Barreras a la oftalmoscopia directa por médicos de familia y comunidade

Resumen

Introduction: Direct ophthalmoscopy is an examination performed for the diagnosis and screening of diseases of the retina, optic disc, and vitreous humor in the context of primary health care. Studies show that this practice is rarely used by primary care physicians. Objective: The aim of this study is to identify barriers for primary care physicians to perform ophthalmoscopy. Methods: This study used a qualitative methodology based on a semi-structured interview with primary care physicians with subsequent thematic analysis. Results: It was verified that barriers to performing direct ophthalmoscopy include difficulty in handling the ophthalmoscope and pupil dilation, little knowledge of eye anatomy, feeling of insecurity in performing and interpreting findings, perception that the examination would be better performed by a specialist, lack of training and practical experience in undergraduate program and medical residency, perception of little use or resolution, difficulty in adjusting the room environment for the examination, absence of equipment and mydriatics in health units, increase in consultation time, absence of referral flows when facing altered findings, presence of teleophthalmology services and lack of training of the multidisciplinary team. Conclusions: Barriers to performing ophthalmoscopy by primary care physicians include emotional, behavioral, cognitive, educational, and work-environment aspects.