis: the movement, the journey

2020-05-02T01:42:00.000-07:00

The year 1997-98:

OEU Institute of Ophthalmology, Kasturba Medical College, Manipal.

For Dr. NC’s farewell, Dr. KRS, Prof and Head of OEU Institute of Ophthalmology, KMC Manipal, wanted a band to perform. Dr. Prashant Bhatia asked me if Suman, Rohan, and I could organize a band for the farewell. Rohan and I were just one year into post-graduation in Ophthalmology and Suman was to give his exams in less than 6 months' time. Suman was an amazing performer with a mesmerizing voice, who played the guitar and the harmonica as well as a pro. Rohan was an excellent Bassist with relaxed and laid back vocals. I was good at playing lead guitar and could also sing. But then we needed a drummer.

We turned to Charlie, Mr. Charles Ambler, a hobbyist sound engineer who worked in the KMC Airconditioning department. Charlie suggested a guy by the name Danny, who was a freelancing drummer in Udupi. We got together at Suman’s house and tried our luck with a few simple songs and there was instant sync and that sparked a magical feeling. We knew that something big was in the making.

The farewell party for Dr. NC was an amazing experience. After all the fun and games, it was time to put the band to test. Charlie was on the sound system and we started off nervously. When you’re nervous, the best song to start off is 'Take it easy', and that was our first song for the show. Immediately, we saw Dr. Gaurav Kakkar, Dr. Prashant and Dr. NC calling out to everyone to jump on to the floor and dance. That was it! What followed was an absolute cracker of a show!

Few days after the excitement settled down, Suman and I were hanging out in front of the KMC library during the afternoon break. Suman then asked me if we could go up on the stage at the KMC greens. We went over to Greens and walked up to the stage, braving the afternoon Sun. The sight from the stage was beautiful, lush green fields with trees in the background, the physiology block, and the basketball court; it was amazing! Suddenly out of the blue, Suman says, “Biju, we must do a show here, and it should be a memorable one”. I just laughed it off - come on - he was a final year, exam going postgraduate and we were in OEU Institute of Ophthalmology, having eye camps every other day, huge workload with OPD and surgeries - it was impossible to even imagine. So as we walked off the stage, so did the idea from my mind.

Then came that day, when Dr. Purnima Maravoor, came to the cubicle asking if we could arrange funds for a deserving baby with retinoblastoma. Dr. Kakkarji was the senior PG with me and we felt the need for a corpus fund for the benefit of such deserving patients. Dr. NC’s influence in OEU was such that we used to think, first with our retinas and then if time permitted, use our brains. So it was but natural that Kakkarji came up with SIGHT RESTORATION FUND - SRF (which in retinal parlance, is Sub-Retinal Fluid). In a jolt, my mind raced back to the Greens! Yes, what Suman visualized that day, standing on the majestic stage at KMC Greens was slowly taking shape!

We discussed with Dr. KRS, Dr. N S Upadhyaya and Dr. Vijaya Pai about this possibility. Though they were skeptical initially, seeing the enthusiasm and that the effort was for a noble cause, they agreed to have a charity show for SRF. Donesis, the name, was my suggestion and we all agreed that it was very apt for such a ‘movement’ in our department.

We got the necessary permissions, but we didn’t have money and it was not fair to ask the department to support us further. Help came in from Dr. Tanvir Alam, my batchmate during our undergraduate days. He donated Rs. 5000.00 for the initial poster printing and publicity. Donesis was up and running!

We practiced hard; almost every day after the OPD or surgeries, from around 9 pm till around 11 pm, at Suman’s house. Soon we had a crowd at Suman’s house and the word spread that some good music is coming to KMC Greens on 25th April 1998. We had a final practice 2 days prior to the show. The entire stage was set in Suman’s garage, with all the speakers in the open ground immediately in front of the house. We had a good crowd that day and it was like a small scale concert. There were technical issues. The low-frequency speakers had some connection issues and it took a while to get the bass sounds coming out clearly. Once the sound was balanced, we were confident, we could pull it off.

We had enough sponsors for the show. This was the first UNPLUGGED concert in KMC Greens, and that was widely covered in the news. For the first time in the history of KMC, we had a live projection with an LCD projector. There was this gentleman who came searching for us and he met us during our practice. He introduced himself as a salesman promoting, what was then a novelty - the LCD projector. He wanted an opportunity to showcase this product and he said he will do it free of cost. Thus, the first LCD projection in KMC Manipal was not for any clinical meeting, but for the Donesis concert! The crowd went berserk seeing their live feeds on the huge screen next to the stage.

Dr. Gulrez was the man in charge of fireworks - yes, we had fireworks too! and we still haven’t found one of the rockets that Guli fired that day!

Suman completed his post-graduation in style and left to Nepal to join TilGanga institute of Ophthalmology where he went on to become the Professor and head of Glaucoma. Both Rohan and I finished our courses soon. Rohan, following Suman's footsteps, became a Glaucoma specialist at Aravind Eye Hospital. And I, inspired by the one and only Dr. NC, took up the vitreoretinal fellowship and went on to become the first board-certified vitreoretinal surgeon in India, from L.V. Prasad Eye Insitute, Hyderabad.

We also had Donesis II at the fag end of our post-graduation, with our junior Dr. Sanjay Ramachandran, the versatile singer in Suman’s position as the frontman of the band. Dr. Ashley was the President of SRF during the second show. Thanks to Dr. KRS, we received a good amount of sponsorship from Alcon and the show was named - the Legacy show and was held at Hotel Valley View. We were fortunate to have the support of Dr. RMR who also performed with us that day. But fate played a cruel joke; Sanjay passed away in Dubai and it was a big loss for all of us at OEU. Like Suman, Sanjay too was an amazing frontman!

After 18 long years, Donesis regrouped in 2016 to play for the OEU Alumni meet. With just half an hour’s practice, we were on stage. Thanks to Dr. NC and Dr. Krishna Rao, the show took off well and we were able to recreate the magic together, once again.

