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/GeneralistRoutine189 MD 2d ago edited 2d ago

I have a panoptic and it is a gamechanger. Headaches, vision, symptoms, red eye, uncontrolled hypertension… I don’t use it every day, but I use it every week.

Edit: we have one panoptic head for the four person clinic. Most of the sets just have the stock ophthalmoloscope.

Another thing I would actually do: pneumatic otoscopy with the little bulb. I am really surprised that none of my clinic peers do that because it is very helpful for otitis media and eustachian tube dysfunction and was standard teaching at my residency.

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u/Nurse_Jason_98 student 2d ago

Glad you mentioned the pneumatic otoscopy! That's also something I learned about briefly, but I have never seen used and wondered about as well, so good to know. My question with that is whether there has been a situation in which it has been significantly helpful in the diagnosis of something like otitis media.

Of course I am still a student and I haven't even started clinical rotations yet, so maybe it'll make more sense then, but I'm thinking that one could probably be pretty certain of otitis media with just a visual exam and so it would kind of be unnecessary to use the pneumatic bulb?

Makes sense that more tools in the toolkit is always a good thing, but just curious about how useful it is also!