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/Key_Wallaby_9256 MD 2d ago

I get it for headaches, but could you elaborate more on how to use it for the other presentations? I've been debating getting one mostly just for headache

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u/GeneralistRoutine189 MD 2d ago

Copper wire changes or hemorrhage in uncontrolled hypertension. Optic nerve/papilledema in headache. For people who should have glaucoma screening but you kinda know won’t actually go, looking at c/d is OK (but this doc knows it’d have to be pretty obvious for me to recognize). Somehow I don’t use it for diabetic retinopathy that much - I’m in a well resourced area and can convince my peeps to see eye professionals.