Donesis has been a significant part of OEU’s history. Several deserving patients received financial assistance through the SRF. We introduced several new concepts way ahead for that time - digital color posters (thanks to our in-house artist, Dr. Ashutosh Bollor), LCD projection, an open-air unplugged show, to name a few. Donesis taught us how we can use the music in us to help Ophthalmology as well as humanity. Suman’s band in Nepal, Rusty Nails, played a major role in fundraising following the devastating Earthquake. For Suman, Rohan, Danny, and me, Donesis was not just a band, it was a powerful movement that taught us some important lessons that we believe have made us better human beings. Donesis salutes all our teachers, seniors, friends, the staff of OEU for their support and help! What a fantastic journey it was for all of us!

Donesis:

Dr. Suman Thapa

Dr. Rohan Daniel

Dr. Biju Raju

Mr. Daniel Saliens

Other members:

Dr. Sanjay Ramachandran

Mr. Prithvi Thomas (Keyboards)

DIY Non Contact Thermometer / Thermal sensor with Buzzer

2020-03-22T10:09:00.005-07:00

We wanted to implement temperature screening for all patients as advised by the Govt of Kerala, Kerala Society of Ophthalmic Surgeons and All India Ophthalmological Society. Many of our colleagues in the Kerala Society of Ophthalmic Surgeons and Cochin Ophthalmic Club had made thermal screening mandatory for all their staff and patients. A non-contact thermal screener is recommended to limit the possibility of the spread of COVID-19. But thermal scanners were out of stock and we could not procure one. But I didn’t lose hope.

A search on YouTube took me to a channel and a video tutorial on the non-contact thermal sensor using Arduino by Miliohm:

https://www.youtube.com/watch?v=NzMncrfZAmU

https://miliohm.com/non-contact-temperature-sensor-mlx90614-arduino-tutorial/

Thanks to my Son, Ishaan, we had an Arduino board and almost all the required components for electronic projects, which I had bought many months ago to calm his curious mind. I had also bought him a Raspberry Pi and together we did a few simple and interesting projects at home. That sums up my expertise (or the lack of it) on microcontroller-based electronics!

When I went through the list of components, the only component that was not available in our collection was the most important one: The Non-Contact Temperature Sensor MLX90614.

The MLX90614 is an infrared thermometer for non-contact temperature measurements and is manufactured by the company Melexis (https://www.melexis.com/en/product/MLX90614/Digital-Plug-Play-Infrared-Thermometer-TO-Can#)

MLX90614 was ordered from Amazon.in

https://www.amazon.in/dp/B01HNP9D2K/ref=dp_cerb_3

It is available at other online sites also:

https://robokits.co.in/sensors/temperature-humidity/infrared-temperature-sensor-gy-906-mlx90614

Wiring diagram

The Sketch or code

Before the code is sent to Arduino, you must download the library from adafruit:

https://github.com/adafruit/Adafruit-MLX90614-Library

You can then copy the Sketch or code below (everything in the box) and paste it in the new sketch in Arduino IDE software:

/***************************************************

This is a library example for the MLX90614 Temp Sensor

Designed specifically to work with the MLX90614 sensors in the

adafruit shop

----> https://www.adafruit.com/products/1748

----> https://www.adafruit.com/products/1749

These sensors use I2C to communicate, 2 pins are required to

interface

Adafruit invests time and resources providing this open-source code,

please support Adafruit and open-source hardware by purchasing

products from Adafruit!

Written by Limor Fried/Ladyada for Adafruit Industries.

BSD license, all text above must be included in any redistribution

****************************************************/

#include

Adafruit_MLX90614 mlx = Adafruit_MLX90614();

void setup() {

Serial.begin(9600);

Serial.println("Dr NSD Raju's Eye Hospital");

mlx.begin();

}

void loop() {

Serial.print("Ambient = "); Serial.print(mlx.readAmbientTempC());

Serial.print("*C\tObject = "); Serial.print(mlx.readObjectTempC()+1.8); Serial.println("*C");

Serial.print("Ambient = "); Serial.print(mlx.readAmbientTempF());

Serial.print("*F\tObject = "); Serial.print(mlx.readObjectTempF()+2.7); Serial.println("*F");

Serial.println();

delay(5000);

}

Serial.println("Dr NSD Raju's Eye Hospital");

you can add your hospital’s name here

Serial.print("*C\tObject = "); Serial.print(mlx.readObjectTempC()+1.8); Serial.println("*C");

You can calibrate the sensor and change the value by adding the approximate error correction (highlighted in red) here for Temperature in degree Celsius

Serial.print("*F\tObject = "); Serial.print(mlx.readObjectTempF()+2.7); Serial.println("*F");

You can calibrate the sensor and change the value by adding the approximate error correction (highlighted in red) here for Temperature in degree Fahrenheit.

Upload the sketch to the board

Connect the Arduino to the computer with the USB cable and upload the sketch to the board.

Once the sketch is uploaded, go to tools and select ‘serial monitor.'

This will open the serial monitor window and the readings will be displayed once in 5 seconds (to change the timing change the code ‘delay(5000);’. 5000 here indicates 5000 milliseconds or 5 seconds.

Calibration of the Sensor

The device can be calibrated by recording the temperature on a normal person and then doing the error correction as mentioned above.

Making the housing

For housing the circuit and the sensor I used the casing that comes with the Leukocrepe bandage. It comes in a transparent cylindrical casing which has a diameter, little more than the width of the Arduino Uno board.

Once the circuit was checked and calibrated, the Arduino board, without the USB connection was positioned inside the transparent cylindrical casing and pushed all the way back, with the USB port facing backward.

With the heated tip of a screwdriver, an opening was made for the USB connector which was then connected to the board.

A similar opening was made on the lid of the casing just enough to pass the pins of the MLX90614. The MLX90614 sensor was placed in front of the lid and from the back of the lid, the jumper wires were connected to the pins. The lid was then screwed tight to the casing.

