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In Part 1 of this topic ( the need for a mature ophthalmic imaging network was described. Here, I provide a scoring scheme that can be used to articulate the maturity of existing devices. As with any scoring system, the hope is to quantify any gap between existing and desired maturity. Units may consider using their device maturity scores to evidence the need for investment. To reflect the importance of ophthalmic imaging maturity, the UK Ophthalmic Alliance (UKOA) intend to promote this tool for national use.

ODM level

An Ophthalmic Device Maturity (ODM) level should be determined for each ophthalmic imaging device. Level 1A is the worst and level 4C is the best. The value from 1 to 4 denotes the connectivity of the device. The letter from A to C reflects the level of data backup or safety. Aiming for a level of 4C should be possible for most devices. Some older devices (without DICOM support) will be limited to level 3C. All imaging devices, whether slit-lamp cameras or a mobile B-scanners should be graded. The ODM level scoring scheme can be seen in Figure 1.


Figure 1: The ODM level scoring scheme.


Figure 2: A network of six connected devices, each with an ODM level of 4C.


Figure 2 illustrates a network of six connected devices, each with an ODM level of 4C. Despite the presence of optical coherence tomography (OCT) devices from multiple manufacturers, all devices still achieve the maximum level possible. To maintain high quality analytic data, two ophthalmic PACS stores are required (FORUM and HEYEX). In this example, FORUM is the primary data store, and acts as the source for DICOM Modality Worklists. Even though the worklist on the Spectralis is populated from ZEISS FORUM, the data is still transferred to the Heidelberg data store (HEYEX). All six devices transfer their data to a server, and worklists replace the need for manual data entry. This earns each device a connectivity score of 4. Both the FORUM and HEYEX servers are backed up, earning the devices connected to them a safety rating of C.

Some aspects of device connectivity are intentionally not captured by the ODM level. Integration with an ophthalmic EPR (such as OpenEyes or Medisoft) is one example. This feature is excluded as it is only available for a few device types (like biometry machines and OCT scanners).

Links to download a PDF of the scoring tool and a data collection spreadsheet are provided:

Scoring tool:
Data collection sheet:

The data collection sheet automatically generates a summary report and graph. Get in touch via the email address below if you have any difficulties downloading the files.

Once the results are understood, a prioritised plan to improve them would be a logical next step. The approach will need to be tailored to the scores and existing architecture.

Dedicated ophthalmic imaging lead

Management of ophthalmic imaging infrastructure has become sufficiently important (and technical) that having dedicated staff should be considered.


Please send feedback on this tool to my email (below this article).

The author has no proprietary or financial interests in the products discussed.





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David Haider

Bolton NHS Foundation Trust, Royal Bolton Hospital, UK.

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