Utility of Nonmydriatic Fundus Camera for Teaching Fundoscopy to Medical Interns: A Prospective Comparative Study

Abstract Background: Fundus examination is an important skill that helps in the diagnosis of many sight-threatening and life-threatening diseases. This study aimed to investigate the usefulness of nonmydriatic fundus photography as a tool for teaching fundus examination to medical interns and compare with conventional direct ophthalmoscopy. Materials and Methods: This prospective study was conducted among interns in ophthalmology rotation from a medical college in South India. After an introductory lecture on ocular fundus examination, medical interns were randomly assigned to receive demonstration and practice with a standard direct ophthalmoscope or nonmydriatic fundus camera initially on an eye exam simulator. Subsequently, they crossed over to the other instrument. A validated questionnaire was administered to acquire data on self-rated confidence with regard to identifying normal retinal structures and pathologic lesions using both instruments. Objective assessment was done by having interns perform direct ophthalmoscopy on a simulator and match the visualized image with a grid of nine fundus images. Results: One hundred twenty-eight interns participated in the study. Self rated confidence in identifying the optic disc, macula, retinal vessels, and pathologic lesions was similar for both direct ophthalmoscopy and nonmydriatic fundus photography. One hundred seventeen (91.4%) felt that the use of nonmydriatic fundus camera will improve their ability to perform direct ophthalmoscopy. Interns who received initial demonstration with nonmydriatic fundus camera performed better in the posttest on the simulator (56 vs. 42; P = 0.003). Conclusion: Nonmydriatic fundus photography can be a potential adjunctive tool for training in fundoscopy and could be considered for integration in the undergraduate medical curriculum.