Using the sensor

With the serial monitor window open, hold the thermal screening unit approximately 1 inch from the forehead, with the MLX90614 sensor facing towards the patient. The readings will start getting recorded every 5 seconds (or as per the time in the sketch).

The ambient temperature also affects the readings of thermal scanners as it gives an average of the infrared energy between the probe and the object. For example, if you have a jet of cold air from an air conditioner flowing in the area the measurement is being taken. This could give a falsely low reading and the device will have to be recalibrated.

Troubleshooting:

Make sure the sensor voltage matches the voltage that is supplied as the sensor can come in 2 voltage settings of 3 and 5V. Connecting a 5 V to a 3 V sensor can damage the sensor.
If the board is not detected, then check if the drivers for Arduino are installed as per the instructions from https://www.arduino.cc/en/Main/Software
Check if the Arduino is properly connected and the COMM port allotted to the board.

Adding a Buzzer to the Thermal Scanner:

Connect the buzzer to Digital Pin 8 and to GND (+). The MLX sensor's connections can be the same.

An Alternative method:

Connect the SCL and SDA of the MLX sensor to A5 and A4 analog pins respectively. The buzzer is connected as usual to pin 8 and GND.

It is better to avoid pins 3 and 11 for the Buzzer.

The code for the Thermal Scanner with the Buzzer:

//The code reamins the same for the MLX90614. The additional code is for the Buzzer - const int buzzer = 8; and const int threshold = <> to assign the Buzzer and to set the threshold for the alarm.
//The threshold value has to be set based on the error correction done in the code. Eg in this code, I have set the threshold at 30 because I have added a correction factor of +7
#include <Wire.h>
#include <Adafruit_MLX90614.h>
Adafruit_MLX90614 mlx = Adafruit_MLX90614();
const int buzzer=8;
const int threshold=30;

void setup() {
Serial.begin(9600);
Serial.println("Dr NSD Raju's Eye Hospital");
pinMode(8, OUTPUT);
mlx.begin();
}
void loop() {
Serial.print("Ambient = "); Serial.print(mlx.readAmbientTempC());
Serial.print("*C\tObject = "); Serial.print(mlx.readObjectTempC()+7); Serial.println("*C"); // The value +7 was arrived at by trial and error, by checking on normal individuals and adjusting the reading to consistently show 37 degrees C or 98 degrees F
Serial.print("Ambient = "); Serial.print(mlx.readAmbientTempF());
Serial.print("*F\tObject = "); Serial.print(mlx.readObjectTempF()+11); Serial.println("*F"); // The value +7 was arrived at by trial and error, by checking on normal individuals and adjusting the reading to consistently show 37 degrees C or 98 degrees F
Serial.println();
if (mlx.readObjectTempC()>threshold){
digitalWrite(buzzer, HIGH);
} else {
digitalWrite(buzzer, LOW);
}
delay(1000);
}

Disclaimer

This project was done based on a tutorial by a channel on YouTube, and I have added a DIY casing and done a bit of tweaking of the Sketch to suit our requirements. In these tough times, with COVID-19 on the rise, this could be an alternative to commercially available thermal sensors. However, the accuracy of the sensor is perfect as it is not made for medical uses. But the company, Melexis, does mention that it can provide a custom-made sensor with a better accuracy. We have not done extensive studies with the DIY device as of now.

References:

La Bamba - My Story

2019-09-11T23:11:00.000-07:00

The year 1988-89; Prasad Swaminathan, my senior at Chinmaya Vidyalaya had taken me to meet Eloy Issacs, the lead guitarist of the band 13 AD. We were on a mission, which I thought was impossible – to learn how to play the solo of the song La Bamba, originally composed by Ritchie Valens and made popular by the band Los Lobos. “He is called Magic Fingers and is one among the best lead guitarists in the country” said Prazi, just before entering Hotel Sealord where the band enthralled music lovers for several years.

Then walks in a tall guy with long flowing hair and well groomed beard and for a moment, I thought I was standing in front of Lord Jesus; the resemblance was uncanny!

Eloy Issacs, Lead and Rhythm Guitas, Vocals, 13 AD

13 AD performing at Hotel Sealord

“I want you to teach me La Bamba. We have a show coming up at the school and these guys want to perform this number.” Prazi was a bit surprised by the way I just blurted out even before a proper introduction. Then Prazi intervened and proper introductions were done. Without even a slightest bit of hesitation, Eloy said, “sure, come over.” Then he realized that my guitar was tuned way off from the normal standard EADGBE and in an instant he too tuned his guitar to my nonstandard tuning. His guitar was a black Fender Stratocaster with a maple neck, I think an American one. Now, after 30 years, I have managed to get one similar to that!

Back then, I knew only 3 chords – C, F and G and may be its minor – Am and I was calling myself a guitarist!! Fortunately for me this song was a 3 chord song – C. F and G; the 3 chords I knew; phew!!! He taught me the entire song and not only did he wish me luck with this awesome instrument, but also treated us to some great food and music at Sealord. We also met the rest of 13 AD – Pauly, Pinson, Jackson and Glen. I had met Glen before. He was a computer programmer and had coded the Electronic Medical Records (EMR) in FoxPro (probably one of the first EMRs in this part of the world) for my father, Dr. NSD Raju on his IBM XT/AT. I came back that night and I don’t think I slept at all. I was practicing the solo the whole night and by dawn, had a grip on it. We put up a good show at school and La Bamba was a great hit!

Ritchie Valens (Richard Steven Valenzuela) [May 13, 1941 – February 3, 1959]

The pioneer of Latin Rock

Los Lobos performing at the White House.

It is now 30 years since I learned my first guitar solo. Ritchie Valens, the genius who gave us the song La Bamba, is no more; he died at the age of 17 in a plane crash. Los Lobos performed La Bamba for the movie of the same name in the year 1987 as a tribute to Valens, one of the first Hispanic Rock Stars. In the same year, La Bamba earned Los Lobos two Grammy nominations.

