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Semin Neurol 2015; 35(05): 496-505
DOI: 10.1055/s-0035-1563572
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Ocular Fundus Photography as an Educational Tool

Devin D. Mackay
1   Departments of Neurology, Ophthalmology, and Neurosurgery, Indiana University School of Medicine, Indiana University Neuroscience Center, Indianapolis, Indiana
,
Philip S. Garza
2   Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
› Author Affiliations
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Publication History

Publication Date:
06 October 2015 (online)

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Abstract

The proficiency of nonophthalmologists with direct ophthalmoscopy is poor, which has prompted a search for alternative technologies to examine the ocular fundus. Although ocular fundus photography has existed for decades, its use has been traditionally restricted to ophthalmology clinical care settings and textbooks. Recent research has shown a role for nonmydriatic fundus photography in nonophthalmic settings, encouraging more widespread adoption of fundus photography technology. Recent studies have also affirmed the role of fundus photography as an adjunct or alternative to direct ophthalmoscopy in undergraduate medical education. In this review, the authors examine the use of ocular fundus photography as an educational tool and suggest future applications for this important technology. Novel applications of fundus photography as an educational tool have the potential to resurrect the dying art of funduscopy.

Keywords

ophthalmoscopy - medical education - fundus photography
 

  • References

  • 1 Jauhar S. The demise of the physical exam. N Engl J Med 2006; 354 (6) 548-551
    CrossrefPubMedGoogle Scholar
  • 2 Sherman SE. The history of the ophthalmoscope. Doc Ophthalmol 1989; 71 (2) 221-228
    CrossrefPubMedGoogle Scholar
  • 3 Mackay DD, Garza PS, Bruce BB, Newman NJ, Biousse V. The demise of direct ophthalmoscopy. Neurol Clin Pract 2015; 5 (2) 150-157
    CrossrefPubMedGoogle Scholar
  • 4 Bennett TJ, Barry CJ. Ophthalmic imaging today: an ophthalmic photographer's viewpoint - a review. Clin Experiment Ophthalmol 2009; 37 (1) 2-13
    CrossrefPubMedGoogle Scholar
  • 5 Darma S, Zantvoord F, Verbraak FD. The quality and usability of smartphone and hand-held fundus photography, compared to standard fundus photography. Acta Ophthalmol (Copenh) 2015; 93 (4) e310-e311
    CrossrefPubMedGoogle Scholar
  • 6 Bruce BB, Lamirel C, Biousse V , et al. Feasibility of nonmydriatic ocular fundus photography in the emergency department: Phase I of the FOTO-ED study. Acad Emerg Med 2011; 18 (9) 928-933
    CrossrefPubMedGoogle Scholar
  • 7 Roberts E, Morgan R, King D, Clerkin L. Funduscopy: a forgotten art?. Postgrad Med J 1999; 75 (883) 282-284
    CrossrefPubMedGoogle Scholar
  • 8 Morad Y, Barkana Y, Avni I, Kozer E. Fundus anomalies: what the pediatrician's eye can't see. Int J Qual Health Care 2004; 16 (5) 363-365
    CrossrefPubMedGoogle Scholar
  • 9 Benbassat J, Polak BCP, Javitt JC. Objectives of teaching direct ophthalmoscopy to medical students. Acta Ophthalmol (Copenh) 2012; 90 (6) 503-507
    CrossrefPubMedGoogle Scholar
  • 10 Keane PA, Sadda SR. Retinal imaging in the twenty-first century: state of the art and future directions. Ophthalmology 2014; 121 (12) 2489-2500
    CrossrefPubMedGoogle Scholar
  • 11 Ahmed J, Ward TP, Bursell SE, Aiello LM, Cavallerano JD, Vigersky RA. The sensitivity and specificity of nonmydriatic digital stereoscopic retinal imaging in detecting diabetic retinopathy. Diabetes Care 2006; 29 (10) 2205-2209
    CrossrefPubMedGoogle Scholar
  • 12 Lin DY, Blumenkranz MS, Brothers RJ, Grosvenor DM. The sensitivity and specificity of single-field nonmydriatic monochromatic digital fundus photography with remote image interpretation for diabetic retinopathy screening: a comparison with ophthalmoscopy and standardized mydriatic color photography. Am J Ophthalmol 2002; 134 (2) 204-213
    CrossrefPubMedGoogle Scholar
  • 13 Bruce BB, Lamirel C, Wright DW , et al. Nonmydriatic ocular fundus photography in the emergency department. N Engl J Med 2011; 364 (4) 387-389
