Longer-term objective is to develop a commercial internet-based collaborative image annotation system that will be used by physicians in both clinical and clinical trials settings. This software will accomplish two goals. First, it will significantly enhance the objectivity, ease and accuracy in reading, interpreting and tracking areas of pathology in an image. Second, it will facilitate effective collaboration among physicians and support personnel at multiple clinical centers. This software will embody three technological innovations: rich annotations tied to areas of pathology in an image; web-browser based markings of images and automated computation of physical properties; and collaborative technology to securely retrieve, store and search rich annotations. Phase I and II will focus on research and development of this technology with ophthalmic images. Research approach is to: Collect functional and technical requirements from two sources the Fundus Photography Reading Center (FPRC) in Madison, WI, and Univ. of Florida Ophthalmology (UFO) in Jacksonville, FL; design and develop the collaborative image annotation system with Ophthalmic images; beta test the application at FPRC and UFO. Benefits will be: superior quality data through objective reading, interpretation and tracking (over multiple visits) of areas of pathology in images; faster turn around on image reading and interpretation through paperless, web-based user-friendly system; and easier searching, statistical analysis and documentation of results. Potential commercial applications are: Ophthalmology reading centers; Collaboration system for clinical trials in image related medical areas; Clinical diagnosis, treatment and monitoring of diseases based on sequential imaging, Computer-based instruction, training and testing on image related medical topics.