Comparison of a Cellphone-Based Fundoscope with Traditional Handheld Direct Fundoscope for Checking Red Reflex in Neonates

Abstract

Background: Traditional handheld fundoscopes are expensive instruments and require training and expertise for their use to check red reflex in neonates. Cellphone based fundoscopes may prove to be a cheaper alternative to check red reflex for screening of congenital cataracts in neonates. Objective: Evaluation of the diagnostic accuracy of a cellphone-based fundoscope Opti Card for screening of cataracts in neonates by checking pupillary red reflex. Methods: An instrument validation study was conducted in the Neonatology Department of Services Hospital Lahore for 3 months from 1st August to 30th October 2021 to assess the diagnostic accuracy of cellphone-based fundoscope OptiCard for screening of cataracts in neonates using Wilson Score. Results: Eyes of 110 neonates were examined for red reflex. Cellphone-based fundoscope OptiCard was found to have a sensitivity of 100% for diagnosing abnormal red reflex while its specificity was found to be 99.06% as compared to the traditional handheld direct fundoscope. Conclusion: Cellphone-based fundoscope OptiCard has good diagnostic accuracy for detecting abnormal red reflex and it allows the images of pupillary glow to be stored for a photo follow-up.