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CC BY-NC-ND 4.0 · Journal of Academic Ophthalmology 2023; 15(01): e62-e67
DOI: 10.1055/s-0043-1763280
Research Article

Comparing the Diagnostic Utility of Conventional Direct Ophthalmoscopy with Smartphone Ophthalmoscopy among Medical Students

Jibran Sharieff
1   Department of Ophthalmology, Dean A McGee Eye Institute, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Victoria Bugg
1   Department of Ophthalmology, Dean A McGee Eye Institute, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Zachary C. W. Barrett
2   Hudson College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Kai Ding
2   Hudson College of Public Health, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Anil Patel
1   Department of Ophthalmology, Dean A McGee Eye Institute, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
,
Preston Choi
3   Department of Ophthalmology, The University of Texas Southwestern Medical Center, Dallas, Texas
,
Tammy Yanovitch 
1   Department of Ophthalmology, Dean A McGee Eye Institute, The University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
› Author Affiliations Funding Dr. Tammy Yanovitch: Jerry Vannatta, MD Academic of Teaching Scholars education research grant.
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Abstract

Purpose To compare the diagnostic ability of medical students using smartphone ophthalmoscopy (SO) with conventional direct ophthalmoscopy (DO).

Methods Twenty-eight first- and second-year medical students were trained to use the SO and DO. They also attended educational seminars regarding optic nerve and retinal pathology and were given hands-on practice with each ophthalmoscopy method. Students were randomized 2:1 into one of the groups (DO or SO). Students then examined six patients and recorded their findings, ease of use, and confidence level on a questionnaire. Two attending ophthalmologists, masked to the randomization, graded the student questionnaires. A priori power calculation determined the sample size. The primary outcome measure was the percentage of correct diagnoses the students made. Two-sample t-test, Wilcoxon's rank-sum test, and Fisher's exact test were used to compare the outcomes.

Results Students using the SO outperformed students using DO in terms of mean percent correct (% correct) diagnosis (smartphone: 42% vs. direct: 23%; p-value = 0.0057), mean % correct photo match (smartphone: mean = 60% vs. direct: 32%; p-value = 0.0052), and mean % correct nerve/retinal descriptors (smartphone: 72% vs. direct: 59%; p-value = 0.0048). There was not a significant difference in terms of perceived ease of use (smartphone: mean = 3.3 vs. direct: mean = 2.6; p-value = 0.0945), or subjective confidence (smartphone: mean = 2.6 vs. direct: mean = 2.1; p-value = 0.0808) between the two groups.

Conclusion SO provides an alternate way for medical students to learn, diagnose, and describe ocular pathology.

Keywords

smartphone ophthalmoscopy - direct ophthalmoscopy - medical student - ophthalmic education - funduscopy


Publication History

Received: 16 August 2022

Accepted: 17 January 2023

Article published online:
01 March 2023

© 2023. 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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