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
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