Method Of Exam
|Author: A. Chandrasekhar, MD
- 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
- margins are sharp
- color: yellowish orange to creamy pink
- shape: round or oval
- Cup to disc ratio: less than half
- AV ratio
- AV crossing: no indentation
- No arterial light reflex
- Fundus background
- No exudates or hemorrhages
- color : red to purplish
- macula is located 2.5 disc distance temporal to disc
- no vessels are noted around Macula
- it may be slightly pigmented