Hamish Dunn, Samuel Marks, Kai Teo, Paul Healey, Andrew White, Stewart Dunn
Purpose: Fundoscopy is performed infrequently outside of ophthalmology and neurology. These examinations can facilitate a screening and diagno- sis, assisting in triage and referral. The decline in fundoscopy has been ascribed to technical examina- tion challenges and difftculty interpreting results. We hypothesise that capturing fundus photos using smartphones would minimise these challenges and increase clinical use.
Methods: 38 second and ftnal-year medical students participated. They accessed a fundus interpretation eLearning course, and were exposed to three devices for fundoscopy: direct ophthalmoscopy; and two smartphone adaptors: the Panopthalmoscope-iExa- miner, and D-eye. They completed examinations on simulators and patients, with a crossover between smartphone and direct fundoscopy. Following they were surveyed on: preferred technique for fundo- scopy; conftdence; and ease of viewing the fundus. Further sessions with another 90 students are pend- ing. Data analysis used one-sample t-test, binomial test, and Wilcoxon signed-rank test.
Results: 32 students (84.2%) completed the post- workshop questionnaire. Clinical interpretation results are pending. Overall, students responded favourably to smartphone-assisted fundoscopy (SF) over direct ophthalmoscopy (DO). 75% pre- ferred SF over DO (p = 0.007), Conftdence levels viewing fundus on a 1-5 Likert scale (1 being least conftdent) was 3.500 (95% CI[3.17-3.83]) for SF vs 3.031 (95% CI [2.69-3.37]) for DO (p = 0.037). Ease
of viewing fundus was 3.469 (95% CI [2.14-2.80])
for sSF and 2.844 (95% CI [2.49-3.20]) for DO
Conclusion: Smartphone-assisted fundoscopy enhances medical students conftdence in fundus examinations and allows easier fundus viewing. Further studies will determine how this translates to long-term clinical use.