title: Video diversion during fundoscopic examination in children: a randomized controlled trial.
abstract: Fundoscopy is an important aspect of a neurological examination but can be challenging in uncooperative children. This study explored whether viewing a video during examination improves the success, duration, and ease of pediatric fundoscopy. This single-practitioner, randomized study involved 60 patients aged 1 to 8 years. Patients were randomized (by eye examined) to the treatment group (video-assisted) or control group (no video). A caregiver and the practitioner ranked the level of difficulty of each examination. There was a 28% improvement in the success rate of visualizing the optic disc (P < .001). Further analysis showed a 48% improvement in the success rate in children aged 1 to 4 years (P < .001) but no difference in children aged 5 to 8 years (P = .23). Time needed to visualize the optic disc also improved (Δ16.3 s, P < .001). Improvement in the ease of examination (P < .001) was noted by both the practitioner and caregiver. This simple adjunct has the potential to improve the efficacy of this aspect of the pediatric neurological examination.
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of British Columbia and British Columbia's Children's Hospital, Vancouver, BC, Canada ash.singhal@cw.bc.ca.
authors.forename: Ash
authors.initials: A
authors.lastname: Singhal
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of British Columbia and British Columbia's Children's Hospital, Vancouver, BC, Canada.
authors.forename: Michael M H
authors.initials: MM
authors.lastname: Yang
authors.affiliation: Division of Neurosurgery, Department of Surgery, University of British Columbia and British Columbia's Children's Hospital, Vancouver, BC, Canada.
authors.forename: John M
authors.initials: JM
authors.lastname: Kerr
mesh_terms: D002648:Child; D002675:Child, Preschool; D005128:Eye Diseases / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019721:Ophthalmoscopes; D017063:Outcome Assessment, Health Care; D010372:Pediatrics; D014741:Video Recording / Q000295:instrumentation / Q000379:methods*
keywords: clinical examination; fundoscopy; optic disc; video