BASIC FUNDOSCOPY

DR. WILLARD BWALYA MUMBI (BSC.HB, MBCHB, PG. DIP. BA, MMED, FCO-ECSA)

CONSULTANT OPHTHALMOLOGISTKABWE GENERAL HOSPITAL EYE DEPARTMENTZAMBIA

26TH OCTOBER, 2016

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.

DISCLOSURES:

No financial disclosures Sources of pictures:

American Academy series Kabwe General Hospital, Eye Department Eye rounds.ORG

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

FUNDUS

RETINAL VESSELS OPTIC DISC MACULAR

INSTRUMENTS USED IN FUNDOSCOPY

DIRECT OPHTHALMOSCOPE INDIRECT OPHTHALMOSCOPE SLIT LAMP WITH 90 D OR 78 D FUNDUS CAMERA

DIRECT OPHTHALMOSCOPE

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

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

RETINAL

COLOUR: RED/ORANGE

VESSELS

o A/V ratio 2 : 3

o Arteries are brighter red

o Veins are slightly purplish colour

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

MACULA

o Located temporal inferiorly

o Fovea reflex

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