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CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2021; 13(02): e270-e276
DOI: 10.1055/s-0041-1736438
Research Article

Smartphone Compatible versus Conventional Ophthalmoscope: A Randomized Crossover Educational Trial

Rachel Curtis 
1   Kingston Health Sciences Centre-Kingston General Hospital Research Institute, Kingston, Ontario, Canada
,
Mark Xu
1   Kingston Health Sciences Centre-Kingston General Hospital Research Institute, Kingston, Ontario, Canada
,
Daisy Liu
1   Kingston Health Sciences Centre-Kingston General Hospital Research Institute, Kingston, Ontario, Canada
,
Jason Kwok
1   Kingston Health Sciences Centre-Kingston General Hospital Research Institute, Kingston, Ontario, Canada
,
Wilma Hopman
1   Kingston Health Sciences Centre-Kingston General Hospital Research Institute, Kingston, Ontario, Canada
,
Isabella Irrcher
1   Kingston Health Sciences Centre-Kingston General Hospital Research Institute, Kingston, Ontario, Canada
,
Stephanie Baxter
1   Kingston Health Sciences Centre-Kingston General Hospital Research Institute, Kingston, Ontario, Canada
› Author Affiliations Funding This work was funded by a Physicians' Services Incorporated (PSI) Resident Research Grant (Grant #R18-21) to M.X.
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Abstract

Objective The aim of the study is to compare performance and ease-of-use (EOU) of optic disk assessment using a smartphone direct ophthalmoscope attachment (D-EYE) to the gold standard direct ophthalmoscope (DO).

Design The type of study involved is prospective, randomized, crossover, and educational trial.

Participants The participants involved were first year medical students inexperienced in ophthalmoscopy.

Methods Optic disks of standardized and volunteer patients were examined using the D-EYE and a conventional DO. Optic disk identification, EOU ratings of the devices, self-reported confidence level in their examination with the devices, and estimation of vertical cup-to-disk ratio (VCDR) were compared. Analyses included Chi-square tests, independent samples t-tests, correlations, and multivariable linear regression.

Results Forty-four medical students voluntarily participated in the study. Students using the DO required more attempts (3.57 vs. 2.69, p = 0.010) and time (197.00 vs. 168.02 seconds, p = 0.043) to match the patient's fundus to the correct photograph. Overall EOU between the devices (6.40 vs. 4.79, p < 0.001) and overall confidence in examination (5.65 vs. 4.49, p = 0.003) were greater when using the D-EYE. There were no statistically significant differences in accuracy of VCDR estimations between the two ophthalmoscopes.

Conclusion Smartphone ophthalmoscopy could offer additional learning opportunities in medical education and may be considered in clinical practice by non-specialist physicians given its greater EOU and increased success in visualizing the optic disk.

Keywords

direct ophthalmoscopy - D-EYE - smartphone ophthalmoscope - medical education - undergraduate medicine


Publication History

Received: 30 January 2021

Accepted: 30 July 2021

Article published online:
25 December 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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