All of us became die-hard fans of 13 AD, absolutely enjoyed their 2 albums - Ground Zero and Tough on the Streets, in addition to their note-perfect covers. We, Dr. Vinodkumar and Adv Harris PM (from Calicut) and, I organized the reunion concert in Calicut, 2008 (it was a charity show to raise funds for eye surgeries for deserving patients) and now we are all eagerly waiting for the show on 6th April 2024.

Los Lobos ("The Wolves" in Spanish) are:

David Hidalgo – vocals, guitar, accordion, fiddle, requinto jarocho (1973–present)
Louie Pérez – drums, guitar, jarana huasteca, vocals (1973–present)
Cesar Rosas – vocals, guitar, bajo sexto (1973–present)
Conrad Lozano – bass, guitarron, vocals (1974–present)
Steve Berlin – keyboards, woodwinds (1984–present)

13 AD:

George Peter - Vocals

Eloy Isaacs - Lead and Rhythm Guitars, Vocals

Paul K J - Bass and Vocals

Jackson A - Keyboards

Pinson C - Drums

Floyd - Drums

Other members who were part of 13 AD

Glen La'rive - Vocals (Vocalist in the 2 original albums)

Rose - Vocals

Sareena - Vocals

Stanley - Vocals

Pedro C - Drums

La Bamba is probably the most storied Spanish Rock and Roll song and my story just adds one more. But to me, it is the song that made the guitar my companion forever! And it is the instrument that has made me what I am – A musician with an unbridled passion for Vitreo-Retinal Surgery!

Prazi, it was your idea - Thank you, my dear Brother!!

The resemblance to Jesus Christ, I think, was real – Thank you, Eloy!

Was Sting really watching? Every breath you take cover by dRbR - a tribute

2019-05-18T09:31:00.001-07:00

#Sting #music #video #youtuber

Hotel California Outro-solo - cover by dRbR

2019-04-25T11:07:00.001-07:00

Epiretinal Membrane (ERM) captured with HopeScope

2019-03-06T09:20:00.001-08:00

ONE MAN BAND videos!

2019-02-07T09:49:00.002-08:00

A tribute to the Mozart of the East, A R Rahman by Dr Biju Raju

2018-12-03T08:21:00.001-08:00

Smartphone Imaging in Ophthalmology - Dr Biju Raju

2018-11-26T05:47:00.001-08:00

BMW - a short tribute to the one and only Santana

2018-11-26T05:21:00.001-08:00

Robotic Ophthalmic Surgery - a day in my OR in 2050

2018-11-08T07:06:00.001-08:00

Waking up on a cold Friday morning, the fag end of a busy week, is not easy. But the excitement of total retinal transplantation was enough to wake me up 15 minutes before the alarm set on my hexoskin garment. So here we are; the 20th Day of November 2050 - the day computing power, bioprinting, nano robotic surgery and ophthalmic imaging come together in the sophisticated ROPHTHALMOLOGIST system for robotic eye surgery.

The gentleman for surgery was blinded by X-linked Retinitis Pigmentosa at the age of 21. He had perception of light (PL) in the left eye and doubtful PL in the right. He had bilateral posterior subcapsular cataract also. He underwent a scan 2 weeks ago, on the Plankscan module. Plankscan uses Planck time, the smallest magnitude of time known - the time required to travel 1 Planck length at the speed of light. At this speed, the resolution is unimaginably high and can scan from the cornea up to the superior orbital fissure. Of the many parameters that are recorded, apart from the usual ones, it maps every cell and capillary on the retina and the choroid in 3 dimensions. Similarly, the entire vasculature of the eye is mapped. The total data size of 12 Exabyte (1 Exabyte 106 Terabytes) captured per eye by Plankscan is transmitted via a twisted beam phase HiWiFi @ 26 terabits per second, to the Bioprint lab. Located on the 4th level, the lab is literally the coolest place to work. This is where many CYRO-CYLs with embryonic stem cells, preserved at -196 degree centigrade, are processed.

After Plankscan, the patient's blood was drawn by VEEBOT, the robotic phelbotomist. Using doppler, VEEBOT not only detects veins, but also confirms blood flow, before drawing blood. Thereafter, the MARROWBOT belt is worn over the hip, and with ultrasound localization, needles are introduced from its inner surface over the Iliac crest and bone marrow cells are drawn. These are sent to the Bioprint lab for processing. The bone marrow cells are transdifferentiated into neural retinal and glial cells by adding specific growth factors. Among the glial cells, the astrocyte transdifferentiation is important. The astrocyte template is the structural framework for retinal cells. Therefore, to mimic the patient’s retina, the bone marrow derived Neuronal Precursor Cells (NPC) are differentiated into astrocytes with Leukemia Inhibitory Factor (LIF). This sets the stage for astrocytogenesis. The astrocytes are then transfected with patient’s astrocytic gene through virus vectors. Once astrocytogenesis is complete, the astrocytes are loaded into multicellular building blocks called BIO-INK and using additive synthesis, the bioprinter injects the astrocytes in a 3-dimensional framework, driven precisely by the Plankscan. The patient’s retinal vasculature is then copied onto the framework using endothelial lineage of stem cells. Once the structural and vascular frameworks are ready, the rest of the cellular bioinks are injected. The whole layer is incubated in oxygen rich nerve growth factor for 2 weeks, when the retinal layers completely integrate and the nerve fibre layer ends on a regenerated optic nerve head. Blood surrogates are injected through vortex veins and ERG is done to confirm functionality of the bioprinted retina.

In the operating room (OR), the patient is under general hypotensive anesthesia. I am on the head end of the patient; and nervous as I place my hand on the micro-actuators. One would expect a large machine controlling the robot, but ROPHTHALMOLOGIST has been so designed that the computing part is kept outside the OR and the actual robotic module, as big as a vacuum cleaner, is placed to the right or left of the surgeon depending on the eye to be operated. The sensors get feedback from Zarl Ceiss EaglEye microscope which sends Plankscan data in real time to the robotic module. The module communicates wirelessly and sends images to the surgeon. I am wearing a pair of contact lenses which are paired to the module and streams real time, as well as Plankscan images. The module has the Cyberknife, which uses high precision Zeptosecond (10-21) laser to cut the tissues.

