Normal fundus

normal fundus

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 cellSingle ganglion cell
20-100 cones 3-15 bipolar cellsSingle 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