Ophthalmoscopy

Joyce Mathan

Assoc. Prof. Jennifer CraigDr Stuti MisraDr Charlotte JordanProf Charles NJ McGhee

The Ophthalmoscope

On/off switch

Current lens

Lens dial(+10 to -10D)

Viewfinder(examiner’s side)

Extra lens(high power)

The OphthalmoscopeViewfinder (patient’s side)

Aperture dial

Filters

Viewfinder (patient’s side)

General Asssessment in Ophthalmology

What to look for and how?

Red Reflex

Also see related Assessing the Child and Paediatric ophthalmology & Squint tutorials

Landmarks:1. Optic Nerve Head2. Blood Vessels3. Macula4. Fundus

Lens

Indirect ophthalmoscopy

Usually binocular Inverted image, laterally reversed Lower magnif ication (x2 - x3) Increased f ield of view (~ 30 °) Provides view to ora serrata (with scleral indentation)

The Normal FundusDisc

ShapeColourMarginsCupping

VesselsColourCalibreCrossings

Left discMacula

ColourFoveal reflexAvascular

The Normal FundusDisc

ShapeColourMarginsCupping

VesselsColourCalibreCrossings

Right disc Left discMacula

ColourFoveal reflexAvascular

The Normal FundusDisc

ShapeColourMarginsCupping

VesselsColourCalibreCrossings

MaculaColourFoveal reflexAvascular

The Normal FundusDisc

ShapeColourMarginsCupping

VesselsColourCalibreCrossings

Right disc Left discMacula

ColourFoveal reflexAvascular

How to differentiate between right and left eye fundus

What’s the cup-to-disc ratio?

cup disc margin

Cup-to-disc ratio: 0.5

Peripapillary atrophy

Disc AppearanceNormal Disc Swollen Disc

Tigroid fundusChoroidalvasculature

Pigment changes

Image used with patient permission

Tigroid fundusChoroidalvasculature

Pigmentary changesPigment

changes

Tigroid fundusChoroidalvasculature

Pigmentary changes

Disc colour will appear differentdepending upon fundus colour

Pigmentary changes

Disc colour will appear differentdepending upon fundus colour

Pale fundus

What do you see here?Are they normal ?

Glaucomatous Optic Nerve

Cup-Disc Ratio

The EndMaterial contained in this lecture presentation is

copyright of The Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, and should not be reproduced without first obtaining

written permission