The system completes the self-test. The left eye has been draped with liquid absorbent sterile polymer and kept open with self-retaining speculum housing a docking station. The docking station has a diameter of 4mm and the side facing the ocular surface has nanosuction pads that atraumatically attaches to the eye. There are 4 micromanipulators which are designed to give precise pincer grasp and ultrasmooth movements that can be controlled by me in X-Y-Z directions using micro-actuators. Two of the manipulators have atraumatic soft tips. The Cyberknife is on the temporal side.

Before docking, the anesthetist intravenously injects Chaperones - the nanobots. They measure 1X2 microns and contain a single biodegradable microchip. They are flexible and are powered by electrolytic transduction which means that the organic fuel cells are powered by the influx-efflux of ions in the blood. The microchip contains vascular data. The incision site is at 3.5mm (over the pars plana guided by Plankscan) from the limbus. The surgeon can change different parameters by real time gaze-tracking and the data is fed to both the module and the Chaperones. The Chaperones reach the vessels and capillaries at the area of the incision and then the tissue cutting laser makes full thickness incision starting from superior to inferior thus splitting the eye into the anterior segment, from cornea up to the lens, and the posterior segment. The Chaperones plug the vessels and through the microchip, continue to communicate their location to the module.

Prior to anterior segment removal, guided by Plankscan, a nanoprobe is introduced into the anterior chamber. Using micro-actuators, the nanoprobe is placed between the anterior capsule and cortex. Once positioned, CAP-PROTECT, a hypertonic antiproteolytic, is injected. This hydro-dissects the capsule from the cortex and acts as a barrier protecting the capsule. The probe is further pushed into the cortex, and LENSOLYTIC, a proteolytic, is injected, liquefying the lens proteins in 10 seconds, sparing the antiproteolytic coated capsule. The lens material and CAP-PROTECT is then sucked out through the same probe. The hypertonicity of CAP-PROTECT destroys the cuboidal cells, thus preventing posterior capsular opacification. Now the capsule is ready to receive LENSIGEL, a polymer that can be remodelled to the patient’s refractive correction based on Plankscan. Once the LENSIGEL is injected, the probe is removed and using a 900nm laser, the GEL is remodelled. The anterior segment is then removed and placed in oxygen rich nutrient media.

Now the nurse opens the STERIPACK containing the regenerated retina following which the cyberknife that is mounted on the Eagleye microscope is started. This one also delivers Zeptosecond lasers and is controlled by the Plankscan. It makes a ring cut around the optic nerve and delaminates the retinochoroidal layer up to the ora. The Chaperones immediately lock the cut ends of blood vessels and nerve fibres. The retinochoroidal layer and vitreous are removed using micromanipulators. The regenerated retina is then passively slided into the empty vitreous cavity. Now using gaze tracking, I set the module in auto-surgeon mode. In the auto-surgeon mode, guided by Plankscan, the retinal layer is rotated and positioned to precision, to the micro-cellular level, based on the patient's retinal data. The Chaperones link up the blood vessels, bridging the vascular networks with the patient's vessels. Once the bridging is complete, the module sends a signal to the Chaperones to self-destruct. The Chaperones, made up of molecules of polyglactic acid, releases a proteolytic enzyme that selectively dissolves the microchip. The outer shell of is retained as a tubular structure bridging the vessels till endothelial tubules form over it. This usually happens in 2 weeks, when the Chaperones biodegrade completely. The neuronal Chaperones join the cut ends of the nerve fibre layer. The vitreous cavity is filled with nerve growth factor, which accelerates the neural integration of the cut ends. The anterior segment is placed on the eye and positioned by the micromanipulators. Chaperones self-destruct after vascular reconnection. The scleral wound is closed by a biodegradable glue, that reorganize the scleral fibres thus strengthening the wound. At the end of the surgery, artificial vitreous made of a collagen-fibronectin polymer in silicon nanomesh, is injected to keep the eye at normal pressure.

There was a big applause from the whole team. We made history, the first total retinal transplantation, and combined robotic eye surgery in the world! The anesthetist was thrilled. He came over, held me on my shoulders and exclaimed “ It's time for a party! It’s time!! You get up now!!” and started shaking my shoulders. Slowly the shaking become so vigorous that I suddenly woke up to see my wife, looking very puzzled. “You get up! It’s time! And why were you thanking your anesthetist?” Confused and totally zapped, I asked her “which year is this?” And that was the day she and I will remember for some time; 3rd November 2018! And waking up on a cold Sunday morning was indeed difficult!

This article was submitted for the Kollam Ophthalmic Club annual essay competition in Ophthalmology during the Kerala Society of Ophthalmic Surgeons conference 2016.

Disclaimer: This is a work of pure unadulterated fiction, and was written when I was in a ludicrous, wacky, preposterous and loony state of mind - just kidding!!! Wrote this after downing couple of glasses of red wine :-)

Do you know these guys??? Two of them are missing :-)
Prosopagnosia

Couple of guys are missing / Do you know these guys! My goodness!!!! How can you miss me in this video????? - Virtual Prosopagnosia!!!

2018-03-11T03:19:00.000-07:00

Facial recognition is a very complex neural activity. This video probably gives some insight in to the complex neural mechanisms that go into identifying the face of a person. In this video, the drummer (Biju 1) is the first person that gets our attention because he is the drummer giving the count-in for the tempo and starting point for the song. Then the rhythm and lead guitarist (Biju 2) and the Bassist (Biju 3) joins in.

