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      Nonmydriatic Ocular Fundus Photography in the Emergency Department: How It Can Benefit Neurologists

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      Seminars in Neurology

      Georg Thieme Verlag KG

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          Abstract

          <p class="first" id="P1">Examination of the ocular fundus is a critical aspect of the neurological examination. For example, in patients with headache the ocular fundus examination is needed to uncover “red flags” suggestive of secondary etiologies. However, ocular fundus examination is infrequently and poorly performed in clinical practice. Non-mydriatic ocular fundus photography provides an alternative to direct ophthalmoscopy that has been studied as part of the Fundus photography vs. Ophthalmoscopy Trial Outcomes in the Emergency Department (FOTO-ED) study. Herein, we review the results of the FOTO-ED study with a particular focus on the study's implications for the acute care of patients presenting with headache and focal neurologic deficits. In headache patients, we not only observed optic disc edema and optic disc pallor as would be expected, but also a large number of abnormalities associated with hypertension. Based upon subjects with focal neurological deficits, the FOTO-ED study suggests that the ocular fundus examination may assist with the triage of patients presenting with suspected transient ischemic attack. Continued advances in the ease and portability of non-mydriatic fundus photography will hopefully help to restore ocular fundus examination as a routinely performed component of all neurological examinations. </p>

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          Author and article information

          Journal
          Seminars in Neurology
          Semin Neurol
          Georg Thieme Verlag KG
          0271-8235
          1098-9021
          October 06 2015
          October 6 2015
          : 35
          : 05
          : 491-495
          Affiliations
          [1 ]Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
          Article
          10.1055/s-0035-1563576
          4909473
          26444394
          © 2015

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