Abstract
Purpose :
Various factors likely contribute to visual search behavior in clinical practice, including examiner expertise. Optometrists encounter diverse landscapes of retinal images and bring a range of experience levels. Our study investigates the difference in diagnostic accuracy and eye-tracking strategies between experts and optometry students.
Methods :
First-, second-, third-, and fourth-year optometry students of the same curriculum and experienced optometrists were enrolled. Visually guided saccades at 5°, 10°, and 15° were recorded in all participants. Ten normal and ten abnormal (diabetic) fundus images were randomly shown for 15 seconds. Eye movements were recorded with EyeLink 1000 Plus gaze tracker at 2,000 Hz. Nine-point calibration was done monocularly before measuring oculomotor function. The subjective response was taken based on whether fundus images appeared normal. The quantitative analysis includes a comparison of mean dwelling time, count of fixation, and diagnostic accuracy. Qualitative analysis focuses on visual scanning patterns. We utilize the SigmaPlot 12 program for statistical analysis.
Results :
A total of 47 participants enrolled in the study. Peak velocity between all the groups was not significantly different (H=5.84, df=4, p=0.21). There was a significant difference in correct diagnostic response between at least two groups (F (4,42)=9.64, p=<0.01). 69±13% of first-year (n=10), 63±7% of second-year (n=10), 67±13% of third-year (n=10), and 86±6% of fourth-year (n=7) optometry students and 83±6% of experienced optometrists (n=10) were able to correctly distinguish normal and abnormal retinal images. Mean value of correct diagnostic response was significantly different between experts and fourth-year in comparison to first-, second-, and third-year optometry students (p<0.05). There was a significant negative correlation between correct diagnostic response and total dwelling time in fourth-year students (R=-0.76, p= 0.04). Qualitative analysis showed that scanning patterns were more organized in experts and fourth-years than first- and second-year students. We observe a systemic improvement in the pattern of visual inspection over the different levels.
Conclusions :
Optometry students in their fourth year were as accurate in diagnosis as experts. The current curriculum equips optometry students to direct their gaze intentionally as reflected in improved diagnostic rate and a more organized scanning pattern.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.