Many of my very close friends and family members, who have known me since childhood and know me as a guitar player, were sure that I was the rhythm and lead guitarist (Biju 2). This is even though they have seen the drummer first. And they thought the drummer and the bassist were a couple of musicians/friends who joined me for the song’s recording. Thus, the past memory and association, i.e., Biju is a guitarist (may be a bit sloppy at it), and he usually plays a bit of rhythm and lead, once in a while, was overriding the glaring visual stimuli (the drummer and the count in) that was presented to their brain initially. Few of them told me that they realized that there was only one person in the video (of course, with digital triple cloning) after viewing the video few times or after I gave a clue (couple of guys in the video are missing, they disappeared soon after the video shoot; do you know these guys, blah, blah….) about it. There was a very good friend of mine who did not pick it up, even after all the clues were given!

Current research shows that our brains rely on the kind of maths that an algorithm may use to perform the task, like facial recognition by smartphones and computers. For facial recognition by smartphones or any digital devices, the important landmarks of the face are marked with dots, creating a dot-to-dot picture of the face. Then 25 measurements between the dots, which allowed the reconstruction of the face, are taken, along with another set of 25 numbers assigned to skin tone, eye color, etc.,

To put it in simple terms, the brain simply converts the facial features into a numerical representation, like an algorithm, which excites specific parts called the ‘face patches’ (clusters of neurons found in the primate temporal cortex ) that respond exclusively to facial features. It seems there are sets of neurons that respond to different hair line widths, to different nose sizes; all that mattered for each neuron was a single-feature axis. Even when viewing different faces, a neuron that was sensitive to hairline width, for example, would respond to variations in that feature. But if the faces had the same hairline and different-sized noses, the hairline neuron would stay silent.

So how did so many people fail to recognize that the 3 musicians in this video were the same struggling musician? Did they suffer from momentary prosopagnosia?? or face blindness—an inability to discern the identity of a person by his face? Some have had prosopagnosia all their lives. According to an article in Scientist.com, author and neurologist Oliver Sacks famously documented his own condition in his writings. In a 2010 New Yorker article, Sacks wrote that he often cannot recognize people he knows well; he has even bumped into his own reflection, thinking it was another bearded man walking toward him.

Given face perception’s importance and ubiquity in social interactions, prosopagnosia is a stressful deficiency to live with. “I avoid conferences, parties, and large gatherings as much as I can, knowing that they will lead to anxiety and embarrassing situations, since I not only fail to recognize people that I know well but tend also to greet strangers as old friends,” Sacks wrote. “I am much better at recognizing my neighbors’ dogs (they have characteristic shapes and colors) than my neighbors themselves.”

Now, going through his description, I feel that I have also suffered from Prosopagnosia, having been embarrassed several times by relatives of mine whom I had no clue of; neither their face nor their name - yes, it can be stressful! Not to worry, next time, you can tell them that you had momentary prosopagnosia, and they will conveniently forget your face also, from then on!

Now, coming back to our question, how can so many people fail to recognize all 3 of me in the video? Virtual prosopagnosia?? NO worries, relax; none of you have prosopagnosia (fingers crossed). The first reason, I think, is that the 3 of us (or is it 3 of me?) were sitting in such a way that the facial features had 3 different profiles, confusing the brain just enough to believe that it was 3 different persons. The other reason, as I already said, is that the past associations from the pre-frontal cortex were probably overriding the visual stimuli to the face patches. And a third reason could be that it is impossible to have such a scenario in the real world. The brain knows it, and it is sort of telling you that "hey!! this guy is taking you for a ride", which probably has a lot of relevance, preventing us from blindly falling prey to imagination or hallucinations (this is purely my funda.. no science in it).

Pauly of 13 AD, who is a wizard in naming everything (the name 'Revelation' for Viju's song was suggested by Pauly), calls this phenomenon, The KAMAL HAASAN effect!! And my dear friend, batch mate and Neuroophthalmologist at Bryn Mawr Medical Specialists, Philadelphia, Dr. Pragati Shukla, says for her it was more like Ilusory Palinopsia [llusory palinopsia (Greek: palin for "again" and opsia for "seeing") is a subtype of palinopsia, a visual disturbance defined as the persistence or recurrence of a visual image after the stimulus has been removed].

In this video, even though the eyes lied, the ears didn’t, right? Oh, come on, the song sounded so good, didn’t it!!

Diabetic Retinopathy - Causes Detection Treatment [Malayalam]

2018-03-10T22:46:00.001-08:00

13 AD' s Revelation

2018-03-04T00:58:00.001-08:00

Dedicated to the memory of George Thomas Jr [Viju] of 13 AD who penned these touching lyrics and made this wonderful song called Revelation. The song was released in 13 AD’s first album, Ground Zero in 1990.by Magnasound. The song starts with the pleasant motif on the guitar by Eloy. There is a small interlude filled with refreshing bass runs by Pauly. Pinson’s drum parts are elegant and proudly supports the whole song. Jackson has given the soul to this song with a fantastic arrangement. The vocals are a delightful blend of harmonies by Glen, Eloy and Pauly; an aural treat to the ears. And when they combine with the strings ensemble in the chorus, it is absolutely blissful. The simple lyrics of revelation are probably few of the most powerful lines penned that choke the emotions of the listener. At the heart of the song is one of the cleanest guitar solos, and through the strings of a Strat, Eloy weaves a sea of emotions with his magic fingers as though trying to soothe and comfort a broken heart. The song loudly projects the personalities of George Thomas as well as the members of 13 AD. They were down to earth, passionate musicians and wonderful people. They taught me the value of humility and to be passionate about what matters. I have never met George; but I can imagine him as nothing short of a genius and a gentle soul. And my favorite song is not Sultans of Swing; neither is it Hotel California or The Wall; it is Revelation by 13 AD, the wonderful melody that celebrates the life of a genius and made a classic by 13 AD. The name Revelation, which is so apt, was given by Pauly. Viju hadn't named it and only after Viju's death did the rest of 13 AD know the story behind the song he made; and therefore Pauly decided to name it 'Revelation'. So here goes, once again….. Thank you Manoj Jons David for the expert advice on mixing and mastering the tracks Thanks Livia for the instructions on triple cloning :-) Thank you Pauly (13 AD) and Stanley (13 AD) for the encouraging support and critical evaluation of the recording. Thank you Neethu, Ishaan, Achan and Amma for the support And Thank you 13 AD! The Gear and Home Studio set up: DAW: Cubase Elements 8 VSTs: Halion, Studio Drummer (Native Instruments), Session Strings (Native Instruments), MM Bass (Native Instruments) Camera: Samsung S8 Video editor: Adobe Premiere Pro CC 2018 Should have known when to move along Could have gone when our love was strong Would have saved, heartache and pain Now it's hard just to carry on Have no words to explain it babe Love is gone, far gone to save All those fears, and all those tears It ain't you I know that I’m to blame Been tryin’ to hide from you, through the years Running faster than time Fighting hard just to break away Feeling lost knowing you can't be mine All I have are just memories They can’t do much to comfort me As I go, down life’s road I have learned how much you mean to me

