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Purpose To investigate the imaging quality, efficiency and satisfaction of fully self-service fundus photography compared with traditional fundus photography performed by experienced operators among middle-aged individuals.Methods Participants aged 45–64 in the community of Shanghai were included, and eye disease screenings were carried out after obtaining informed consent. All participants had no cataracts or other conditions that could potentially compromise the quality of fundus imaging. Participants voluntarily chose the fully self-service fundus photography group or the traditional fundus photography group. A statistical analysis was performed to analyse the imaging quality, efficiency and satisfaction of self-service fundus photography.Results We included 457 individuals with an average age of 56.93 years. Fully self-service fundus photography produces similar imaging quality to manual examinations. Additionally, this photography significantly increases residents’ willingness to undergo eye disease screening again, particularly among those with better visual acuity, compared with traditional doctor-led screenings.Conclusions This study confirms the reliability of fully self-service fundus photography, and its ability to enhance compliance and willingness for follow-up screenings among individuals aged 45–64. Promoting fully self-service fundus photography is beneficial for screening blinding eye diseases in the middle-aged population. Given the limited geographical scope and age range of this study, larger multicentre studies are needed to confirm the broader applicability of fully self-service fundus photography and to establish effective screening models for high-risk occupational populations.