Basic fundoscopy

Fundoscopy for medical students

1. BASIC FUNDOSCOPY DR. WILLARD BWALYA MUMBI (BSc.HB, MBChB, PG. DIP. BA, MMED, FCO-ECSA) CONSULTANT OPHTHALMOLOGIST KABWE GENERAL HOSPITAL EYE DEPARTMENT ZAMBIA 26 TH OCTOBER, 2016

2. NOTHING COMES EASILY, BUT WHEN IT ARRIVES IT STAYS WITH YOU. THEREFORE, THE IDEA OF PRACTICE DURING YOUR FREE TIME MAY NOT BE OVER EMPHASISED.

3. DISCLOSURES: No financial disclosures Sources of pictures: American Academy series Kabwe General Hospital, Eye Department Eye rounds.ORG

4. WHAT TYPES DIESEASES REQUIRE FUNDOSCOPY GENERAL INDICATIONS Diabetes LUMBER PUNCTURE Hypertension CVA RVD ( CD4 < 200) Kidney disease Cardiac disease ETC EYE DISEASES All patients visiting the eye clinic Diabetic eye disease Glaucoma Age related macular degeneration Squint

5. FUNDUS RETINAL VESSELS OPTIC DISC MACULAR

6. INSTRUMENTS USED IN FUNDOSCOPY DIRECT OPHTHALMOSCOPE INDIRECT OPHTHALMOSCOPE SLIT LAMP WITH 90 D OR 78 D FUNDUS CAMERA

7. DIRECT OPHTHALMOSCOPE

8. PROCEEDURE EXPLAIN WHAT YOU ARE ABOUT TO DO TO THE PATIENT DIM LIGHT ROOM CHECK FOR RED REFLEX: STAND 1 METER AWAY AND COMPARE BOTH EYES THEN EXAMINE 1 EYE AT A TIME. YOUR RIGHT EYE TO EXAMINE THE RIGHT EYE OF THE PATIENT GET AS CLOSE TO THE PATIENT AS POSSIBLE

9. CONT’D EXAMINE FUNDUS IN ANY ORDER SUITABLE, BUT ALWAYS END WITH MACULA RETINA: DIVIDE IT IN 4 QUADRANTS AND THEN EXAMINE EACH QUADRANT AT A TIME TO EXAMINE THE MACULA, ASK SUBJECT TO LOOK AT THE LIGHT TO EXAMINE THE DISC, ASK PATIENT TO SLIGHTLY LOOK NASALLY. ANOTHER TRICK IS TO FIRST LOCATE THE VESSELS AND THEN FOLLOW THEM TO THEIR ORIGIN

10. RETINAL COLOUR: RED/ORANGE

11. VESSELS A/V ratio 2 : 3 A rteries are brighter red V eins are slightly purplish colour

12. OPTIC DISC Colour; rich yellow different from rest of retina Clarity of the Edges/margins Depression in the middle: optic cup Elevation Shape: oval/round

13. MACULA Located temporal inferiorly Fovea reflex

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