Fundoscopy

Using an ophthalmoscope
 Objectives
• Identify patients at risk from eye disease
• Recognising the normal fundus
• Describe Patient preparation
• Demonstrate correct procedure using the
ophthalmoscope
• Describe abnormal findings, and recognise
disease process
 Patients requiring ophthalmology
investigation
• Chronic diseases (HIV Top 5 Common eye
arteriosclerosis) conditions
• Diabetes • Cataract
• Glaucoma
• Hypertension
• Age related macular
• CVA degeneration
• Cardiac disease • Squint
• Pts on certain drugs • Diabetic eye disease
(anticholinergics / steroids
Normal fundus
 Normal fundus
• Disc: Clear outline; optic cup is pale and centrally
located.

• Retina: Normal red/orange colour, macula is dark.

The macula is approximately 2 disc diameters away
from disc and 1.5 degrees below horizon.

• Vessels: Arterial/venous ratio 2 to 3; the arteries

appear a bright red, the veins a slightly purplish
colour.
 What to observe
• Optic disc- colour/size/edges
• Cup – size
• Blood vessels – number/width/tortuosity
• Macular / fovea
• Other findings –haemorrhages, soft and
hard exudates, oedema
 Procedure
• Ask patient to fix stare at object
• Turn on scope and set dial to 0
• Remember right eye right hand
• Rest hand on patients forehead
• Begin at arms length away, should see red reflex.
• Move closer until optic disc visible ( aprox. 3-
5cms) Turn dial until disc in focus.
• Hyperopic – turn disc for plus numbers (green)
• Myopic – minus numbers (red)