Abstract
Purpose :
To evaluate the use of smartphone external photography in determining the diagnosis and urgency of patients presenting to the emergency department with an ocular complaint.
Methods :
A survey was created using consecutive patient encounters in the Parkland Memorial Hospital Emergency Department with an in-person ophthalmology consult and external and/or anterior segment findings. The diagnosis and severity of the ocular condition was determined by an attending physician, and a short clinical vignette corresponding to each patient was created. Only half of participants were shown an external photograph of each eye. Participants were asked to provide the most likely diagnosis and urgency for each clinical vignette.
Results :
Main Outcome Measures: Accuracy of diagnosis and urgency determination
Results: There were 15 participants in each group. In the group without external photographs, the correct diagnosis was identified on average in 58.6% ± 7.7% of cases, compared to 67.9% ± 9.2% in the group with photographs (p=0.0105, Figure 1). The correct urgency was identified on average in 55.5% ± 6.8% of cases, and a delay in triage occurred in 15.4% ± 10.2%. There was no statistically significant difference between the photo and no photo groups regarding urgency, and there were no statistically significant differences in all comparisons between faculty and residents. In the 11 cases identified as emergent, the correct urgency was identified more than 80% of the time in both groups.
Conclusions :
The addition of high-quality external photographs improved the diagnostic accuracy of patients presenting to the emergency room with abnormal ocular examination findings. However, identifying the correct urgency of these patients did not improve with the addition of external photographs.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.