To the Editor We read with great interest the recent article by Byrd et al1 presenting an innovative method to improve ophthalmic training in medical school. They reported that medical students who voluntarily participated in a community service project (CSP) dedicated to ophthalmic care for the underserved had increased ophthalmology knowledge and short- and long-term direct ophthalmoscopy skills assessed by matching a patient’s fundus to 1 of 4 fundus photographs. Long-term ophthalmoscopy skills were reportedly higher in the CSP group, even without additional skill reinforcement. Although this pilot study included a small number of participants and the possibility of bias from the self-selection of more motivated ophthalmology learners in the CSP group, we hope these results will be helpful in furthering the important missions of improving ophthalmic care to the underserved and improving undergraduate ophthalmology education. We and others have demonstrated that medical students’ direct ophthalmoscopy skills decrease over time without longitudinal skill reinforcement, signaling the importance of medical school curriculum reform to facilitate increased longitudinal exposure to ophthalmoscopy.2-4