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Ophthalmology · Community ophthalmology: retinopathy screening method
Sample itemA primary health centre without an ophthalmologist wants to screen many diabetic patients for retinopathy. Which approach is most practical for population screening?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Non-mydriatic digital fundus photography with remote grading
Non-mydriatic fundus cameras can be operated by trained technicians, and images are graded centrally or by telemedicine, so only those with referable disease go to the ophthalmologist. This is practical in a community programme. Fluorescein angiography is a diagnostic procedure, not a screening tool.
Option by option
A. Non-mydriatic digital fundus photography with remote grading (correct)
Correct. Fundus photography with remote grading is practical and scalable for screening.
B. Slit lamp biomicroscopy with gonioscopy
Gonioscopy examines the angle and not the retina.
C. Direct ophthalmoscopy by a physician through a small pupil
Direct ophthalmoscopy through an undilated pupil misses much of the retina.
D. Fluorescein angiography for all patients
Angiography is invasive and unsuitable for mass screening.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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