This presents a systematic thinking approach for better identification of lesions found during ophthalmoscopy .

2. Systematic Fundus
Examination
· Mohamed Zaki Abd El-Samea (M.B.B.CH)
·
Resident In Ophthalmology Department

3. Aim of this presentation
· To present a method of systematic
thinking for identification of fundus
lesions .

4. Fundus Regions
90 D Biomiocroscope
Indirect Ophthalmoscope
+
Scleral Indentation

5. · 9 Regions ± Scleral depression

6. Once a lesion is found
Is it elevated ?
Is it colored ?
Is it distortion of
normal anatomy ?

7. Elevated ?
1- Border
2- Blood vessels
3- Light reflection.
4- Light Focus

9. Double vessel effect = shallow RD

10. Elevated Lesions
Color
Level

11. retinoblastoma

12. Nevus

13. hemangioma

14. hamartoma

15. · Morphology
· Movement
· Multiplicity
and extent

16. *Folds
*Wavy
*Single
extends to
ora
RD

17. Old RD

18. *Dome,
stretshed
*no move
*Multicentric
extends beyond
ora
choroidal

19. Cause ?

20. Color code

21. Black lesions

24. Yellow lesions

26. Hard drusen

27. Soft drusen

28. Stargartd disease

29. Best disease

30. Choroidal rupture

31. Red Lesions

37. · Red
· Remote
· Raised distinct
edges
· Revealed by
indentation

40. White lesions
Cilioretinal artery occlusion

41. Berlin edema

46. Distorted anatomy

49. · Optic disc lesions
· Blood vessel abnormalities