Making of the Video: World's First Fluorescein Angioscopy of the Retina on a Smartphone Device - DIYretCAM

2016-03-11T09:05:00.001-08:00

Making of the Video: World's First Fluorescein Angioscopy of the Retina on a Smartphone Device - DIYretCAM

The patient was ready; the nurse had already loaded the fluorescein sodium in the syringe. The cannula was placed and a final run down of the procedure was planned with Dr. Sreevalsan, the anesthetist. The Zeiss Visucam was kept ready as standby, just in case. There were pangs of anticipation, apprehension and I could feel the lump in my throat: this was the first time a fluorescein angioscopy was being attempted on a smartphone. If it succeeds, that would mean a major breakthrough in making a portable device that would be able to capture the fundus images or retinal photos and do an angiography at a fraction of the cost of a conventional fundus camera.

Few months ago, I had designed the DIYretCAM, the world’s first do it yourself retinal camera adapter for a smartphone. It was the culmination of the efforts using the smartphone for documenting the retinal changes and designing a device that could make the procedure easy and acceptable to all ophthalmologists. It was a cost effective device and could take photographs from the central retina to the pars plana. Even with an ultra-wide angle laser based imaging system, pars plana was too far in the periphery and beyond reach. The DIYretCAM can be mounted on the slit lamp and used like a conventional camera. Thus, this device is a pan modal imaging device and can be used as a hand held or a slit lamp mounted imaging device for the smartphone.

The All India Ophthalmological Society and its Scientific Committee Chairman, Dr. Lalit Verma, recognized the importance of the device, its role in our country and tele-ophthalmology. I was surprised to see an invitation from the scientific committee, to conduct a session along with another inventor, Dr. Ashish Sharma (Make In India RETinal CAMera – MiiRETCAM) and Dr. Zain Khatib, on innovative fundus camera. That was the recognition for this humble project. But that was not path breaking enough. To take it to a totally different level, I had to do the first angioscopy of the retina with the DIYretCAM. Sutto and his group from Japan tried a technique with just the smartphone and a 20 D lens with matched filters. But there were no reports in Ophthalmic literature on fluorescein angioscopy being done.

Various designs were drawn on my research notebook, which my wife Neethu gave me, knowing my ever forgetful nature. Some looked ridiculous and others were impossible. Finally one design looked feasible and, with the help of our maintenance person, Mr. Baby, I designed the mechanism to support the matched filters. It worked well in the lab and in the midst of a routine fluorescein angiography with the conventional fundus camera, wherein, a few snap shots were taken with the DIYretCAM. Therefore, few trial runs gave hope that this might work.

And we would know in a few moments from now. I kept on looking on my Note 3 mounted on the DIYretCAM, repeatedly checking the filters. Everything seems to in place and we were ready to push the dye. For the last time I focused the retina, which was seen hazily through a dense cloud of asteroid hyalosis. Asteroid hyalosis, made the best case scenario for fluorescein angiography as the dye will give all the details of the retinal vasculature, despite the fact that retinal view is very hazy in normal evaluation and documentation. And none of those asteroid, how much ever dense they are, will obstruct the view as the light scattered from them are blocked by the barrier filter.

The anesthetist gave the instruction to start, I started the timer, and then began the long wait…no dye was see even at the 11^th second, not even at the 20^th! I panicked, told the nurse that we will move to the Zeiss for completion of the angio, the filters it seems, did not work. The puzzled nurse, with a confused smile, told that she has not injected the dye and that she was waiting for my instructions. It was a big relief…at least there is a second chance. After I reset the timer, I boldly to her to inject the dye. The timer ticked on…7 sec, 8 sec…9…10 and 11….and then “up ahead in the distance, I saw a shimmering light”. That was the retinal arterial filling, the whole vascular tree started lighting up, the arteries filled, followed by the veins and we had the first ever fluorescein angioscopy on a smartphone. History was made and for the first time in my life, I felt I was part of it!!!

Producing the video was even more exciting. I wanted my own music and I wanted it to be the kind of music I grew up listening to. Heavily influenced by Dep Leppard, GNR and my wonderful friends in 13 AD, I decided to produce the music using Mixcraft DAW (called the musicians DAW), a Casio MIDI keyboard and a Fender Strat going through a BOSS GT-10. It took me less than a couple of hours and the result were amazing. I chose a Heavy metal drum kit, a clean delayed tone for the rhythm guitar and a compressed distorted tone for the lead guitars. The guitar tracks were overdubbed to harmonize the lead.

