Indirect ophthalmoscopy is a technique used to examine the back of the eye. The key steps are: 1) Adjusting the ophthalmoscope and positioning the patient lying down looking directly up. 2) The examiner stands to the side and holds the lens about 2 inches from the patient's eye to focus the view. 3) By tilting their head and walking around, the examiner views different parts of the retina, instructing the patient to look in various directions. The macula is examined last when cooperation may be reduced.

1. INDIRECT
OPHTHALMOSCOPY
DR. IDDI NDYABAWE

16. Technique to Perform BIO
• Adjustment of the ophthalmoscope
• Adjust headband crown
• Adjust the pupillary distance
• Check illumination intensity. Usually start with lower illumination and slowly increase illumination as
needed and as tolerated by the patient. Check for a proper elevation/position. Check can be done by
extending arm or by looking at a wall.
• Apply filter if desired
• Positioning the patient - Patient should be in a supine position
• Patient should be looking directly up, initially (primary position)
• Examiner should initially stand to the side of the patient, leaning over the patient
• Keep handheld lens approximately 2 inches away from patient's eye, moving it closer or farther away
to focus and refine the view
• Examiner swivels his view around to view different parts of the retina, by tilting the head and
walking around the patient
• The doctor instructs the patient to look at various extremes of their vision
• The macula is examined at the last, as the light is bright and patient cooperation for BIO may reduce
drastically if macula is examined at the initiation of BIO

23. .

83. • The retinal nerve fiber layer contains ganglion cell axons that run
toward the optic disc, with the temporal fibers following a arcuate
course around the fovea.
• The retinal nerve fiber layer is seen as bright striations and is most
easily visible where it is thickest, at the vertical poles of the optic disc

87. ..