    CrossrefPubMedGoogle Scholar
  • 14 Bruce BB, Thulasi P, Fraser CL , et al. Diagnostic accuracy and use of nonmydriatic ocular fundus photography by emergency physicians: phase II of the FOTO-ED study. Ann Emerg Med 2013; 62 (1) 28-33.e1
    CrossrefPubMedGoogle Scholar
  • 15 Colenbrander A. Simulation device for ophthalmoscopy. Am J Ophthalmol 1972; 74 (4) 738-740
    CrossrefPubMedGoogle Scholar
  • 16 Kahlenborn C, Sassani JW, Sherrard M, Frankel CA. A mannequin for teaching ocular fundus examination skills. Arch Ophthalmol 1989; 107 (12) 1725-1726
    PubMedGoogle Scholar
  • 17 Dodaro NR, Maxwell Jr DP. An eye for an eye. A simplified model for teaching. Arch Ophthalmol 1995; 113 (6) 824-826
    CrossrefPubMedGoogle Scholar
  • 18 Lippa LM, Boker J, Duke A, Amin A. A novel 3-year longitudinal pilot study of medical students' acquisition and retention of screening eye examination skills. Ophthalmology 2006; 113 (1) 133-139
    CrossrefPubMedGoogle Scholar
  • 19 Chung KD, Watzke RC. A simple device for teaching direct ophthalmoscopy to primary care practitioners. Am J Ophthalmol 2004; 138 (3) 501-502
    CrossrefPubMedGoogle Scholar
  • 20 Hoeg TB, Sheth BP, Bragg DS, Kivlin JD. Evaluation of a tool to teach medical students direct ophthalmoscopy. WMJ 2009; 108 (1) 24-26
    PubMedGoogle Scholar
  • 21 Swanson S, Ku T, Chou C. Assessment of direct ophthalmoscopy teaching using plastic canisters. Med Educ 2011; 45 (5) 520-521
    PubMedGoogle Scholar
  • 22 Korenfeld MS. Manual occluder for use in ophthalmic education. Arch Ophthalmol 1991; 109 (11) 1491
    PubMedGoogle Scholar
  • 23 Mottow-Lippa L, Boker JR, Stephens F. A prospective study of the longitudinal effects of an embedded specialty curriculum on physical examination skills using an ophthalmology model. Acad Med 2009; 84 (11) 1622-1630
    CrossrefPubMedGoogle Scholar
  • 24 Kelly LP, Garza PS, Bruce BB, Graubart EB, Newman NJ, Biousse V. Teaching ophthalmoscopy to medical students (the TOTeMS study). Am J Ophthalmol 2013; 156 (5) 1056-1061.e10
    CrossrefPubMedGoogle Scholar
  • 25 Larsen P, Stoddart H, Griess M. Ophthalmoscopy using an eye simulator model. Clin Teach 2014; 11 (2) 99-103
    CrossrefPubMedGoogle Scholar
  • 26 Mackay DD, Garza PS, Bruce BB , et al. Teaching ophthalmoscopy to medical students (TOTeMS) II: A one-year retention study. Am J Ophthalmol 2014; 157 (3) 747-748
    PubMedGoogle Scholar
  • 27 Akaishi Y, Otaki J, Takahashi O , et al. Validity of direct ophthalmoscopy skill evaluation with ocular fundus examination simulators. Can J Ophthalmol 2014; 49 (4) 377-381
    CrossrefPubMedGoogle Scholar
  • 28 Byrd JM, Longmire MR, Syme NP, Murray-Krezan C, Rose L. A pilot study on providing ophthalmic training to medical students while initiating a sustainable eye care effort for the underserved. JAMA Ophthalmol 2014; 132 (3) 304-309
    CrossrefPubMedGoogle Scholar
  • 29 Åsman P, Lindén C. Internet-based assessment of medical students' ophthalmoscopy skills. Acta Ophthalmol (Copenh) 2010; 88 (8) 854-857
    CrossrefPubMedGoogle Scholar
  • 30 Afshar AR, Oh FS, Birnbaum AD, Namavari A, Riddle JM, Djalilian AR. Assessing ophthalmoscopy skills. Ophthalmology 2010; 117 (9) 1863 , 1863.e1–1863.e2
    CrossrefPubMedGoogle Scholar
  • 31 Milani BY, Majdi M, Green W , et al. The use of peer optic nerve photographs for teaching direct ophthalmoscopy. Ophthalmology 2013; 120 (4) 761-765
    CrossrefPubMedGoogle Scholar
  • 32 Mackay DD, Bruce BB, Newman NJ, Biousse V. Teaching ophthalmoscopy to medical students. JAMA Ophthalmol 2015; 133 (2) 223-224
    CrossrefPubMedGoogle Scholar
  • 33 Jin J, Bridges SM. Educational technologies in problem-based learning in health sciences education: a systematic review. J Med Internet Res 2014; 16 (12) e251
    CrossrefPubMedGoogle Scholar
  • 34 Leger MC, Wu T, Haimovic A , et al. Patient perspectives on medical photography in dermatology. Dermatol Surg 2014; 40 (9) 1028-1037
    CrossrefPubMedGoogle Scholar
  • 35 Morrison AS, Gardner JM. Smart phone microscopic photography: a novel tool for physicians and trainees. Arch Pathol Lab Med 2014; 138 (8) 1002
    CrossrefPubMedGoogle Scholar