iDEAS: a web-based system for dry eye assessment

Abstract

Background and objectives: Dry eye disease is a public health problem, whose multifactorial etiology challenges clinicians and researchers making necessary the collaboration betweendifferent experts and centers. The evaluation of the interference patterns observed in thetear film lipid layer is a common clinical test used for dry eye diagnosis. However, it is atime-consuming task with a high degree of intra- as well as inter-observer variability, whichmakes the use of a computer-based analysis system highly desirable. This work introducesiDEAS (Dry Eye Assessment System), a web-based application to support dry eye diagnosis.Methods: iDEAS provides a framework for eye care experts to collaboratively work usingimage-based services in a distributed environment. It is composed of three main compo-nents: the web client for user interaction, the web application server for request processing,and the service module for image analysis. Specifically, this manuscript presents two auto-matic services: tear film classification, which classifies an image into one interferencepattern; and tear film map, which illustrates the distribution of the patterns over the entiretear film.Results: iDEAS has been evaluated by specialists from different institutions to test its perfor-mance. Both services have been evaluated in terms of a set of performance metrics usingthe annotations of different experts. Note that the processing time of both services has beenalso measured for efficiency purposes.Conclusions: iDEAS is a web-based application which provides a fast, reliable environmentfor dry eye assessment. The system allows practitioners to share images, clinical informa-tion and automatic assessments between remote computers. Additionally, it save time forexperts, diminish the inter-expert variability and can be used in both clinical and researchsettings.