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Author Notes:

Address correspondence and reprints to Dr. Nancy J. Newman, Neuro-Ophthalmology Unit, Emory Eye Center, 1365-B Clifton Rd. NE, Atlanta, GA 30322. Phone: (404)778-5360. Fax: (404)778-4849. ophtnjn@emory.edu.


Research Funding:

This study was supported in part by a departmental grant (Department of Ophthalmology) from Research to Prevent Blindness, Inc., New York, by core grant P30-EY06360 (Department of Ophthalmology). Dr. Bruce has received research support from NIH/NCRR (KL2- RR025009, UL1-RR025008), the NIH/NEI (K23-EY019341), Knights Templar Eye Foundation, and received the American Academy of Neurology Practice Research Fellowship. Dr. Lamirel receives research support from Institut Servier (Paris, France), Fondation Planiol (Varennes, France), Ophtalmologie Progrès en Anjou (Angers, France), and the Philippe Foundation, Inc. (New York, NY). Dr. Wright received research support from NIH/PHS (KL2-RR025009). Dr. Biousse received research support from NIH/PHS (UL1-RR025008) and the Knights Templar Eye Foundation. Dr. Newman is a recipient of the Research to Prevent Blindness Lew R. Wasserman Merit Award.

Nonmydriatic Ocular Fundus Photography in the Emergency Department


Journal Title:

New England Journal of Medicine


Volume 364, Number 4


, Pages 387-389

Type of Work:

Article | Post-print: After Peer Review


Examination of the ocular fundus is imperative in the diagnosis and treatment of many acute medical and neurologic conditions, but direct ophthalmoscopy is underused and difficult to perform without pharmacologic pupillary dilation. We believe that nonmydriatic ocular fundus photography (i.e., performed without pupillary dilation) represents a promising alternative to direct ophthalmoscopy, particularly in the emergency department, where limited training in ophthalmoscopy, increased demands on physicians' time, and underappreciation of the prognostic value of ocular fundus examination can place patients at risk for poor outcomes and expose their caregivers to medicolegal liability. The FOTO-ED (Fundus Photography vs. Ophthalmoscopy Trial Outcomes in the Emergency Department) study hypothesized that the use of nonmydriatic fundus photography in the emergency department would result in increased detection of abnormalities in the ocular fundus relevant to emergency-department care, a majority of which would be missed during routine clinical practice in the department.

Copyright information:

© 2011 Massachusetts Medical Society. All rights reserved.

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