The Mixcraft Window

The music track – Lost in Anticipation, was ready. Why lost in anticipation? Well, may be because it reflected the moments in my mind when I was literally lost in time, anticipating the arrival of the fluorescence in the retinal blood vessels. Once I edited the video along with the music, I was happy. This was one great video, probably the best I have ever made – it is a land mark achievement. Hope you enjoy it too…

2016-03-07T09:19:00.004-08:00

World's First

Fundus Fluorescein Angioscopy

on a

Smartphone

with DIYretCAM

Pars plana cysts

2015-10-04T02:20:00.001-07:00

Fundus documentation with Smartphone - Presented at AIOS 2015

2015-09-23T08:02:00.001-07:00

DIYretCam V 2.0 Videos

2015-09-12T11:38:00.001-07:00

This video shows Scleral depression for evaluating the peripheral retina

This video is of a rare split of ozurdex implant in the inferior vitreous cavity

How to take a RETINA selfie using a smartphone

2015-08-27T06:21:00.000-07:00

What you need:

A smartphone with flash on option in video mode
A 20 D or 28 D lens
Your pupil needs to be dilated for this technique of imaging
A mirror to observe and align the image

How to do a RETINA Selfie:

Face the mirror

Turn the phone camera towards you with the flash turned on

Watch the phone's screen on the mirror and align the phone to get the red reflex from the dilated eye

Interpose the condensing lens and adjust the position to get a full image of the retina in the lens, all the while aligning the position of the phone as well as the lens using the screen's reflection on the mirror as a guide

Once the video is captured, you can edit and capture images from it

Concept and technique: Ernique Palacois

Presenting the World's First Do It Yourself Smartphone Fundus Camera (DIYretCam)

2015-05-27T10:17:00.002-07:00

Materials required:

Smartphone with flash on option in the camera mode (in Still or video capture settings)
Smartphone’s hard back cover
Condensing lens – 20 or 28 or 40 D
PVC pipe (40 mm dia)
PVC pipe reducers
Instant adhesive - Flex Kwik (Pidilite)
Light absorbing fabric (black in color) - (in this device, I used the Rexin like material cut from an old bag)
Sponge
Axo blade

It is assumed that the user already has a smartphone, its hard cover and the condensing lens

Do It Yourself

Cut the PVC pipe – 14.5 to 15 cm and level the cut surface

Place the pipe centred on the camera hole on the smartphone cover

Once aligned, apply the quick setting glue

Roll up the black, light absorbing fabric and insert it into the pipe so as to reduce the reflections from the pipe’s internal surface. Make sure that it fits exactly and is contoured to the inner diameter of the pipe. The reflective surface of the fabric should face outwards (see the photo below)

Cut the sponge to a small strip with the width matching the metal rim of the condensing lens and length approximately the circumference of the lens and wrap the sponge around the condensing lens and insert the lens with the wrapped sponge in to the larger opening of the reducer (45 mm outer dia and 38 mm inner dia) and align the lens. Note that the silver rim of the lens faces the patient’s eye.

For the 20 or 2.2 pan retinal lens, a larger reducer (60 mm outer dia, 50 mm inner dia) is required and an additional coupling attachment (50 mm outer and 42 mm inner) is needed to fix it to the pipe.

The additional coupling attachment for 20 D

Attach the reducer to the pipe (for the 20D, along with the coupling attachment as shown in the photograph below)

DIY-RetCam is ready to use

If one uses 20 and 28 or 40 D, these lenses can be kept ready in the respective reducers and can be interchanged easily

One can cover the pipe and reducer with the same black fabric (and some black insulation tape) and the device is ready for use.

Total Cost:

[Still assuming that the user has a smartphone, a hard back cover for the phone and the 20 D lens. And also assuming that the user has a piece of sponge and an axo blade :-)]

Pipe – 0.5 m Rs. 30.00

Reducer Rs. 28.00

Coupling Rs. 20.00

Glue Rs. 80.00

Total cost: Rs. 158.00 (My previous estimate of Rs. 500.00 was too high!!)

Few tips:

Use it on a cooperative patient with good dilatation

There is a learning curve to master this technique.

You can hold the reducer like you hold the normal 20 D for indirect ophthalmoscopy. Initially an assistant can support the device while you can hold the entire set up with your lens holding hand and the other hand can be used for scleral depression. The capture mode should be in Video for taking pictures of retinal periphery with scleral depression. Peripheral photographs can be taken in the still capture mode (better resolution), but the assistant will have to touch the camera focus as well as capture button to capture images on instruction from the surgeon.

Even when the posterior pole pictures as taken, it is advisable that an assistant helps in retracting the lids.

When taking the photographs of the central fundus, one can hold the phone in one hand and stabilize the device with the lens holding hand. Focus mode should be in touch focus, zoom to the maximum or to the extent that the central lens covers most of the field.

As in indirect ophthalmoscopy, it is better to see the red reflex through the dilated pupil and then move the device either closer or away from the patient to finally fill the image in the central lens area completely. Then one can touch either the area of interest or the edge of the image of the lens on the screen to focus the retina. Once satisfied with the field and focus, touch the capture button to capture the image.

I think iPhone will give the best images than android phones.

Please make sure that you have a stable hold on the device while examining a patient who is lying down - Gravity is still active!!! Always make sure that the device does not come too close to the eye. Patient safety is of utmost importance. Therefore please be careful when using the device especially when examining the periphery and while doing scleral depression.

Need all your suggestions and comments! This is version 1.0. Hopefully there is a version 2.0 which will be better!! But for now, this seems to be the most cost effective and world's first DIYRetCam!!
Thank you!!!

Biju

Do It Yourself Smartphone Fundus Camera

2015-05-26T12:13:00.000-07:00

I've been working on smartphone fundus photography techniques since 2010. I have now made a device that has the capability of documenting peripheral retinal images and it can be made out of commonly available material at a cost less that Rs. 160.00. Yes, you can do it yourself!!

These are the first images with the device.

This is a fundus photo of a boy with X linked retinoschisis showing the typical foveal appreance.

Images of the retinal periphery showing retinoschisis and inner retinal holes.

FEVR with ERM and VMT

FEVR with peripheral neovascularization at the junction of vascular and avascular retina

FEVR - Periphery showing avascular retina and lattice like changes

Horse shoe tear

I have tried documenting fundus changes in neonates during ROP screening. Here are the first pictures with the device.

Normal Retina in a Neonate

Avascular retina in Zone III. Ora serrata is also visible.

Smartphone fundus photography

Global Diabetes Walk

2011-10-10T02:47:00.000-07:00

Kochi walks on 14th November 2011
Durbar Hall Gound
7.30 am