Does the COVID-19 Pandemic Spell the End for the Direct Ophthalmoscope?
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COMMENTARY
Does the COVID-19 Pandemic Spell the End for the Direct Ophthalmoscope? Kendrick C. Shih . Charlene Y. C. Chau . Jonathan C. H. Chan . Jasper K. W. Wong . Jimmy S. M. Lai
Received: July 26, 2020 Ó The Author(s) 2020
ABSTRACT Despite advances in ophthalmic diagnostics, the direct ophthalmoscope remains a key clinical skill taught to medical students and is the tool of choice for retina examination among non-ophthalmic physicians. However, in recent years viable alternatives have become available. The coronavirus disease 2019 (COVID-19) pandemic has forced a major re-thinking in medical education worldwide. In this commentary, we examined the current merits and limitations of the direct ophthalmoscope in both the clinical sense and in the context of infection control. Furthermore, we compared the direct ophthalmoscope with alternatives, including commercially available portable non-mydriatic fundus cameras, that would allow a change in focus during ophthalmic teaching. We concluded that the latter will better prepare our medical students for the age of telemedicine and deep-learning systems. While the COVID-19 pandemic will not be the sole reason for the ‘death’ of the direct ophthalmoscope, the global situation will inevitably serve to expedite Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12816434. K. C. Shih (&) C. Y. C. Chau J. C. H. Chan J. K. W. Wong J. S. M. Lai Department of Ophthalmology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong, SAR e-mail: [email protected]
long overdue changes in our teaching of ophthalmic skills to non-ophthalmic physicians.
Keywords: COVID-19; Direct ophthalmoscopy; Medical education; Pandemic Key Summary Points The COVID-19 pandemic necessitates a rethinking of ophthalmic teaching for medical students worldwide. Direct ophthalmoscopy remains a key clinical skill taught in medical schools worldwide, but for non-ophthalmic physicians it remains a difficult skill to acquire and confidently maintain. Direct ophthalmoscopy has become even more difficult to teach online in the setting of social distancing. In addition, the skillset itself requires close face-to-face contact with patients, placing examiners at risk of infection. The availability of non-mydriatic portable fundus cameras allows medical educators a greater emphasis on the interpretation of salient retinal signs of systemic disease. Furthermore, the retina findings can be objectively documented and used in both telemedicine settings and deep-learning systems.
Ophthalmol Ther
DIGITAL FEATURES This article is published with digital features to facilitate understanding of the article. You can access the digital features on the article’s associated Figshare page. To view digital features for this article go to https://doi.org/10.6084/m9. figshare.12816434.
COMMENTARY Ocular fundus examination with a direct ophthalmoscope has long been regarded as an essential clinical skill in medical education worldwide. The advan
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