Comparison of Ophthalmoscopy Findings Using PanOptic vs PanOptic + iExaminer

Direct ophthalmoscopy is a vital skill for screening emergent conditions as well as chronic
ocular pathologies for nonophthalmic physicians. Many eye care practitioners are first
exposed to this tool during their medical education and are expected to have a certain degree
of proficiency with it down the line. This skill requires practice, however, and given that
there is a limited amount of time and exposure, it is not surprising that there is a general
lack of familiarity and confidence among students and physicians with using the direct
ophthalmoscope (Gilmour et al.,2017; Schulz et al., 2014; Day et al.,2017).

A myriad of techniques and models have attempted to change this and improve the efficacy in
teaching direct ophthalmoscopy. Studies have shown that students prefer learning how to use
the direct ophthalmoscope with human subjects rather than simulators, and that the students
prefer using fundus photographs to learn important diagnostic findings over the
ophthalmoscope (Kelly et al.,2013). There have also been studies comparing the direct
ophthalmoscope to the PanOptic, which gives a fixed working distance from the patient and a
larger field of view (Day et al.,2017). These studies have noted more "ease of use" and
accuracy in using the PanOptic among first year medical students and physicians (McComiskie
et al.,2004; Petrushkin et al., 2012). New technological advances such as the iExaminer
application have also been recently introduced, allowing the eye care physicians to take
fundus images on their smart phone using a smart phone application and attachment to the
PanOptic. Studies have shown the iExaminer application is able to produce "clinically
adequate" fundus images (Day et al.,2017).

From the literature review, there have not been any studies that compare the PanOptic alone
versus the PanOptic with the iExaminer application as an introductory teaching tool for
medical students. The iExaminer will not only allow the user to utilize the view obtained
from the PanOptic, but also allow an instructor to observe and help coach the user on
relevant findings and take pictures for future reference or instruction. This provides a
potentially effective learning device which can help users accurately identify more relevant
ophthalmic findings. The investigators also believe that this will help increase the medical
students confidence level and encourage them to practice with these devices again at future
opportunities.

Inclusion Criteria:

- All second-year medical students at the University at Buffalo Jacobs School of Medicine
and Biomedical Sciences may be included in our final study sample.

Exclusion Criteria:

- Students who have had significant prior exposure to direct ophthalmoscopy (e.g. they
have used the direct ophthalmoscopy, PanOptic, or PanOptic with the iExaminer on a
regular basis for more than one week).

- Students with poor enough visual acuity that will prevent them from doing direct
ophthalmoscopy