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User Guide

Direct Image Editing

This guide explains how to edit directly uploaded fundus images to remove or obscure patient information and improve image quality for grading.

Overview

The image editing tool allows users to modify directly uploaded images to protect patient privacy and enhance image clarity. This is particularly important when images contain visible patient identifiers or require adjustments for optimal grading.

Accessing Image Editing

Required Permissions

  • Admin: Full access to edit all images
  • Data Manager: Can edit images within assigned lab units
  • File Uploader: Can edit images they uploaded
  • Optometrist: Can edit images based on permissions
  1. Log in to the system
  2. Navigate to Direct Uploads in the main menu
  3. Select the image you want to edit
  4. Click the Edit button in the image toolbar

Image Editing Tools

Available Tools

  • Brush: Draw on the image to cover or highlight areas
  • Eraser: Remove edits to restore original image areas
  • Crop: Select an elliptical area to keep, removing everything else

Tool Controls

  • Brush Size: Adjust the size of the brush/eraser (1-50 pixels)
  • Brush Color: Select color for the brush tool
  • Undo/Redo: Navigate through editing history
  • Clear: Remove all edits and restore original image

Step-by-Step Editing Workflow

Step 1: Open the Image Editor

  1. Locate the image in Direct Uploads
  2. Click the Edit button
  3. The editor will load with the image displayed

Step 2: Choose Your Tool

  1. Select the appropriate tool for your task:
  2. Brush for covering patient information
  3. Eraser for correcting mistakes
  4. Crop for focusing on specific areas

Step 3: Make Your Edits

  • For Brush/Eraser: Click and drag to draw on the image
  • For Crop: Click and drag to create an elliptical selection

Step 4: Review and Save

  1. Use the preview to check your edits
  2. Save the edited version when satisfied
  3. The original image is preserved separately

Common Editing Use Cases

Removing Patient Information

  • Text Overlays: Use the brush tool to cover patient names or IDs
  • Barcode Labels: Cover or remove barcode labels
  • Date Stamps: Obscure examination dates if needed
  • Institution Information: Cover hospital or clinic names

Improving Image Quality

  • Cropping: Focus on the relevant anatomical structures
  • Removing Artifacts: Cover dust spots or reflections
  • Enhancing Clarity: Crop to eliminate peripheral distractions

Privacy Protection

  • Face Protection: Cover any visible facial features
  • Identifier Removal: Obscure any unique identifying marks
  • Metadata Considerations: Note that editing doesn't affect metadata

Cropping Tool Details

Creating a Crop Selection

  1. Select the Crop tool
  2. Click and drag on the image to create an ellipse
  3. Adjust the size by dragging the handles

Moving the Selection

  • Click inside the ellipse and drag to move it
  • Use the handles to resize the selection

Applying the Crop

  1. Click Apply Crop when satisfied with the selection
  2. Everything outside the ellipse will be removed
  3. The cropped image becomes the new base for further editing

Editing Restrictions

When Editing Is Blocked

  • If grading tasks are already in progress for the image
  • If the image is locked by another user
  • If you don't have sufficient permissions

Error Messages

  • "Editing blocked. Grading tasks already in progress"
  • "You don't have permission to edit this upload"
  • "Image file not found on server"

Saving and Managing Edits

Saving Changes

  1. Click Save Image to store your edits
  2. The system creates an edited version alongside the original
  3. A success message confirms the save

Restoring Original

  1. Click Restore Original to revert to the unedited image
  2. This deletes the edited version permanently
  3. The original image becomes the active version again

Edit History

  • The system maintains a record of editing sessions
  • Original and edited versions are tracked separately
  • Access to editing is logged for audit purposes

Best Practices for Image Editing

Before Editing

  1. Identify all areas that need modification
  2. Plan your editing approach
  3. Ensure you have sufficient permissions

During Editing

  1. Use appropriate brush sizes for the task
  2. Work systematically to avoid missing areas
  3. Use undo if you make mistakes
  4. Zoom in for precise work on small areas

After Editing

  1. Review the entire image carefully
  2. Ensure all patient information is obscured
  3. Verify that clinical information remains intact
  4. Save when satisfied with the result

Quality Considerations

Maintaining Clinical Value

  • Preserve all relevant anatomical structures
  • Don't obscure pathology while removing identifiers
  • Keep image quality sufficient for grading

Privacy Protection

  • Ensure all patient identifiers are completely obscured
  • Check for reflected information in the eye
  • Consider indirect identifiers (room numbers, etc.)

Troubleshooting Common Issues

Tool Not Working

  • Check if editing is locked due to grading tasks
  • Verify you have the necessary permissions
  • Try refreshing the page

Edits Not Visible

  • Ensure you're using a contrasting color
  • Check brush size isn't too small
  • Verify you're on the correct layer

Cannot Save

  • Check your internet connection
  • Verify the session hasn't timed out
  • Try refreshing and re-applying edits

Crop Not Applying

  • Ensure the selection is completely within the image
  • Check that the crop area isn't too small
  • Try creating a new selection

Integration with Grading Workflows

Edited Images in Grading

  • Graders see the edited version by default
  • Original images are preserved for reference
  • Edit status is indicated in the grading interface

Quality Assurance

  • Review edits before submitting for grading
  • Ensure edits don't interfere with grading accuracy
  • Document any unusual modifications

Security and Privacy

Access Control

  • Only authorized users can edit images
  • Edit access is logged for audit purposes
  • Original images are preserved for reference

Privacy Compliance

  • Editing helps ensure compliance with privacy regulations
  • Audit trails demonstrate privacy protection measures
  • Access is restricted based on user roles

Technical Limitations

File Format Support

  • Works with standard image formats (JPEG, PNG)
  • Large images may load more slowly
  • Very high resolutions may impact performance

Browser Compatibility

  • Works best with modern browsers
  • Requires JavaScript to be enabled
  • Touch devices support basic editing

Contact Support

For editing issues: - Check the troubleshooting section - Contact your system administrator - Report specific problems through the support channel - Request additional training if needed