Nonmydriatic Fundoscopic Imaging Using the Pan Optic iExaminer System in the Pediatric Emergency Department

Abstract

Objectives

The primary objective of this study was to determine the percentage of clinically adequate (CA) fundoscopic images that could be obtained using the Pan Optic iExaminer system to perform nonmydriatic fundoscopic imaging in the pediatric emergency department. Secondary objectives were to identify target age groups in which this technology is best utilized, and evaluate the overall ease of use in this setting.

Methods

Children 18 years of age or less who presented to the pediatric emergency department with a non-eye related chief complaint were enrolled and stratified by age group (0-2 years, 2-6 years and 6-18 years). Each enrolled patient underwent a bilateral eye examination using the Pan Optic iExaminer system. Images were submitted for review to a pediatric ophthalmologist and were graded based on clarity and field of view. Ease of use was defined as 80% of patients having at least 1 image of quality to be considered “clinically adequate (CA)” for obtaining a full view of the optic nerve, examination time for both eyes 15 minutes or less, and 3 attempts or less for each eye.

Results

Overall, 91.06% (95% CI 86.01-96.1) of children ages 2-18 years had at least 1 CA image obtained. 16.39% (95% CI 7.10-25.68) of children 0-2 years, 85.25% (95% CI 76.35-94.15) of children 2-6 years, 96.77% (95% CI 92.38-101.17) of 6-18 years had at least 1 CA image. The median total examination time was 3 minutes 24 seconds (IQR 2 minutes 27 seconds, 4 minutes 49 seconds).

Conclusion

Fundoscopic images were consistently obtained using the Pan Optic iExaminer system in the pediatric emergency department particularly in children 2-18 years of age. Clinically adequate images were obtained in children less than 2 years old, but less consistently.

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