Panoptic versus conventional ophthalmoscope

The 'ease of use' and accuracy in measurement of the vertical optic cup/disc ratio (VCDR) was compared between the conventional direct ophthalmoscope (CO) and Panoptic direct ophthalmoscope (PO) in a group of 'naïve' first year medical students to determine which would be more suitable for non-ophthalmologists.

In this quasi-randomized method comparison study, eight students received an introductory session on ophthalmoscopy then examined 18 eyes (9 left, 9 right) with each ophthalmoscope in a private practice. The subjects were the eight students themselves plus two other subjects. Each subject (n = 10) had one eye dilated. Students determined a VCDR and a subjective score of 'ease of use' on a scale of 1 (difficult) to 10 (easy). A consultant ophthalmologist (GAG) determined the benchmark VCDR for each eye with each ophthalmoscope.

Of 288 eye examinations, there were 111 measurements of VCDR using the CO (47 undilated, 64 dilated), and 140 measurements using the PO (75 undilated, 65 dilated). Differences in the students' estimated VCDR and the benchmark were similar for the CO and PO (P = 0.67). 'Ease of use' was scored in 288 eyes and the median score was higher in the PO overall (CO: median 8, IQR 6-9; PO median 9, IQR 8-10; P < 0.0001), and within each session (P < 0.0001 for each session).

Medical students found the PO much easier to use, with accuracy of rating the VCDR similar to the CO. This comparison would support the wider use of the PO amongst medical students, general practitioners and other primary care providers.