None listed
Conditions
Brief summary
Funduscopy is not widely performed, to the detriment of patients whose vision-threatening and life-threatening disorders may not be detected. The decline of fundoscopy has been ascribed to technical challenges of the examination, and difficulties interpreting the findings. Non-mydriatic fundus photography (NMFP) has been demonstrated to improve detection of fundus abnormalities in patients presenting to the emergency department (ED). We aim to determine the prevalence of fundus abnormalities amongst selected patients presenting to Australian EDs, and the clinical impact of NMFP for these patients.
Interventions
Intervention Name: Non-mydriatic fundus photography (NMFP)
*VisuCam registered trade mark (Zeiss, Oberkochen, Germany): table-mounted camera provided to enrolled patients in the eye examination room in RPA Hospital Emergency Department (ED)
*RetinaVUE registered trade mark (Welch Allyn, Macquarie Park, Australia): portable camera provided to enrolled patients at the bedside in Westmead Hospital ED
*performed in the ED by a nurse, physician or medical student researcher with prior computer-based
Intervention Name: Non-mydriatic fundus photography (NMFP) *VisuCam registered trade mark (Zeiss, Oberkochen, Germany): table-mounted camera provided to enrolled patients in the eye examination room in RPA Hospital Emergency Department (ED) *RetinaVUE registered trade mark (Welch Allyn, Macquarie Park, Australia): portable camera provided to enrolled patients at the bedside in Westmead Hospital ED *performed in the ED by a nurse, physician or medical student researcher with prior computer-based and face-to-face NMFP training *administered once during the ED admission, taking approximately 2-10 minutes for complete examination of both eyes *digital fundus images are loaded to the patient electronic medical record *fundus images are then interpreted by the treating emergency physician *fundus images are then reviewed by the local ophthalmology team (and a study investigator) *any urgent clinical considerations discovered on routine image review are discussed with the treating ED team *screening protocol adherence monitored by comparing enrolment data with hospital records of ED admissions
Sponsors
Discipline of Clinical Ophthalmology & Eye Health, Faculty of Medicine & Health, University of Sydney
Study design
Allocation
Non-randomised trial
Intervention model
Other
Primary purpose
Diagnosis
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients presenting to ED Monday-Friday between the hours of 8am - 5pm with: *Headache *New neurological disturbance (defined as motor and/or sensory deficits, speech impairment or dizziness) *Visual disturbance *Severe hypertension (defined as diastolic blood pressure greater than 120mmHg)
Exclusion criteria
* Unable to give informed consent: normal guardianship consent hospital regulations will be followed * Medically unstable: once immediate care is provided and the patient is deemed medically stable, inclusion may be considered * Self-discharge from ED prior to medical review
Outcome results
None listed