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The aim of this thesis is to explore how modern computing technology can advance clinical ophthalmology. In particular it will investigate the potential for computer programming in developing measures for assessment of ophthalmic disease. Such measures could be used to advance clinical care or as research tools, providing objective outcomes to power more robust clinical trials. Key aspects of clinical ophthalmic assessment are measurement of visual function and observation of anatomical structures. To provide a full demonstration of the scope for computing this thesis will demonstrate innovative measures for both peripheral and central vision as well as image analysis algorithms applicable to structures from the anterior of the eye to the posterior. For peripheral vision testing we investigated a novel technique for assessment of young children using computer games to hold their attention. Our device demonstrated the potential for drastically improving compliance to obtain useful and accurate visual field results. For central vision assessment we developed a prototype visual function tester for patients with macular degeneration. Specifically we were able to demonstrate the feasibility of programming an iPad© such that patients with macular degeneration could perform and physically respond satisfactorily when self testing their vision. Combining advances in electronics and computing we present data to support the potential for using iris recognition cameras to image eyes of children with diseases that cause their corneas to become cloudy and lose transparency. We were subsequently able to apply our own algorithms to produce a score for the opacification of the cornea that would be useful in quantifying these diseases. Finally, with regard to image analysis applications, we describe the development and validation of algorithms for assessment of posterior capsule opacification (re-growth of cataract) and for haemorrhage assessment. All programming and scientific development was done by the author and this thesis therefore presents the potential for computer software development by an ophthalmologist as a model for the invention of new and novel measures at the interface of computing and ophthalmology. |
