Direct ophthalmoscopy – salvageable skill or pointless pursuit?
The direct ophthalmoscope was invented in 1851 and ophthalmologists were first able to visualize retinal detachment through it in 1853. Subsequently, the first viewings of central retinal artery occlusion and papilloedema were obtained in 1855 and 1860, respectively. Despite being around for more than a century, today’s medical students still lack the confidence and competence to perform it well. Concerningly, this lack of confidence is not exclusive to medical students. Amongst junior doctors, only one in five foundation year doctors felt confident identifying papilloedema by the end of foundation year. Amongst more senior doctors, up to 43% of General Practitioners admitted to lacking confidence in performing direct ophthalmoscopy.