key: cord-0871624-azxj6kmt
authors: Hua, Hong-Uyen; Pieramici, Dante J.; Bagheri, Nika
title: Understanding seizure risk with wide field fundus photography: Implications for screening guidelines in the era of COVID-19 and telemedicine
date: 2020-08-05
journal: Am J Ophthalmol Case Rep
DOI: 10.1016/j.ajoc.2020.100844
sha: 596f4e7d4bf27d28ffa4198b1ae0bfe448475f7a
doc_id: 871624
cord_uid: azxj6kmt

PURPOSE: To report two cases of photosensitive seizures due to fundus photography flash. OBSERVATIONS: Two patients with seizure history present to a retina clinic for routine follow up. While obtaining imaging, these patients experienced a seizure triggered by fundus camera flash. CONCLUSIONS: and Importance: Fundus photography is essential and ubiquitous amongst optometry and ophthalmology practices, especially in the rising era of telemedicine in the setting of the recent COVID-19 pandemic. To our knowledge, there are no other reports in the literature of seizures triggered by fundus photography flash. However, we believe this to be an under-reported phenomenon and suggest that all eye care providers screen patients for a history of seizures or epilepsy prior to fundus photography.

In today's rapidly evolving clinical landscape, the increasing utilization and value of 30 wide field fundus photography cannot be understated. For example, a 2013 New Zealand survey 31

reported that 82.6% of optometry practices had fundus photography capabilities. 1 In light of the 32 COVID-19 pandemic, fundus photography's potential role as an essential screening tool for 33 eyecare providers is unprecedented, as telemedicine with wide field fundus photography is 34 increasingly being implemented in ophthalmology and optometry private and institutional 35

practices. Here we present two cases reflecting the unlikely but possible risk of seizures in 36 patients undergoing flash fundus photography. We suggest that appropriate screening for patients 37 may be of benefit as wide field fundus photography continues to develop into a vital and ever 38 more popular diagnostic tool. 

Health information technology adoption in New Zealand 137 optometric practices

Photic-and pattern-induced 139 seizures: A review for the epilepsy foundation of america working group

Optos plc, Dunfermline, Fife KY11 8GR, UK. 146 5. Clarus 500 User Manual

TRC-50DX User Manual Retinal Camera. TOPCON CORPORATION, 75-1 Hasunuma-149 cho

Visually-induced seizures

Consent to publish the case report was not obtained. This report does not contain any personal 120information that could lead to the identification of the patient 121 122Acknowledgements and Disclosures 123Funding: 124California Retina Research Foundation 125 126Conflicts of Interest: 127The authors have no relevant financial disclosures. 128 129Authorship: 130All authors attest that they meet the current ICMJE criteria for Authorship. 131 132Acknowledgements: 133None 134 135