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Ophthalmoscopy skills in primary care: a cross-sectional practitioner survey
  1. Freya M Mowat,
  2. Kenneth D Royal and
  3. Hans D Westermeyer
  1. Department of Clinical Sciences, North Carolina State University College of Veterinary Medicine, Raleigh, North Carolina, USA
  1. E-mail for correspondence; hdwester{at}ncsu.edu

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Ophthalmoscopy is challenging to master. Medical professionals regularly practising ophthalmoscopy exhibit greater confidence1–3 and competence.4 Methods practised in veterinary medicine include direct, PanOptic and indirect ophthalmoscopy (Fig 1). Direct ophthalmoscopy is relatively straightforward, but its utility is diminished by a narrow field of view, limiting the ability to visualise the entire fundus during examination, although its use can complement other methods by providing a magnified view of a detected lesion. The PanOptic ophthalmoscope provides a wider field of view, intermediate between direct and indirect ophthalmoscopy. Indirect ophthalmoscopy is arguably the most technically challenging method (requiring optimal orientation of light source, lens and eye), but allows visualisation of a wide fundus area5 facilitating quick identification of lesions during short periods in which an animal’s eye is still. Indirect ophthalmoscopy use by primary care veterinary practitioners is low compared with direct ophthalmoscopy, although no studies have confirmed this speculation. This limited use of indirect ophthalmoscopy could impair detection of ophthalmic diseases with focal or multifocal manifestation that may not be immediately obvious from the small fields of view visible with direct ophthalmoscopy. Since in some cases of systemic illness ophthalmic manifestations may be the only changes present on physical examination, inability to perform comprehensive funduscopic examination may result in delay in diagnosis and poorer patient outcomes. …

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