The College is aware that some members have established a policy of using digital imaging and/or fundus photography for all patients as the only method of examining the fundus. Currently, there is no peer-reviewed, scientific evidence that shows digital imaging to be effective for all patients as a stand-alone technique for examination of the fundus. Accordingly, the College does not support such a policy.
The College believes that there is no single technique currently available that can be used exclusively for the examination of the fundus of all patients. The College acknowledges that in some subsequent examinations, retinal digital imaging/photography alone may be sufficient. In other cases, digital imaging or photography will reveal the need for further examination using one or more additional techniques, including binocular examination through a dilated pupil. In these cases, use of digital imaging/photography alone may lead the optometrist to miss certain pathologies. Accordingly, the College believes that digital imaging/photography should be used in conjunction with other current techniques, including pupil dilation.
With regard to record keeping, the College expects members to record their analysis of a digital image or photograph in the patient’s record. This may be accomplished using a note-taking feature of a digital imaging system if it is so equipped. Simply acknowledging that the picture was taken is not considered an analysis of the fundus.