PT - JOURNAL ARTICLE AU - Dooley, Eleanor AU - Kousha, Obaid AU - Msosa, Joseph AU - Ndaule, Eric AU - Abraham, Carl AU - Parr, Jennifer AU - O'Hare, Bernadette AU - Blaikie, Andrew TI - Comparative evaluation of a low cost direct ophthalmoscope (Arclight) for red reflex assessment among healthcare workers in Malawi AID - 10.1136/bmjinnov-2019-000361 DP - 2020 Jul 01 TA - BMJ Innovations PG - 113--116 VI - 6 IP - 3 4099 - http://innovations.bmj.com/content/6/3/113.short 4100 - http://innovations.bmj.com/content/6/3/113.full SO - BMJ Innov2020 Jul 01; 6 AB - We compared the diagnostic performance and ease of use of a new solar powered low-cost Arclight direct ophthalmoscope (AO) to a more expensive traditional direct ophthalmoscope (TDO) (Keeler Professional V.2.8) in detecting abnormal red reflexes in simulated eyes. Both devices were used by 19 optometry students and 17 paediatric doctors based in the Kamuzu Central Hospital Campus in Lilongwe, Malawi. Participants examined four normal and four abnormal red reflexes using the two devices in random order. We scored the participants on their ability to identify clinical signs and make a diagnosis. Participants scored each device for ‘ease of use’. There was no statistically significant difference in diagnostic performance or ‘ease of use’ between the AO and the TDO when attempting to detect abnormal red reflexes in simulated eyes. We conclude that AO is an inexpensive yet equally effective alternative to the TDO in detecting red reflexes and due to its low cost, portability and consumable independence is well suited for use in low-income and middle-income countries.