Enhancing Undergraduate Ophthalmology Teaching Through Virtual Reality: Integrating the Eyesi Direct Ophthalmoscopy...

Ophthalmoscopy is a key component of both neurological and general medical examinations, yet medical students consistently report low confidence and competence in performing the skill. Newly qualified doctors are expected to perform direct ophthalmoscopy with indirect supervision, yet opportunities for students to develop this skill are often limited due to reduced ophthalmology teaching and limited access to suitable patients. Simulation-based education has emerged as a valuable adjunct to clinical teaching, providing opportunities for deliberate practice, feedback, and safe skill acquisition. This study evaluated the educational impact of the Eyesi Direct Ophthalmoscopy simulator (Haag-Streit Group, Köniz, Switzerland) on medical students' confidence and perceived competence in fundoscopy.

122 undergraduate medical students from the University of Dundee (fourth-year medical students and third-year ScotGEM students) attended a two-hour ophthalmology workshop in groups of four to eight. Each session incorporated a short teaching component followed by hands-on practice using the Eyesi simulator. Students examined simulated patients with normal fundi and various pathological findings, including swollen optic discs, central retinal vein occlusion (CRVO), central retinal artery occlusion (CRAO), and proliferative diabetic retinopathy (PDR). Immediate feedback was provided by facilitators, allowing for guided, deliberate practice. After the sessions, participants were invited to complete an anonymous online questionnaire assessing perceived confidence, learning effectiveness, and engagement, accessed via QR code or email link. Participation was voluntary, and feedback was collected anonymously.

All 122 students provided feedback. Feedback indicated that 98% of students felt confident performing ophthalmoscopy under supervision after training. One hundred percent reported increased competence in fundoscopy, and 100% recommended integration of simulator training into the undergraduate curriculum. Qualitative feedback highlighted realism, repeated practice without patient discomfort, and the value of immediate visual feedback from facilitators who could observe the same fundus view.  Conclusion: The Eyesi simulator offers an effective and engaging method for teaching ophthalmic examination skills to undergraduate medical students. By combining realistic visualisation, varied pathology exposure, and immediate feedback, the simulator fosters confidence and diagnostic competence while reducing the anxiety often associated with clinical fundoscopy. Integrating simulator-based teaching into undergraduate curricula aligns with General Medical Council (GMC) outcomes and addresses key educational challenges in ophthalmology. The results support wider adoption of virtual reality simulation as a core component of undergraduate ophthalmology training.