Author Affiliations: Departments of Ophthalmology (Drs Bruce, Newman, and Biousse), Neurology (Drs Bruce, Newman, and Biousse), and Neurological Surgery (Dr Newman), Emory University, Atlanta, Georgia.
We appreciate Chakrabarti and Perera's interest in our work,1 and we thank them for their thoughtful comments about our study and its relation to developments in the application of mobile devices to ophthalmology and other fields of medicine.
We should clarify that the relatively high proportion of poor-quality images in our analysis was not due to any particular limitation of the camera or our imaging protocol. Rather, the distribution of image quality was reflective of all images obtained during the study, allowing us to have a sample representative of the full spectrum of photographic quality. From a clinical perspective, images of some diagnostic quality were obtained in 97% of patients and a high-quality image (grade 4 or 5) of at least 1 eye was obtained in 83% of patients, despite the challenges of obtaining high-quality nonmydriatic photographs in the emergency department setting.2- 4
Bruce BB, Newman NJ, Biousse V. Nonmydriatic Digital Ocular Fundus Photography With iPhone 3G—Reply. JAMA Ophthalmol. 2013;131(3):405-406. doi:10.1001/jamaophthalmol.2013.1943