Red-Free (Green) Filter-Enhanced Gonioscopy with Smartphone: A Pilot Study

Abstract

Aim: This pilot study aimed to demonstrate the usefulness of the red-free (green) filter as a novel modification for better iridocorneal angle visibility during routine gonioscopy.Methods: As a pilot project, we observed 20 eyes of 10 patients aged 22 to 60 who attended the glaucoma department of a tertiary eye hospital in Bangladesh. All patients underwent a thorough ocular examination, from best-corrected visual acuity to the dilated fundus evaluation. Images and videos were obtained with a smartphone during gonioscopy with standard halogen light and the red-free (green) filter, subjectively analyzed by two glaucoma specialists.Results: The mean age of the patients was 37 ± 13.42 years, of whom 70% were men. In this study, 40% of the patients had open-angle glaucoma, and 60% had open-angle without glaucoma. Without impairing the ability to see the iridocorneal angle structures in detail, the gonioscopy picture contrast was enhanced objectively for red-free filter images compared to standard light photos. The built-in warm filter of the slitlamp also provided better visualization of the iridocorneal angle structures.Conclusion: Using the red-free (green) filter and a warm filter instead of the traditionally used standard light of the slit-lamp may significantly enhance the diagnostic capability during routine gonioscopy.