ArticleCJEM2025
Emergency department ophthalmoscopy: physician confidence and clinical practices.
Article in CJEM, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- The Underutilized Ocular Fundus in Emergency Departments: Current Progress and Future Prospect of Imaging and Artificial Intelligence for Patient Care.Ophthalmology science · 2026Review
- Curriculum Innovations: Implementation of a Targeted Longitudinal Rotation to Enhance Direct Ophthalmoscopy Learning for Neurology Residents.Neurology. Education · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesFundoscopy is crucial in the emergency department to identify or rule out serious ocular and neurological conditions. Despite its clinical importance, fundoscopy is often omitted due to the technical challenges associated with traditional direct ophthalmoscopy, particularly for non-ophthalmologists. This study examines emergency physicians' practices, confidence levels, and training related to various modalities of fundoscopy including traditional direct ophthalmoscopes, binocular indirect ophthalmoscopes, panoptic ophthalmoscopes, slit lamp fundoscopy and fundus cameras; and explores the potential role of alternative modalities, such as fundus cameras, in Canadian emergency departments.
methodsA cross-sectional survey was distributed to approximately 1000 emergency physician members of the Canadian Association of Emergency Physicians between March 4 and April 10, 2024. The survey, developed with ophthalmology and emergency medicine experts, included Likert scales and multiple-choice questions addressing confidence, practices, training, and experience with various fundoscopy modalities. Demographic data and responses were analyzed using descriptive statistics. Surveys were anonymous and available in English and French.
resultsSeventy-four emergency physicians participated (mean experience 17.8 years), representing all Canadian provinces and territories. Most reported experience with traditional direct ophthalmoscopes (97.3%), slit lamp fundoscopy (82.2%) and panoptic ophthalmoscopes (58.9%). Only 1.4% had used binocular indirect ophthalmoscopes. No participant had experience with fundus cameras. Confidence in identifying fundus findings was low across all modalities, with only 13.7% reporting confidence using traditional ophthalmoscopes. Fundoscopy was performed frequently or always by 57.5% of the respondents, yet only 6.8% routinely used pupil dilation. Only 35.6% of the respondents felt their training in fundoscopy was adequate.
conclusionEmergency physicians in Canada report low confidence in fundoscopy despite its critical role in identifying vision- or life-threatening conditions. Traditional modalities are widely used but remain challenging for non-ophthalmologists. Fundus cameras, which offer ease of use and higher diagnostic accuracy, are underutilized.
Indexed as
Identifiers
39755766What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.