Accepted for/Published in: JMIR Formative Research
Date Submitted: Dec 12, 2025
Date Accepted: Aug 23, 2026
Digital Anterior Segment Photography in Clinical Practice: A Mixed-Methods Evaluation of Four Anterior Segment Photography Workflows
ABSTRACT
Background:
In the digital era, smartphone technology has significantly advanced ocular imaging, allowing for high-resolution anterior segment photography (ASP) to enhance referrals, clinical decision-making, and disease monitoring.
Objective:
This study aims to explore clinician experiences with four smartphone-based ASP modalities used in eye casualty and corneal services.
Methods:
A mixed-methods study was conducted at a tertiary eye hospital in England, between 21 October and 6 December 2024. Four imaging modalities were evaluated: the Magnifier App (Apple, USA), QuikVue Smartphone Adapter (VisuScience Meditech, China), Celestron NexYZ Slit-Lamp Adapter (Celestron, USA), and the Zeiss SL Imaging System (Carl Zeiss AG, Germany). Ophthalmology residents and corneal fellows completed semi-validated surveys and participated in one-to-one interviews. Survey data was analyzed using descriptive statistics, while interviews were transcribed and subjected to reflexive thematic analysis.
Results:
Among 25 survey respondents (17 residents, 8 fellows) and 12 interviewees, Magnifier received the highest ratings for usability (76% strongly agreed) and cost-effectiveness (92% strongly agreed). Five key themes emerged: obstacles to implementation, accessibility, documentation, innovation, and ethical concerns. Although all devices had specific strengths and limitations, Magnifier was favored due to its ease of use and integration with existing smartphone infrastructure. Other concerns included time pressures, integration difficulties, digital reluctance among clinicians, and data protection.
Conclusions:
No single ASP modality proved universally effective. However, Magnifier demonstrated the most favorable balance of usability, functionality, and accessibility amongst clinicians. Future efforts should focus on workflow integration, robust data governance for smartphone imaging, and understanding patient perspectives on ASP. Clinical Trial: Not applicable. This project gained approval by Moorfield Eye Hospital’s clinical audit department (audit ID number 1606) as a quality improvement project and the need for ethical approval was waived
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