An ophthalmoscopic evaluation is an important part of the physical exam but takes significant training and practice to be successful. Most medical trainees express uncertainty surrounding their abilities to perform the examination. It is unknown whether recurrent structured training, as well as improved panoptic ophthalmoscopic equipment with novel video adaptors, can improve trainees’ comfort level.

A pilot survey study of neurology and emergency medicine (EM) residents at UMass Chan Medical School was conducted. A pre-training survey was provided, followed by the training session with the phone-adapted panoptic ophthalmoscope. Trainees had a 3-month window to practice in the clinical arena. Subsequent post-training survey and training evaluations were performed.

5 EM and 5 neurology residents participated in the panoptic study (N=10). A scale of 0 to 5 was used, with 0 indicating the lowest score, and 5 indicating the highest. Due to the small sample size, a median number was used for analysis. The pre-study surveys showed that the most residents did not feel prepared when performing an ophthalmoscopic examination (median 2).  They did show a willingness to try out a new technique (median 4). No statistical significance was seen in comparison between pre-survey and post-survey regarding frequency of ophthalmoscope examination performed in the past month, quality of ophthalmoscope exposure, comfort of using an ophthalmoscope, and confidence in visualizing papilledema, venous pulsations, or a retinal artery occlusion (p>0.05). However, many residents expressed improvement in their fundoscopic examination (median 4.5) as well as comfort level (median 4) after the training and follow-up post-survey.  The majority responded that they would consider using the panoptic again (median 4.5) and recommend the training (median 4).

The ophthalmoscopic examination is a necessary part of the neurologic examination. Our study indicates an opportunity to further improve training. A larger future study will be needed for further evaluation.