Replacing the Direct Ophthalmoscope: Diagnostic Accuracy and use of Non-Mydriatic Ocular Fundus Photography by Emergency Department Physicians (Phase II of the FOTO-ED study)

During the first phase of the FOTO-ED Study, 13% of patients had an ocular fundus finding, such as papilledema, relevant to their emergency department (ED) management. All of these findings were missed by ED physicians, who only examined 14% of enrolled patients by direct ophthalmoscopy. Our aim was to evaluate the sensitivity of non-mydriatic ocular fundus photography, an alternative to direct ophthalmoscopy, for relevant ocular fundus findings when photographs were read real-time by ED physicians during routine clinical care.