B-SCAN: A SIGNIFICANT TOOL IN EVALUATION OF VARIOUS OCULAR LESIONS AND ITS MERITS OVER CONVENTIONAL OPHTHALMOSCOPIC EXAMINATION

INTRODUCTION: USG study of 118 patients in the present study highlights the advantages of ocular ultra sonography (B-mode) in the evaluation of retinal disorders. AIMS & OBJECTIVES: To evaluate the role of USG in cases with opaque light conducting media where direct vision by ophthalmoscopy is impossible, trauma where direct ophthalmoscopy is challenging even for experienced clinicians and in orbital diseases and in localization of intraocular foreign body. CONCLUSION: Ultrasonographic ndings were well correlated with clinical and operative observations. Sonographic examination unambiguously deserves foremost position in the algorithm for imaging pathological states of the eyeball.

Virtual and Augmented Reality Direct Ophthalmoscopy Tool: A Comparison between Interactions Methods

Direct ophthalmoscopy (DO) is a medical procedure whereby a health professional, using a direct ophthalmoscope, examines the eye fundus. DO skills are in decline due to the use of interactive diagnostic equipment and insufficient practice with the direct ophthalmoscope. To address the loss of DO skills, physical and computer-based simulators have been developed to offer additional training. Among the computer-based simulations, virtual and augmented reality (VR and AR, respectively) allow simulated immersive and interactive scenarios with eye fundus conditions that are difficult to replicate in the classroom. VR and AR require employing 3D user interfaces (3DUIs) to perform the virtual eye examination. Using a combination of a between-subjects and within-subjects paradigm with two groups of five participants, this paper builds upon a previous preliminary usability study that compared the use of the HTC Vive controller, the Valve Index controller, and the Microsoft HoloLens 1 hand gesticulation interaction methods when performing a virtual direct ophthalmoscopy eye examination. The work described in this paper extends our prior work by considering the interactions with the Oculus Quest controller and Oculus Quest hand-tracking system to perform a virtual direct ophthalmoscopy eye examination while allowing us to compare these methods without our prior interaction techniques. Ultimately, this helps us develop a greater understanding of usability effects for virtual DO examinations and virtual reality in general. Although the number of participants was limited, n = 5 for Stage 1 (including the HTC Vive controller, the Valve Index controller, and the Microsoft HoloLens hand gesticulations), and n = 13 for Stage 2 (including the Oculus Quest controller and the Oculus Quest hand tracking), given the COVID-19 restrictions, our initial results comparing VR and AR 3D user interactions for direct ophthalmoscopy are consistent with our previous preliminary study where the physical controllers resulted in higher usability scores, while the Oculus Quest’s more accurate hand motion capture resulted in higher usability when compared to the Microsoft HoloLens hand gesticulation.

Ophthalmoscopic Changes of Normal Tension Glaucoma: A Study in Peshawar

Aim: To determine the ophthalmoscopic findings of normal tension glaucoma. Study design: This is a cross sectional study Study site: Department of Physiology, Khyber Medical College, Peshawar. Study period: six months Sample size: One hundred cases were selected. Results: In this study, 33(33%) males and 67(67%) females. On direct ophthalmoscopy, in right eye glaucoma, there were 93(93%) cases with cupped discs, while 7(7%) had gross cupping of the discs. In left eye glaucoma, there were 98(98%) cases who had cupped discs, while 2(2%) had gross cupping of the discs. Conclusion: On direct ophthalmoscopy, there were 93(93%) cases who had cupped discs in right eye glaucoma. Keywords: Ophthalmoscope examination, open angle glaucoma, normal tension glaucoma

Comparison of conventional and wide field direct ophthalmoscopy on medical students’ self-confidence for fundus examination: a 1-year follow-up

Background Fundus examination is an easy, quick and effective way to diagnose sight- and life-threatening diseases. However, medical students and physicians report lack of proficiency and self-confidence in perform fundoscopy. The aim of this study was to compare students’ self-confidence in fundus examination, using two different direct ophthalmoscopes, 1 month and 1 year after practical training. Methods In this prospective cohort, medical students (MS) of the same class were divided in small groups for PanOptic (PO) or conventional (CO) direct ophthalmoscope training. The intervention group encompassed MS of the 4th -year (class of 2019), and the control group encompassed MS of year behind (class of 2020). A questionnaire to measure self-confidence in fundoscopy technique assessing optic nerve, cup-to-disc ratio and macula was translated and validated to Portuguese, and applied 1-month and 1-year after practical training. Results One-hundred and sixty-seven MS were enrolled (35 PO group, 38 CO group, and 94 control group). PO group had a significantly higher overall self-confidence comparing either control or CO groups, respectively (3.57 ± 0.65 vs. 2.97 ± 1.03 vs. 2.46 ± 0.87, p < 0.01) as well as in evaluate cup-to-disc ratio (3.09 ± 0.75 vs. 2.32 ± 0.87 vs. 1.46 ± 0.81, p < 0.01), optic disc margins (3.26 ± 0.85 vs. 2.71 ± 0.96 vs. 2.01 ± 0.97, p < 0.01) and macula (3.43 ± 1.12 vs. 2.89 ± 1.08 vs. 2.02 ± 0.89, p < 0.01) 1-month after practical training. One-year after intervention, CO group showed a significantly higher score compared to PO group in overall self-confidence (3.31 ± 0.69 vs. 3.18 ± 0.73, p = 0.03) and in optic disc margins assessing (3.16 ± 0.85 vs. 2.95 ± 0.78, p = 0.03), but not significant in the evaluation of cup-to-disc ratio (2.78 ± 0.97 vs. 2.68 ± 0.94, p = 0.08), and macula (3.34 ± 0.79 vs. 3.27 ± 0.98, p = 0.07). Conclusions Students were more confident in use PO as an instrument to perform direct ophthalmoscopy immediately after practical training, but confidence level of CO was higher compared to PO one year after practical training. These findings would help medical schools decide which ophthalmoscope to choose to teach fundus examination.

Teaching the Technical Essentials of Direct Ophthalmoscopy Using a Portable Fundus Camera

Aim: A portable fundus camera could allow the third person to observe the technique essentials of direct ophthalmoscopy from a real time screen. This study was designed to compare the proficiency of teaching direct ophthalmoscopy using a portable camera with conventional way in medical students. Methods: Medical students of fourth year were invited to participate the study. At baseline, the participants were taught fundoscopy with a conventional direct ophthalmoscope shortly. Then they were randomized to be taught the skill of fundoscopy either with a portable fundus camera or with a conventional direct ophthalmoscope as control for two days. Accuracy tests to match a subject’s fundus with one of the four photographs after examining an undilated eye using a direct ophthalmoscope were performed at baseline and end point. Accuracy test scores and self-reported confidence were compared between the two groups. Results: A total of 160 students participated the study, with 79 assigned to the intervention group, and 81 to the control group. All the students finished the study. At baseline, there was no difference in accuracy test score between the two groups. After two-day training session, the accuracy score improved in 26/79 (32.9%) students of intervention group versus 15/81 (18.5%) of the control group (p=0.037). At end point, a total of 39/79 (49.4%) students in the intervention groups versus 25/81 (30.9%) in the control group identified the correct fundus photograph (p=0.017). The confidence levels were significantly higher in the intervention group than the control group. Conclusions: Teaching direct ophthalmoscope using a portable fundus camera is associated with improved accuracy score and elevated confidence level in medical students when compared with conventional method.