“For years we have known that the eye/fundus exam is a critical part of the physical exam and patient evaluation, but typical ophthalmoscopy is difficult to perform and is often underperformed. Very important pathology can be missed if it is not performed, and fundus photography is a far superior way to accomplish it,” Dr. Wright told Reuters Health.

Asked about plans for further related study, he said, “It would be interesting to know the prevalence of underlying disease and abnormalities in the population of patients without the symptoms used for inclusion, such as headache. There are also likely subpopulations of patients in whom even more pathology is expected, which the data may not reflect.

Dr. Wright would also like to know the long-term outcomes of the patients in the study who were missed compared to those who were identified.

“We are continuing to explore how fundus photography can identify patients at risk in the ED,” he said. “For example, can the fundus provide information about the risk of stroke in patients with a transient ischemic attack? Can the fundus exam help identify patients at risk for stroke, and heart disease in patients with acute hypertension?”

“The eye is the window to the brain and can provide a lot of important information,” he added.