Comparison of the efficacy of three direct ophthalmoscopes: a clinical study

Parthasarathy, Mohana Kuppuswamy; Faruq, Ibrahim; Arthurs, Eugene G.; Lakshminarayanan, Vaseudevan

doi:10.1117/12.2529439

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…Though more medical students preferred DO over SF coupled with higher performance marks for DO and more favorable attitudes toward DO, the data show those students who had a better experience with SF viewed it just as positively as DO, if not even more positively. Our results contrast with other comparable 2018 studies in the literature; 23,24,[28][29][30] however, these other studies used commercially available smartphone imaging apparatuses, D-EYE and PEEK retina, which are also imaging techniques that are more directly comparable to conventional DO. We posit the stark differences in our study are due to imaging technique and difficulty of freehand positioning a condenser lens with a smartphone, such that the imaging axis is aligned well enough to produce a quality image.…”

Section: Discussioncontrasting

confidence: 99%

Teaching Smartphone Funduscopy with 20 Diopter Lens in Undergraduate Medical Education

Kohler¹,

Tran²,

Sun³

et al. 2021

OPTH

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To assess attitudes of pre-clinical undergraduate medical students toward learning smartphone funduscopy (SF) and its appropriateness as a teaching tool. Patients and Methods: Second year medical students received instruction on direct ophthalmoscopy (DO) and SF; they were then paired with a peer and randomly assigned to perform DO or SF first. The SF technique involved freehand alignment of the axes of the smartphone camera with a condenser lens. Both techniques were done through a maximally dilated pupil. A questionnaire was completed to acquire data on baseline experience, performance of both examination techniques, attitudes, and appropriateness. Statistical significance testing and Bland-Altman analysis were used to determine differences between DO and SF, and a multivariable mixed regression model was fitted to identify any predictors for positive attitudes toward DO or SF. Results: One hundred thirty-seven (137) individuals completed the study. A similar proportion of students could identify the optic nerve, macula, and vessels using DO and SF. However, self-reported quality scores were higher for DO for the optic nerve (p = 0.006) and macula (p = 0.08). The mean (standard deviation) attempts to identify these major structures were 2.7 (SD 2.3) for DO and 4.5 (SD 2.9) for SF (p < 0.001). Attitudes of students were consistently more positive toward DO across the five questions assessed. A small subset of students had equally positive attitudes toward DO and SF. Improved quality scores were predictive of positive attitudes for both DO and SF. Ultimately, 24% of students preferred SF over DO. Conclusion: Among inexperienced examiners of the fundus through a dilated pupil, SF is a non-inferior technique to DO in identifying structures. Despite overall favorable attitudes towards the more familiar DO, those students who quickly learned the SF technique had similar satisfaction scores. Teaching SF should be considered in undergraduate medical education.

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