Critical Evaluation of the Usability of Augmented Reality Ophthalmoscopy for the Training of Inexperienced Examiners

Authors: Leitritz, Martin A. MD; Ziemssen, Focke MD; Suesskind, Daniela MD; Partsch, Michael MD; Voykov, Bogomil MD; Bartz-Schmidt, Karl U. MD; Szurman, Gesine B. MD.

Publication: Retina, 2014 Apr;34(4):785-91. doi: 10.1097/IAE.0b013e3182a2e75d.


Purpose: To measure the value of augmented reality technology usage to teach the medical students performing binocular indirect ophthalmoscopy.

Methods: Thirty-seven medical students were randomly assigned to the training of binocular indirect ophthalmoscopy either in the conventional way or with augmented reality ophthalmoscopy (ARO). For testing student’s skills, they had to examine a real person using a conventional ophthalmoscopy system and draw the optic disk. They also had to fill out a questionnaire. Subjective and objective evaluations were performed.

Results: Thirty-seven students were randomly assigned to two groups. Eighteen students were trained with conventional ophthalmoscopy and 19 students with ARO. The questionnaires showed no differences. Performing an objective analysis, the median ophthalmoscopy training score for the conventional ophthalmoscopy group was 1.2 (range, 0.67–2) and showed a significant difference (P < 0.0033) to the ARO group (median 2; range, 0.67–2).

Conclusion: The study provides evidence that a single ARO training is efficient to improve ophthalmoscopy skills. As the objective analysis showed, the ARO group had a significantly superior performance. Our study also indicates that subjective evaluation of the fundus drawings without systematic analysis is prone to errors.