Video diversion during fundoscopic examination in children: a randomized controlled trial

Area of Science:

• Pediatric Neurology
• Ophthalmology
• Medical Education

Background:

• Fundoscopy is crucial for neurological examinations in children.
• Uncooperative behavior in pediatric patients poses challenges to successful fundoscopy.
• Optimizing examination techniques is vital for accurate diagnosis.

Purpose of the Study:

• To evaluate the effectiveness of video-assisted fundoscopy in improving success, duration, and ease of examination in children.
• To determine if video distraction impacts the pediatric fundoscopy procedure.
• To assess the utility of video as an adjunct in pediatric neurological assessments.

Main Methods:

• A single-practitioner, randomized study involving 60 pediatric patients aged 1 to 8 years.
• Patients were randomized to either a video-assisted group or a control group (no video).
• Practitioner and caregiver assessments of examination difficulty were recorded.

Main Results:

• A 28% overall improvement in the success rate of visualizing the optic disc was observed (P < .001).
• Significant improvement (48%) in success rates was noted in younger children (1-4 years, P < .001).
• Examination time decreased (Δ16.3 s, P < .001) and ease of examination improved (P < .001).

Conclusions:

• Video-assisted fundoscopy is an effective adjunct for improving pediatric fundoscopy success rates and ease.
• This simple intervention is particularly beneficial for younger children (1-4 years) during neurological exams.
• Implementing video distraction can enhance the efficacy of fundoscopy in pediatric practice.