Comparison of Mydriatic Smartphone-Based Screening vs Nonmydriatic Handheld Fundus Camera for Detecting Undiagnosed Diabetic Retinopathy in Type 2 Diabetic Patients at a Rural Hospital: A Descriptive Study (Code-T0113)

Introduction: Diabetic retinopathy (DR) is a leading cause of preventable blindness among individuals with diabetes, especially in rural areas with limited access to specialized care. Early detection is critical for timely intervention. This study compares the effectiveness of a mydriatic smartphone-based screening method and a nonmydriatic handheld fundus camera for detecting undiagnosed DR in type 2 diabetic patients.

Aims and Objectives

• Detection of Early Diabetic Retinopathy in known cases of Diabetes Mellitus in rural population .
• Early refferal to tertiary health care centre.
• Early intervention in newly detected early diabetic retinopathy in rural population

Methods: This descriptive study involved 200 type 2 diabetic patients attending a rural hospital. Both screening methods were used on each patient, and images were graded for DR severity by an ophthalmologist. Mydriatic images were obtained after pupil dilation using a smartphone-based adapter, while nonmydriatic images were captured using a handheld fundus camera. Diagnostic accuracy, image quality, and patient comfort were analyzed and compared.

Results: The mydriatic smartphone-based method detected DR in 35% of cases, compared to 30% with the nonmydriatic handheld fundus camera. Mydriatic imaging produced superior image quality (85% vs. 70%) and identified more mild and moderate cases. Patient comfort was higher with the nonmydriatic approach. Sensitivity and specificity were 92% and 88% for mydriatic imaging versus 85% and 82% for the nonmydriatic method.

Conclusion: Mydriatic smartphone-based imaging offers better diagnostic accuracy and image quality for DR screening, while nonmydriatic methods remain useful for patient-friendly initial assessments. Both approaches can complement each other in resource-limited rural settings.

Keywords: Diabetic retinopathy, mydriatic screening, smartphone imaging, nonmydriatic fundus camera, rural healthcare, diagnostic accuracy.