Ophthalmology residents at the University of Colorado School of Medicine never know exactly what kind of eye or vision complaints will land in their care while on-call in a hospital, but they’re prepared for almost anything.
Now, with portable fundus photography cameras, they have even more cutting-edge tools at their fingertips.
“Ophthalmology is unique because it’s a clinic-based specialty, and we rely on specialized equipment to get the most accurate diagnosis and treatment plan,” says third-year resident Nihaal Mehta, MD. “We have a backpack stocked with dozens of eyedrops and tools that help us perform even seemingly simple tasks, like checking eye pressure, for example.”
More than a year ago, the CU Department of Ophthalmology added the portable cameras to the on-call residents’ backpacks, marking a new era in resident training and patient care.
The portable cameras are about the size of a smartphone and are equipped with a long lens that brings valuable imaging to wherever a resident is needed. This has enhanced the initial evaluation of patients and facilitated follow-up care. Supervising physicians can now easily see what a resident is seeing, confirming a treatment plan or being able to access more information when a question or concern arises.
“As a retina specialist, I have always been fascinated by the value of an ophthalmic image, not only in making a diagnosis but also in sharing cases with colleagues,” says professor and department chair Naresh Mandava, MD. “The opportunity to deploy a simple imaging technology into a dynamic tertiary care center environment has the potential to improve outcomes for patients as well as decrease the time needed for consultation with colleagues and other experts.”
Phelcom gifted the department three Eyer portable cameras, allowing residents to have them ready at whichever hospital they’re stationed for a shift. The addition to their toolbox saves time, especially in fast-paced environments.
At UCHealth University of Colorado Hospital, on-call residents completed 1,200 emergency department consults and 800 inpatient consults in 2023. In addition to those calls, they cross the University of Colorado Anschutz Campus to see patients at Children’s Hospital Colorado or the Rocky Mountain Regional VA Medical Center.
“Residents might see 10 to 15 patients in 24 hours, so it can be really hectic,” Mehta says. “Any tool that can help you while you’re on-call is a huge godsend.”
An image from the Eyer portable fundus photography cameras shows a detached retina.
Eye pathology can be especially difficult to put into words, making these new cameras all the more helpful. The images have increased communication between residents, fellows, and supporting doctors, who might’ve previously needed to re-evaluate a patient for a second time because they only had a written description of the condition.
“These cameras expedite the process and make it more streamlined when verifying exam findings,” Mehta says. “It helps us to make a clinical plan, which is also really helpful for the patient."
The cameras are proving to be worthy in the long term, too.
“These cameras have been helpful in monitoring patients over time,” Mehta explains. “If a patient has bleeding in the back of their eye, you can describe what you see, but a photo a week later can tell you more accurately how the condition is changing.”
Beyond the hospital, residents are finding the tools useful in classroom and academic settings, too.
“This helps us to present at a conference or publish a paper,” Mehta says. He was able to use an image taken with a portable fundus camera to help complete a paper on a rare and remarkable exam finding.
“Because we had those photos, we were able to submit it as a picture case,” he says.
An image from a portable fundus photography camera used by CU ophthalmology residents shows severe papilledema from malignant idiopathic intracranial hypertension. The images became the basis for a paper resident Nihaal Mehta, MD, and faculty published in October 2022.
The residents also bring photos from the camera to weekly conferences where they discuss cases.
“Every Wednesday morning, we have a debrief with all the residents on interesting cases from the past week. The addition of imaging to the consult workflows has improved the educational environment for our residents, fellows, and faculty alike,” Mandava says. “In addition, the time needed to gain multiple opinions has been reduced drastically, which is ultimately a benefit to the patients.”