{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:21:46Z","timestamp":1772778106284,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: To develop an effective learning method for using a smartphone-based slit-lamp microscope (SBSL) and to identify key points to emphasize when coaching individuals with no prior SBSL experience. Methods: This study included 60 orthoptic students: 40 second-year students (control group: 20, training group 1: 20) and 20 first-year students (training group 2). Subjects were instructed to record the anterior eye segment of a patient-role subject using the Smart Eye Camera. The control group was given paper instruction and was shown the demonstration of the SBSL beforehand. In addition, training groups 1 and 2 watched a tutorial video, practiced using the SBSL for 30 min, and received guidance from an expert. Four ophthalmologists evaluated the recordings based on the eyelid, conjunctiva, cornea, pupil including iris, lens, and anterior chamber depth. Results: ANOVAs showed significant differences among groups for all items. The control group had significantly lower scores than both training groups, while no significant differences were found between training groups 1 and 2. Principal component analysis of training groups 1 and 2 showed that the first principal component accounted for 74.36% of the variance. The second principal component accounted for 10.71%, with a wide range of loadings (anterior chamber depth of 0.7780 to conjunctiva of \u22120.5585), implying the existence of different favorite focusing depths within subjects. Conclusions: A coaching program consisting of tutorial video learning, a 30 min hands-on trial, and feedback is effective in helping individuals without an ophthalmological background acquire anterior segment imaging skills using SBSL. Comprehensive focusing across the entire anterior segment should also be emphasized.<\/jats:p>","DOI":"10.3390\/jcm15051928","type":"journal-article","created":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T15:15:29Z","timestamp":1772550929000},"page":"1928","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Devising a Coaching Method for a Smartphone-Based Slit-Lamp Microscope and Its Learning Effects: A Pilot Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8446-7501","authenticated-orcid":false,"given":"Hokuto","family":"Ubukata","sequence":"first","affiliation":[{"name":"Department of Orthoptics and Visual Sciences, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata 950-3198, Japan"},{"name":"Major in Health and Welfare, Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata 950-3198, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9188-1058","authenticated-orcid":false,"given":"Haruo","family":"Toda","sequence":"additional","affiliation":[{"name":"Department of Orthoptics and Visual Sciences, Faculty of Medical Technology, Niigata University of Health and Welfare, Niigata 950-3198, Japan"},{"name":"Major in Health and Welfare, Graduate School of Health and Welfare, Niigata University of Health and Welfare, Niigata 950-3198, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-2832-4934","authenticated-orcid":false,"given":"Hiroki","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan"},{"name":"Yokohama Keiai Eye Clinic, Kanagawa 240-0065, Japan"},{"name":"OUI Inc., Tokyo 107-0062, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shintaro","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan"},{"name":"OUI Inc., Tokyo 107-0062, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mai","family":"Nishio","sequence":"additional","affiliation":[{"name":"Aoba Eye Clinic Takenotsuka, Tokyo 121-0801, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7152-5176","authenticated-orcid":false,"given":"Takahiro","family":"Mizukami","sequence":"additional","affiliation":[{"name":"Fuchu Eye Center, Fuchu Hospital, Osaka 594-0076, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kosei","family":"Tomita","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Kawasaki Medical School, Okayama 701-0192, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3422-8578","authenticated-orcid":false,"given":"Eisuke","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan"},{"name":"Yokohama Keiai Eye Clinic, Kanagawa 240-0065, Japan"},{"name":"OUI Inc., Tokyo 107-0062, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1136\/bjo.2006.103408","article-title":"Recent advances in ophthalmic anterior segment imaging: A new era for ophthalmic diagnosis?","volume":"91","author":"Konstantopoulos","year":"2007","journal-title":"Br. J. