Objective:

This study aimed to assess the practicality and diagnostic utility of portable fundus camera (Eyer, Phelcom, Cambridge, MA) in identifying neuro-ophthalmological findings in patients with neurological diagnoses.

Background:

Fundoscopy is a critical portion of the neurological exam and is essential for detecting inflammatory, vascular and intracranial hypertensive disorders. Despite its importance, it remains underutilized due to its technical challenges and training requirements. Recently, alternatives like smartphone fundoscopy and portable fundus camera have emerged as viable options.

Design/Methods:

This pilot study evaluated the use of a fundus camera during a neurology ward service block.  Total number of patients seen, number of times the fundus camera was utilized, number of different users, and diagnostic findings were recorded. Qualitative research analysis was utilized for usability and comparison to conventional ophthalmoscopy.

Results:

A total of 49 patients were seen by the neurology team during the service block. Of that total, nine patients (18%) had fundoscopy indication or abnormalities. The following diagnosis were obtained:  intracranial hypertension due to CNS mycobacterium infection, IIH (2), neurosyphilis with optic neuritis and retinitis, MOGAD with optic neuritis (2), optic atrophy in mitochondrial disease, NAION secondary to GLP1 inhibitors. The users reported high usability, and superiority to the conventional methods, ability to share findings with patients and trainees and to document daily changes in the EMR. All fundoscopy images were uploaded to EMR as part of a diagnostic report and appropriate billing code was used.

Conclusions:

This pilot study demonstrates the practicality and utility of the fundus camera for detecting and documenting neuro-ophthalmological conditions in the neurology ward. Its ease of use and seamless integration into clinical workflows suggest its potential for improving diagnostic accuracy and patient care. Larger studies are needed to validate these findings and explore its role for neurology cases in the emergency room and teleneurology.