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![PUPILLARY DILATION
Combination of phenylephrine [2.5 %] &
tropicamide [1 %]
then eyes closed
Dilation attained = 15-30 min
Normal reactivity = 4 - 8 hrs
Conditions which to avoid : iris supported lens
shallow AC](https://image.slidesharecdn.com/fundusexamination-170813095622/85/Fundus-examination-5-320.jpg)
![Optic disc
DISC:
DIAMETER – 1.5mm [1 disc diameter]
COLOR – Pale pink
SHAPE – Circular
EDGES – Regular
TERMINATION OF ALL
LAYERS EXCEPT NFL
CUP: C/D ratio – 0.3 to 0.4](https://image.slidesharecdn.com/fundusexamination-170813095622/85/Fundus-examination-22-320.jpg)
Uploaded byDR.SOUMITRA DAS
Fundus examination
This document discusses different methods for examining the fundus of the eye, including direct ophthalmoscopy, indirect ophthalmoscopy, and indirect slit lamp biomicroscopy. It provides details on how each method works, including magnification, field of view, advantages, and disadvantages. Key structures that can be observed during fundus examination are also described, such as the optic disc, blood vessels, macula, and signs of common eye conditions like glaucoma, optic nerve diseases, retinal problems, and diabetes-related changes.
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Fundus examination
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- 3. METHODS OF EXAMINATION DIRECTOPHTHALMOSCOPY INDIRECT OPHTHALMOSCOPY INDIRECT SLIT LAMP BIOMICROSCOPY
- 4. Why do wedilate pupils?
- 5. PUPILLARY DILATION Combination ofphenylephrine [2.5 %] & tropicamide [1 %] then eyes closed Dilation attained = 15-30 min Normal reactivity = 4 - 8 hrs Conditions which to avoid : iris supported lens shallow AC
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- 7. Viewing ocular media ◦Observe red reflex ◦ Look for media opacities ◦ Cataracts ◦ Corneal scars ◦ Large floaters Right eye to right eye Left eye to left eye
- 9. •An erect uprightvirtual image •Magnification = 15 x •Field of view = 5 degrees •No stereoscopic view •Several plus and minus dial up lenses • Structures - optic nerve, blood vessels of posterior pole fovea
- 10. Advantages ◦ Portable ◦ Easyto use ◦ Upright image ◦ Magnification 15x ◦ Can use w/o dilation Disadvantages ◦ Small field of view ◦ Lack of stereopsis ◦ Media opacities can degrade image
- 11. - retinal arterioles- exudate retinal haemorrhage edema microaneurysm attached retina - vitreous opacity hole /break vitreous bleed - Retinal venules - pigmentation detached retina detached choroid outine of break - ora serrata /drusen hyperpigmentation Colour codes :
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- 15. •An inverted reversereal image •Magnification = 2 to 4 X •Field of view = 40 to 50 degrees •Optimal working distance = 40 to 50 cms •Good illumination & stereopsis •Ease of use with scleral indentor •Lenses from 14 to 30 D range
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- 17. Monocular or binocular Advantages: ◦Wide field of view ◦ Binocular instruments provide stereopsis Disadvantages: ◦ Requires more skill ◦ Decreased magnification (3x) ◦ Requires dilation ◦ Inverted image
- 19. Indirect slit lampbiomicroscopy
- 20. •Field of View& Mag: • FOV <indirect but >direct • varies w/lens & slit lamp mag •Inverted image •Stereopsis •Dilated pupil •Requires skill
- 21. Slit-Lamp BIO Aninverse real reversed image with hand held lenses Field of view = 30 to 40 degrees Lens power = + 78 or + 90 D , other lenses= + 60 to 132 D Magnifying knob to 10 X or 16 X
- 22. Optic disc DISC: DIAMETER –1.5mm [1 disc diameter] COLOR – Pale pink SHAPE – Circular EDGES – Regular TERMINATION OF ALL LAYERS EXCEPT NFL CUP: C/D ratio – 0.3 to 0.4
- 23. Vessels RETINAL SYSTEM :CENTRAL RETINAL ARTERY AND CENTRAL RETINAL VEIN 4 major branches Arterioles, Venules Capillaries CILIARY SYSTEM : POST.CILIARY ARTERIES Choriocapillaries
- 24. MACULA Specialised region ofretina Diameter – 5.5 mm Location – 2 DD - temporal margin of disc Color – Yellow; deep pigmented 4 zones : Foveola -0.35 mm Fovea -1.50 mm Parafovea Perifovea Retinal vessels Cilioretinal artery
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