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1167\/tvst.10.8.29","article-title":"Design and Performance Characterization of a Novel, Smartphone-Based, Portable Digital Slit Lamp for Anterior Segment Screening Using Telemedicine","volume":"10","author":"Dutt","year":"2021","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1080\/08820538.2021.1887899","article-title":"Anterior Segment Imaging Devices in Ophthalmic Telemedicine","volume":"36","author":"Armstrong","year":"2021","journal-title":"Semin. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1038\/eye.2008.11","article-title":"Telemedical Diagnosis of Anterior Segment Eye Diseases: Validation of Digital Slit-Lamp Still Images","volume":"23","author":"Kumar","year":"2009","journal-title":"Eye"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1258\/004947506775598824","article-title":"Ocular Leprosy in Nigeria: A Survey of an Eku Leprosorium","volume":"36","author":"Omoti","year":"2006","journal-title":"Trop. Doct."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1111\/j.1440-1584.2007.00906.x","article-title":"Ocular Health Status of Rural Dwellers in South-Western Nigeria","volume":"15","author":"Adegbehingbe","year":"2007","journal-title":"Aust. J. Rural Health."},{"key":"ref_7","unstructured":"(2025, November 29). Ericsson Mobility Visualizer. Available online: https:\/\/www.ericsson.com\/en\/reports-and-papers\/mobility-report\/mobility-visualizer."},{"key":"ref_8","unstructured":"The International Telecommunication Union (ITU) (2025, November 29). Global and Regional ICT Data. Available online: https:\/\/www.itu.int\/en\/ITU-D\/Statistics\/Pages\/stat\/default.aspx."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Shimizu, E., Ogawa, Y., Yazu, H., Aketa, N., Yang, F., Yamane, M., Sato, Y., Kawakami, Y., and Tsubota, K. (2019). \u201cSmart Eye Camera\u201d: An Innovative Technique to Evaluate Tear Film Breakup Time in a Murine Dry Eye Disease Model. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0215130"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1037689","DOI":"10.1155\/2020\/1037689","article-title":"Portable Handheld Slit-Lamp Based on a Smartphone Camera for Cataract Screening","volume":"2020","author":"Hu","year":"2020","journal-title":"J. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1111\/cxo.12381","article-title":"Tele-Manufactured Affordable Smartphone Anterior Segment Microscope","volume":"99","author":"Chiong","year":"2016","journal-title":"Clin. Exp. Optom."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1080\/08820538.2023.2211160","article-title":"A Review of Smartphone Adapters Capable of Imaging the Anterior Segment in Ophthalmology","volume":"38","author":"Baker","year":"2023","journal-title":"Semin. Ophthalmol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2416","DOI":"10.4103\/IJO.IJO_292_23","article-title":"A Study Establishing Sensitivity and Accuracy of Smartphone Photography in Ophthalmologic Community Outreach Programs: Review of a Smart Eye Camera","volume":"71","author":"Andhare","year":"2023","journal-title":"Indian J. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Yazu, H., Shimizu, E., Sato, S., Aketa, N., Katayama, T., Yokoiwa, R., Sato, Y., Fukagawa, K., Ogawa, Y., and Tsubota, K. (2021). Clinical Observation of Allergic Conjunctival Diseases with Portable and Recordable Slit-Lamp Device. Diagnostics, 11.","DOI":"10.3390\/diagnostics11030535"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s12599-023-00804-z","article-title":"Digital Therapeutics (DTx)","volume":"65","author":"Gersch","year":"2023","journal-title":"Bus. Inf. Syst. Eng."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1016\/j.jjcc.2024.11.005","article-title":"Digital Therapeutics in Japan: Present and Future Directions","volume":"85","author":"Nomura","year":"2025","journal-title":"J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Shimizu, E., Hisajima, K., Nakayama, S., Nishimura, H., Khemlani, R.J., Yokoiwa, R., Shimizu, Y., Kishimoto, M., and Yasukawa, K. (2024). Epidemiological Survey of Anterior Segment Diseases in Japanese Isolated Island Using a Portable Slit-Lamp Device in Home-Based Cases in Miyako Island. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0306845"},{"key":"ref_18","first-page":"e65153","article-title":"A Case of Traumatic Hyphema Diagnosed by Telemedicine Between a Remote Island and the Mainland of Tokyo","volume":"16","author":"Shimizu","year":"2024","journal-title":"Cureus"},{"key":"ref_19","first-page":"e73783","article-title":"Diagnostic Assessment of Nuclear Cataracts Using a Smartphone-Attachable Slit-Lamp Device: A Cross-Sectional Study in Vietnam","volume":"16","author":"Duong","year":"2024","journal-title":"Cureus"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Haken, I.T., Allouch, S.B., and van Harten, W.H. (2018). The Use of Advanced Medical Technologies at Home: A Systematic Review of the Literature. