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: direct ophthalmoscopy; funduscopy; medical student; ophthalmic education; smartphone ophthalmoscopy.
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