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. 2018 Apr 24;14(1):1-5.
doi: 10.22599/bioj.106.

Routine Orthoptic-led Paediatric Fundus Digital Imaging: Benefits to Patients and Healthcare System

Laura B Ramm  1 , Clare Bradbury  1 , Manoj V Parulekar  1
Affiliations

Routine Orthoptic-led Paediatric Fundus Digital Imaging: Benefits to Patients and Healthcare System

Laura B Ramm et al. Br Ir Orthopt J. .

Abstract

Aims: Dilated fundus examinations are a vital, yet time-consuming and sometimes distressing part of paediatric ophthalmology examinations. Limited resources, personnel and time can result in prolonged waiting time and increase risk from delayed diagnosis and treatment. Using a Nikon D80 TopCon TRC-NW6S non-mydriatic fundus camera (TopCon (GB) Ltd, Newbury), we aimed to demonstrate the safety and efficacy of orthoptic-led fundus digital imaging and the potential time and cost benefits to the healthcare system.

Methods: We conducted a retrospective review of all digital fundus images taken over a six month period in 2012 (n = 616, age range 2.1-16.5 years, mean age 8.7 years).

Results: Overall success rate for paediatric fundus digital imaging was 97%. Successful images were achieved in 87% of patients without the need for pupil dilation. Images were taken for a variety of clinical reasons. 45% of patients were discharged immediately, many with copies of photographs to facilitate follow-up with community optometrists.

Conclusions: Orthoptic-led fundus digital imaging is an innovative, speedy, safe and efficient method of documenting fundal appearance, enabling serial documentation of stability/progression of ocular disease. It allows adequate examination of routine patients, freeing up time within busy clinics. Paediatric fundus digital imaging brings a potential positive cost benefit to healthcare systems under pressure, and facilitates skill development for allied health professionals.

Keywords: fundus digital imaging; orthoptic-led; paediatric.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
The Nikon D80 TRC-NW6S TopCon (UK) non-mydriatic, table-mounted fundus camera, as used in this study.
Figure 2
Figure 2
Bar graph showing reasons for unsuccessful imaging in 3% of patients included in this study.
Figure 3
Figure 3
Bar graph showing the clinical indications for paediatric fundus photography in this study.
See this image and copyright information in PMC

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