The Arclight: A New, Low-Cost Ophthalmoscope for Medical Student Teaching

Abstract Introduction Many physicians lack confidence in performing ophthalmoscopy. Limited training at the undergraduate level, low ophthalmoscope ownership rates, and lack of access in wards have been identified as potential factors that contribute to the negative cycle that precludes development of this vital skill. We evaluated the Arclight (AO), a new low-cost (£50) pocket ophthalmoscope, against a ‘traditional’ direct ophthalmoscope (TDO) to assess whether it maybe a suitable alternative for medical student training. Methods 18 third year medical students were split into two groups to use either the AO or the TDO device to perform two tasks: 1) Identify a range of core retinal pathologies on seven simulated eyes and; 2) Identify specific signs of diabetic retinopathy on four simulated eyes. Results For the first task, the mean score for correct identification of pathologies for the AO group (n=9) was 4.33 (95% confidence interval (CI): 2.90 to 5.77) and the mean score for the TDO group (n=9) was 3.78 (95% CI: 5.10 to 2.46). For the second task, the mean score for the AO group (n=9) was 7.17 (95% CI: 5.11 to 9.23) and for the TDO group (n=9) was 5.61 (95% CI: 4.43 to 6.79). There was no statistically significant difference between the two groups’ results for the first (p = 0.52), or the second task (p = 0.15). Conclusions Our results show that the AO performs just as well as the TDO in examination of both general retinal clinical signs and specific signs of diabetic retinopathy. The equal clinical effectiveness combined with low cost, consumable-independence and portability of the AO make it a suitable alternative to the TDO in medical schools. If the device was more widely adopted by students we would envisage greater and more confident use as a post-graduate doctor, improving quality of care.