Handheld digital fundoscopy – a useful bedside tool for neurologists, particularly critical care

<h3></h3> ‘Oculomics’ - information about systemic health gained from ophthalmic assessment - is increasingly recognised to be of clinical benefit. This is due, at least in part, to the relative ease of microcirculation visualisation within the eye. Many of the complications of severe coronavirus disease-19 (COVID-19) are attributable to endothelial cell dysfunction and microvascular thrombosis but, during the pandemic, handheld ophthalmoscopy was relatively contraindicated due to infection risk. For patients unable to access standard digital fundoscopy or indirect fundoscopy, fundal assessment was often precluded, and digital image capture impossible. Feasibility of bedside digital fundoscopy was examined using the Remidio™ handheld fundus camera, including in critically ill patients. Image quality from a sample of 32 patients was rated ‘average’ or ‘good’ in &gt;70% by a consultant ophthalmologist. Where available (n=15), images from the handheld fundal camera were compared with photographs previously acquired in the diabetic retinopathy (DR) screening programme; the DR grade could be determined in all and there was complete agreement in 66.7%. High-resolution, digital images of the fundus can be obtained at the bedside without pupillary dilatation using a handheld camera. This is a useful tool for neurologists, particularly in the critical care setting.