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5123-4"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2171","DOI":"10.1007\/s40123-023-00733-w","article-title":"Efficacy of Simulator-Based Slit Lamp Training for Medical Students: A Prospective, Randomized Trial","volume":"12","author":"Deuchler","year":"2023","journal-title":"Ophthalmol. Ther."},{"key":"ref_22","first-page":"e215","article-title":"Evaluation of an Instructional Video and Simulation Model for Teaching Slit Lamp Examination to Medical Students","volume":"15","author":"Collis","year":"2017","journal-title":"J. Acad. Ophthalmol."},{"key":"ref_23","first-page":"e57986","article-title":"Medical Students\u2019 Perspectives Regarding the Use of a Slit-Lamp Smartphone Adapter for Clinical Slit-Lamp Photography","volume":"16","author":"Emam","year":"2024","journal-title":"Cureus"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1097\/ICL.0000000000000051","article-title":"Global Teleophthalmology with iPhones for Real-Time Slitlamp Eye Examination","volume":"40","author":"Ye","year":"2014","journal-title":"Eye Contact Lens"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.survophthal.2019.09.001","article-title":"Smartphone Use in Ophthalmology: What Is Their Place in Clinical Practice?","volume":"65","author":"Hogarty","year":"2020","journal-title":"Surv. Ophthalmol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/01.JAA.0000541482.54611.7c","article-title":"Smartphone Imaging for the Ophthalmic Examination in Primary Care","volume":"31","author":"Bifolck","year":"2018","journal-title":"JAAPA"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.2147\/OPTH.S412233","article-title":"Interobserver Reliability of Tear Break-Up Time Examination Using \u201cSmart Eye Camera\u201d in Indonesian Remote Area","volume":"17","author":"Handayani","year":"2023","journal-title":"Clin. Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Shikino, K., Rosu, C.A., Yokokawa, D., Suzuki, S., Hirota, Y., Nishiya, K., and Ikusaka, M. (2021). Flexible e-Learning Video Approach to Improve Fundus Examination Skills for Medical Students: A Mixed-Methods Study. BMC Med. Educ., 21.","DOI":"10.1186\/s12909-021-02857-8"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1089\/tmj.2017.0120","article-title":"Accuracy and Reliability of a Handheld, Nonmydriatic Fundus Camera for the Remote Detection of Optic Disc Edema","volume":"24","author":"Bursztyn","year":"2018","journal-title":"Telemed. J. E Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.ophtha.2011.09.013","article-title":"Quality of Nonmydriatic Digital Fundus Photography Obtained by Nurse Practitioners in the Emergency Department: The FOTO-ED Study","volume":"119","author":"Lamirel","year":"2012","journal-title":"Ophthalmology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1038\/eye.2013.143","article-title":"The Impact of the Virtual Ophthalmology Clinic on Medical Students\u2019 Learning: A Randomised Controlled Trial","volume":"27","author":"Succar","year":"2013","journal-title":"Eye"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2200","DOI":"10.1016\/j.ophtha.2012.05.005","article-title":"Smartphone Photography Safety","volume":"119","author":"Kim","year":"2012","journal-title":"Ophthalmology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1167\/tvst.10.4.28","article-title":"Smart Eye Camera: A Validation Study for Evaluating the Tear Film Breakup Time in Human Subjects","volume":"10","author":"Shimizu","year":"2021","journal-title":"Transl. Vis. Sci. Technol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"12691","DOI":"10.1038\/s41598-021-92232-w","article-title":"Learning Curve Evaluation Upskilling Retinal Imaging Using Smartphones","volume":"11","author":"Jansen","year":"2021","journal-title":"Sci. Rep."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/1928\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T05:19:00Z","timestamp":1772774340000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/5\/1928"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,3]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["jcm15051928"],"URL":"https:\/\/doi.org\/10.3390\/jcm15051928","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,3]]}}}