Direct ophthalmoscopy is an integral part of the physical examination and is the most widely used technique to assess the fundus, especially in primary care. The gold standard slit-lamp technique is used in specialty clinics and in some EDs. Most medical professionals own smartphones, and a smartphone ophthalmoscope could bring the quality of a slit-lamp examination into primary care. Imaging techniques with smartphones are easy to learn and use, providing a significant step toward reversing the lack of confidence that students and clinicians have in traditional methods. Current evidence supports the potential of smartphone imaging to replace direct ophthalmoscopy in primary care settings.