A simple eye model to objectively assess the competence of direct ophthalmoscopy
Direct ophthalmoscopy is an important investigative technology not only for ophthalmologists, but also for general practitioners and other specialists. The aim of this study was to develop a simple and robust ocular model for an efficient and objective assessment of ophthalmoscopic competence.
A series of eye models were assembled using commonly available materials, including 26mm diameter double hemispherical brown plastic balls and convex lenses. A 6mm circular aperture was drilled on a hemisphere as a pupil behind which the lens was glued to provide the refractive component. Ten pieces of letters were placed on the inner surface of the other hemisphere. The ophthalmoscopic skills of the ophthalmology residents were first assessed subjectively using a checklist by two tutors, and then objectively using the eye models. The discrimination index was calculated to assess the effectiveness of the assessment. Finally, a feedback questionnaire was completed.
A total of 76 residents were recruited. The checklist score was 9.25 ± 0.47, with a discrimination index of 0.11. The model evaluation score was 4.24 ± 3.10, with a discrimination index of 0.79. There was no correlation between the checklist score and the model scores (r= 0.133, P= 0.251). Two-thirds of participants agreed or strongly agreed that model assessment might reflect the ability to visualize the fundus.
We have developed simple eye models to assess ophthalmoscopy proficiency with excellent discriminating power to differentiate proficiency levels of ophthalmology residents.