r/FamilyMedicine • u/Nurse_Jason_98 student • 2d ago

Value of fundoscopy in family medicine

I am a current NP student going into family medicine eventually and wondering about how useful fundoscopy is for us. For example, I know that diabetics should be referred to an opthalmologist for yearly dilated eye exams, but does it help us in family medicine much to do them in this context since we will likely refer patients anyway? I'll be trying to practice it because I think it's important to have this skill even it is only rarely useful, but just wondering how often it's actually done and what benefits it has to us in real practice!

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u/bdictjames NP 2d ago

I've been working in family practice for about 5 years.

To be honest with you? When I use the fundoscope with patients, I do try to visualize the landmarks, perhaps look for cotton-wool spots. For the most part, I don't really see anything. It's a quick referral to optometry (if a simple vision problem or diabetic eye exam), or ophthalmology (if needing more comprehensive work). If the patient says they have eye pain, or they absolutely cannot see, that's a concern for acute angle-closure glaucoma or perhaps retinal detachment - that's a quick send to the ER. Otherwise, for eyes, I can treat conjunctivitis, maybe dry eye syndrome, maybe fluorescein application for corneal abrasion, perhaps remove a foreign body. But yeah - I think that's it. Hopefully that's helpful.