Virtual Instrumentation System with Real-Time Visual Feedback and Needle Position Warning Suitable for Ophthalmic Anesthesia Training

In this paper, the design and development of a novel mannequin-based ophthalmic anesthetic training system with two cameras integrated into it to provide a real-time visual feedback to the trainee is presented. The system developed uses anatomically accurate 3-D printed ocular structures and a novel feature for ophthalmic training system where the trainee is able to see the needle and ocular structures on a monitor in real time during the training. Other new features of the system include a virtual instrument, which has been developed to acquire the images, process, and automatically capture the required information from the images from the cameras. The system is developed in such a way that when a trainee practices using the proposed system, it detects and tracks the needle tip position automatically using an appropriate algorithm. Then, the position of the needle is used to trace the path of the needle, and the system warns if the needle enters locations within the orbital cavity that are classified as unsafe. The entire training session as observed by the two wisely positioned cameras can be recorded; the same can be reviewed by an expert anesthetist at any point of time to give the feedback. The trainee with information provided by the training system and the feedback provided by the expert instructor helps him/her to improve and perform safer regional ophthalmic blocks. The system developed was tested at a pilot study, which comprised of 21 trainees and 20 consultant ophthalmic anesthetists to validate its utility.