{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:28:37Z","timestamp":1792718917195,"version":"4.5.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Smartphone-based microscopy tool like foldscope (FS) may serve the purpose of a low-cost diagnostic alternative to the compound light microscope especially in areas with limited resources. The purpose of this study was to detect fungal pathogens causing keratitis on direct smear by smartphone-mounted FS and to evaluate the efficacy of FS against routine compound light microscope (CLM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      The prospective study was conducted at a tertiary eye care center from September 2019 to March 2020. The study included 60 smear examinations (Gram stain [GM]\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 30, Lactophenol Cotton Blue [LCB]\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 30) to detect fungal pathogens from corneal scraping material of clinically suspected fungal keratitis (FK) cases. The diagnostic utility of FS was compared with CLM for both GM and LCB wet mount. Data collected were used to quantify the agreement using Cohen\u2019s kappa between CLM and FS imaging.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Forty-six samples out of 60 were positive for fungi using CLM. GM stain and LCB showed 22\/30 (73.33%) and 24\/30 (80%) positive results with CLM, respectively. Moderate agreement (0.49) was observed between CLM and FS with the smartphone method. LCB mount showed high specificity of 1.00 over 0.87 of GM stain for FS with the smartphone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Direct smear can be an early and sensitive measure to diagnose FK other than clinical suspicion. The smartphone-mounted FS has limited sensitivity as an alternative to CLM, but excellent specificity in the present study for FK. The FS as a smartphone-based diagnostic tool is simple, portable, and inexpensive in resource-constrained rural or remote clinical and public health settings in the absence of CLM and other higher diagnostic modalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijo.ijo_3331_20","type":"journal-article","created":{"date-parts":[[2021,10,5]],"date-time":"2021-10-05T11:42:39Z","timestamp":1633434159000},"page":"2836-2840","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Foldscope: A smartphone based diagnostic tool for fungal keratitis"],"prefix":"10.4103","volume":"69","author":[{"given":"Dipali P","family":"Parmar","sequence":"first","affiliation":[{"name":"M and J Institute of Ophthalmology, (Government Eye Hospital), B.J. Medical College, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay S","family":"Rathod","sequence":"additional","affiliation":[{"name":"M and J Institute of Ophthalmology, (Government Eye Hospital), B.J. Medical College, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minhaz M","family":"Karkhanawala","sequence":"additional","affiliation":[{"name":"Consultant Ophthalmologist at Apollo Prime Eye Hospitals, Ahmedabad, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradnya K","family":"Bhole","sequence":"additional","affiliation":[{"name":"M and J Institute of Ophthalmology, (Government Eye Hospital), B.J. Medical College, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darshana S","family":"Rathod","sequence":"additional","affiliation":[{"name":"Cornea Consultant, Dr Kazi\u2019s Eye Hospital, Junagath, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,9,25]]},"reference":[{"key":"B1-20240828","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.sjopt.2019.09.002","article-title":"Challenges in the diagnosis of microbial keratitis:A detailed review with update and general guidelines","volume":"33","author":"Alkatan","year":"2019","journal-title":"Saudi J Ophthalmol"},{"key":"B2-20240828","doi-asserted-by":"crossref","first-page":"e6320","DOI":"10.1371\/journal.pone.0006320","article-title":"Fletcher mobile phone based clinical microscopy for global health applications","volume":"4","author":"Breslauer","year":"2009","journal-title":"PLoS One"},{"key":"B3-20240828","doi-asserted-by":"crossref","first-page":"2213","DOI":"10.4103\/ijo.IJO_2032_19","article-title":"Smartphone-based intraocular lens microscope","volume":"68","author":"Chandrakanth","year":"2020","journal-title":"Indian J Ophthalmol"},{"key":"B4-20240828","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/ICO.0000000000000359","article-title":"Detection of fungal hyphae using smartphone and pocket magnifier:Going cellular","volume":"34","author":"Agarwal","year":"2015","journal-title":"Cornea"},{"key":"B5-20240828","doi-asserted-by":"crossref","first-page":"1690","DOI":"10.4103\/ijo.IJO_52_19","article-title":"Anterior segment photography with intraocular lens","volume":"67","author":"Chandrakanth","year":"2019","journal-title":"Indian J Ophthalmol"},{"key":"B6-20240828","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.4103\/ijo.IJO_986_19","article-title":"Commentary:The glued intraocular lens smartphone microscope","volume":"67","author":"Akkara","year":"2019","journal-title":"Indian J Ophthalmol"},{"key":"B8-20240828","doi-asserted-by":"crossref","first-page":"e98781","DOI":"10.1371\/journal.pone.0098781","article-title":"Foldscope:Origami-based paper microscope","volume":"9","author":"Cybulski","year":"2014","journal-title":"PLoS One"},{"key":"B10-20240828","first-page":"195","article-title":"A simplified gram stain for demonstrating fungi in tissues","volume":"33","author":"Schneidau","year":"1963","journal-title":"Tech Bull Regist Med Technol"},{"key":"B11-20240828","first-page":"490","article-title":"Usefulness and limit of Gram staining smear examination","volume":"58","author":"Nagata","year":"2010","journal-title":"Rinsho Byori"},{"key":"B12-20240828","first-page":"31","article-title":"Early diagnosis of mycotic keratitis:Predictive value of potassium hydroxide preparation","volume":"46","author":"Sharma","year":"1998","journal-title":"Indian J Ophthalmol"},{"key":"B13-20240828","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/0732-8893(91)90035-E","article-title":"Use of lactophenol cotton blue mounts of corneal scrapings as an aid to the diagnosis of mycotic keratitis","volume":"14","author":"Thomas","year":"1991","journal-title":"Diagn Microbiol Infect Dis"},{"key":"B14-20240828","first-page":"24","article-title":"Gram Stain","volume":"12","author":"Matheson","year":"1999","journal-title":"Community Eye Health"},{"key":"B15-20240828","first-page":"24","article-title":"Preparation of lactophenol cotton blue slide mounts","volume":"12","author":"Leck","year":"1999","journal-title":"Community Eye Health"},{"key":"B16-20240828","doi-asserted-by":"crossref","first-page":"912","DOI":"10.4103\/ijo.IJO_821_17","article-title":"Fungal keratitis:The Aravind experience","volume":"65","author":"Prajna","year":"2017","journal-title":"Indian J Ophthalmol"},{"key":"B17-20240828","first-page":"315","article-title":"Epidemiological characteristics and laboratory diagnosis of fungal keratitis. 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