Our study suggests that the use of a smartphone-based alternative to the direct ophthalmoscope may improve the accuracy and quality of fundal examinations by non-ophthalmologists.

Objective: To review our experience with cochlear implant infections over the past 5 years, the management strategy and to identify predictive factors that led to explantation. Study Design: Retrospective record-base case series of cochlear implant infections. Setting: Tertiary otology and implant center. Patients: All patients who had cochlear implantation over a period of 5 years. Intervention(s): None. Main Outcome Measure(s): To identify risk factors, rates and outcomes of cochlear implant infections, and to formulate strategies to develop clearer management protocols to prevent cochlear implant explantation. Results: Of 704 implanted patients, 22 suffered a postoperative soft tissue infection (3%). Fifty-nine percent of these infected patients resulted in explantation, giving an explantation rate of 1.8% over the whole study population. One hundred percent of the infected implants identified as having either Staph. Aureus or Pseudomonas spp. as the single causative organism resulted in explantation. Conclusions: There is a high rate of explantation when infection is detected. Currently there is no clear consensus on medical management, such as choice of antibiotics or length of antibiotic course. A registry of cochlear implants would facilitate standard reporting methods for severity and type of infection, to be able to pool data across centers and form a more robust management protocol for cochlear implant infections.