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Simple Model for Teaching Postmortem Monocular Indirect Ophthalmoscopy

NCJ Number
226908
Journal
Journal of Forensic Sciences Volume: 54 Issue: 3 Dated: May 2009 Pages: 676-677
Author(s)
Patrick E. Lantz M.D.
Date Published
May 2009
Length
2 pages
Annotation
This paper proposes a simple, inexpensive teaching model for facilitating skill acquisition in monocular indirect ophthalmoscopy for use by pathology residents and forensic pathology fellows.
Abstract
The postmortem monocular indirect ophthalmoscope (PMIO) consists of a light source attached to a headband along with a hand-held lens. This permits a wide view of the fundus after death. Other advantages of this instrument include a relatively large field of view, high resolution, and an ability to visualize the peripheral retina. Disadvantages include low magnification and a projected aerial image that is inverted and laterally reversed. Also, the postmortem retina near the ora serrata cannot be visualized without maximal pupillary dilation and sclera depression. Teaching PMIO to pathology residents and forensic pathology fellows is a challenge, because the projected aerial image is inverted and laterally reversed, which makes precise descriptions or the recording of fundal abnormalities difficult. Unlike binocular indirect ophthalmoscopy with a teaching mirror attachment, the projected monocular image cannot be viewed simultaneously by the instructor and the fellow or resident. This paper proposes a simple model devised for teaching direct ophthalmoscopy that can be used for instructing pathology residents and fellows in the technique of PMIO. A simple, inexpensive teaching model can be constructed from hinged, cylindrical plastic containers. An artificial pupil created in the lid and a removable color fundal image placed in the bottom of the opaque container allows the pathologist-in-training to practice the technique of monocular indirect ophthalmoscopy and correctly identify, localize, and describe fundal abnormalities such as retinal hemorrhages. 3 figures and 6 references