This document provides information on key anatomical structures of the fundus including: 1) It describes several structures that can be seen on examination of the fundus including the optic disc, macula, retinal blood vessels, and peripheral retina. 2) It explains features of the optic disc including that it is insensitive, round or oval in shape, and contains the lamina cribrosa through which ganglion cell axons exit the eye. 3) The macula is described as being located temporally from the optic disc, containing the highest concentration of cones, and responsible for photopic vision and color vision.

1. Dr samarth mishra

2.  Briggs coined papilla for optic disc
 Buzz,Sommering,Reil described macula
 Helmoltz invented eye mirror
 Ruete introduced indirect ophthalmoscopy

3.  Fundus is the portion of the inner eye that can be
seen during an eye examination while looking
through the pupil.
FUNDUS OCCULI
OPTIC DISC/PAPILLA MACULA LUTEA PERIPHERAL RETINA

4.  Insensitive area in retina where ganglion cell
axons exit eye to form optic nerve
 Diameter-1.5mm
 Shape-round/vertically oval
 Colour-pale red/yellowsh red tint due to
lamina cribrosa
medullated nerve fibres and
capillary plexus

5.  Fibres continuous with sclera & choroid
bridge the sclerochoroidal aperture forming
a sieve like structure
 LC is partly collagenous & partly neuroglial
and derived from
Sclera (major part),
pia mater &
perivascular sheaths of central retinal artery

6.  Funnel shaped depression from which retinal
vessels appear to emerge
 15% cases do not show cup
 Nasal border steeper than temporal border
 Cup disc ratio- is<0.4
 Depth of cup depends on
–size, shape, obliquity
,vascularity of optic disc
degree of development & regressionof
hyaloid artery and glial tissue.

7.  Diameter-5.5mm
 Situation-2DD temporal to OD
 Colour-yellow
 Function-photopic vision & colour vision
 Consists of-
fovea centralis (1.5mm)
foveola (0.35mm)
parafovea(0.5mm),
perifovea(1.5mm),

8.  Fully developed after 4yrs
 Diam - 1.5mm,0.25mm thick
 Situation - 4mm temp to OD
 5 degree of visual field
 Foveola - no rods ,highest visual acquity
 Umbo - tiny depression in centre of foveola
 Foveal avascular zone(0.4-0.6mm)

9.  densely packed red & green cones
 central fovea has no rods
FOVEA 3MM AWAY FROM
FOVEA
10MM AWAY FROM
FOVEA
1,00,000- 3,24,000
cones/mm2
Avg- 1,99,000
cones/mm2
6000 cones/mm2 4000 cones/mm2

10. Central retina:direct one-to-one relationship
In extra macular region
At least 1/3rd of all the nerve fibres which
enter the ON originates in macular region.
Single cone cell Single bipolar cell Single ganglion cell
20-100 cones 3-15 bipolar cells Single ganglion cell

11.  Nasal fibres-superior and inferior fibres
 Macular fibres-papillomacular bundle
 Temporal fibres-arcuate fibres
 Nerves are nonmedullated

13.  Near periphery – 1.5mm around ML
 Mid periphery – 3mm around near periphery
 far periphery – extend from OD 9mm on
temporal side & 16mm on nasal side
 Ora serrata - region where retina ends
- 2.1mm wide temporally &
0.7mm nasally

15.  colour - orange to vermilion.
 Factors - amount of pigment in the choroid,
- hexagonal epithelium of retina &
- Choroidal vasculature
At birth Choroid
unpigmented-
most brilliant.
In old age Choroid fully
pigmented
Greyish brown tint
Walls of choroidal
BVs lost trasparency

16.  finely granular or stippled texture.
 due to variation or unequal pigmentation
of hexagonal cells of pigmented
epithelium of retina.

18.  Watersilk reflex:
 Mainly patchy type.
 May be round, oval or irregular in shape.
 They are highly mobile & elusive.

21.  Tapeto-retinal reflex: seen near macular
area
 specular ill-defined patch of light against
which a striking picture of the circumfoveal
vessels can be seen

22.  Gunn’s Dot: minute + highly glistening +
colourless specs usually in the posterior part
of the fundus
 seen best in the course of the retinal nerve
fibres above & below the disc
 Weiss’s Reflex: annular reflex concentric
with the border of the disc & is mobile
 formed by the elevation of the internal
limiting membrane where the nerve fibre
layer is thickened
 present at the nasal border of the disc

23.  Many a times tunics of eye at the margin of
OD don’t make contact with ON.
 narrow zone of border tissue produces a
narrow pale border to the disc, known as SR
 mostly seen at the temporal
border of disc

25.  Retinal vessels are end arteries.
 anastomosis b/w the retinal vessels & cilliary
system of vessels exist near the LC.
 Retinal vessels form 4 groups to supply 4
quadrants of fundus

26.  Only vessels in body not controlled by ANS
 Blood flow 35-45ul/min
 4% of total blood to eye
 Wall to lumen ratio-artery-1:5,vein-1:10
 AV ratio-2:3
 Mean retinal circulation-4-5sec
 20% shows cilioretinal artery and vein

27.  More on temporal than nasal
 Arteries never cross arteries and veins never cross
veins
 When 2 vessels cross they share a common
adventitia

28.  Direct ophthalmoscopy
 Indirect ophthalmoscopy
 Biomicroscopic methods-
negative lens positive lens
Hruby lens, El biyardi lens,+78
Goldmann3 mirror +90D,Mainster lens
panfunduscopic lens

29.  Done on a printed form with 12clock hours
area
 3 circles- inner corressponds to equator
- outer to ora serrata,
- outermost to anterior border of
pars plana ciliaris

31.  Mydriasis
 Media
 OD-Size,shape,colour,margin,cup disc ratio
 Macula-foveal reflex
 Peripheral retina
 Blood vessels

32. FUNDUS of eye is the only
part of human body where
microcirculation can be
observed directly

33. THANK YOU