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
