Method Of Exam

• Keep both yours and the person's eyes
• Have the patient focus on a distant object
• Look at right fundus with your right eye
• Ophthalmoscope should be close to your eyes. Your head and the scope should move together
• Set the lens opening at +8 to +10 diopters. With the ophthalmoscope 12-15 inches from the patient's eye, check for the red reflex and for opacities in lens or aqueous.
• While adjusting the diopter setting, approach the patient more closely and systematically inspect the disc, noting the color, shape, margins and cup-to-disc ratio.
• Inspect the vessels, noting obstruction, caliber and arterial/venous ratio.
• Note the presence of arterial/venous nicking and arterial light reflex.
• Check the background by inspecting for pigmentation, hemorrhages and hard or soft exudates.
• Next, try to identify the macula.
  • Have the patient look at light

Normal: Images of normal provided by Dr Cronin MD

• Disc 
  • margins are sharp
  • color: yellowish orange to creamy pink
  • shape: round or oval
  • Cup to disc ratio: less than half
• Vessels
  • AV ratio
  • AV crossing: no indentation
  • No arterial light reflex
• Fundus background
  • No exudates or hemorrhages
  • color : red to purplish
• Macula
  • macula is located 2.5 disc distance temporal to disc
  • no vessels are noted around Macula 
  • it may be slightly pigmented